A doctor too many !

In the eighties, most of the sales representatives from drug companies were not graduates – most of them who serviced my clinic studied till either Form 5 or Form 6.

Then in the early nineties, the profile of sales representatives, especially those from multinationals, changed. Majority of them were graduates, many of them local graduates from Science stream but a few were even from business stream.

Then came the 1997 financial crisis.  I remember that I was very surprised to read a card from a sales representative that stated his qualification as law graduate. On enquiring, he answered that there was simply too many law graduates, and many of them who had no  strings/connections had difficulty to do chambering with established law firms, and unfortunately he was one of them, and so while hunting for a place to do his chambering ( some sort of housemanship), he decided to work as a sales representative.

I remember at that time, I told the young man that the country was still short of doctors, and that doctors would have no problem finding a place to do housemanship in Malaysia. That was not many years ago.

Now, Malaysia is churning out doctors by the thousands. Not  joking, literally by the thousands. I have lost count how many medical schools are there. At least ten or more, someone told me .

With the country mass producing thousands of doctors each year, it will come a time when the Health service simply cannot accommodate all of them to do housemanship.

There will be a glut of doctors in the foreseeable future.. AUstralia, with about the same population, has fewer medical schools than Malaysia. But even so, they have a health care system which is way ahead of us..

To have a glut of doctors does not mean that healthcare standard will automatically goes up. On the contrary, a glut of doctors will mean fierce competition and undercutting..

Even at the moment, private hospitals which have mushroomed all over the places.. We are beginning to have  too many specialists , especially those in secondary care, like general surgeons and physicians.. Those in the tertiary care are not facing much problem now, but if there is a glut of doctors, they too will ultimately be affected.

Private hospitals are finding it difficult to compete. Many of them are now resorting to setting up primary care clinics (like GPs clinics except they are run by salaried doctors from these private hospitals) in many places. The primary function of these primary care clinics is not to treat , but to source patients for these private hospitals.

SInce many of the private hospitals are now listed entities, they are now answerable not just the patients, but to the shareholders as well. As a listed entity, the shareholders are not interested to see how many patients are cured , they are more concerned with yearly growth of profits, meaning that these hospitals will have to show higher profits year on year. ( I’ve repeatedly voiced out that hospitals should be not allowed to list, but who will bother to listen to a small voice?)

This year-on-year profit growth will have to come from either one of the 3 methods:

1. Increased number of inpatient .. But with private hospitals mushrooming faster than the growth of the number of people who can afford private healthcare, this is not happening. Hence, the setting up of primary care clinics to source for patients… With increased competition, the doctors that are employed to run these primary care clinics will be hard-pressed to refer cases to the ‘mother’ hospitals, and many cases that can actually be treated without hospitalisation will be refered for hospitalization. In other words, there are  over- referrals.. The unsuspecting patients are the ones that are being squeezed dried by this cut throat competition, which will be more and more intense.( As an example, a simple cyst removal which cost less than a hundred if done in a clinic will cause the same patient many hundreds if done in a hospital clinic.)

2. Since the number of patients are not increasing much, to get a higher growth and higher revenue means that the hospitals  have to raise their charges year on year. That is why health care is so much more expensive compared to before.

3. Cost cutting resulting in lowering of overhead. SO far this has not been happening, but with a glut of doctors and specialists, do not discount this possibility. With cost cutting, patients will not be getting value for money..

The government should realise that the days when there will be a glut of doctors are not far away. Instead of mass production of doctors, what should be emphasised should be the standard of these healthcare personnel .Those passing out from Universities must be able to diagnose common diseases. But from what we have seen, the standard of local housemen seems to have dropped , so much so that the government has no choice but to increase housemanship from one year to 2 years.

Doctors are tasked with saving lives. We need competent doctors. We do not need to mass produce doctors because we want to change the social fabric of the nation. We have to be colour blind when we choose to educate our doctors. Medical students should be chosen from those with compassion, with an aptitude for doctoring , and not by imposing certain quotas and trying to fill the quotas with second rated materials. Not all stones can be turned into jade..

I think now that we have enough number of doctors , we should emphasize on quality instead.

We should not be in the business of producing doctors just for the sake of producing them, otherwise there will bound to be adverse consequences later on. Mind you, that day is pretty near..

33 Comments (+add yours?)

  1. clearwater
    Nov 24, 2009 @ 17:16:18

    Dr Hsu,

    One inevitable result of intensifying competition in business or the professions would be downward pressure on prices, something the consumer would welcome. I cannot quite reconcile your comments on the 3 methods of profit growth for private hospitals with intensifying competition in the health care industry. One would logically conclude that the consumer has more choices with competition and if he was rational, he would do his homework and be smart enough to avoid those excessive profit oriented private health care hospitals. Unless of course, they are all the same. Is that possible?

    With regard to too many doctors being churned out, that is a good thing provided quality is not compromised. Unfortunately, that does not appear to be the case these days. Here, I cannot agree more with you that being a doctor is a calling above all else and not all are suited for it. The hospitals in Singapore seem to have many Malaysian doctors working there.

    Like

  2. Dr Hsu
    Nov 24, 2009 @ 19:50:00

    clearwater,

    In the normal case, when supply exceed demand, prices will come down. It may yet happen one day, but it is not happening now. You can compare the prices of hospitals now and 5 years ago.. It has gone up so much..

    One of the reasons is that most private hospitals belonged to listed companies.. ANd as I have explained above, the listed compannies have only proift in mind..

    And I can tell you that i have come across cases where unnecessary operations and expensive procedures were done as a result of specialists seeing less patients a day. I do not mean all the doctors, only the black sheep.. Before when they see 10 patients a day, now they are seeing only 5, and so some of these balck sheep resorted to unnecessary investigations and operations just to make back their income.

    I foresee this to be more intense once competition becomes so keen that their survial is at stake.

    That is why now, I always insist on my patients seeking second opinion if any doctors asked them to go for operation.

    Of ocurse , among doctors , opinion and style of management differs, but to be too aggresive in management may have exceeded the ethical limits…

    Like

  3. A true Malaysian
    Nov 24, 2009 @ 21:13:44

    It is sad to see the medical profession is reduced to such a state in our beloved country. Many people want to be a doctor not for the noble intention of saving lives, but more for the purpose of become millionaires.

    The issues raised by Dr. Hsu here are very real and whoever in charge of the government should take immediate measures to arrest such tendencies. If not, very soon we will reach a stage where when a dying patient approach a doctor for treatment, the doctor will tell the patient, NO MONEY, NO TALK, NO TREATMENT.

    We may also reach a stage where, we have no confidence on doctors if we emphasise on quantity and not quality of doctors. I see this is happening now as good quality doctors are no more working in Malaysia, but grabbed by other countries who offered better perks. Here again, $$ is the attraction, not noble intention of saving lives, serving humanity.

    For a society which does not value meritocracy, one problem leads to many problems, i.e multiplication effect.

    We have many doctor politicians, but they are busy with fighting for powers, not our lives.

    Like

  4. A true Malaysian
    Nov 24, 2009 @ 21:27:30

    I missed out the point on medical insurance.

    Medical insurances, to me, are the main contributor for the ever increasing health care cost. Very often, medical centres will charge exorbitant fees if they know you are covered by insurance.

    What is the point of being modern, I wonder. Wouldn’t it be better to remain a simple society rich in humanity with compassion?

    I am sicked or all these rots, not because of illness.

    Like

  5. Ken
    Nov 24, 2009 @ 21:47:47

    Dr. Hsu, what do you think of the article in MI that Malaysia will be exporting maids in 20 years?

    http://www.themalaysianinsider.com/index.php/malaysia/44439-malaysias-next-export-maids

    Like

  6. Dr Hsu
    Nov 24, 2009 @ 21:57:15

    ken
    I have written a fewpostd on that and many commentators have commented on that too.. I can’t recall which post, since i have wirtten 989 posts, and i have lost tracks of which is which, poor memory starting to get to me as age is catching up.

    Like

  7. meet joe black
    Nov 24, 2009 @ 22:32:05

    exporting maids? or exporting sex? in macau..u will find many malaysian ayam hanging around at lisbon n land mark…that earm foreign currency..we have also established quite a reputation in taipei and kaoshiong.

    Like

  8. Ken
    Nov 24, 2009 @ 22:40:53

    Actually I disagree with the article. I think it should be 15 years when we start exporting maids, not 20 years if BN is still in power.

    Like

  9. daffodils
    Nov 24, 2009 @ 23:28:59

    So many clamour to be a doctor despite their not so scintillating results. U have private colleges mushrooming all over offering not only medical degrees but also medical related like pharmacy and medical technology courses.

    Even the exclusive university reserved for a special group runs medical programs. Isnt there any body monitoring the quality of these programs?

    The fact that we have doctors too many, uppermost on the minds of most people, are these medical graduates up to the mark?

    One cant just simply allow any Tom, Dick and Harry to pass out as a doctor without stringent qualifications.

    Like

  10. klm
    Nov 25, 2009 @ 10:40:54

    I have a different of this matter. The only thing that matters is that we maintain the standards of doctoring. Let the students choose. Let the public choose. We should revert to free market force. The best shall survive. The bad shall fall by the roadside.

    In this way, we will have constant evolution of the medical profession.

    Like

  11. klm
    Nov 25, 2009 @ 10:42:41

    Oh forgot to add.

    Those who want to do doctoring and cannot make can sweep the street. This is the basic rule of selective evolution.

    Like

  12. A true Malaysian
    Nov 25, 2009 @ 10:47:08

    A comment by someone in Malaysiakini of M, how true,

    by Sivadas bBalakrishnan

    Mahathir doesn’t deserve the “Statesman” title as he has never been one. Not only did he destroy democracy in this country, the sorry state of a whole generation of Malays, so dependent of subsidy and government projects is the result of spoon feeding. he did so to make the malays happy only to swap for votes to stay in power. He has robbed the poor malays of their integrity so that he can stay in power. To continue doing this he allowed corruption in his cabinet. The end result… everybody was happy making money for themselves and left the malays to rot. However, fiery speeches are often offered by the ministers to drum up the feelings of the malays to enable to continue robbing the country, the malays and non-malays of their money. My malay brothers unfortunately fell for these tricks and have paid a heavy penalty for it and are continuing to pay. I urge my malay brothers to stand up against these actions by BN to regain their integrity. Observer………..

    Like

  13. clearwater
    Nov 25, 2009 @ 11:33:16

    Dr Hsu,

    Yes, the cost of private health care has gone through the roof in recent years. Being a healthy individual, I did not have to visit the doctor at all the past 5 years but I still carry high medical insurance only for major illness, just in case.

    In my previous career, I dealt with the public listing of companies and yes, profit is always at the forefront of private hospital managements’ concern; the welfare of patients too if it does not conflict with the profit objective. That means, if you can pay for your stay, you will get good health care. Paying patients need not be local, many foreigners come to take advantage of our relatively lower hospitalization cost. This is health care tourism and can be good business. However, they will not come if health care quality and ethics decline due to over commercialization.

    Like

  14. Phua Kai Lit
    Nov 25, 2009 @ 14:17:45

    Dear klm

    Unlike the market for more typical goods and services, the market for medical services is more prone to market failure for various reasons e.g.
    information asymmetry between the doctor and the patient, the principal-agent problem where an unethical provider (agent) can provide or recommend more services than medically necessary and so on.

    (You can check health economist Uwe Reinhardt’s
    writings on this).

    Signs of market failure abound in the most
    market-oriented of the Western world’s healthcare systems i.e. the USA (where increase in the number of doctors is accompanied by rising prices)

    Like

  15. Phua Kai Lit
    Nov 25, 2009 @ 14:20:53

    Dear Dr Hsu

    If I may post one more message
    (this is something I prepared for MPs from a certain political party):

    The following proposals in Budget 2010 will have an impact on public health and medical services:
    1. Government to allocate RM 14.8 billion to manage, build and upgrade hospitals and clinics
    2. Government to implement Goods and Services Tax (GST)
    3. Government to grant income tax exemptions of 100 per cent on the value of increased exports (services offered to foreign health tourists) from the current 50 per cent

    PROPOSAL 1: RM 14.8 billion to manage, build and upgrade hospitals and clinics
    Since a public hospital is very costly in terms of construction, routine operation and staffing, it is absolutely necessary to determine if there is a need for it in the first place. Can the medical services to be provided by the public hospital be provided more efficiently by other means? For example, through an increase in the number of clinics (primary care) or through a better functioning referral system to the existing network of public hospitals (secondary and tertiary care). Many developed countries are reducing the number of public hospital beds in order to control rising costs, it is unwise for Malaysia to build more hospitals (and thus increase the number of hospital beds) unless there is a strong need to do so.

    The primary task of health care facilities such as clinics and hospitals is to provide “medical services”. So the focus and spending priority of the Government should be on this and not on their upgrading simply to provide better “hotel services”.

    PROPOSAL 2: Introduction of a Goods and Services Tax (GST)

    Economic incentives and economic disincentives are powerful influences on human behavior. “Subsidies” can be used to encourage certain kinds of behavior while “taxes” can be used to discourage other kinds of behavior.

    Health and medical goods and services proven to improve the health (or quality of life) of people should be exempted from GST. Examples would include essential pharmaceutical drugs and medical devices such as wheelchairs. Other things that affect health such as basic foods (especially those consumed by the poor) should also be exempted from GST.

    PROPOSAL 3: Encouragement of medical tourism through income tax exemption of 100% on services offered to foreign health tourists

    When evaluating medical tourism, the focus should NOT be on the citizenship of patients. Promotion of medical tourism is simply the equivalent of encouraging more consumption of medical services by more affluent patients (i.e. patients who are able to pay for higher end or more expensive medical services).

    Although encouragement of medical tourism may contribute positively to the Gross National Product, there will also be negative impact. These include:
    Increased demand resulting in higher prices for Malaysian patients in the short run
    Increased demand for higher end services, thus further distorting the distribution of health personnel supplying the different kinds of medical care (“primary care” versus “secondary/tertiary care”) and the different medical specialties
    Increased outflow of personnel (especially specialist doctors) from the public hospitals to the more lucrative private hospitals that cater to medical tourists

    Phua Kai Lit, PhD FLMI
    Associate Professor
    School of Medicine and Health Sciences
    Monash University Sunway Campus

    Like

  16. Meng
    Nov 25, 2009 @ 14:32:58

    Mamak Mahathir once said in a speech to the medical association..all doctors are conman.

    When I visited a skin specialist for some foot fungus/ itch, he gave me a medicine which did not work at all. On checking with a pharmacist..comments was, it will take a long time to heal…he is playing with you.????

    Paid RM 80/- ..no cure. The pharmacist sold me the medicine 12 ringgit..cured in 2 weeks.

    How about that Dr, was I conned??

    Like

  17. Dr Hsu
    Nov 25, 2009 @ 16:47:22

    Professor Phua,

    thanks for the very insightful comments.

    I see the way to arrest the rising high healthcare cost in private sector is to have a very good quality public health service.

    At the moment, there are more and more government hospitals and clinics, and in fact waiting time for outpatients havs come down very impressively.

    However, despite that, many patients, including inpatients as well as outpatients , complained about the poor quality of care.. One reason is that in these government hospitals, cases are managed mainly bythe first line doctors , eg housemen and medical officers , whereas in the private hospitals, cases are managed by the consultants themselves. So this is where the lack of experience of these junior doctors show up.

    ANother reason why there is a perceived poor care in government hospitals is that there is hardly any communications among the doctors and the patients.

    I have just seen a patient who was operated in HUKM a few weeks ago , and who did not even know what illness he was suffering from. And his is not an isolated case.

    This perhaps is again due to the fact that in public hospitals, medical officers do not go the extra mile to tell the patients and comfort the patients, whereas in the private sectors, the consultants and specilaists being more matured and more experienced and there are self interest involved, they go the extra mile to explain what is wrong and why such and such treatments are needed.

    That is why we need to produce good quality doctors who care and who are able to communicate effectively, and also make the working environments in these public hospitals more conducive and less taxing for these junior doctors. An overworked doctor will be a grumpy doctor, this is human nature…

    The way as I see it, we need to emphasise on quality, and not just produce doctors for the sake of producing, or just make up the quotas because of certain ethnic considerations.

    This is equally true in Healthcare as well as education.

    Like

  18. kl_boy
    Nov 26, 2009 @ 09:07:35

    I am sceptical over the quality of some of the housemans in public hospitals. My mother went to UH to have a blood test and the doctor there poked my mom’s arm 2X ! and still could not get it right. Mind you, getting injected and not getting the correct results can be painful as the needle is unlike the normal jab type. She got upset and told the doctor 3 things:

    1. How come you are taking such a long time to do this (15 minutes +)?
    2. You seem unsure of what to do now, do you know the correct procedure actually?
    3. I don’t want you to do it anymore, it is painful you know ! Can you get a senior doctor here instead?

    At that time, a senior nurse nearby heard what was going on and immediately assured my mom while showing the doctor the way to do it correctly. The doctor was quite silent after that and another houseman took over the rest of the procedures. While you would have asked me to give the houseman a break as she is not a ‘doctor’ yet. My mom only lost her patience when the houseman asked her to let them (she and another houseman) do a third try and since there was no supervisor nearby, my mom lost faith in their ability. Bear in mind, the case when the Klang baby lost her arm as a result of this procedure was fresh in her mind. What do you think Dr Hsu ? Is this the state of our medical service now ? Even a blood test also cannot carry out properly.

    Like

  19. Phua Kai Lit
    Nov 26, 2009 @ 09:12:54

    Dear Dr Hsu

    My response to your comments in capital letters:

    “I see the way to arrest the rising high healthcare cost in private sector is to have a very good quality public health service.”

    THERE’S NO PERFECT HEALTHCARE SYSTEM IN THE WORLD. BUT SOME OPERATE MORE EFFICIENTLY AND EFFECTIVELY THAN OTHERS E.G. THE NHS IN ENGLAND. HERE IN MALAYSIA, THE PUBLIC SECTOR NEEDS TO WORK IN TANDEM WITH THE PRIVATE SECTOR (INCLUING THE NGOs). IN MY OPINION, THE GP CLINICS IN MALAYSIA ARE DOING A RELATIVELY GOOD JOB IN TERMS OF PROVIDING PRIMARY CARE AT REASONABLE COST TO THE PUBLIC. BUT WE ARE FACED WITH PROBLEMS WITH RESPECT TO THE PRIVATE SECTOR HOSPITALS E.G. AS INDICATED BY HIGH PRICES.

    “However, despite that, many patients, including inpatients as well as outpatients , complained about the poor quality of care.. One reason is that in these government hospitals, cases are managed mainly bythe first line doctors , eg housemen and medical officers , whereas in the private hospitals, cases are managed by the consultants themselves. So this is where the lack of experience of these junior doctors show up”.

    YES, JUNIOR DOCTORS NEED TO CARRY OUT THEIR DUTIES UNDER CLOSE SUPERVISION BY MORE EXPERIENCED SENIOR DOCTORS. BUT THE CHALLENGE IS THAT MORE AND MORE SENIOR DOCTORS ARE LEAVING FOR THE PRIVATE SECTOR HOSPITALS.

    “ANother reason why there is a perceived poor care in government hospitals is that there is hardly any communications among the doctors and the patients.

    I have just seen a patient who was operated in HUKM a few weeks ago , and who did not even know what illness he was suffering from. And his is not an isolated case.”

    THIS IS AN INDICATION THAT THE PATIENT LOAD IS SO HEAVY IN SOME GOVT HOSPITALS THAT THERE IS INSUFFICIENT TIME FOR PROPER COMMUNICATION WITH PATIENTS.

    “That is why we need to produce good quality doctors who care and who are able to communicate effectively, and also make the working environments in these public hospitals more conducive and less taxing for these junior doctors. An overworked doctor will be a grumpy doctor, this is human nature…”

    YES, DR HSU. IT IS VERY INHUMANE TO MAKE JUNIOR DOCTORS WORK VERY LONG HOURS WITH LITTLE SLEEP IN PUBLIC HOSPITALS. IT ALSO INCREASES THE RISK OF MAKING SERIOUS ERRORS AND HARMING THE HEALTH OF PATIENTS.

    The way as I see it, we need to emphasise on quality, and not just produce doctors for the sake of producing, or just make up the quotas because of certain ethnic considerations.

    This is equally true in Healthcare as well as education.

    AGAIN, I AGREE WITH YOU. THERE IS SUCH AN AMAZING PROLIFERATION OF MEDICAL SCHOOLS IN MALAYSIA! SOMETIMES, I WONDER HOW AND WHERE SOME OF THESE MEDICAL SCHOOLS FIND GOOD QUALITY LECTURERS FOR THEIR STUDENTS.

    Like

  20. kl_boy
    Nov 26, 2009 @ 09:21:26

    Another thing, i got this from ppl living near the area, don’t think they were bluffing as it sounds so real..

    A certain private medical college in the southern region has also been having problems with the quality of students there lately. While there are some genuine medical students studying there, many of them gain entry into the college through having a rich family and have been known to spend a lot of time fooling around the city (hanging out to the wee hours of night) and partying.
    There was once an incident where a group of these students crashed their car into a house gate (apparently they were all drunk) and had initially tried to flee unsuccessfully (too drunk, what do you expect).
    When they were sober, the owner demanded compensation for the damages caused which they surprisingly were refusing to do so citing numerous lame excuses (ie “your house gate was in the way” “you put so many pots outside the house” “who asked you to stay near a junction”). It was when finally when the owner got fed-up with them and warned them about getting sued that they came up with this reply which chilled everyone there (including the policeman)……” You wait next time when you visit GH, I’ll make sure you ‘kena’. That time, you sue government also no use !”

    Just imagine, next generation of Malaysian doctors servicing the nation is going to be from this stock. I pray none of them pass the subsequent exams that would open the doors to them !

    Like

  21. Dr Hsu
    Nov 26, 2009 @ 10:22:13

    There is another aspect why the standard of new doctors being churned out is getting lower, as pointed out by Prof Phua in his excellent comments.

    There is only so few qualified and good medical teachers. Not all specialists can be good teachers. A good medical teacher, in the mould of the late Dr danaraj, is hard to come by.

    There are only a small number of good teachers. the sudden increase in the numbers of medical schools means that there is a huge demand on teaching staff. But where to source for all these? You can see some staff pinching, and staff moving from one school to another. because of the shortage of experienced teachers , many who are not as good as they should be are also roped in to become medical teachers. This are especially true in state funded schools– The newer ones just do not have the time to train good teachers, and if the faculty is not as good as it should be, how do you expect the students to excel?

    We need proper planning to start a new medical schools, based on needs, and not based on political considerations. Just because the central needs the support of certain state leaders who lobbied to have medical schools, they agree to set up medical schools in those states.

    Just like all other projects in Malaysia, Medical schools are set up not based on needs or the requirements of the people, but for certain self interest, and these schools and projects are often dispensed like candies to exchange for votes or support, or to fulfill certain self interest..

    And like all things Malaysian, excellence is lost and mediocrity and rots set in..

    Sad!

    Like

  22. Ooi
    Nov 26, 2009 @ 14:01:24

    Dr.Hsu
    I do agree with you that we need to improve the public sector in order to make the pivate sector to improve as competition will be there. However with the BN “policy of dicrimination”, we are loosing all the good doctors to the private practice. As mentioned by you, this leaves the houseman or the medical office to take care of the patience. On top of this, the working conditions for such doctors are unbelievable.
    My daugher just join the hospital as houseman. For the 1st 3 weeks she has to worked from 6am to 12.30am without any off day. Now she has to worked at least 12 hrs daily (not too bad) but one or twice a week, she has to be “on call”. To be on call does not means sitting at home waiting for them to call you. It means you work say mon 6am to tues 6pm. This means a total of 36 hrs of work and you do not even get a day off. You have to go back to work on wed 6am. How do you expect these doctors to be able to put their effort to learn (reading for more knowledge) as well as to give their best services when they are so tired. What they want to do is to be able to come back asap to sleep. This is what is happening today.

    Like

  23. CYC
    Nov 26, 2009 @ 17:05:03

    During learning stage, the level of competency is already been determined. My senior a bumi who failed his HSC miserably, got a place in UM matriculation. He was later admitted to do medicine. This is the kind of quality u get in our medical graduates. This happened during the 80s where non bumi will need 3As or 4As to be admitted.

    Approximately the same time around 1985. there was an exodus from local medical and engineering professors/lecturers/tutors due to pressure to lower passing mark purely to accommodate bumi undergrads. This marked the biggest wave of brain drain in our education history. And guess who engineered it if not pemuda UMNO. Just ask ourselves what had MCA and Gerakan done to protect the standard of our medical education ? Again they were looking at the bigger picture and compromised !

    Coming back to today’s health care business, I understand that all specialist centres are hurrying to equip themselves with the latest MRI, CT Scan, Heart Scan, and so on with the primary objective of increase profit margin and reduce cost. I have came across a doctor who operate a specialist centre achieve break even for his RM2 million MRI machine in less than a year. This is much more lucrative than any business u can find and u only need to employ a technician to operate the machine. The doctor’s role is to study the test result and sign it if there is no major adverse finding.

    Dr Hsu, what is your stand on the alleged privatization of IJN ? Can u agree with that move? Where should we set the border to segregate between public and private health care services ? Healthcare is a major national issue but it is hardly debated in Parliament, why?

    Like

  24. jct
    Nov 26, 2009 @ 19:23:13

    Not far behind from exporting maids to foreign countries, Malaysia will be exporting doctors to other developing countries to work as nurses. As a matter of facts, what they earn as a nurse will be more than what a doctor earn in Malaysia.

    Like

  25. Dr Hsu
    Nov 26, 2009 @ 19:35:59

    CYC,
    I am against the privatisation of IJN and I have written a post in my blog which was alos carried by MalaysianInsider..Just use the search engine in my blog and type IJn andd you will proabbly get that article.

    Like

  26. A true Malaysian
    Nov 26, 2009 @ 21:12:03

    I believe a system need to be there to screen thoroughly those aspire to become a doctor so that only qualified candidates allowed to enroll into medicine schools. At the same time, the fees involved should be inexpensive and perhaps scholarship should be offered to the right candidates.

    Many parents have to spend their hard earned savings to finance their aspiring children overseas, to the tune of thousands if not millions. Just imagine since so much money spent, logically the top priority for these doctors is to recoup what their parents already spent on them, and not noble intention of saving lives. The effect of this is of course high cost of consultation fees.

    That is the reason why a small fraction saved on less corruption and leakages can do wonder to make production of doctors inexpensive, and balance up the health care bills.

    Anyhow, in whatever circumstances, MORALITY is important. Cilipadi is definitely right.

    Like

  27. Trackback: A doctor too many II « Dr. Hsu's forum
  28. mun yee
    Jul 28, 2011 @ 12:53:36

    Dear Dr,

    So in your opinion, how long will it takes before medical students will become jobless?

    Like

  29. mun yee
    Jul 28, 2011 @ 13:00:37

    And also, what is your opinion about pharmacist then? Will it be the same as doctors as well?

    Like

  30. Dr Hsu
    Jul 28, 2011 @ 14:09:37

    mun yee
    It is ot so much of not able to finding a job in government hospitals but rather later on the competition in private sectors will make lots of doctors unable to make ends meet.
    For the government hospitals, they will create many posts of housemen and medical officers.. like the situation now, 60 housemen in a ward? never heard of before, there is simply no standing space, but the authority is putting all these 60 in a ward in hopsitals in KL, pPenang and so on..
    Same with pharmacists and even radiographers… there are now simply too many radiographers,

    Like

  31. henry
    Apr 14, 2012 @ 21:02:21

    Dr Hsu,

    we need good doctors who are not only good in technical but also able to communicate with human beings . Remember they are not deal with machine!.
    suggestion:
    instead of put all the doctors in hospitals, can we have doctors looking after rural community, industrial safety and health, schools & other health organizations?

    Like

  32. fakhy
    Feb 11, 2013 @ 19:54:45

    Dr Hsu,
    My question might be out of the discussion.. I have no intention to be in medical school. My parents urge me to be one. How to cope with this kind of situation. I do realize and try to convince them how the the glut of doctors came in the medical field nowadays. what do you think,, should I just be one and yet I do not have the guts to say no to what my parents’ decision. What should I say to them? It’s such a burden to me and it’s unbearable.

    Like

  33. Trackback: Physician Workforce Planning in Malaysia: Better Coordination Needed - Teh & Associates

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