Old fashion medicine

Recently a female houseman was assaulted by a newly admitted female patient at a public hospital. The patient is a middle age Chinese who could not communicate either in English or Bahasa Melayu. The houseman, a Malay, had requested the Chinese medical officer on duty to attend to the patient but she was scolded because he considered it very rude for a junior to instruct a senior. As a result she did her best to clerk or interview the patient. Her persistent questioning led to the patient losing temper and hit her several times and broke her spectacles.

The management of a public hospital is much more than a matter of filling it up with more doctors, nurses, paramedics and other support staff. These various skill sets must be organised to work as a team for better patient care. People work best where they are valued as individuals and recognised as key members of the hospital. Those assigned with supervisory role such as the consultant and medical officers must ensure that procedures are administered uniformly and followed judiciously by treating subordinates fairly and consistently. The time has come to abandon the old style hospital management that seniors are untouchable and therefore will not help juniors while patients are dying.

In fact the most important innovation needed in the public hospital and the public sector in general is building better team work. Investment in new technologies is secondary compared to the importance of optimal utilisation of its existing human resources. The adage in Mayo Clinic, one of the best hospital in the world, is "No one is big enough to be independent of others".

At the center of the storm

Former CIA chief had just released his book entitled At the Center of the Storm. The main theme of the book is to restore his damaged reputation as a result of misrepresentation by Bush and Cheney in justifying the invasion of Iraq.

A group of officers from CIA wrote a letter to the publishers stating that Tenet has no reason to complain that he was victimised. He was a willing participant in the ill conceived war. Off course Tenet was not alone for failing to speak up and protest when it matters, but he was in charge and opted not to do the right thing. In fact he collaborated with the British Intelligence in fixing evidence that Colin Powell resented to the UN. He therefore did not show the leadership and integrity that is worthy of the Medal o f Freedom awarded to him by George Bush, and to this the signotories to the letter urged him to return it. They also urged him to donate half of the royalties from the book to the victims of Iraq war.

The book is therefore a misleading and self serving in his attempt to correct the blame for the mess.