Angry Doctor

Tuesday, November 08, 2005

Clues for the Clueless - Chapter 6

Chapter 6 - I am not slow

I know you think I am slow. You are wrong.

I am actually trying to get this over with as quickly as possible. To you it’s 'seeing the doctor'; to me it’s work. I don’t enjoy this any more than you do. I get paid for doing this because that’s the only way I will do this. It stands to reason then that I will not spend a minute more doing this than I have to, or am paid to.

I don’t spend more time with the patients before you on the queue than I have to. But I also do not spend less time than I think is necessary to do my job well. Believe me, you will appreciate this when it's your turn to be seen. You can't cook a pack of 3-minute instant noodles in two minutes.

Between the two of us, I am the better judge to how much time is required, because you don’t know about the cases before you, and because no matter how many times in your life you have seen doctor, I have seen patients more times than you have seen doctors.

In fact, you don’t actually think I am slow. You are just blaming your own impatience on me. Face it, you will think I am slow even if I was rushing through my cases if you were the last patient in a long queue, and you will think I am fast even if I was in fact slow if you happened to be the second patient in the queue.

Finally, try to understand that coming into my room before your turn is up is NOT going to help me go through the cases faster. I don't know how you imagine that is possible, but it really doesn't. In fact it slows me down when I have to explain to you the stuff I just wrote.


  • But I guess most of the time, patients are not frustrated with the fact that doctors spend too much time with other patients.

    It's like being stuck in a traffic jam, u somehow get frustrated and irritated.

    Even more so when they are feeling unwell.

    It really helps when clinics offer comfortable sofas, lots of magazines, water coolers, TV, radio etc to "entertain" the patients.

    Think that helps ease the long waiting time.

    But in any case, I love your blog..

    Any emails where I can communicate with you. Need some career advise. Am thinking of going into medicine. But lots of reservations

    Gal at a crossroad

    By Anonymous Anonymous, At November 08, 2005 5:16 pm  

  • "It's like being stuck in a traffic jam, u somehow get frustrated and irritated."

    That's another example of an immature thought pattern. You (as in patients, not 'YOU') know being frustrated is not going to help, you don't enjoy feeling frustrated, yet you continue to feel frustrated.

    (Well, at least when I blog about my frustrations I feel better, hurt no one, and hopefully entertain and educate some folks.)

    One of the aims of this blog is to point out immature thought pattern and discourage them.

    You have control over your thought patterns, even if it's not on every occasion (like 'YOU' said especially when you are unwell, and when you are hungry, tired, too hot or too cold..., but most patients in the outpatient setting are actually the 'healthy sick').

    Learn to recognise you are going into an immature, unproductive thought pattern, and make an effort to avoid it. Being disruptive to the function of the ward or clinic isn't going to help.

    As for communication... well, angry doc is wary, not just for his identity, but also in giving personal advice.

    For something as important as a career choice, you should really ask someone you actually know and whose opinions you respect. Like your GP, maybe? A runaway monk never speaks well of the monastery... ask angry doc and he will think no one should be subjected to the life of being a doctor...

    To contradict myself, I personally think that it is ridiculous to ask a teenager to decide what he or she wants to do with the rest of his or her life. Perhaps the American system where you have to do a basic degree is better as it gives you a wider perspective and gives a 'cooling off' period.

    Depending on how much a career/job features in your overall worldview, medicine may or may not be the right choice. At the end of the day the questions are many, including:

    What do I want to achieve in this life, and does my career choice affect this aim?

    Will I be happy with this kind of work? If I decide to switch career mid-stream, will I be able to accept the fact that I will be behind my peers?

    What kind of lifestyle do I desire when I go into working life? Married life? Life with children?

    As you see, many of the questions are impossible to answer when you are just 18 or 19.

    But decide you must. So think hard, think passionately, but above all be honest with yourself.

    By Blogger angry doc, At November 08, 2005 6:20 pm  

  • Dear Angry doc,

    There are times where people can't help it isn't it? As in managing emotions, managing anger, frustrations etc.

    That's human nature as such.

    Perhaps that's why you are the doctor; The strong one. But there are lots out there who are just so vulnerable.

    The world would be a perfect place to live in if everyone can be rational in their thinking, act responsibily and manage their emotions and think logically etc etc ...

    But I guess you manage to make readers more aware of such behaviour.

    It's just that when it comes to the real situations, things just happens.

    I don't know why .. it just does. Somehow.

    Okay , understand your wanting to remain anonymous.

    Thanks for your reply anyway.

    Btw, I am not a teenager.

    I had wanted to take medicine few years back. But backed out bec of some immature and stupid reason that is so typical of an 18/19 year old.

    Now am just so so scared to return to it.

    Guess you are right, honesty with oneself. Perhaps that's what I really need. Rather than some advise from an unknow doc.

    Love ur blog anyway


    Gal at a Crossroad.

    By Anonymous Anonymous, At November 08, 2005 6:54 pm  

  • It's not natural to control your emotions. In fact, it's a long, arduous process that takes children years to learn. Some people fail to complete the course and end up becoming 'anti-social'. I think this is one area where I think it's better to believe 'you can do it' than 'it's only human'. Afterall, it's the Holy Grail we call 'civil society' we all seek.

    I'm not advocating not feeling, I am advocating not acting out. The profession and society at large must send out the message that certain types of behaviour will not be rewarded.

    If you have the luxury of experience from age (and maybe having done another degree or even worked?), and time and the money to decide whether to do medicine or not, you are in a much better position than most of us when we decided to go into medical school. Use those resources wisely!

    I wish you the best.

    By Blogger angry doc, At November 08, 2005 7:16 pm  

  • Qn:
    Could it be a case of making minor changes to the process flow, to make the system more efficient?

    And also a case of going to the dr during off-peak hrs?

    Hehe... i always bring my own reading materials juz in case need to wait long while... die also won't touch the periodicals in the clinic... dunno what kind of virus hanging around... :P

    By Anonymous Anonymous, At November 08, 2005 9:37 pm  

  • problems at work are part and parcel of life. venting is a good way to relieve frustration, but only if one vents, then move on.

    i hope angry doc (or angry doctors) don't feel angry most times. not good for your health leh. otherwise become like me... got dysthymia... sigh.

    By Blogger ckyh, At November 08, 2005 11:31 pm  

  • My personal doctor could be described as "slow" - I learned to take the last appointment of the day, show up 90 minutes after the appointment time and bring a good book to wait. But when that doctor was with me, I felt like I was his only patient and had his undivided attention. Worth every minute of waiting. He used to apologize profusely and I would laugh and tell him that (1) I was an ER nurse and understood completely and (2) it was the only chance I had to put my feet up and read! LOL!

    By Blogger Kim, At November 09, 2005 11:22 am  

  • I actually rigged the definition of 'slow' here such that no doctor can be accused of being slow as long as he is spending time with patients. :)

    But yes, some doctors are more meticulous and detailed than others.

    I think it is acceptable and appreciated when a doctor spends quality time with a patient, but unacceptable when the doctor spends clinic time doing personal stuff or making small-talk with patients when other patients are waiting.

    By Blogger angry doc, At November 09, 2005 11:38 am  

  • Dear ANgry Doc,

    Isn't the message loud and clear?

    Jumping queue is rude;
    Smoking is bad for health;
    Drugs trafficking is punishable; Talking loudly on the phone in the cinema is distrubing;
    Head Popping in the clinic is, err, rude etc etc ..

    Yet....And I really mean Yet, People still continue to "ACT" as such knowing that it's unacceptable in our "civil society".

    The approach I have taken is that I have stopped being angry long time ago. (Not worth my time)and just accept them as they are and do my job to the best of my ability.

    Some people will not change.

    There are really a lot of immature people around.

    Or are they just "Different" ? I don't know.

    The line is blurred.

    FOr every reason I think smokers shouldn't smoke, there are thousands of "crap" reasons they will continue to.

    For every logical reason I think he should see a doctor, there are thousands of "silly" reasons that he won't.


    Thanks for your wishes.

    Gal at a crossroad.

    By Anonymous Anonymous, At November 09, 2005 2:38 pm  

  • I think people act in 'unacceptable' ways because of one of two reasons:

    1. They are REALLY stupid, or "Different" to the point of being "Special".

    2. They don't get punished for it, or indeed get rewarded for it. If a patient gets seen early because he made a fuss and the administration decided to placade him, chances are he will do it again.

    I guess the message must be backed up by action. We just haven't had enough people hauled to court for abusing medical staff.

    Or take smokers for example. Certainly when a new area ban is enacted there will be flouters. But fine a few heavily and splash the info on the newspapers and see how quickly it stops.

    By Blogger angry doc, At November 09, 2005 2:46 pm  

  • Medical student here. Totally understand what you feel.

    By Blogger Colognscente, At November 09, 2005 10:42 pm  

  • Agree with Angry Doctor.

    You have nice patients. You have not-so-nice patients.

    My husband has had appointment cards thrown in his face by the relative of a patient because they "waited too long". And he "isn't supposed to get angry" at their behaviour.

    What can he do when the administrators decide that all appointments should be scheduled in 3 - 5 minute blocks non-stop? It takes time to read case-sheets, and time for the patient to saunter in to the clinic, so on and so forth.

    I don't believe there's a surefire solution to this because demand for appointments at public hospitals is just too high.

    But if patients don't want to wait weeks or months to see the doctor and demand that the doctor sees them on the dot, then I suggest they pay a premium and see a private doctor.

    By Anonymous Anonymous, At November 10, 2005 10:22 am  

  • Yikes!

    I think when a patient threatens (assault) or physically abuses (battery) a medical staff, it's no longer a customer-service issue but a criminal one. I remember reading a few reports of patients being hauled to court for such behaviour. Maybe we just need a lower threshold for doing so and greater publicity when ithappens (yes, I have an ambivalent relationship with the media).

    I've always wondered why the patient load is so high in Singapore. Are Singaporeans sicker than others?

    By Blogger angry doc, At November 10, 2005 11:46 am  

  • I don't think we Singaporeans are sicker. We're just hypochondriacs ;) Every little thing - see doctor. Otherwise, must seek 2nd opinion.

    It's also a case of what-we-want-we-must-get-and-we-will-get. If we want to see the doc, we will get to see the doc, it's just a matter of when.

    My friend who lives in London recounted this experience when she got really ill with persistent high fever for a few days of 40degrees celcius and a horrible throat. She finally crawled out of bed, took a 1 1/2 hour bus journey to the hospital all by herself to see the doctor.

    When she got there, she never got to see the doc. The furthest point she got was to see the nurse who refused to let her see any doctor. Finally, the nurse "prescribed" her a notice. A notice that explained what Hay Fever was and sent her off. Without any meds even.

    Can you imagine if we did this in Singapore? Our ISO certifications would probably never allow this. :)

    By Anonymous Anonymous, At November 10, 2005 4:23 pm  

  • I think the other problem is because we need MCs and we have NS. :)

    If our workers could just call in sick and self-medicate, I am sure workload would be reduced.

    Likewise if we didn't have to do IPPT or have to seek downgrading...

    By Blogger angry doc, At November 10, 2005 4:41 pm  

  • "I don’t spend more time with the patients before you on the queue than I have to. But I also do not spend less time than I think is necessary to do my job well."

    Haha, I agree. I also work in a job that has high human throughput, and some ppl I cater to can be sooooooo rude. And I'm not supposed to rebuke them either. My sympathies, and hope your blog post inspires more awareness in these ppl of how frustrating they themselves are to the personnel trying to help them.

    By Anonymous Anonymous, At November 10, 2005 11:25 pm  

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