Monday, January 4, 2010

1M Clinics: More Comments from Concerned Doctors

1M Clinics: More Comments from Concerned Doctors

Dr Liew Houng Bang, (KK, Sabah):

This is another trying moment for our profession.

The emails and most feedback we seen from MMA, is "blame", is wrong has been done to us.
Are we truely victimized, or we have someway led to this, and partly responsible.

Perhaps, we need to ask, and debate:
1. Why 1Malaysia clinic is conceived? Why politician thinks this is an opportunity? What gap is not filled?
2. If 1Malaysia clinic is a threat to the profession, how should we resolve this? Can we 'integrate' or 'transit' this into a health system that will address the issues raised, and win-win situation for all stakeholders. Not forgetting the biggest stakeholder is the public at large, and every corner of our nation, East and West, rich or poor, rural or urban.

Open confrontation like demonstrations and walk-outs have severe repercussion. Lest not be rash. First do no harm.

Our strategy must be guided by our ultimate objective of "public good" as priority, and "professional interest" as second, and although the encroachment of our doctor's rice-bowl is an underlying reason, this should not be the trump card!
We will lose our credibility if we do so.

If we go public, this intention must be to engage the public, as advocate to the public interest. Walkouts and public protests will be counterproductive.

can the professional members in the community (GP) rise to the challenge and say, we can fulfill the society's needs?

3. How can MMA be 'relevant'? Not risk marginalised by society at large, and alienated by members within the profession.

Prof Sim's subtle words signal transformation, if not revolution. I like to see this beginning of our "revival" of our professionalism; rooted in altruism, service, caring, and humility; not selfishness, mercenary, apathy, and arrogance. The latters are gaining as characters of our profession in Malaysia.

Public trust and respect, including our self-respect, cannot be demanded but earned.

"One who is skilled at directing war always tried to turn the situation to his advantage" SunZi

Prof Dr Sim Kui Hian (Kuching, Sarawak):
Indeed, you had worked harder than anyone else in terms of time and sacrifices with the MOH which I personally had the first hand knowledge myself. 

Several things just coming thru my minds (as still suffering from jet lag and massive paper works after away for 3 weeks. Patients always come first in my daily practice), the best action for the doctors (none MMA members) and the MMA is to have the intelligence on the ground well before 1 Msia Clinic was ever announced in parliament. 

Since is too late, the next best action perhaps is to embrace 1 Msia Clinic and extract the best deals within the limitation of 1 Msia Clinic.  Is up to us to plan, to create a win-win situation, perhaps suggesting that negotiated for a payment for our members to work in 1 Msia clinic, what types of patients should be seen in the clinic, operational hours, etc.  

Otherwise, after June, our younger colleagues (majority are non member) will be more than happy to work in 1 Msia Clinic instead of district posting or nite duty.  By than, what is the issue apart from the perceived self interest of the doctors of MMA (not you or me) by the public (be it rightly or wrongly)?  (We need to articulate what are the actual examples that we are not just advocating passionately but doing sincerely for the public interest.)

We need our members to understand the dynamic, the reality, the PR, etc rather than what MMA should do for my interest alone (while at times, our own people is the one who broke rank, leading to our diminishing voice at best and embarrassment to the MMA at worst.  Fortunately is only minority but still one too many).  

Dr Kuljit Singh (via blackberry):
Prof Sim is right as we may have to work something out to benefit doctors as the entire project is going to go on. Fighting it in the street is not going to work.

Dr Liew Houng Bang:
I do agree with your points. This is a challenge we all have to face. I merely share a perspective, bare and honest. This is necessary so that we all know what we may face.
Glad, you are "keeping the peace" as strategy. You have my full support, "as of now" too.

My suggestions:
Before the 8th January 2009, MMA nationwide should urgently convene to brainstorm on:
1. Consistent Strategy: "the big picture"
2. Action plans: all options, pros and cons.
3. Proposals: win-win solutions; "ground"
4. Negotiation: find common ground, common interest, respect difference, always refocus on way forward; expect stalemate, ready to give-and-take.

Then MMA council should represent. My concern of a open-for-all dialogue with Minister may be chaotic and sentiments may betray the better part of us.
I suggest, the Council meet with branch leadership first. After the Council meeting with YBMK, perhaps an opportunity to meet the 'grassroot'.

Trust is essence, we have to ask, how to help our minister do the "right thing" for all. We may even need to accept "no commitment" until all sides have their say, and allow time and space, for a follow-up Second meeting with YBMK.

Never begin a battle, that we can't win. If we plan to lose, this must be for the victory of the War at large.
Sometimes, our greatest enemies are within.

"The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy."
Martin Luther King Jr.

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