Tuesday, January 5, 2010

1M Clinics: Some More Comments from MMA members urging caution

1M Clinics: Some More Comments from MMA members urging caution, unfortunately mostly government servants, GPs must speak out, or your voices will not be heard...

Dr Krishna Kumar (NS):

dear all
I think you should clearly heed what datuk Mohandas has said
do not shoot yourself in the foot
one of the main reasons for these clinic has been to address the urban poor who have been neglected for some time. as hospitals become specialised and sub-specialised, the A & E being streamlined to only address the emergency problems, minor ailments need to be channeled somewhere. it is therefore being used as achannel to divert the overload from the hospitals
Please note that these clinics are a big hit with the general public who cannot afford to go to the provate and do  not want to wait for long queues by the colour coding systems in the A & E depts of hospitals
there are a lot of doctors being produced annually as an excuse does not hold water. there will then be an arguement of the experience and training of these doctors. any mistakes by any doctors will then be further highlighted and will not receive any pity from the general public
My advise is to be very carful in addressing this issue and not appear to be looking at doctors' pockets only

My Comments: (DQ)

We hear you, but does anyone hear the GPs?

Being in govt service has comfort zones which unfortunately many in the private sector do not have the luxury of enjoying.

But of course we will be careful. But the MOH and the govt must understand that policy changes no matter how 'noble' the intentions, have implications. The medical profession must maintain our relevance in being important partners to dialogue with the authorities.

Our Private Healthcare Facilities and services Act also came about from noble intentions, but look how much it has impacted so many GPs and those in the private sector? We need to be powerful shapers of our own destiny, not simply reactors to insensitive dictates of policy makers and possible political ploys.

I will try balance what is two glaringly opposite and increasingly divergent clusters of viewpoints.

My only concern is that ultimately, we the doctors will be the that professional who might be facing greater and greater constraints and possible too much oversight, initially within the private sector, but soon when the overcrowded public sector cannot sustain all the newer graduates, then what?

I have always posited that the public must be our first concern, and that there must be better mechanisms to help everyone have universal access to health care. But being a student of medical interests and issues over the past 15 years, I am also in the position to recognise mounting challenges for the 'doctor' whose professionalism, livelihood and even modes of practice will evolve into something quite alien to what is currently experienced.

It is nice to sound so altruistic, but do look into the future, most of the MOs will likely be exploring the private domain, but in what capacity... Just my musings...

For many who are interested, please read the WMA's resolution just passed at the General Assembly after huge debate, end of last year.

Here's the WMA resolution that was adopted in the last General Assembly, which discusses the nuances and implications of Task shifting, and underscores what the medical profession is facing... WMA also cautions on the safety and quality of care. Even the increased nurse practitioners program is an eroding force for the future of doctors...

May be like dinosaurs, the medical profession will evolve into a toothless beasts of burden, worker ants/bees?

Knowledge of what has been happening around the world regarding the medical profession will help place some balance and focus on the possible future for us doctors...

WMA Resolution on Task Shifting from the Medical Profession

Patient Safety and Quality of Care Should be Paramount When Task Shifting

1 comment:

gavinykw said...

The government has implemented the 1Malaysia clinic concept after great thoughts and feedback. It has no intention to burden the private or the government doctors, alas it wants to alleviate the suffering of the urban poor by implementing this concept.

My patient who stays in an urban settlement 30 minutes from the nearest town (that has 6 GP clinics) has to spent rm15 one way taxi fare to the GP to seek treatment. On return, she again spends rm20 on the taxi fare. the treatment at the GP cost her rm30. On the whole this urban poor patient had spend near rm80 for this treatment. I asked her if she had lunch, she said no. The kid she's carrying had some biscuits in hand. This are the group of patients the government wants to target. They have little voice to express the joy of a clinic nearer to home that will only cost her rm2. That clinic is 1Malaysia clinic.
So for doctors who speaks so loudly about your objections, spare a thought for this poor urban patient.