18 June, 2007

Very Irritating Person?


V.I.P.

What it means to me :

  • patient with acute myocardial infarction - needs my immediate attention and antifibrinolytic therapy STAT. Time is myocardium
  • patient with respiratory failure - needs my immediate attention and early anaesthetic assessment for consideration of assisted ventilation
  • patient with upper gastrointestinal bleed - needs my immediate attention and judicious fluid resuscitation while we arrange for means to stop the hemorrhage
  • patient with a sudden deterioration in GCS - needs my immediate attention and assessment for need for airway protection while measures are underway to determine its cause
  • patient with cardiac arrest - you know what he/she needs
What it doesn't mean to me :
  • high-ranking government officer who walked in (or chauffeured in, whatever) with fever for 3 days, but stable
  • relative of some MP who has mild abdominal discomfort
  • some Datin with moderately high BP but asymptomatic
  • resident orthopedic surgeon's neighbour who has diarrhoea
Can't we just do our job? Your order of importance is dictated by the nature of your medical condition, not your status. Don't pry me away from a patient who deserves my attention more just because you are an "important" person who happens to have a trivial medical problem.

Did I just commit professional suicide? Maybe. Not that I have any political aspiration anyway.

I took an oath to be fair and just to my patients, and I intend to honour it.

5 comments:

Hospital Slave said...

Undoubtedly one of your best blog so far. Well said!

I however noticed that you didn't list stroke as a priority. It is afterall also known as acute brain attack. I know..I know...there are so many medical emergencies, you can't possibly list them all. Fair enough.

Could you please enlighten me on the stroke service provision in your hospital?

fibrate said...

I just feel strongly about the "un-justness" of double standards.

How did I miss out on stroke? Probably slipped my mind.

Stroke service could be so much better in Malaysian hospitals. What we lack : the access to CT brain and neurosurgical backup - hence no rTPA (only available in a few select centres).

Otherwise, we provide standard evidence-based medical care. Sadly, the rehab aspect could be so much better. Stroke care should be a multi-disciplinary affair, I know. Many hospitals here are now putting in place dedicated stroke teams. Things should pick up from there.

Anonymous said...

Aye Aye, gird up our loins and hold our waters! We're healing people!!! Sorry your blog entry totally inspired me again (and I happened to just watch Pirates Part 3 yet again) hence the pirate talk. :-)
We're doing good work ya my sister in the hypoocratic oath!

fibrate said...

Jimbo : Savvy! Did you mean Hippocratic oath? Or pun intended hypocritic oath?

Anonymous said...

Typo there, sorry. :-)