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Doctors! Have we lost our common sense?

I am no senior doctor to brag about anything. However I cannot avoid to realise that most of the doctors junior than me have lost their common sense.

Hippocrates once said that medicine is an art with experience and common sense (not quoting the exact words but that's how he used to say if I am not mistaken). Thus common sense is so important in practicing medicine.

Nowadays, those with a title of specialist will brag about their knowledge, and do this and do that. Everything is possible. A doctor with a title of medical officer will brag on how now he is already a medical officer. Power is now in his or her hand. Thus everything is about telling his house officer to do this and do that. A doctor with a title of house officer is the one who always told to do something. All he or she did was the thing that was told by those two person mentioned earlier.

The only one who has common sense now is the medical student. A fresh young eager mind. Not polluted or abuse by anyone else yet. I once sat in a clinic accompanying my dad on his regular orthopaedic appointment when I heard a medical student clerking a patient. A to Z. Everything is an interesting fact for them. They really want to know more about that patient.

In term of common sense, everything goes hay wire nowadays. The attitude of dumping patient and playing 'football' or 'badminton' with patient are so common among doctors. This patient have this disease, need surgery - dump to surgery. Finish surgery patient went to sepsis - kick to medical. Do this and that and in the end nothing can be done, throw to palliative care unit.

Nobody bother to bear the responsibility to treat patient as a whole. Nobody bother about what patient really feel anymore.

My wife work in Palliative care unit and once she told me that their team was called by medical team just to tell patient's relative that the patient is dying and they can't do anything anymore. Do we need other people to do that if we are treating that patient up to the point that we can't do anything anymore? Is it a common sense to just...perhaps...talk to patient and his or her relative?

Once my wife was called at midnight by a house officer because a patient is dying in their ward. Need to transfer to palliative ward stat. A dying patient and you want to transfer at midnight? Is it common sense to just...perhaps..talk to patient or patient's relative explaining about prognosis instead of transferring? As usual house officer will tell that their MO ask to do so. So now MO also do not have common sense.

I once had a referral to do FNAC to a left thyroid swelling. No problem with that until I ask that patient on which side the swelling is. She said it is in the right side. When i flipped that person case note, I saw all review documenting right side thyroid swelling. So why request left? To my surprise they request left side because CT scan report told that there is left side thyroid nodule which is bigger than the right side. Do we lost our common sense..? A palpable swelling on the right, and the right it is no matter what radiology report says. I have to struggle for 10 minutes examining that patient to make sure that I do not wrongly palpate the wrong side. Common sense - if a swelling is on the right side and you can't even felt the left swelling, do we order left side FNAC?

Once I heard from family of a patient that they regret signing that consent form to put a stent for their father because that procedure is rather painful and their father did not survive that long after procedure. The cancer still cause him to deteriorate and unable to fight the infection perhaps introduced during the major procedure. It's a common sense to do no harm to patient especially those that we know bearing incurable diseases.

What is going on with our common sense nowadays? Is it because we are too busy making us lose all of our senses including common one. Do we forget what we have learn in med school?

Instead of giving lectures on the advance technology on interventional medicine update... I guess someone should start thinking of giving a talk on how we should not loses our common sense and to practice medicine with ethics so that we will not entangle this already haywire mess..


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