28 March 1998

Gaining Professional Respect and Reputation out of Deeds

(Keywords:- specialist registry, dwindling image, patients¡¦ rights, doctors¡¦ rights) 

          At last, the medical specialist registry has been published yesterday by the Medical Council -- the registration body of the medical profession. A new page is turned in the history of medicine in Hong Kong. As our society attains a high degree of sophistication, as we become more affluent, it is only natural that patients would be more demanding for specialised services. A specialist registry is, therefore, unavoidable.

          For decades, however, Hong Kong has never had our own structured post-graduate vocational training on the many branches of medicine, nor do we have a body to vet specialist standards. The establishment of the Academy of Medicine by statute, together with the formation of some 15 specialist colleges under the umbrella of the Academy, heralds a new era and paves the way to specialist registration.

          To those in the medical profession who fall into this rank, there is obvious cause for jubilation. For the ordinary man-on-the-street, hopefully there will be less confusion of going to the wrong doctor: a man with a hernia will not present himself in the surgery of a gynaecologist because that doctor has done wonders for his wife¡¦s problems.

          Understandably, those who are missed out in the specialist registration exercise are aggrieved. It is, therefore, up to the different specialty colleges to ensure that adequate continuing medical education programmes be extended to those less fortunate and to formulate ways to upgrade them to qualify for specialist registration later, for public good.

          There should not be any misconception however that  specialist registration, in any way, points to two grades of standards of medical practice. The fact remains that whilst specialists deal with a sub-sector of medicine, generalists look after the overall care, all with the same high standard as demanded by the public through the Medical Council.

          Talking about standards brings home the issue of the image and reputation of the medical profession.

          For some time, there is the belief that the image of professionals -- be they doctors, lawyers, accountants, etc -- is dwindling and their reputation touches rock bottom. Understandably, with a more open society, a more enlightened community, the days of ¡§professionals know best¡¨ are something of the past.

          The same happens to medical doctors. With political development, promotion of human rights, establishment of performance pledges, patients are much more demanding. Patients rights are often times taken to the level of being abused whilst doctors rights are conveniently forgotten. Doctors are often accused of working in a ¡§black box¡¨ or ¡§professionals shielding professionals¡¨. The recent series of medical mishaps, the returning of prolonged waiting list to see a doctor, let alone admit for treatment, become the last straw that break the camel¡¦s back. Many of these are, in fact, outside the control of the doctors. Yet, the accusing finger is still constantly whacking at the medical profession.

          Has the doctors¡¦ performance fallen below acceptable level? Unfortunately, few are willing to publicise the positive side of medical practice -- the amount of diseases cured, let alone lives saved, most of the time out of selfless devotion disregard of personal comfort or even safety by the professional concerned says all. To wit, more than 958,000 patients went through our public hospitals in 1996-97 alone, needing different dimensions of treatment and care. The majority returned home comforted and cured.

          Nor will laurels be placed on those of the profession working in private institutions who would offer free treatment, often times even expensive medication, out of their own pockets for the real needy. They are unsung heroes in the Hong Kong environment where financial gain, to most, is of prime priority.

          Whilst there is thus no cause for the profession to be dejected, there is no grounds for them to be complacent either. Respect is not something one asks for, rather it is an element that one gains out of deeds. Let the profession work in a united fashion to regain the respect we deserve.

(Hongkong Standard)