The Oracle Said So

 

I don’t know since when there has been a tradition that on the second day of the Lunar New Year, officials of the Hong Kong Government or VIPs will go to the Che Kung Temple in Shatin and draw a fortune stick for Hong Kong.  This year, stick number 86 was drawn.  The oracle read: 石田為業喜非常，畫餅將來未見香。怎曉田耕耘不得，那知餅食不充腸。

The oracles from the Che Kung Temple are user-friendly because, unlike oracles from other temples such as the Wong Tai Sin Temple, they are written in simple Chinese language.  They are not in parables.  You can try to interpret the oracles yourselves without any knowledge of ancient stories.  Metaphors, when used, are also often easily understood.

Literally, the oracle said that it was nothing joyable to own a field composed of stone.  Bread drawn on a piece of paper would not smell good.  These were because a stone field could not be cultivated to yield; and a picture of bread would never lead to satiety.  The VIP who drew this fortune stick extrapolated the oracle and urged Hong Kong citizens to support government policies.  An expert in oracle interpretation, however, explained that we should instead be skeptical in government policies and visions.

This incident was widely reported in news.  Interestingly, another piece of news was that the winter surge of influenza highlighted the shortage of doctors in Hong Kong, and the government was considering inviting overseas doctors to practice in Hong Kong with all sorts of exemptions.

It was nothing new that GOPCs, A&E departments, medical wards and pediatrics wards became war zones during influenza peak seasons.  Patients had to wait hours or even days to be seen.  Occupancies of wards reached statistically impossible data of over 100%.  Doctors and nurses were seriously over-worked.  These happened every year since I was old enough to read news, that was more than 45 years ago.  I guessed reporters could just copy and paste their reports from previous years.

An amateur’s knee-jerk reaction would be to increase manpower: If there were more doctors, everything would be okay.  However, upon second thought, one should realize that merely having more doctors would not solve the problem.  Would there be more GOPC sessions or more sites?  Could A&E departments increase their turnover?  How about medical wards?  Would more doctors mean more beds?

Healthcare management requires special knowledge and skills different from any medical specialties.  That was the reason Hong Kong had to pay much for management personnel of the Hospital Authority.  When we heard complaints of extremely heavy workloads from frontline doctors, we expected more than producing and disseminating “add-oil videos” from TV stars.  When we read complaints from frontline doctors on wasting time on paper works and meetings, it should be understood that they were not asking for snacks or fish balls.  When we saw fleeing of doctors from the HA, we knew that there were management problems.  

However, what we encountered were propaganda here and there and everywhere that increasing the number of doctors instantly from allowing overseas doctors to practice in Hong Kong would be the magic bullet.  Suggestions were many, some innovative, most impractical.  Loopholes were poked in the MRO.  The Medical Council was asked to cater for it through the route of Limited Registration.  Various exemptions were proposed to attract overseas doctors.  Even the Licentiate Examination was deemed exemptible.

Ignoring the root cause of management problems and focusing on increasing the number of doctors was exactly like ploughing a stone field.  No matter how hard you worked, it would yield no crop.  It was a waste of time and effort.  The harder you worked on it, the further away from fruitful results you were.

Promising the public that no more chaos would be encountered in future influenza peak seasons after overseas doctors were allowed to practice in Hong Kong was exactly like drawing bread on paper.  No matter how beautiful the vision was pictured, it would not smell good, nor would it be of any practical use.

Actually, I am not against overseas doctors working in Hong Kong.  This is not something new.  There are recognized and time-honored routes.  The Licentiate Examination and the application of Limited Registration are open and fair.  Of course, there can be discussion on how to modify such procedures.  However, over-emphasizing overseas doctors and forget about solving the real problem is obviously 耕耘石田 and 畫餅充腸.  It would just serve to out-focus the discussion.  Worst, it would jeopardize the standard of doctors in Hong Kong.

Doctors should have scientific minds and should be evidence-based.  It is no way that we are going to rely on fortune sticks and oracles to guide patient treatment and healthcare system management.  We are not the superstitious types.  However, chanting that overseas doctors can solve the coming influenza surge crisis is no better than fortune telling.

It might work to beat superstition by superstition.

So I preach: THE ORACLE SAID SO!

 

（Source：HKMA News Feb 2019）