The typical schedule of a Medical Officer in a busy public hospital:
630 am - 800 pm: How early we get up depends on the amount of patients we have - This can range between 15 - 25, divided between 3 - 4 doctors. Usually, I have to show up around 7 am.
I start the day by logging into the computer system, and running through the list of patients I have to see for the morning. Along the way, I note down all my patient's blood test and imaging results, and also their vital signs: temperature, blood pressure, oxygen saturation and heart rate.
I say a quick hello to my patients, and then examine them. Everyone's still rather sleepy at this point, so I'm not too chatty, since there will be another round of doctors coming their way soon! I like to ask my nurse how my patients have been - nurses are the most useful source of information, as they would have observed the patient overnight.
I follow up by compiling a list of all the issues my patients have that are keeping them in hospital, eg:
- Pneumonia
- Growth on lung X-Ray
- Fall risk due to a long period of bedrest and deconditioning
Each issue will have a corresponding plan which I propose, as follows:
- Continue with IV antibiotics treatment
- Order a CT scan of the lungs to get a closer look at the growth on the lung
- Request for a physiotherapist to assess and perform physical therapy on my patient
0800 - 1030 am: A senior doctor ward round, during which I talk about each patient's progress. This ensures that all my decisions have been vetted by a senior doctor. It's also a good time to discuss how to proceed with outstanding issues.
I enjoy the challenge of hospital doctoring - I think of it as a problem solving exercise, with a simple question: What's keeping my patient from going home? Once I resolve all of my patient's active problems, he can be discharged.
No one likes staying in hospital, and doctors hate keeping patients for longer than necessary as this puts them at risk for hospital acquired infections.
1030 - 12 pm: My team spends this time carrying out the plan that was discussed during the ward round.
This typically includes:
- Writing a referral letter to another specialist within the hospital - eg the lady with the new diagnosis of lung cancer needs to be seen by a cancer specialist.
- Performing procedures, such as inserting a chest tube or drawing blood.
- Updating patients and relatives about the action plan for the day, as well as any discharge plans.
We also prepare all the discharge documents for a patient who is ready to go home - this involves a summary of any events that happened in hospital, a prescription, and any follow up doctor appointments.
12 - 1 pm: Lunch! If time permits, we hop over to a nearby restaurant for food. We keep our phones on us at all times, in case a nurse calls us with a question, or a patient becomes unwell. It's common to have a lunch time meeting, which means we have to pack our lunch. My colleagues surprised me with cake during our lunch break earlier this year :)
1 - 4 pm: After lunch, we trace all the laboratory results for our patients. Sometimes it's bad news - My 51 year old patient who was admitted with lung fluid has just had a confirmed diagnosis of Stage 4 lung cancer, which we picked up from analysis of the fluid. His wife and son are present - It's going to be tough breaking the bad news to him, especially because he's a non-smoker, and his wife and son are both really young.
Apart from reading results, any specialists whom we referred in the morning will typically have reverted with their advice.
Often, there are also new patients to see who have just arrived on our ward.
4 - 6 pm: Exit round, during which we discuss our patients' progress with a senior. Before we leave the hospital, we handover results to trace to the on call doctor, as well as sick patients to be aware about.
6 pm: Time for home, and then to rinse and repeat early the next morning!
