Being a Medical Doctor.

After all medical students graduate medical school and finish their clerkship, before becoming doctors, they are sworn in by the Hippocratic Oath. Now, what is the Hippocratic oath and what does it say? 

The Hippocratic Oath is an ethical code. There are a few versions of it, in the older versions, the doctors-to-be swore upon the Greek Gods - Apollo,  Asclepius, Hygieia, and Panacea. But now, we use the modern version of the Hippocratic Oath which is very long, so if you want to read it fully you can visit http://en.wikipedia.org/wiki/Hippocratic_Oath. The oath mentions about the obligations of a practitioner to provide only beneficial treatment according to his/her judgement and abilities. He/ She also swears to not cause harm or hurt. These points are what medical ethics are made of. 


Okay after swearing in, we have our internship and then this hassle of getting our license. And the license has to be maintained over the years to ensure of the quality of the service provided. I have mentioned this in my previous post. Anyway, this maintainence is called continous professional development(CPD). In Indonesia, The Indonesia Medical Association says that every medical practitioner has to have 250 credit points within 5 years if the practitioners wants to prolong their license. The credits can be obtained from attending seminars, number of patients treated and et cetera. Whereas, in Malaysia, CPD is also practiced by obtaining credits, but its not compulsory as it is in Indonesia. The MMC (Malaysian Medical Council) are planning on making it compulsory in the near future. 

As long as we have a valid license, we are free to practice. However, the battle doesnt end there. We have medical law to be scared of. Okay first lets see the outline of a doctor's job scope. :)

Built a relationship with patients ---> Patient's data (Health history, Physical examination, Supporting examination) ----> Analyze the date ---> Planning medical treatment and informing patient about the condition they are in ---> Treating patients ---> Follow up. 

It looks simple, but its pretty complicated. Besides the fact that the doctor has to be very skillful and knowledgeable to be able to complete his/her tasks successfully. He or she has to be cautious about the medical law which if not followed, a very high price has to be paid. So now, lets look at medical law.


In Indonesia, the legal aspect of medicine is based upon Health Act 1992, Medical Practice Act 2004, Role of Minister of Health on Informed Consent, 1989 and the penal code. These laws makes malpractice as a criminal matter especially if it involves bodily injury. Bodily injury may be caused by medical negligence. Whereas in Malaysia, malpractice is treated as a civil matter. Even medical negligence are treated as a civil matter and not a criminal matter where the accused medical practitioner who has caused bodily injury is not charged as a criminal. (Susila, 2005). 


So now lets look at what are the doctor's and patients' right and obligations.

Doctor's rights :
1. To have certainty when performing medical procedures and throughout the practice.
2. To have propers Standards and Guidelines from the medical association in giving medical service to patients.
3. To get a complete patient health data.
4. To obtain salaries for the job done.


Doctor's obligations :
1. To give service based on Standard Operating Procedures and guidelines.

2. To refer a patient to a more competent doctor or to a better well equipped hospital if necessary.

3. To protect patient's confidentiality

4. To give emergency aids if needed

5. To have medical records on each patient.

6. To update knowledge and skills (life long learning)

Patients' rights :

1. To get a good, understandable and clear explanation about the problem (disease) they are having and also on the medical procedures done.

2. To get a second opinion from other medical practitioner.

3. To refuse any medical procedure or interventions.

4. To get their medical record anytime they want it.

5. Not being made to wait for an excessive period of time.

Patients' obligations :

1. To provide a full truthful health data

2. To abide by medical service and rules.

3.  To take care of medical service costs. 

However, the patients' obligations are up to the patients to follow. Whereas there are laws to make sure of doctor's fulfill their obligations. This is because being a doctor is a very risky career. In the past, medical practitioners are not answerable to law where the doctors had a high position in the society. During that era, the patients think of doctors as "Gods" and listen to every word they say. But in this modern times, this doesnt apply anymore. Doctors can be questioned both by the patient and the law. Medical malpractice has affected the doctor-patient relationship significantly. The Washington Times has reported that 70% of Maryland's Obstetrics and Gynecology specialist have been at least sued once for medical malpractice. Looks like it is getting harder and harder to be a good practicing doctor as the years goes on. 

References :

1. Lecture Note - Legal Aspect of Medicine, dr. Hendro Widagdo

2. Wikipedia - http://en.wikipedia.org/wiki/Hippocratic_Oath

3. Encyclopedia Brittanica- http://www.britannica.com/EBchecked/topic/266652/Hippocratic-oath

4. Malaysian Medical Council - http://mmc.gov.my/v1/index.php?option=com_content&task=view&id=10&Itemid=96#Q2

5. Law relating to medical malpractice : A comparative study between Indonesia and Malaysia, Muh Endriyo Susila, 2005

6. Legal Aspect of Medicine, Jonathan Montgomery.