March 05, 2016 429
GetDoc: What services do you provide in this hospital?
Dr Kong: I specialise in Nephrology which deals with kidney-related diseases. This includes the care of patients with acute and chronic kidney diseases, patients on haemodialysis and peritoneal dialysis as well as kidney transplant patients, before and after their transplant. I perform procedures like dialysis catheter insertions including tunnelled and non-tunnelled catheter as well as kidney biopsies. Since patients with kidney diseases often have many other medical problems, for example hypertension and diabetes, I do manage these conditions as well. Occasionally, they may also present with complications like infections and heart diseases. Hence, I also manage a broad range of internal medicine diseases.
GetDoc: What is the biggest challenge that you have faced throughout your career? What measures did you take to overcome?
Dr Kong: This would be the long journey undertaken during my medical training. The road to being a nephrologist is a long and arduous one. After medical school, I underwent 2 years of housemanship before becoming a medical officer. To specialise in internal medicine, I chose to enrol for the Membership of the Royal Colleges of Physicians (MRCP), United Kingdom (UK). Since this examination is by the UK body, there is no structured programme locally. Hence, I needed to study on my own while working full time and being on call almost every other day. Furthermore, the cost of this examination was borne solely by myself and even back then, this was a considerable expense. Looking back, it was indeed challenging. But, I was young and energetic and with a fair amount of discipline, I could overcome the challenges.
Having specialised in internal medicine, things settled for a while and life was more comfortable. I was working in a district hospital at that time and since there was no nephrologist in that hospital, I had the responsibility of managing the patients at the dialysis centre. I felt the need to learn more about the issues and complexities relating to kidney problems, and this led to my interest in nephrology. Subspecialty training is limited only to certain centres and training positions are also few and far between, usually at the universities and tertiary hospitals. Fortunately, my alma mater, University Malaya, had an opening for nephrology training so I took up this opportunity to pursue this subspecialty there.
GetDoc: Could you give a little insight of the timeline of your path into becoming a doctor?
Dr Kong: Firstly, I graduated in 2001 from University Malaya. A few months later in July of the same year, I started my housemanship at Muar Hospital (currently known as Hospital Pakar Sultanah Fatimah). I spent nearly seven years and completed my postgraduate qualification while working there. I stayed on for an additional two years there as a physician in general medicine. Subsequently, I returned to University Malaya Medical Centre in 2008 to join the nephrology subspecialty training programme. In 2010, I was offered a scholarship by the International Society of Nephrology to further my training in Perth, Australia. As part of my fellowship training there, I was given the opportunity to undertake further training and research in hypertension, glomerulonephritis, acute kidney injury and kidney transplantation.
GetDoc: So are you from Johor?
Dr Kong: No, I was posted there to do my housemanship. I am from Kuala Lumpur.
GetDoc: Enrolling into MRCP is tough, so what motivated you to finish it?
Dr Kong: I chose to do the MRCP examination because it is an internationally recognised qualification. The examination is in English and this proved to be a challenge because I was educated in Chinese during my primary school years and Bahasa Malaysia when I went on to a national secondary school. However, the satisfaction of meeting the high standards set both in the medical knowledge and skill required and the English language was an achievement that I cherished.
GetDoc: Any message or advice you would like to send to your patients?
Dr Kong: There has been a steady rise in the number of patients suffering from kidney-related diseases among Malaysians. This is mainly due to the increasing prevalence of diabetes and high blood pressure. Patients with chronic medical conditions like these should have regular medical check-ups and monitor their kidney function periodically. If any problem is identified, do continue follow-up to assess the progression rather than disregarding it and coming back very ill a few years later with life-threatening complications of kidney failure.
GetDoc: Are there any signs or symptoms that will indicate that a patient should seek help?
Dr Kong: There are no symptoms or signs at the early stages. The earliest sign of kidney problems is usually detected only during urine and/or kidney function test. Symptoms like swollen legs or face, nausea or breathlessness indicate that the patient already has established kidney failure.
GetDoc: How frequent should patients come for a check-up?
Dr Kong: Diabetic and hypertensive patients who are well controlled and do not have symptoms or signs of kidney problems should have at least a yearly urine and kidney function tests. Those who are already diagnosed with kidney disease should be monitored 3 to 6 monthly depending on the severity of their condition.
GetDoc: Is diabetes a chronic disease?
Dr Kong: Yes, it is. Unfortunately, once one is diagnosed with diabetes, there is no turning back. Patients generally dislike taking medications because they perceive that once the medications are started, they will have to take it life-long. Then there are some who are in denial and refuse to acknowledge that they are diabetic. Hence, it is sometimes very difficult to get patients to accept this and even if they do, it is a hurdle to get them to control the disease optimally.
GetDoc: Do you have medical programmes for your patients to help get them back on a healthy lifestyle?
Dr Kong: Treatment of diabetes not only encompasses medications. Diet and lifestyle changes are equally important. I usually provide a simple but comprehensive dietary advice to my patients. Alternatively, they may seek help from a dietitian. Lifestyle change including exercise to reduce weight and maintain overall good health is also essential.
GetDoc: Regarding medications, certain patients are reluctant to take medications for fear of side effects. What is your opinion about this?
Dr Kong: It is a misconception that consuming high blood pressure and diabetes medications may lead to kidney failure. Studies show that good control of sugar level and blood pressure in fact prevents and can even slow down kidney damage. Medications and lifestyle changes are essential to achieve tight control. It is true that certain medications may cause damage to the kidney or other adverse effects if taken incorrectly or long-term, for example certain pain medications. My advice to patients is to always ask and discuss any uncertainties with their doctor.
GetDoc: How different are you from your peers in terms of personality or philosophies in doing medicine?
Dr Kong: My philosophy in treating patients is to build a patient-doctor relationship based on trust and respect. Only then will patients continue to seek your opinion and follow any advice given. In order to do this, it is crucial to provide a detailed explanation about their disease, its implications, treatment and prognosis. This will also enable patients to have sufficient knowledge so that they themselves are empowered to make decisions that are based on fact and not on myths or suppositions.
GetDoc: What is your biggest satisfaction of being a doctor?
Dr Kong: I think the biggest satisfaction of being a doctor is to be in a position to offer help and advice to patients and their relatives.
GetDoc: What is the most difficult case you have encountered?
Dr Kong: The most difficult encounters would be patients or their relatives who are suspicious and doubtful of a doctor’s intentions. As I mentioned before, the basis of a good doctor-patient relationship is based on mutual trust and respect. Unfortunately, whether through previous bad experiences personally, or through others or the media, some patients and relatives are very distrustful and resistant to any advice. In this case, it is a difficult task, but not an impossible one to regain the patient’s trust again.
GetDoc: Last question doctor, how do you unwind yourself from the stress at the workplace?
Dr Kong: I usually try to take 30-60 minutes off just to work out every day. The workout regime helps to reduce stress as well as to maintain overall fitness.
To know more about Dr Kong Wai Yew, kindly check here
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Qian's interest in healthcare industry came about after her father was diagnosed with bladder cancer. This experience has led her to become a strong believer in empowering individuals to take charge of their own health. View all articles by Qian.