1Malaysia Clinics: Comments in Malaysian Medical Resources:

Dr Alan Teh's Comments in Malaysian Medical Resources:

1Malaysia Clinics

The recent introduction of the 1Malaysia clinics has more political connotations than a genuine attempt at providing quality healthcare to the poor. Clinics run by medical assistants with the minimal of equipment is to me a waste of public funds.

As a person who has worked for many years with medical assistants, I can attest to the fact that the government is toying with the health of the public in order to earn some political points.

The quality of medical assistants is suspect, from the selection of candidates to their training methods. Many of these medical assistants lack basic aptitude to practice medicine. Some are even poorly qualified. Training of medical assistants are different and hardly involves the rigours of medical schools. Their diagnostic ability is questionable.

Their role in the rural community is understandable but to allow this responsibility of managing clinics in the urban areas where doctors suffice, is tantamount to dereliction of duty by the policy makers.

Would any of our VIPs visit a medical assistant for even a simple ailment? Many would flock to ’specialists’ for the best available care. Why then are we toying with the health of the general public?

The reason of providing accessible healthcare to the urban poor is a misdirection. There are many clinics in the urban area, way too many actually. It might have been more prudent to implement schemes for the poor where their visits to the general practitioner is subsidised.

There are actually existing programmes in place via the Welfare Department to cater to these group of individuals where their healthcare is fully borne by the government. So what is the role of 1Malaysia clinics?

The name speaks for itself. Promoting a political agenda using tax payers money with total neglect of their wellbeing.

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

He is VERY CORRECT

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
 

krishna

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

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

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

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(19.10.2009) A clear message to governments to give patient safety and quality of care the highest priority when considering task shifting in the delivery of health services has come from the World Medical Association.


In a new policy document approved at the its annual General Assembly in New Delhi, India, the WMA expressed a series of concerns about the global development of task shifting - where a task normally performed by a physician is transferred to a health worker less well qualified.

Chief among the significant risks was the possibility of the quality of patient care being compromised, particularly if medical judgment and decision making was transferred. Although the WMA accepted that in certain situations task shifting might improve quality care, there could in other situations be risks of reduced patient-physician contact, fragmented and inefficient service, lack of proper follow up, incorrect diagnosis and treatment and inability to deal with complications.

The Association warned that task shifting should not be undertaken or viewed solely as a cost saving measure and should not replace the development of sustainable, fully functioning health care systems.

It should be seen as only one response to the shortage of health workers and where it was implemented it should be seen only as an interim measure.

Assistive workers should not be employed at the expense of unemployed and underemployed health care professionals and task shifting should not replace the education and training of physicians and other health care professionals.

The resolution adopted by the WMA Assembly said that task shifting was often being initiated by health authorities, without consultation with physicians and their professional representative associations, and that consultation should always take place.

Dr. Edward Hill, Chair of the WMA, said:
‘We recognise the relevance of task shifting in countries where the alternative is no care at all. But the solution for one country cannot automatically be adopted by other countries.

‘And wherever this occurs it is important that tasks that should be performed only by physicians are well defined, including the role of diagnosis and prescribing. There must be a clear understanding of what each person is trained for and capable of doing, clear understanding of responsibilities and a defined, uniformly accepted use of terminology.’