Friday, October 23, 2009

Malaysian Mirror: Private hospitals breaking the law

Thursday, 22 October 2009 17:16
KUALA LUMPUR – Private hospitals, which initially aimed to provide specialist treatment, are now directly competing with general hospitals in providing ‘outpatient’ treatment.

This, said the Malaysian Medical Association (MMA), is a breach of the Private Healthcare facilities and Services (Private Hospitals and Other Private Healthcare Facilities) Regulations 2006.

MMA president Dr David K L Quek quoted a part of the regulations that stated: A private hospital shall not maintain or provide outpatient facility or service, except a specialist facility and service.

He said it had come to the knowledge of the association that a private medical centre had set up a primary care centre (feeder clinic) outside its hospital premises.

“We understand that several others are considering doing the same, as if to test the waters,” he said, adding that the MMA is ‘vehemently’ opposed to such move.

'Do not compete with general practitioners and family doctors'

Dr Quek said private medical centres should just stick to tertiary specialist services and not to compete with primary care physicians; that is, general practitioners and family physicians.

He added that such practices, if left unchecked, would not be consistent with the Private Health Care and Services Act (1998) and Regulations (2006).

Dr Quek said the issue of private hospitals or medical centres running ‘general practice’ type of services is not new.

He said this had been attempted before and some of these hospitals had failed in the wake of complaints by the MMA.

“In our discussions with several ministers (of Health) and other ministry officials, we deemed such practices as anti-competitive, monopolistic and place family physicians and general practitioners at a great disadvantage.

“Therefore, it has been agreed that this should not be allowed, whether in-house or outside, as feeder clinics.”

Dr Quek said feeder clinics, when they are set up, will be directed to only refer their patients to a particular medical centre.

On the other hand, he said, most general practitioners act as ‘gatekeepers’ to refer patients to doctors on a ‘best choice’ basis, dependent on the individual doctor’s experience and knowledge.

“Also, there may be pressures and conflicts of interest if medical officers working in the feeder clinics only refer to specific private medical centres.

The carpenter and his hammer
“Possibly, there may be greater resort to costly laboratory tests or greater over-utilisation of amenities such as CT scanners,” he said.

“We understand that medical centres with huge investments in diagnostic and curative care services have to recruit some of the costs by casting a wider net.

“But this is fraught with other dangers – what some have called ‘misdirected care’ – over the utilization of available resources, inappropriate investigations leading to unnecessary operations or other services; all adding up to extra costs but not necessarily improving the health of the people,” Dr Quek said.

Giving a metaphor to the situation, he said: “The carpenter with a hammer will use it on any nail that he sees; so everything is a nail tohim who has a hammer.”

He urged the Health Ministry to quickly and seriously take urgent actions to curb the unethical practices.

It also urge the Malaysian Medical Council to consider such practices as ‘unethical and tantamount to fee splitting.’ - Malaysian Mirror

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