Pros and Cons for Reduced Houseman Working Hours

Writer's note :
It took me hours to finish this one article! Its been awhile since I wrote about facts. I had to look up into many references, many other articles. Now I know that to be a good writer, I need to be a good reader. This one was wrote for I-Medic. Mainly about the status quo of medics in our country. As every other writings, hopefully readers can gain something from it.

Shocking news rocks the cradle of the medical world. 2011/08/02, The Malaysian Ministry of Health announce that work hours for houseman will be reduced significantly from 90hours/week to 54hours/week starting next September. According to Berita Harian, the action was based on a research carried out on 2009 where 67.3% of trainee doctors happen to be in the state of stress.
First, let us identify the possible sources of stress.

What stresses a houseman?

1. Work Hours
Mainly, it will be about heavy working hours.All HOs are required to work from 7am to 5pm. If they are oncall, the HO must stay in and spend the night until the next day at 5pm. So HOs need to work 34-40 hours straight. Imagine doing this in 2 years of housemanship. Stories about houseman giving up on their career are nothing strange.

2. Workloads
Not only that the work hours are heavy, work overload does not make life easier for houseman. The basic procedure may be less worrying but what really annoys houseman is actually the clerking work. Documenting time of admission, patient signs and symptoms, drug prescription, patient’s discharge and follow up. It seems most houseman spend more time typing than patient examining. No wonder patient says that most houseman only sit on their desk and do nothing.

3. Social Life
Work hours, workloads, and being oncall. Houseman enjoys limited social life and interactions. Maybe this is not the case in city hospitals where consultants keep on complaining on the fact that Houseman are too many. But in the outskirt of capitals, in Sabah and Sarawak mainly, imagine how less than 10 houseman operates in each department. Some job to be done there.

4. Others
Tagging, assessment, short breaks, patient’s incompliance, bad terms nurses, will just add to the misery.

Advantages and disadvantages
1. Stress Management
It is well understood by the public about the great challenges a HO face. Reduced work hours will help reduce stress for HOs. HOs are given more time to rest and recover. They will have a better state of body and mind to focus on their work and learn something new. Patients should expect better services from doctors. Hence, doctors now must rise to the occasion. Fulfill high expectations. All and all, a good news for medical students who fear of a stressful life.

2. Lack of training hours
It has been a mouth watering talking point that less working hours for houseman would mean less training hours. Medical officier, specialist, and consultants in the future will no longer have enough physical and mental strength to handle critical conditions when the need arise. Doctors will be less trustworthy. Nurses and patient will have hard times to be dealing with weak incompetent doctors. Every now and then we hear stressful doctors let it out on nurses and patients. However, since the time course of houseman training has been prolong from 1 year to 2 years, some will consider it to be less troublesome. Trainee doctors will still receive enough experience to give the best service to their patients.

3. Commitments
The most important thing about reduced work hours is that houseman can enjoy more free time. Nowadays, we do not only see doctors as a person who gives treatments, but also as a respected individual who plays a big part in contributing to the life of others. Doctors should not only focus on works in the hospital. Instead, they should be given more time and space to work for their religion, society and nation. They have families to be love. A husband to cook. A wife to pick up from work. Children who need to be send to school. It’s ironic to see a successful doctor as half of one's half, but on the other half, being a failure parent. We do not wish to see more children suffer from lack of care. Children need to be taught about the beauty of Islam, taught on how to read the Quran, taught to live their life as true muslims. The young represents the future. And as parents, doctors should not be hold back from their responsibilities to foster the generation of hope.

Lastly, let us not forget that reduced work hours for HOs reflects the increasing number of medical graduates each year. With reduced work hours, the public will be evermore encouraged to choose medicine as a course of study. Local medical schools in Malaysia, when fully functioning will produce 4000 doctors a year. Thousands more are being produced overseas as Malaysian are studying in the UK, Australia, New Zealand, Indonesia, India, Russia, Egypt, Jordan and more. Medical workforce is growing. Not so long now, we will reach the magical number of 100 Houseman per hospital. Overflooding with doctors, the medical world will be ever more competent. And at the same instance, the government and private sectors will have the power to choose between the best medical graduates out of the rest. Possibly, there will be a time when we see a medical graduate without being posted to any hospitals. So can we just stay relaxed and hope for the country to produce more hospitals, more outpatient clinics, hoping for more working opportunities? Or do we work harder to compete? Wake up doctors-to-be. Enough will all of the praising and respect you receive by families and friends around you. Wake and be a real doctor-to-be!

References :