I REFER to several articles on the plight of general practitioners in the press recently, especially the points brought up by Dr John Teo of Sabah.
While all points on the plight of general practitioners as raised by him are real, I wish to add that another aspect that the government needs to look into, i.e. postgraduate programmes for general practitioners to upgrade their knowledge.
This is a topic which has been discussed every now and then, together with the discussions on Health Transformation and the National Health Financing Scheme.
General practices in Malaysia have long been self-funded by solo medical practitioners for about a century now. A practitioner has to upgrade his facilities and knowledge by his own initiative and expense.
Having been self-regulated for more than 80 years before the Private Healthcare 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 globally acknowledged.
However, with rising overheads and costs, this may soon come to an end, if the government does not step in to financially help private primary care facilities by providing scholarships and grants, and confines itself narrowly to regulation, enforcement and punishment.
After the PHFSA’s introduction, the Health Ministry regulated 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.
The assistance available to practitioners to upgrade their practices leaves much to be desired.
With the Voluntary Health Insurance and National Health Financing Scheme in the pipeline, the self-enhancement of 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 disease patterns in the country, the population’s socio-economic strength and the accessibility and affordability of the programme itself to encourage practitioners to enrol.
There should be more than one provider of such programmes to prevent a monopoly and create competition, enabling general practitioners to sign up for the programmes that best suits them.
Some options that we would like to suggest are the introduction of master’s degrees in general practice by local public or private universities, and the recognition of the FRACGP, MRCGP Brunei and the MRCGP South Asia qualifications, negating the need to go through middlemen or brokers.
The introduction of compulsory Continuing Professional Development CPD points for the Annual Practising Certificate in 2020 can be taken as a stepping stone. We can move on from there.
The Medical Practitioners Coalition Association of Malaysia will work with the Ministry of Health to make this request a reality.
DR RAJ KUMAR MAHARAJAH
Medical Practitioners Coalition
Association of Malaysia
Putrajaya