"Job Satisfaction" ( from the September 2018 issue of the SLMA newsletter)

By Dr. Sarath Gamini De Silva, Consultant Physician and Council Member

I was compelled to write the following after receiving an e mail message from a Sri Lankan expatriate doctor in UK.

I quote; 

“My non return to Sri Lanka could be a blessing as I probably avoided falling into this type of system. I am now retired after nearly 47 years of service in accordance with the principles inculcated at entry to the profession. But my only regret is that it was not a service to fellow Sri Lankans (except for the first 7 years). I console myself being a Buddhist, it was nevertheless to other human beings.”

In my reply, the last sentence was “How nice it would have been if all the well meaning doctors remained in Sri Lanka and set an example of proper ethical practice”

Let me elaborate. What I write below is not a boast. I am sure many of my colleagues and contemporaries will express similar sentiments. Let it give some inspiration to the younger members of the profession, that one can do a good and satisfying job even in a corrupt and disorderly “system” like ours. Ethical practice with a good knowledge of what is expected of a doctor is essential to have job satisfaction. In retirement, one can look back and feel happy about the good job done, appreciated by others. It should be stressed that contentment and sense of accomplishment later in life comes from appreciation of one’s work from patients, colleagues, students and others and not so much from what one has accumulated in material and monetary terms.

I am a senior consultant physician who retired from government service nearly ten years ago, after thirty six years of service in the state sector. I am still active in the private sector. Apart from treating thousands of patients, for twenty five years I was teaching medical students and post graduate doctors. I was also involved as an office bearer in various medical associations and was a member of the Sri Lanka Medical Council (SLMC) for ten years. I was an active member of the Government Medical Officers’ Association (GMOA), its’ vice president for two years. May I hasten to add that I was elected to the SLMC nominated by the GMOA but did not act as its representative safe guarding the interests of the union. All my actions and sayings there were according to my conscience.

I had a reasonable private consultation practice which enabled me to enjoy a decent standard of living albeit working for long hours in the evenings. I never compromised my hours of work in the state hospital to engage in private practice. My private patients were not given special care if they sought treatment in the state hospital. I earned enough resources to give my three children a sound education, having paid the due share to the state coffers. I have always found enough time for my leisure activities like travel and literary work. 

In my consultation practice now I come across many patients who mention how they are grateful to me for treating their kith and kin so many years ago. They mention how I made the correct diagnosis or referred the patient to the appropriate sub specialist for timely action. They express gratitude for not doing unnecessary tests or for cutting short a long prescription given by others. I never considered myself infallible and consulted my colleagues when ever I had a problem in my hands. No doubt I must have had a few failures in my clinical judgment or in my dealings with others. 

Large numbers of my students are serving as doctors in the length and breadth of the country. Many are specialist consultants in their own right. When I meet them they often mention even the details of classes I have conducted for them many years ago. My patients talk of the doctor in their village or town proudly claiming to be a student of mine. It is very satisfying to feel that I have been a positive influence on my students hopefully making them better doctors.

In an earlier essay I said that the doctors are a product of this corrupt society where making money has become the main goal in life. I argued then that it is unreasonable to expect the doctors to behave any differently from the rest. However I insist that for a professional, job satisfaction is of paramount importance. Members of our noble profession should be above board so that the society that looks up to them, will not feel let down.

In semi-retirement now, I consider myself to be very fortunate having done what I consider to be a reasonable and an honest job. I have a “weakness” in my tendency to openly criticize various faults and irregularities in others, a trait I inherited from my late father, despite having my own faults no doubt. I write to medical newsletters, journals and the national press and speak up at gatherings of doctors on these matters. I am supposed to be not very diplomatic in my dealings, in the process making many adversaries. However in our culture, I believe “diplomacy” is often considered to be a weakness and is unlikely to achieve results. I am disheartened by so many letters and articles appearing in the press criticizing the doctors, indicating that the society in general is fast losing faith in this once noble profession.

Now to go back to the quotation at the beginning; those who left the country for greener pastures have been well remunerated, have had comfortable lives and educated their children without much of a hassle. They are now in full retirement probably traveling all over the world on leisure tours or engaged in meditation and other religious practices. Many of them are now serving the motherland in various ways. Most of them are good people whose practice must have been above board. All are necessarily compelled to be ethical and fool-proof in what they do as otherwise the punishment would have been severe in those countries where the laws are strictly enforced, or else litigation could have finished them off.

But are they being recognized now for their contribution of a lifetime? Or are they being treated as spent forces who have been well remunerated for their work and the society feel no further obligation or need for them? They should think again before feeling relieved to have escaped the “mess” that is Sri Lanka!