Friday, August 19, 2011

transferring out


we do that quite often.

that is, transferring patients, invariably from the ICU, to a public hospital. sometimes, the patients are doing well except that the bill is getting to be a burden for the family. but more often than not, the patients aren't doing well; remaining in the ICU with no obvious light seen in the proverbial tunnel & with a big hole burning in the pocket, moving to a public hospital is the only way out.

also we have a situation here that is far from satisfactory. there are 4 neurosurgeons in the state & all of them are in private practice. so, if there are patients with serious head injury but who cannot afford the exorbitant private hospital bill, they get the initial immediate treatment at the local emergency department but will need to make the 100km+ journey to a neighbouring state for definitive neurosurgical management. all that delay will not improve functional or survival outcome for such patients.

so, it is with some sadness that we had to transfer out one such person yesterday. he had emergency brain surgery done & was not recovering well. staying in the ICU has been taxing on the family finances & after 10 days, they have no choice but to move to a public hospital in another state.

if only there were a neurosurgeon at the local hospital, the initial surgery & subsequent rehabilitation would have been done at an affordable cost. at least, the average man on the street would have been given a better chance at survival.

so, in this respect, it's easy for me to see why people harbour so much disdain for submarines, national service programs, overseas study trips & 100-storey towers. what good is all that when their right to proper medical care is eroded by the day.

12 comments:

iml said...

We have come so far and still......

ilene said...

If only .....

Many lifes would have been saved if only ....

My mum is one such victim. If only I had a pot of overflowing wealth ... *sigh*

doc said...

Iml,

we have come so far and still.....spiralling downwards.

doc said...

Ilene,

learn from the past - get medical insurance.

Wang Tai Tai - 王太太 said...

your story reminded me when my dad was in ICU two years ago before he died. He had a brain aneurysm but hung on for more than a week. The bill was spiralling upward uncontrollably and the neurosurgeon couldn't tell us how long my dad would be in ICU so we requested that he be transferred to a govt hospital but he kept telling us that it would be very difficult to get a bed in the ICU of a govt hospital. He said he'll try but my dad passed away two days after our conversation. If my dad had recovered and knew how much we had spent in that one week in a private hospital, he would have had a heart attack. :(

doc said...

WTT,

things haven't changed since your dad's time. the govt hosp wouldn't accept this patient unless certain conditions were met, which i can understand too, because their resources (aka ICU beds, ventilators, etc) are limited. we finally transferred out 5 days after satisfying GH's conditions.

being in a private hospital, sometimes we are caught in between. if we intervened, we are accused of money-faced; if we don't, then we are accused of delaying treatment, esp if the patient deteriorates.

incidentally, this patient also had an aneurysm. his 2-wk stay in ICU including 2 surgeries came up to RM40k+.

yes, he would have a heart attack, too, if he recovered.

Yvonne Foong said...

Yeah, when I was treated at KLGH, there were many people being sent from other states. There were also patients who flew from Sabah just for brain surgery.

Sadly, coming to KL doesn't guarantee that they are in safe hands either.

But after hearing from my friends serving their housemanship now, I learned that the system itself limits how far doctors can go in their careers. If I am not mistaken, Malaysia doesn't recognize an international qualificatrion in Oncology. You have to be trained by the government in Oncology, or something like that.

doc said...

Yvonne,

at least KLGH gives you a chance at neurosurgery; elsewhere, it's just touch & go.

the govt recognises, rightly or wrongly, the local post-grad degrees over the foreign ones.

Yvonne Foong said...

But getting into local oncology programs is.... should I use the word difficult? It's only open to local MBBS holders. And getting into local unis to study the MBBS is... impossible. So who will ultimately be enrolled into local oncology courses?

doc said...

Yvonne,

affirmative action.

Yvonne Foong said...

Affirmative action on a medical specialty so crucial for the survival of Malaysians!

doc said...

Yvonne,

affirmative action pervades all levels of our society!