I refer to the letter Doctors must put patients first, allowances second, which I must say saddened me.

Saddened because when someone tries to make a stand to improve the healthcare system, there would always be those who would try to belittle the effort and making it that much harder to achieve.

I would like to point out to the writer that somebody had to fight in order for government doctors to get paid for on-calls. And when this was achieved, all government doctors benefitted.

Many of my colleagues have expressed that in public service, the pay is lousy while the work burden and expectations are overwhelming. Our Health Ministry continuously tries to make it that much more harder for us to work by adding more and more pressures via so-called polices that are supposed to improve the image of public healthcare.

Towards this, overworked and underpaid doctors are expected to provide service with a smile despite hectic on-call hours, listening to hundreds of different complaints, woes, pleas and expectations at odd hours in the wee mornings. Don't you just love being a doctor in the Malaysian public service?

And mind you, we have to come to clinic on time at 8am every morning (or else be labeled as tardy by your patients) This after preparing breakfast for the family (we can't afford a maid), sending the kids to school during the morning rush hour.

We then do our ward rounds first and attend to more pressing matters in the ward (outlining the important stuff for my HOs to do for each patient) before another round with the specialists and consultants (yet again outlining further stuff for my HOs) and making sure my operating theatre list is completed (for surgical related departments).

Wow! All this and then we rush to clinic (I have sustained falls several times before, I consider it a work hazard... ) where patients have already swarmed the waiting area and even the corridor giving you sinister looks.

It's amazing that we do all this just so that the ministry can look really good and say that yes, a 90-minute maximum waiting time for patients is achievable for public hospitals.

Then we have to battle with two major issues affecting the medical profession with regards to confidentiality versus ethics. Recently, someone urged that doctors breach patient confidentiality by informing the spouse/partner of HIV/Aids patients of the latter's condition should they refuse to consent for treatment.

Are we protected by law if the patient decides to take legal action against the doctor? What about the patient's best interests since HIV/Aids is a taboo topic in Malaysia? And is it ethical for us not to notify and counsel the spouse/partner since they would be at risk of contracting the infection?

And during counseling, is it ethical for us to disclose how the patient contracted the infection? This are very sensitive issues that doctors are now expected to deal with. What a headache.

Now am I proud to be a doctor? The answer is 'yes'. And I believe the answer is the same for many others in this profession. However, improving the healthcare system as well as the welfare of doctors is something I feel the Health Ministry should focus on before dabbling in other matters.

There is nothing wrong in make a stand or fighting in order to improve our working conditions. God knows we desperately need an improvement here in Malaysia. Just because we chose medicine as our profession, doesn't mean we need to suffer unnecessarily.

I do not see what could be so wrong in fighting for better working hours, better pay and improved welfare benefits. Does that make me a greedy doctor who does not provide service to his patients?

I think not, I am still with the public service, seeing patients on daily basis and doing my best to improve their health. In return, I only ask for a small remuneration and that doctor's welfare be properly taken care of by our employers, i.e. the government.

I know of many colleagues who agree that the system desperately needs improvement; but many of them unfortunately choose to simply roll over and play dead. Many instead choose the easiest way out, which is to leave public service.

It is very depressing indeed that doctors cannot work together to improve the system. Well, I suppose we are all selfish in that sense.