This article was shared by a friend who has moved on to become a doctor in greener pastures away from Malaysia:
It’s interesting that English-speaking people don’t understand full-blown medicine-speak.
We have no time to wait for you. Not in the developed Western world, and definitely not in a more resource-constrained environment. In Malaysia, housemen are expected to see patients before 7 am (what time do you think they woke up and drove to work?). Rounds may start by 8 (occasionally even 7.30 am). They have no time to know whether your favorite child is planning to follow the same career.
We’re all guilty of rushing things. But when you’re rounding 40 patients in the general ward (as a specialist), general talk with patients is a luxury. Unless if you plan for rounds to finish at 1 pm, give HO's and MO's an hour or two to settle ward work (while others go for lunch breaks) and finish the PM rounds by 6 earliest, followed by 1-2 hour traffic (I'm very lucky to commute by public transport most of the time, with the option to just walk at times). But yes, we can do better to be more human in an efficient manner.
This is a problem, for both patient and doctor (there are times when the patient's memory is the account of his/her medical history). With time at a premium, getting patients to read their discharge notes is a head start. Ensuring that patients know their diagnosis during the major rounds is probably effective too.
When our doctor-population ratio is better (senior doctor numbers, not just housemen and junior medical officers), this is definitely something that we should focus on as proper bio-psycho-emotional-spiritual treatment of patients. Not when rounds already take forever with the need to teach etc. Having more people means that 1 specialist has to see only less patients.
I’m so lucky that my “ward rounds” consists of seeing critically ill patients (the majority of whom can’t talk, of which one review typically takes 30 minutes-1 hour) or patients being managed specifically for their pain and not in charge of them as a whole. When new cases are referred for preop assessment in the ward, it’s not uncommon for the review to take more than an hour without other extracurricular talk. You need more manpower to treat patients as people and not as diagnoses.