DOCTORS’ FEES: Rising costs, competition affect profession
BEFORE any party joins in the debate over the proposed doctors' fee rise and lashes out with knee-jerk responses, please pause to hear a balanced view from an unbiased doctor.
No one welcomes a fee increase. And everyone hates inflation, including the doctor. Hence, the natural knee-jerk response to this matter, raised by the health minister himself, is to object, reject or protest against it.
Though I am a specialist, I would like to speak for the family practitioner or general practitioner. Fifty years ago, just after Merdeka, I recall that my visits as a child to my family doctor would cost my parents between RM10 and RM15, depending on whether I was given antibiotics or whether an injection was administered.
My cousin working for the same doctor revealed that our dear doctor saw about 200 patients a day. Simple arithmetics will show that he was "minting money", being able to buy a bungalow or a Mercedes-Benz every month! A Mercedes-Benz 280s then cost only RM36,000. So, too, was the cost of bungalows in many towns.
This may come as a shocking revelation for some in this generation. But doctors in private practice then were few in number and rich (there were only four in my hometown).
No one really noticed the wealth of the private doctor then, as everyone else was "poor" and "happy", using bicycles, trishaws and buses. Only a few members of the upper segments of the society owned cars, mainly professionals like doctors, dentists and lawyers. Rich businessmen were equally few in number.
At that time, RM15 could buy a person a pair of shoes or a pair of trousers (tailor-made) or a pair of spectacles. Fifty years on, with progress and development, the "poor" doctor has arrived -- struggling to make a living.
He can now charge between RM20 and RM30 for a simple consultation, with medication, while he competes with dozens, if not hundreds, of clinics in the neighbourhood, hoping to see perhaps 20 or 30 patients a day.
Meanwhile, that pair of shoes has gone up to RM250 and the pair of pants is also around RM250. A pair of good multi-focal lenses and designer frames costs between RM1,000 and RM3,000.
A hair cut has shot up from 50 sen to RM10, or more in sophisticated salons. Let us not forget that the doctor's plate of chicken rice has risen from 50 sen to RM4, while rental could be from RM200 to RM5,000 or more, if he does not buy over the shoplot.
His dentist counterpart, who used to charge RM10 to RM15 for an extraction, now charges ten-fold the pre-Merdeka rates.
Time has caught up with the family practitioner, and many have lost the battle and quit. For that reason, among others, the solo practitioner has become a dying breed.
It is true that doctors somehow seem to survive and still remain up there as the upper-ranked wage-earner.
Just Google "top salaries in the United States or worldwide", and the doctor is among the top 10 all the time.
So, why are doctors (family practitioners) a frustrated and angry lot? Their fee is capped, by law, at a mere RM18; any fee rise has to be approved by the health minister, and he is unlikely to do so if repercussions from the public are drastic.
Rumour is that with a national healthcare fund, this fee is likely to be reduced to RM15, back to the early Merdeka days. That will be the day when the plumber and electrician overtake the doctor, and indeed, the final humiliation will be when the barber beats the doctor for each visit.
Dr K.H. Sng, Kuala Lumpur.