I would like to share the current reality faced by health care workers at Sultan Haji Ahmad Shah Hospital (HoSHAS) in Temerloh, Pahang.
Many Malaysians may not be familiar with HoSHAS or where it is located. Some may simply regard it as a district hospital. However, HoSHAS serves as the main referral centre for the region and functions as the leading district hospital, providing specialist services and receiving referrals from surrounding hospitals such as Jengka, Jerantut, Bera, and Bentong.
Despite an increasing number of referrals and patient load, there remains an expectation that the hospital can continue operating at the same capacity as before.
The Department of Internal Medicine currently has approximately 15 medical officers, following the departure of many doctors pursuing specialist training. With another six officers expected to leave for interim placements soon, the department will be left with only nine medical officers.
Unfortunately, those in higher administrative positions often see only KPI achievements and service statistics. As long as the system appears to function above the minimum required standard, it is considered acceptable.
What is often overlooked is the toll this takes on the physical and mental well-being of health care workers. If decision-makers were placed in our position, even briefly, they would understand the immense pressure we face every day.
These few medical officers are responsible for managing five major medical wards: K14, K12, K11, K10, and Bunga Raya 2/1. Together, these wards account for approximately 150 beds, excluding responsibilities in the Coronary Care Unit (CCU) and Intensive Care Unit (ICU).
In addition, the Medical Outpatient Department (MOPD) manages up to 80 patients on its busiest days. The department also receives approximately 20 to 30 new referrals daily from the Emergency Department.
Peripheral services contribute another 10 to 15 cases requiring reassessment each day, along with an additional five to ten new referrals on top of existing workloads.
Despite these demands, medical officers continue to perform 24-hour on-call shifts from 8am to 8am, often every other day due to severe manpower shortages. At the same time, there is continued pressure to review patients within KPI targets in the Emergency Department. When reviews are delayed, calls continue relentlessly until a doctor can be reached.
What is often not seen is what health care workers are doing before those calls arrive. Some are actively resuscitating critically ill patients. Others are still completing ward rounds, managing admissions, reviewing deteriorating patients, or handling administrative and clinical responsibilities accumulated throughout the day.
Despite these realities, there remains an expectation that we should continue performing at our absolute best at all times.
The truth is that we are pushing health care workers beyond reasonable limits.
The consequences are predictable. When people become physically and mentally exhausted, their priority shifts from delivering optimal care to simply getting through the workload. Fatigue can affect clinical judgement, reduce attention to detail, and increase the risk of missing important findings.
As many health care professionals have warned, chronic fatigue in health care eventually leads to delayed reviews, missed signs of deterioration, medication errors, emotional burnout, and ultimately the loss of experienced staff from the public health care system to the private sector.
At the same time, highly subsidised health care services have unintentionally created a situation where some patients no longer fully appreciate the importance of continuity of care. Defaulters often return repeatedly because hospital services remain accessible.
While access to health care is essential, health care workers cannot refuse treatment and continue to carry the burden of an ever-growing workload because it is our duty to care for every patient who walks through our doors.
This is not a complaint about serving patients. We chose this profession because we care. This is a plea for understanding and for meaningful action before the situation worsens.
Health care workers are not machines wearing stethoscopes. We are human beings. And like every human being, we have limits.
The author is a medical officer at HoSHAS. CodeBlue is providing the author anonymity because civil servants are prohibited from writing to the press.
- This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.
