Wednesday, December 15, 2010

malaysiakini: Moratorium won't solve healthcare problems.... Dr Ong Hean Teik

Moratorium won't solve healthcare problems
Dr Ong Hean Teik
Dec 15, 2010

A moratorium on new medical courses in Malaysia will not solve the main problem faced by our healthcare system today, namely the large numbers of housemen with poor skills and questionable competencies.

Since these poorly trained doctors come from foreign as well as local institutions, stopping local medical intake does nothing to solve the issue.

What is needed now is a training system to improve the abilities of these young doctors, and even to weed out those who do not have the desire or competency to practice medicine.

Some may have hoped that registering a lot of housemen will ultimately solve three problems; fill vacancies in the Health Ministry, reduce healthcare costs by increasing doctor supplies and achieve a developed country status with a doctor-population ratio of 1: 400.

However, in our haste, we have registered poorly trained housemen, exposing them to a system that is not ready to cope with the numbers and their inability.

The call for action comes not from private doctors seeking to protect their rice-bowl; rather it is from dedicated senior government doctors who are worried about the future when these housemen take up increasingly responsible positions in public healthcare institutions.

Poorly trained doctors will be a burden to the Health Ministry, and may have to spend an increasing proportion of its budget on doctor salaries since such incompetent doctors will not be able to attract fee-paying patients who are very sensitive towards doctor competency.

No patient, no matter how poor, deserves an incompetent doctor, and no one, no matter how powerful can feel totally safe once incompetency creeps into the healthcare system.

We already have in place a system to train and assess our housemen. What is now needed is to formalise the system and have an end-of-housemanship examination.

Housemen must be transparently graded, with one-third coming from consultant's assessment, one-third from a theory paper and one-third coming from a practical examination.

After all, housemanship is only the beginning of a doctors' educational process. With many examinations still to go through, the houseman should not worry about a formal end-of-housemanship assessment. Those who do well should be rewarded with posting of their choice and entry to specialist training programs.

The majority should pass and proceed onto service as responsible medical officers. The really incompetent or disinterested ones should repeat their housemanship postings.

In the near future, the MMC must de-recognise poor-quality medical schools whether locally or abroad, without fear of political pressure.

The country cannot support 4000-6000 new doctors annually into the infinite future.

It should not be too difficult for the Ministry to calculate how many doctors are required annually, then seek to limit new medical registration to the calculated numbers.

Whatever the numbers, the aim must be to finally produce only capable, competent and dedicated doctors. Medical education, and the medical profession, should be for those interested in the art of healing, not those seeking financial rewards.

The public must try to understand that on this issue of having a competent medical workforce, doctors in both private practice and government service are speaking with one voice and truly have the interests of our community at heart.

Dr ONG HEAN TEIK is a cardiologist consultant in Penang

1 comment:

yinyin said...

I totally agree with you. You have put everything in a nutshell - diagnosis and treatment.