Inhumane working hours the cause?

Trainee doctor found dead after suspected overdose
By M. KUMAR
kumar@thestar.com.my

KUALA LUMPUR: A trainee doctor was found dead in a restroom at Kajang Hospital.

Police believe he had overdosed on an unidentified drug.

Lee Chang Tat, 29, was found dead in the men’s room of the paediatric ward at 7am yesterday by hospital staff who went looking for him after they noticed that he was missing.

He was found with a used syringe beside him, which police believe he had used to inject himself with a drug to fight off fatigue.

It is learnt that Lee, who had been working at the hospital for the past three years, had been working on call for five consecutive days.

Selangor health director Datuk Dr Azman Abu Bakar said hospital staff, who found Lee, tried to resuscitate him but were unsuccessful.

“He was rushed to the emergency room but it was too late,” he said.

Lee, he stressed, had no previous medical problems.

A security guard at the hospital said they found him when someone tried calling Lee on his handphone and heard the ringing tone coming from the restroom.

“We broke into the toilet cubicle and found him lying there with the needle,” he said.

Kajang OCPD Asst Comm Abdul Rashid Abdul Wahab said Lee, who studied medicine in Uruguay, had been complaining to his family about the hectic working hours.

“His family said he had also been planning to go on a holiday to Cambodia soon with friends,” he said.

ACP Abdul Rashid confirmed that an initial post-mortem indicated that Lee had died of an overdose, adding that the case was being investigated as sudden death.

Editor’s Note: A few things concerned us at this time.

Firstly, it was reported that this trainee doctor actually was on call for 5 consecutive days prior to his death. Was this truly the case? I find it surprising when the latest Director General’s directive was for house officers to work on a shift system. If it was truly the case, this should never have happened.

Secondly, if he was found with drugs, drug addiction among healthcare professionals can be a worrisome trend considering the ease of access to certain drugs. Being trained in Uruguay itself creates suspicion as to whether this habit was picked up there. South American countries are notorious for drug addiction and trafficking.

Correction: It has come to our attention that the news report about Dr Lee graduating from Uruguay may be inaccurate. Nevertheless the issue of sending students to some countries may not be justified under the current circumstances.

This case could highlight whether there is a need to send medical students all the way to countries that are dubious in their medical training as well as being put into a risky environment for many years. Without a good social support, succumbing to drug addiction is high.

This case needs the attention of the Ministry of Health and Higher education apart from the police. From the wide choices of medical schools in Malaysia, there should not be any more need to go to countries that may pose a danger and hardly a conducive environment to study medicine.

A study below is one of the many articles that highlights the problem and attempts to rectify it.

Substance Abuse Among Physicians: A Survey of Academic Anesthesiology Programs
John V. Booth, MB ChB, FRCA*, Davida Grossman, MD†, Jill Moore, BS‡, Catherine Lineberger, MD*, James D. Reynolds, PhD*, J. G. Reves, MD* and David Sheffield, PhD§
+ Author Affiliations

*Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina; †West Jersey Anesthesia Associates, Marlton, New Jersey; ‡School of Medicine, East Tennessee State University, Johnson City, Tennessee; and §Division of Cardiology, Department of Psychology, Staffordshire University, Stoke, United Kingdom
Address correspondence and reprint requests to John V. Booth, MB, ChB, FRCA, Box 3094, Department of Anesthesiology, Duke University Medical Center, Durham, NC 27710. Address e-mail to booth006@mc.duke.edu.

doi: 10.1213/?01.ANE.0000026379.66419.DB A & A October 2002 vol. 95 no. 4 1024-1030

Abstract

Efforts to reduce controlled-substance abuse by anesthesiologists have focused on education and tighter regulation of controlled substances. However, the efficacy of these approaches remains to be determined. Our hypotheses were that the reported incidence of controlled-substance abuse is unchanged from previous reports and that the control and accounting process involved in distribution of operating room drugs has tightened. We focused our survey on anesthesiology programs at American academic medical centers. Surveys were sent to the department chairs of the 133 US anesthesiology training programs accredited at the end of 1997. There was a response rate of 93%. The incidence of known drug abuse was 1.0% among faculty members and 1.6% among residents. Fentanyl was the controlled substance most often abused. The number of hours of formal education regarding drug abuse had increased in 47% of programs. Sixty-three percent of programs surveyed had tightened their methods for dispensing, disposing of, or accounting for controlled substances. The majority of programs (80%) compared the amount of controlled substances dispensed against individual provider usage, whereas only 8% used random urine testing. Sixty-one percent of departmental chairs indicated that they would approve of random urine screens of anesthesia providers.

9 thoughts on “Inhumane working hours the cause?

  • April 12, 2012 at 3:38 am
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    Firstly, the reports have been unfair towards the deceased. The reporter who published the article failed to exercise proper reporting investigation and jumped to a conclusion he graduated from Uruguay. This is further compounded by the site administrator who made the Editor’s note who concurred with such a statement.

    A simple check on MMC’s website shows that Dr Lee graduated from Crimea State University, which is Ukraine and not Uruguay.

    To quote the Editor “Secondly, he was certainly on drugs.”…. I think again this is a very derogatory statement to make and generalise just because he is holding a syringe at the location of demise. If investigations are still going on, even if it was drugs, it is not fair and proper as a reference website to many other people to make such a statement until the official report is out.

    I hope the administrator would be more careful when it comes to publishing information and making personal comments in the future.

    • April 12, 2012 at 4:08 am
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      Hi Malik,

      Thank you for your comments.

      The statement mentioned has been rectified. It is meant to highlight general issues that can be a problem that is often unrecognised. It was not meant to relate specifically to the case.

      We do apologise for the earlier statement.

      Editor

  • April 12, 2012 at 7:35 am
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    This unfortunate case highlights the fact that doctors have little time to care for their own health.

    Often doctors do not have any doctors to see for mental health issues eg Depression, feeling stressed

    In Australia, I know of cases of a few young trainee doctors who have committed suicide in the hospitals where they worked.

    Such a waste of life and talent.

    I hope this case can bring about the setup of better doctors health services esp for stressed overworked trainees

  • April 12, 2012 at 8:55 am
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    a lesson to parents around da world..if ur children are not fit academically/mentally to be a doctor please dont push them..i know nowadays its easy to be a doctor (provided you have the money to send ur unqualified children to private medical schools)but if ur children are not interested there are a lot more degrees in other fields that u can buy..there are a lot of private universities that provide degrees in engineering, biotech, IT, etc..at least they wont harm human lives..
    its not easy to be a doctor,,u must be the best amongst the best..no other choice..
    nowwadays there are so many private medical schools till some u dont even know how to pronounce..everybody is cashing in..
    the increase in number of private med schools coincides with incompetent/dangerous doctors
    most problematic doctors are graduates from private medical universities because they are practically unqualified to be one in the first place..if they are qualified then why bother paying half a milliuon to become one??????

  • April 12, 2012 at 11:10 am
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    just to add on that, yes, it’s very improper for you to assume that he was a drug abusers, many people who tried to suicide from drug overdose were not drugs abusers, they are just stress. i’m talking from someone who knows the deceased.

  • April 13, 2012 at 1:24 am
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    It is very sad to hear a trainee doctor died because of overdose due to stress most probably. Eventhough the government already enforced shift working system there are still departments that did not comply to the regulation due to various reasons including not enough housemen. Some departments also practise hostile working environment that includes threaten and non specific extension which add to the stress. There are lots of housemen who are over stressed or depressed but unfortunately they go undetected or not well recognised by their respective department. I hope the goverment will do something about this issue. Thanks

    • April 13, 2012 at 12:52 pm
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      i agree with the your statement that “Some departments also practise hostile working environment that includes threaten and non specific extension which add to the stress”. Unfortunate for housemans as we can’t do anything about this.

  • April 13, 2012 at 11:04 am
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    Housemen stressed out … really ?? how about senior medical officers who are working non stop for few days. Those shift systems are meant for HOs, what about MOs need. Maybe one of these days we’ll hear a suicide case by a medical officer instead. SMH

  • January 30, 2013 at 12:14 am
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    It is unfortunate that any medical care professional has to undergo the physical and mental strain that cost Dr. Lee his life.

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