Exclusive: Doctor-ed out by language

Tasnim Lokman

KUALA LUMPURTHOSE in the medical profession want an age-old practice of doctors using languages other than English or Bahasa Malaysia during ward rounds to end.

Failure to put a stop to this, they said, would not only hamper critical learning processes, but also risk the safety of patients, as their conditions might not be fully understood by other doctors and personnel.

Doctors told the New Sunday Times that ward rounds were intended to allow every doctor in the ward to share updates on a patient’s progress, participate in an active learning process and discuss complex clinical issues with each other seamlessly.

“However, with what is happening, discussions, and the sharing of clinical knowledge and patient updates are kept within the circle of medical officers and specialists who converse in Mandarin or other Chinese dialects,” said Dr Johan Suksmajaya, who uses a pseudonym online, to avoid conflict with his colleagues.

As one of the doctors who has been fighting this trend, he said it had been a common rumour among housemen and medical officers that certain Chinese-dominated hospitals were hotspots for such practices.

“It was something we joked about. But when we experienced it, it was no longer a laughing matter,” he said.

Doctors from various hospitals had also taken to social media to compile feedback on this practice and had reportedly sent their findings to the health minister.

Dr Johan told the New Sunday Times that this non-conducive practice had been hindering the learning process of housemen, medical officers, pharmaceutical and medical students and nurses who do not speak Mandarin.

These “inconsiderate doctors”, he said, almost never translate their discussions for the others to listen in and understand.

“Sometimes, they go on and on and only in the end narrate the conclusion of the discussion, denying housemen and medical officers who do not understand them the chance to understand how clinical decisions were made.”

He has received criticism online after raising the issue, where many accused him of “deliberately creating racial tensions”.

He debunked the claims, saying that he had to raise the issue as the trend was becoming a norm on hospital floors.

He added that this was not a racial issue as he was Chinese.

“It makes it impossible for those who do not understand Mandarin or Cantonese, for instance, to participate in clinical discussion during ward rounds.

“In fact, this prevents housemen and medical officers who do not understand these languages from becoming as competent as their colleagues who do.”

He cited an incident in Penang where an orthopaedic medical officer was unable to learn how to set a central venous line because the senior teaching him refused to teach in English.

The senior preferred to teach in Mandarin because there were other Mandarin-speaking medical officers present, he claimed.

Based on the result of the online survey gathered, Dr Johan said the problem of senior doctors using languages other than Bahasa Malaysia or English was happening in hospitals where the significant percentages of doctors were from a specific race.

This, he said, were most notable at Penang General Hospital, Ipoh General Hospital, Kuching General Hospital, Queen Elizabeth Hospital in Kota Kinabalu, as well as certain departments in Sultan Ismail Hospital and Sultanah Aminah Hospital in Johor Baru.

He said this was also a trend in these hospitals’ key departments’s ward rounds, particularly the medical, obstetrics and gynaecology, and paediatrics units.

“The medical officers and housemen who do not understand the language used are left out of the loop, and based on the responses received, this was done intentionally,” he said.

He added that those in the medical fraternity who gave their feedback said when this happened, they would ask the doctors to use English or Bahasa Malaysia, but were often ignored.

“It has reached an extent where these ‘victimised’ housemen and medical officers are depending solely on whatever conclusions the Mandarin-speaking medical officers and specialists have arrived at, because they could not participate in the discussions.

“They will certainly not be able to understand what had been planned for the patient,” Dr Johan said, adding that this increased the risk of the mismanagement of patients.

He said nurses and pharmacists were also affected by the problem.

“The management of patients can get confusing as those involved with the medical service do not understand why a certain course of action was taken or carried out.”

He said he was flabbergasted when he discovered that doctors who were guilty of this did not see it as a problem.

He had raised the issue in a private Facebook group for members of the Malaysian Medical Council (MMC).

“In Dobbs (the name of the Facebook group), you’ll find that there are indeed doctors who feel that what I have highlighted is a non-issue.

“This occurred when my tweet on this matter was shared with the Facebook group.

“It was initially deleted because the administrators thought it would spark a racial debate.

“When it was reposted after multiple requests by other members of Dobbs, the resulting discussions showed that there are doctors who think it is fine to conduct rounds in a language that not all understand.

“So you see, one of the reasons why this issue has persisted is because we have doctors who think it is fine to do so,” he said.

Dr Johan said he has reached out to the health minister and hoped to receive feedback on the matter soon.

“We still have a few people who think the topic we highlighted is a non-issue.

“Well, the issue has reached the minister. The ball is in his court now.” © New Straits Times Press (M) Bhd