As i first day become doctor, i think medical career is one of the noble job just like teachers. I realised before become doctor that medical profession is very hard to become millionaire unless you went into research and become scientist to create new medication. Recently , i feel very ashamed and angry towards a department of the doctors (so called doctors) and it happens in Pg. I am doing my calls yesterday and received a referral from A & E department ( a referral from Balik Pulau hospital) . A paitent find suddenly unable to move the left side of hands. Patient has already unable to move the lower limb bilaterally due to accidents (tree fell at his trunk). Ct scan done that is a bleed at parietal lobe (can be seen in 4 slice of CT scan). GCS is 14-15/15 on admission. When casualty ask me for opinion , i asked them whether they already asked for opinion. Casualy MO said they don't dare to asked for it.She just got scolded 3 days ago for referring a intracerebral bleed at 8 pm. She asked for neurosurgical MO opinion and the MO need to consult the case to their boss Mr R*#% and
ended up he scolded the MO. Reason of scolding is GCS13/15 and any cases need to referred to neuromedical prior to refer to them. I wondered since when we can decide on whether patient need op or not. Are neuromedical already promote to become neurosurgical consultant or their first line MO. The bad news is i ended up advice the patient's family about the CT of bleeding, surgical intervention not available until the GCS worsening . When they asked me if op now or later (worsening)what is the difference to the prognosis.I failed to answer to them because i am not neurosurgical people and how can i answer them. Later ,they broke into tears and sound dissappointed towards us. I really pissed off about this condition. Since they want us to do the judgement ,they better teach us the technique of doing Burr hole and EVD tubing insertion. Next time ,we just performed the op if needed and close down his department and establish a new department called neuromedical-surgical department. Take note, the operation is done by his MO and they only consult him whether want to go in or not.He set up one guideline because he don't want his MO disturb his sleep concerning going in or not.I think if this type consultant appear more , next time people will sign AOR and went for Bomoh next time when inform about bad condition. I think this condition create a social condition happening now that a lot of patient's family talk to doctors rudely.
Do you want to know the guideline of referral or not? Only can refer if GCS worsening ,GCS 6-13,not dominant hemisphere bleed.Patient not too old.
Actually, i hope that one day his family members got the intracerebral bleed and not fulfill the criteria for referal and i definitely wont refer to neurosurgical!
