Is Medicine a Noble Profession Today?

 

 I received a WhatsApp warning sent to a chat group about how people are cheated to take unnecessary medicine since birth to enrich the pharmaceutical industries and the doctors working gloves-in-hand with each other.

Then there was another letter of warning sent separately by someone else who was so disgruntled when he was asked to undergo an unnecessary highly expensive scan of his heart at a private hospital which later found in another hospital there was nothing wrong with his heart. 

Both letters / warnings to others about the drug and medical professions were very lengthy and in detail to include here. 

Here’s my thoughts as a retired clinician and a former Senior Medical Researcher myself 

When I was in school, I was told many times that medicine was a very noble profession, in fact the noblest of all professions. I was told a doctor treats the sick and the sufferings all for free without charging them with so much charity at heart. But they did not tell me how a doctor lives without being paid and without money? They avoided this very important question.

 Years on when I was in this profession myself, I felt disillusioned by what they told me. The examples sent to us in this WhatsApp is just a tiny tip of an iceberg how commercial and money-grubbing doctors and the medical profession is.

I am talking about doctors in private hospitals who charge patients exorbitant fees for unnecessary ‘investigations’ like the misgiving of a patient who went to a private hospital that did an unnecessary heart scan that turned out negative at another hospital but was charged outrageously by the first private hospital.  Even government doctors are not that charitable as we only think. Although most treatments in government hospitals are free, it is not the doctors there who give us free treatment. It is the government who paid the doctors their salaries, else they would not come to work, and it is the Ministry of Health that provides us this free service, not the doctors.

As a clinician I find doctors in government hospitals hardly do any clinical work. They all spend most of their time at the desk writing, and writing the same clinical notes again and again, tons of them, until the file of each patient needs to be carried in a trolley. I just don’t know what notes they are scribbling, scribbling again and again. As a clinician I can understand the importance of talking to a patient, and clerking their medical history, but there must be a limit to all these notes writing while the patients lie down on the hospital bed unattended in pain and in sufferings. The doctor while busy clerking all these tons of the same notes of the patient’s medical history, filing the results of lab examinations and radiological investigations, it is the nurse who does all the clinical work such as, set up the IV drips and monitoring their rates, gives  oxygen through a face mask at 5 litres per minute, takes the temperature, blood pressure, dress up the wounds, gives the medication, gives the injections, monitors the vital signs of the patients who are critically-ill, etc, etc. All these are clinical work hardly done by the doctor. The doctor merely takes the medical history, examines the patients for signs and symptoms or other work-out. The only other clinical work they do is to establish an IV line or insert a cannula into the brachial vein, but the rest are all done by the nurses. Then why are doctors called “clinicians” and not the nurses who do most of the clinical work? But there are countries like Singapore and the United States where some nurses are called nurse clinicians after undergoing further degree graduate training. But most of these nurse clinicians do administrative and paperwork leaving their junior colleagues to do the clinical work. So, we are back to square one. Looks alike if paperwork is more important and higher up than in a clinical setting? The work “clinical” means “directly hands-on” with the patient. In other words, bed-side medicine in contrast with laboratory medicine where the doctor or medical researcher does not see them at all, but directly or indirectly translates the results of their research findings to the bedside. In other words, it is called translational medicine that may take years to be applied to the bedside of the patient.

The only exceptions are the anaesthesiologists and the surgeons who are “hands-on” directly on the patients, but not the physicians who merely take the medical history, do the necessary physical examinations, send the patients for blood tests or radiological examination, and merely prescribe the medication. 

The other exception probably are the O&G people who do need to deliver babies hand-on or do a Caesarean. This applies to all surgeons in various areas of expertise. They are the clinicians who do hand-on clinical work. 

The most aggressive of all clinicians are the emergency and trauma doctors, especially the paramedics on the scene who truly aggressively work on patients to try to save a life in either a pre-hospital environment such as in mass casualty or in an emergency room of a hospital where they place them in the Red Zone of the Triage System. The term “triage” is a French word to mean “sort out” to mean preliminary assessment of patients or casualties to determine the degree of urgency.  These are the medical doctors to whom I salute. They have no time to write any notes, not even a single letter. They only have time to work aggressively on the patient to save his / her life. Notes can come later. 

I was involved in emergency medicine myself in KL Hospital, at Selayang Hospital, Kuala Lumpur and at the University Hospital, National University of Malaysia where I had my advanced training and attachment. Later I became a Regional Officer for Training for paramedics and advanced first responders for St. John Ambulance Malaysia.

I am also a Section Member on Emergency Medicine, and on the History of Medicine at the Royal Society of Medicine ever since I was admitted as a Fellow into the 200-year-old Royal Society of Medicine in London in 1993, besides other medical Fellowships in the UK.  

Hence, I knew this area of medicine well before I fully retired from all medical research and clinical work. 

Since I am now retired I write about my life experiences and other light scientific articles on astronomy, the origin of life, on evolution, toxicology, on nutrition, biological sciences, food science, food analysis, analytical chemistry, food quality control, microbiology, about the body and soul, on forensic science, most of them I gained at Oxford, Cambridge, London and at Reading Universities and from the  Massachusetts Institute of Technology (MIT), besides from my own thoughts.

I write them for the general lay-readers without the need to cite references unlike I did for my research papers. I make them all readable like an essay, sometimes in parable form to make them easier to understand. 

I wrote only a few articles on medicine or on nutrition here in this blog of mine as I am already bored about medicine or on nutrition even though nutrition is the most popular and widely written subject in preventive and curative medicine throughout the world. But I need to leave both areas now.  

But for a doctor who requests for various blood tests or to do a biopsy for HPE (histopathological examination), these are all not done by him. It is the job of a surgeon and the sample sent to a histopathologist after tissue staining for examination under a microscope to determine how the cells have differentiated as malignant or benign cells. 

Same for all those various types of blood tests, from full blood picture, serological, biochemical all the way down to genetic and DNA analysis. All these are not done by the medical doctor or the clinician. They are done by the medical technologists working in a pathological laboratory, and the results read and examined by a scientist first, and he / she is satisfied, and signs the lab report to be passed on to the clinician. All these lab studies are not conducted by the doctor as already explained. Even for X-rays and all other imaging, including ultrasonography, CT, MRI, PET scans etc are initially done by a radiographer and the results read and interpreted by a radiologist before passing them on to the attending doctor. The patient’s doctor doesn’t realize all these teamwork efforts by the clinician counterparts using their expertise. But the patient only thinks it was his or her doctor who did all of them or her and gives credit only to his doctor and no other more expert doctors, scientists, radiographers, lab technologists who work silently behind the scenes whose combined efforts provided the diagnosis.

 However, I must emphasize very strongly that doctors are very careful about the safety of their patients before surgery. They will conduct all necessary safety checks on the heart, lungs, blood pressures, blood sugar levels, drugs the patients are taking, any allergies of any drugs or food, history of all past illnesses… all the way down working together with their doctors such as the anaesthesiologists. Then they need signed consent from the patient, that is rechecked again against their names, their illnesses, the type of surgery they will be undergoing, and more consent form signed again just before they are pushed into the operation theatre. 

Then after the surgical procedure they will wheel you out from the operation theatre into the recovery area where they will monitor you closely until you are stable before they wheeled you into a surgical high-dependency ward where you will be monitored again.

We salute our counterparts for all these careful critical cares. I need to stress on this very strongly.

Beside these ethical practices, the patient’s doctor charges the patient exorbitantly which were teamwork efforts of the rest of the medical team working behind the scenes, but it was the doctor face-to-face with the patient who gets the credit. I don’t think this is fair, noble, and ethical for a doctor in this profession. Medicine has now become a commercial and a money-oriented enterprise for sure. But when I was in school, I was told doctors do charity work and he or she sacrificed his / her entire life to alleviate pain and sufferings without being paid, without charging any patient even for the medicine? It was all free-of-charge, and the doctor himself or herself did not get paid or receive any salary. It was all charity work. How then did the doctor live without being paid and without money, they didn't want to tell me. 

What a disillusion it was. I was outright cheated into this thinking.  

Everything in this profession is about money. For instance, in private hospitals anyone can ask for any investigations they want, as much as they want whether or not they are necessary as long as they have the $$$ to pay, especially if you buy medical insurance where they will cutthroat the patient so to speak. 

This has made the medical profession from a "noble one" to a commercial industry, sorry to admit this. I was disillusioned in the past when I was just an ignorant boy only to realise years later the medical profession especially in private practice is a money-grubbing commercial profession. 

Of course, the only exceptions are those doctors working in government hospitals and small health clinics. That service is not free either. Their salaries are paid by the government and most treatments are paid by the government and thus free for outpatients with simple medication except for in patients requiring surgery or other treatment that requires devices or equipment that needs to be bought from commercial companies. Even then the waiting time to see a government specialist is unbearably long – some 3 to 8 months, but by then the patients' conditions became worse or have already died from the disease. 

In the UK where I was familiar, the doctors and the nurses in the National Health Service (NHS) there go on strike asking for a pay rise. So are some of the contract doctors in government service here in Malaysia too who went on strike a few times because they were not given permanent service.  Is this what we call a "noble profession"?  

In a government hospital it takes 5 to 6 months to get a simple ultrasound done that takes only 10 minutes to do. A CT scan takes 10 - 15 months for an appointment, and an MRI two years to have it done, often the patient never gets it at all despite being requested by a senior specialist. This is because of too many requests, and all done free-of-charge. While waiting at government hospitals, the patient goes to a private hospital to have them done at ridiculous fees. It is the case of either the devil or the deep blue sea. It’s not free or charitable at all. What then is so noble about this medical profession I too ask myself?  

So long for this “noble profession” for the sick and sufferings I was cheated into thinking this in school.

The ONLY true noblest of all physicians I know is Jesus. His system of medicine is tens of thousands of light years ahead of ours. He did not ask for appointments first, take medical history, write down tons of clinical notes, ask for any of those lab tests, radiological examinations, all types of scans, take biopsies and HPE, or give any kind of chemical and synthetic drugs under the glorified name as “medicines”. 

All Jesus did was just one single touch with His hands, or even the patient just needed to touch the clothes He was wearing as He walked past in a huge crowd milling around touching Him everywhere and following Him.  But Jesus immediately knew who touched Him in those multitudes of crowd all touching and milling around Him. I think Jesus may have felt someone in need touched Him. He must have felt His horrendous healing powers suddenly drained away even from the garments He was wearing. Simply amazing!

Even without touching, all Jesus needed was a loud voice to open a grave where Lazarus had already died for four days, was buried, and his body began to decompose, but the grave automatically opened up when He called out with a loud voice “arise Lazarus” and the grave opened up and Lazarus arose from his grave. It was just mind-blogging. Many others too who already died Jesus raised them all up from their "sleep”.  

From lepers, the blind, the deaf, the paralyzed, those with fevers, to the women with bleeding disorders for 12 years all the way down to those who were already dead for days, Jesus instantly raised or cured them even from a distance with just His voice.

Jesus performed many, many more other miraculous healings, far, far too many to be recorded in the Bible as the Bible is a very vital Book on Salvation for our souls and is not a book on the science of medicine. 

Jesus never asked anyone to make an appointment first, take medical history, write tons of notes, use all sorts of lab tests, request for radiological imaging, perform any surgery, ask the patient to take this medicine or that medicine and all that stuff with follow-up one month later. 

Neither did Jesus ask for money from those who sought His help.

Jesus was just simply amazing, simply, simply very, very amazing to the highest of us all doctors, surgeons, clinicians, and medical scientists. 

Only for Jesus, His practice of medicine was truly the noblest of all professions His medicine was tens of thousands of light years in advance than ours. But Jesus' kingdom was not of this world. He came from another world not our own bringing along His horrendously powerful divine powers our world.  Where on Earth can we ever get this kind of miracle physician, doctor or surgeon here today?   

What a Great Physician Jesus was who came from another world into ours over 2,000 years ago to teach us, but unfortunately, we never learn. Instead, we crucified Him on the cross. And yet before He died, He forgave us all. What a divine beauty.  Our torture on Him and His forgiveness to all makes us very emotional to shed our tears silently.

 Jesus put us all doctors into great shame, money-minded commercial shame. 

 lim ju boo