Wednesday, November 30, 2011

Post-GP Posting

Assalammualaikum wrt wbt.
I've just finished my enjoyable, fascinating, adventurous 4 weeks GP placement!
Even though I had to travel more than 10 miles a day to the GP (GP means General Practitioner; basically a doctor who works in a clinic), I loved it.
Not only because the doctors and healthcare assistants were nice and helpful, but also because I get to travel and walk around.

I said before that I want to write about the primary care in England and how does it differ from the primary care in Malaysia (primary care means the first level of care patients get; the first person patients go to eg clinics). I am not sure if this is gonna be an interesting post for my regular readers but it might be of interest for those who want to know more about the healthcare system here, through my eyes and thoughts.

Medical Certificate (or better known as "MC" in Malaysia)

One stark difference that striked me was the procedure of giving out MCs. In Malaysia, we need to produce MC to our employers/teachers/univ admin for even one day of sick leave. And that includes sick leave due to a terrible flu; because only an MC can "certify" our illness.

Here however, employees/students can self-certify their sick leaves for up to 5 consecutive days, if I'm not mistaken, or was it 7 days? But anyway, this means that if we're down with flu we can just call the company/office up and inform that we cant make it to work/class, without having to show any MC.

Which system is better?
I'm not sure but I think the answer depends heavily upon the reason of the system. Having to produce MC for even one day of viral fever makes doctors' work unbelievably more. They had to attend to even the slightest tiniest self-limiting fever; which could have been easily treated by paracetamols, plenty of fluids and a good rest. But bcos the employers WANT TO SEE the MC, these poor workers had to get out of their comfortable beds to a clinic for Drs to see them and "certify" their illness.

Drs here do not have to attend to these illnesses and that changed the whole statistics of "most common illnesses presented to a GP".

Duringn my 4 days of GP attachment in Malaysia, I see mostly cough, cold, flu, fever and diarrhoea.
So I do agree that GPs in Malaysia have more work to do, bcos they see a lot more patients in a day. But imagine the 5 day self-certify illness is implemented in Malaysia, I think there will be quite a considerable number of workers/students that will use illness as an excuse to not attend work/class. I am not sure if the people here abuse that self-certification, I do not have any statistics to comment on it, but I have to admit that even the number of prescribed sick-leave days are frightening. Patients came in with depression and guess what, they were prescribed a 4-6 week sick leave!
How abused, or un-abused is the sick leave? I don't know.

Personal GP

In Malaysia, we rarely go to one GP in particular, especially if we are used to a government clinic. Yes, we may go to a certain clinic, but we rarely ever get the same GP attending to us on every visit.

But here, we have to register ourselves with a surgery (they call clinic as surgery here), and u'll get a "Usual GP". U might not get that particular GP on ur visits but still, u most likely will. So every time we are down with non-self-treatable illness, we HAVE TO go to that particular GP. Other GP will not accept u unless it is a very emergency case (but might as well go to A&E dept for that).
This is good in the sense that the surgery knows ur whole medical history; in which month did u come in with pneumonia, which month did u come in with syncope etc where as in Malaysia, people tend to go to private clinics if they want to get a fast treatment; and even then, people don't usually go to the same clinic. I myself went to quite a few clinics in my area, depending on which clinic has the least number of patients waiting for a consultation. That means, my medical history were split into at least 3 different private clinics and a government clinic back in Malaysia. Not good for documentation isn't it?

But the drawback is when you are not yet registered (which should not happen to British).
When I first got here, I was down with something that really required treatment (well actually I could have self-treat myself but the drug dispensing regulation here is tighter than Malaysia that I can't buy those medication over the counter). And because I have not registered myself (the registration itself takes 3-4 weeks) with any practice (a clinic), I could not go to a surgery for treatment. I then had to resort to A&E. Funny isn't it? I went into the A&E Dept in the hospital I am based in, wearing the scrubs all medical students are wearing. At first the staff thought I was there for a posting.

Ok sorry, I really think I gtg now.
I'll continue writing when I have the time.

-Because life is a test-


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