Sunday, January 16, 2011

Changing Trends of Medical Practice in Malaysia

A very interesting article by a senior doctor in Malaysia published in the Sunday Star (Malaysia)

Sunday January 16, 2011

Modern docs


Changing trends of medical practice in Malaysia.
AFTER graduating in medicine from Australia, I started medical practice at the beginning of 1969. I have witnessed vast changes in medical practice. I came home to Malaysia at the end of 1971 before completing my postgraduate training in teaching hospitals in Sydney when my father took ill.
Back home, I joined the government service in Taiping Hospital and then University Hospital in KL for nearly five years. Then I went for post-graduate studies in Edinburgh before returning to Malaysia to start my own private practice.
I have therefore been through and seen the changes of medical practice in Malaysia for over 40 years. Recently, there have been many changes affecting medical practice and therefore I feel this will be an interesting topic, which I am qualified to write on, especially being a past president of the Malaysian Medical Association (MMA) and a council member of the Malaysian medical Council (MMC).

In the past, the doctor could just concentrate on his role as a healer. A doctor now has got to be a good administrator as well . – AFPRelaxnews

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Blogger Paul Long said...

Intersting article. Even for a non medical person like me I have noticed many of the things he has brought up. I would love to hear your input as a medical practioner (is thus the PC term for doctor? :-) )

I particularly have been "rambling" for years - back in late 80s while in seminary that too many people want to specialize too fast instead of taking time to develop (and even stay) as good GPs. Of course my context was using this as an analogy to defend my position to be focus on learning to be an all rounded pastor and be able to be reasonably competent and well rounded in as many areas of ministry as possible rather than " specialize" and say for example something like "my gift is teaching so I do not want to do visitation ..." etc.

I think in hindsight I made a wise decision by God's grace. But it still is worrying to me that it seems pastoral ministry seems to be getting more and more complicated that may not be deemed enough for a pastor to be love God (as much as humanly possible?), know and teach the Bible (on a level) and love his flock and the lost.

Seems like a pastor needs to not just be decently competent as well in Administration, knowledge of media, counsellor, financial acumen, etc (the list is so long) but needs to excel in every area. SCARY!

1:58 PM  
Blogger Alex Tang said...

Hi Paul,

Thank you for your comment. There seem to be two aspects to your comment: one of specialisation and the other of roles.

I shall respond to specialisation first. I agree with you wholeheartedly that we need to be generalist before we become specialist. In medicine, young doctors needed to be trained as generalist before allowed to specialise. The reason is that a generalist sees the patient as a whole, not a subset. These used to be the normal practice in UK upon which the Malaysian health system was based.

Specialities and sub-specialities disciplines became more developed. The specialists became more glamorous, powerful and attractive than the generalists. They began to lobby to shorten the generalsit training.

Housemanship in the UK has resisted this. In fact they have lengthened the housemanship period to two years because of the mandatory allowed shorter working hours of housemanship.

The Americans however are more gung-ho in specialisation and they started their specialisation in their first year residency (housemanship). In other words, there is no generalist training in the US. A generalist itself become a specialty.

The consequences of this is that if you are admitted to a US hospital for high fever, cough and runny nose, you will likely be seen by a infectious disease expert, a respiratory physician, an allergies and an ENT surgeon. You think this unlikely, just get yourself admitted to a specialist hospital in the Klang valley (all private hospitals are specialist hospital).

Surprisingly, this early specialisation seems attractive to the Health Ministry in Singapore which started their residency programs (instead of housemanship)last year. God help all patients everywhere.

Increasingly, aside from being a healer, doctors are called to take on roles of administrators, businessman, book-keepers and store-keepers. BTW we use the term medical practitioners because there is another strange group of people who call themselves doctors but do not offer medical care. In a larger setting, such as a hospital, these roles are taken upon by others who are trained for these. In smaller settings, practitioners have to take on these additional roles.

In my observation, pastoral training and pastoral practice faces the same challenges as medical practices.

2:58 PM  

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