NST Leader: Hello, doc

FINALLY, the doctors are getting the call they were waiting for 10 years: new on-call rates. About time, given the aged rate. Doctors, too, succumb to the disease called rising cost of living.

But when and by what quantum remains to be announced. As for the timing, Health Minister Datuk Seri Dr Dzulkefly Ahmad says "soon".

The doctors are hoping the "soon" of the ministry wouldn't turn out to be the same as the typical Malaysian promise of "on the way". Can't blame them, as this debate has been going on for at least a year. Rates, too, may not be what the doctors are pinning their hopes on.

The Malaysian Medical Association (MMA) had suggested to the ministry that the on-call rate for weekends be RM25 per hour, a whopping 178 per cent jump. Don't blame the MMA for going after a "whopping" hike. The fault lies in Putrajaya keeping a low hourly rate — RM9.16 — for more than a decade.

Just to give a context to the MMA argument, a barista in Kuala Lumpur earns RM14 per hour. With their gruelling years in medical school and at least a year spent as house officers, the doctors surely deserve the RM11 per hour more.  

But this isn't the only demand the MMA has put the government on notice. Staffing and issues related to promotions are problems waiting for solutions. We may be having more than enough medical schools, but contrary to official figures — one doctor to 420 people in 2021 — there seems to be not enough doctors in hospitals and clinics throughout the country to cater to the increasing number of patients there.

Long queues and doctors clocking more hours than necessary point to similar shortfalls. Is the ministry using crude statistics or is there more to it than what the anecdotal evidence suggests? Doctors-to-population ratio just doesn't do the job.

It may serve some theoretical purpose, such as comparing one country with another, but nothing more. We suggest our Health Ministry switch from ratios based on population to one based on workload. Complex no doubt, but more real. 

Resignations are spiking. Start with contract doctors. According to MMA data, contract medical officers are leaving in hordes. Is the ministry in search of clues? They are not telling. If in 2017, only 110 quit the public health service, in 2022, a mind-boggling 1,354 left. And that is beyond the graph in percentage terms.

The public health sector is also bleeding specialists, according to MMA. Between 2011 and 2017, 1,000 of them called it quits. Between 2018 and 2022, 890 of them opted out for various reasons. It may appear as a drop, but it isn't. The former was over seven years while the latter was for five years.

But the point is, junior and senior doctors are leaving in droves. If we understand the MMA right — from the noises the association has been making over the years — the exodus is due to issues related to human resource management.

Low wages, burnout due to maldistribution of doctors, non-transparent criteria for promotion, and so the list goes on. The MMA may be seen as a thorn in the side of the government, but Putrajaya will do well to listen to it. If not for anything, the MMA knows the doctors' tachycardia and bradycardia better.

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