Health and Medical Professional Issues in Malaysia
Tuesday, December 21, 2010
NST: EDITORIAL: The doctor's high calling
The doctor's high calling
DOCTORS must be prepared to work where they are needed, said the health director-general to some 100 would-be medical students on Sunday. Certainly, as a doctor's job is to treat the sick, and sickness knows no borders, there is no good reason for a doctor to pick and choose where he or she works. But as most Malaysians live in cities, it is no surprise that most doctors live and work in the cities.
However, the problem is that too many do, and as a result, city dwellers are over-serviced and rural communities under-served. And as we don't have enough doctors, and too many choose private medicine, this leaves government hospitals and clinics short-handed, with the shortage most felt in states that are more rural than urban. Though he does not give any indication whether this perennial problem has worsened, given the implications for rural healthcare, it is little wonder that the top health official was moved to remind future doctors of their professional and social obligations.
Certainly, rural postings represent a searching examination of their dedication. However, unless they are the type who want to make a difference and take time off to volunteer for humanitarian work with organisations like Doctors Without Borders, it is hard to see if they will be moved by the appeal to the mission of medicine and the doctor as public servant.
It is a fact of life that people serve their own personal agendas and that the bright lights and the hustle and bustle of the city attract people. Doctors are no different from teachers or other professionals in their immunity to the pastoral charms of rustic life and their reluctance to serve in far-flung villages. And Malaysia is no different, as virtually every country in the world, developed or developing, is grappling with a shortage of doctors in rural and remote areas.
So, what can we do that we have not done? We have used the stick of compulsory service but it invariably comes unstuck as many feel as if they are serving time and can't wait to leave. We have hired foreign and retired doctors, but these are stop-gap measures, not long-term solutions.
Rural doctors get faster promotions, preference for post-graduate training and hardship allowances. Yet many seek early transfers. Perhaps they need more potent incentives. But, perhaps, after all, what we are left with is the hope that more young doctors will see their career choice as a calling, a vocation, rather than just a meal ticket to the good life.