NST Leader: Treating doctors

It should not have come to this. Doctors going on strike in the midst of a killer pandemic. Very unHippocratic. The men and women of medicine may have hurt their cause more than they may realise.

Even the national chairman of the Malaysian Medical Association SCHOMOS, Dr Vijay Ganasan, appeared to entertain such a hurt, just in case. In a post on the MMA website, he expressed his worry thus: "The country's healthcare system is at stake here.

Walking out may or may not cost any lives but if it does, we will regret it for life." As right as Dr Ganasan is, Covid-19 has reinforced the importance of medical personnel to the country. They are the ultimate frontliners now.

The entire nation is behind them and, as a result, would support measures to address their needs and concerns. But as Dr Ganasan is suggesting, the timing is certainly off. Our advice to these young and long-suffering souls is this: Don't gamble with people's lives, or use them as a bargaining chip.

It seems opportunistic. And can backfire and reverse people's perception towards medical staff. Not to mention lives lost as a result. Once Covid-19 is defeated, or at least controlled, the 22,000-strong heroes and their plight should be top priority.

But the blame shouldn't be all on the young shoulders of the contract doctors. It takes two to tango. The people who have been given the responsibility to resolve the issue have missed the forest for the trees.

Sure, the ones now in the decision-making seats aren't the only people seeing "trees". The failure to see the big picture — the issue related to contract doctors being part of it — is an old problem of successive administrations.

A product of poor strategy? Or just bad policy? Or a habit of mind? Perhaps a bit of all. It is not that the government wasn't warned about the looming problem of the medical profession.

A decade ago, Malaysia's Council of Deans, on seeing the spiralling numbers of medical graduates in the country, called on the government to put a cap on the number of doctors being produced every year, says epidemiologist Professor Datuk Dr Awang Bulgiba Awang Mahmud from the Faculty of Medicine, University of Malaya. The quick answer then was: we don't have enough doctors. The government wasn't wrong, but it was only half right.

According to Dr Awang Bulgiba, Malaysia is short of specialists, but not generalists. Herein lies a conundrum. How do you get enough specialists if you don't have enough generalists? If history serves us well, it takes four years to produce more than 500 specialists out of a similar number of generalists.

If we need more, we better look now at the 22,000 contract doctors to grow the pool of specialists. The Public Service Department, the recruiting arm of the civil service, appears to be in a downsizing mode. Downsizing isn't the answer. Rightsizing is. This isn't a matter of terminology. It is a way of thinking.

After all, different labels lead to different pathways. Covid-19 has taught us many lessons, one of which is: we shouldn't make decisions for tomorrow with today's lens. Or worse, with yesterday's lens. The contract doctors issue is still with us because we planned for today's world with yesterday's lens. There is no forest in this view. Only trees.

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