By Dr Raj Kumar Maharajah
I refer to an article in Free Malaysia Today, “Listen to the woes of the GP, the family doctor”, by my respected colleague from Sabah, Dr John Teo.
While all points on the plight of the general practitioners as raised by Dr John Teo are real, I wish to add that another aspect that the government needs to look into is the post graduate programme for the general practitioners to upgrade their knowledge – a topic which has been discussed every now and then, together with the discussions on Health Transformation and the National Health Financing Scheme.
The general practice in Malaysia, a shop lot practice, has long been self-funded by solo medical practitioners for about a century now. Any intention to upgrade the practice facilities and knowledge is on the practitioner’s own initiative and expense.
Self-regulated for more than 80 years before the Private Health Care Facilities and Services Act (PHFSA) was introduced in 2006, the general practitioners have kept primary healthcare in the country accessible and affordable at their own expense – a fact acknowledged by the world.
However, with rising overheads and costs, this may soon come to an end if the government does not step in to help the private primary care facilities financially by providing scholarships and grants, and not just confining itself narrowly to regulating, enforcing and punishing.
After the PHFSA was introduced in 2006, the health ministry regulated the private healthcare services and enforced the rules as per the Act.
Most general practitioners have argued that they are being micromanaged by the Act, while others have argued that enforcement officers have interpreted the law at their own whims and fancies, creating Little Napoleons and Cleopatras.
While the emphasis has been to regulate, enforce and punish, the help and assistance to upgrade the practitioner and his practice leaves much to be desired.
With the impending Healthcare Transformation, Voluntary Health Insurance and National Health Financing Scheme in the pipeline, the self enhancement of the knowledge of the general practitioner as the gatekeeper has to be given importance.
The programmes have to be tailored to cater to the needs of the Malaysian general practitioner and the public.
We need to take into consideration the disease patterns in the country, the socio-economic strength of the population and the accessibility and affordability of the programme itself to the practitioner to encourage the general practitioner to enrol.
There should be more than one provider to prevent monopoly and create competition so as to give choices to the general practitioner to sign up for a programme best suited for him.
Some options that we would like to suggest are the introduction of the Masters in General Practice by local public or private universities and the recognition of the FRACGP, MRCGP Brunei and the MRCGP South Asia, without having the need to go through a middleman or broker.
The introduction of the compulsory Continuing Professional Development CPD points for the Annual Practising Certificate in 2020 can be taken as a stepping stone and we can move on from there.
The Medical Practitioners Coalition Association of Malaysia will work with the health ministry to make this request a reality.
Dr Raj Kumar Maharajah is a member of the Medical Practitioners Coalition Association of Malaysia.
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