Patients need right docs

Star: PUTRAJAYA: A specialist can treat a patient outside his specialty in an emergency, but subsequently he has to refer the patient to the right specialist, Health Minister Datuk Seri Dr Chua Soi Lek said yesterday.
Commenting on a recent case of a boy who died after being treated by a nephrologist for dengue and typhoid, Dr Chua said he was under treatment for almost two weeks without being referred to an infectious disease specialist or physician.
Specialists should not disappoint their patients as they put total trust in them, he said, adding that doctors had a moral and professional responsibility to refer patients to the right specialist.
Dr Chua was responding to doctors who had written to newspapers and argued that sub-specialists with their background training and experience in general medicine were qualified to treat most infectious diseases.
The Council of the Malaysian Society of Nephrology had said diseases did not always manifest in a specific compartmentalised manner that delineates which particular specialist should address it.
On Aug 9, Dr Chua said three cases of specialists giving treatment outside their field were reported to the ministry and the Malaysian Medical Council (MMC) recently, and that two of the patients had died.
Asked if MMC would take action against one of the specialists concerned, he said it was difficult for MMC to take any action because the specialist said he was trained to look after the patient.
“But if he was trained to look after kidney patients, why was he looking after an infectious disease case? Why was he keeping the patient to himself? MMC is looking into the case and the hospital has to come up with a better explanation,” he said.
Malaysian Medical Association president Datuk Dr Khoo Kah Lin said the association shared the opinions expressed by specialists in the press recently.
While doctors should treat patients as whole persons and not as isolated organ systems, it was not possible for specialists to keep up with the latest developments in fields other than their own, he said.
“In a patient who has many diseases involving several organs, we have to differentiate between patients who are acutely ill and those who have several chronic stable conditions.
“In the latter case, he should be seen by a general practitioner who knows the patient as a whole and follows up with the patient regularly and refers him back to relevant specialists when the condition is not well-controlled,” he said.
In the case of an acutely ill patient, there should be one main specialist taking care of the patient and other specialists called in for consultation according to changes in his condition, he said.