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Dear all,

The PMCSA is currently coordinating a survey on the expansion of PMC to The Penang Home on Residency Road.

We would be very appreciative if you could take some time out to fill up the survey available on Moodle, under the Faculty Centre, titled “PMCSA Survey on Proposed PMC Expansion to Penang Home”, or if you click on the following link: http://vle.pmc.edu.my/mod/questionnaire/view.php?id=5027

The survey is essential to form the student voice regarding this matter, and we need as many of you as possible to fill this survey up to ensure that it is truly representative of what the students want.

The survey is expected to close on Tuesday at 5pm. Your cooperation is very much appreciated.

picked up from Malaysian Medical Resources (www.medicine.com.my)

FPMPAM: Malaysia Not Ready For AFTA Healthcare Liberalisation

Liberalization of Healthcare is probably inevitable. But instead of rushing in headfirst, FPMPAM recommends that proper safeguards be put in place to protect Malaysians and the overall healthcare system.

FOR IMMEDIATE RELEASE

PRLog (Press Release) – Mar 30, 2009 – A national doctors’ medical association is concerned that the Malaysia is rushing towards liberalizing its healthcare services without a proper regulatory framework, which will jeopardize the overall healthcare system.

The Federation of Private Medical Practitioner’s Association of Malaysia (FPMPAM) believes that although the basic aspects globalization are inherently good and in some ways inevitable, the Malaysian healthcare services sector in particular is not ready for this.

According to the President of FPMPAM Dr. Steven Chow, there is a need for ASEAN to move toward harmonization of healthcare standards (such as in the EU) before opening up market access but this should be done as a gradual process

“Currently, there is an absence of a suitable legal and regulatory framework to prevent the exploitation of the national healthcare market by foreign businesses which may be driven solely for commercial interests.

“In this weak regulatory environment, we can expect more resources to be poured into the more lucrative aspects of healthcare, jeopardizing the standard of healthcare in areas such as rural and preventative care.”

Dr. Chow said that without proper safeguards, the move will not answer but exacerbate Malaysia’s healthcare woes as market forces and business sense is unlikely to encourage foreigners to start their business in small towns, where the problem of shortage and poor access to healthcare services is more apparent.

“But more importantly, we cannot rush this process, especially if it is for the sake of boosting medical tourism. Healthcare is not just another business commodity.

“The government needs to answer how it sees the liberalization of healthcare fitting into the larger process of healthcare reforms earmarked under the 10th MP. We need to ensure that this move will benefit the people of Malaysia and not just businesses,” Dr. Chow said.

Dr. Chow also added that the framework must not compromise the quality of care and also be able to monitor the conduct of foreign doctors as well as provide an avenue to protect patients.

“There are too many unanswered questions on the macro and micro levels. Right now, if patients are shortchanged by a foreign doctor, they lack suitable avenues to seek redress.”

“What if the doctor absconds? What is there to prevent such business entities from just closing shop and disappearing when they are faced with problems?” said Dr. Chow.

Dr. Chow also highlighted that another area of concern is also about how to ensure that these doctors can uphold our standard of services in delivery and in other crucial areas such as local socio-cultural norms and doctor to patient communication.

RCSI SMJ is now available in limited copies!

Kindly get yours from:

2009 - Izwan
2010 - P’ng Hon Shen, Abadi, Cheng Mao Li, Edmund
2011 - Atika and Anjana

or point your browser to http://www.rcsismj.com/

JENNIFER GOMEZ:
Poser over training centres for housemen

A specialist (right) showing trainee doctors how to treat a serious neck injury in the Emergency Room.

WE do not have enough doctors, but the 38 hospitals accredited for houseman training are struggling to cope with the increasing number of medical graduates. These hospitals can handle only about 3,500 housemen each year. Of the 38, three are university hospitals and the rest come under the Health Ministry.

Next year, more than 4,000 medical graduates are expected to need places in the compulsory local programme, a Health Ministry source reveals. The main reason for the increase will be medical students returning from studies abroad.

The number of housemen reporting for duty has risen steadily from 1,290 in 2007 to 2,267 last year.

The rise in house officers is justified, however: the current doctor population ratio is 1:1,145, whereas the ideal ratio is 1:600.

But the strain is being felt, with medical officers and specialists having to take bigger groups of trainee doctors on their ward rounds. If 10 years ago there were 15 house officers at any one time in a department, now it’s 45.

The two-year housemanship training rotates among six departments — internal med-icine, paediatrics, general surgery, orthopaedics, obstetrics and gynaecology (O&G) and emergency medicine.

The bigger groups mean that not all trainees get to practise all the procedures under the scrutiny of their superiors. This is bound to result in a “lower than desired level of training” when they are done with their two-year housemanship stint.

Given these serious implications, what are the immediate and medium-term solutions to this dilemma?

At the recent convocation for graduates of Russia’s Kursk State Medical University in Subang, Malay-sian Medical Association Committee on Medical Education chairman Datuk Dr N. Athimulam called on the authorities concerned to look into increasing the number of training hospitals so that housemen get optimum training benefits during their two-year stint.

He suggested that since the 38 accredited training hospitals were finding it hard to cope with the increasing number of housemen, one option would be to open up the two army hospitals in the country for training.

His second suggestion was to allow housemen to train at private hospitals. This option would require further study, he noted. It would be hard to imagine, and unfair to expect, paying patients to accept being pricked and poked by inexperienced medical staff with “a smile and an encouraging nod”.

Association of Private Hospitals of Malaysia president Datuk Dr Jacob Thomas adds that those who come to private hospitals are paying patients and want to be examined and treated by specialists.

Houseman training includes performing procedures, and it is highly unlikely that paying patients at private hospitals would be agreeable to this, he argues.

The other issue, of course, is whether the consultants themselves would be able to cope with their duties while watching housemen under their charge. Private consultants often practise at various places and their time may be limited.

Director-general of Health Tan Sri Dr Ismail Merican points out that there are many other issues to iron out, such as the unavailability of comprehensive support services like pathology labs, emergency services and O&G services at private hospitals.

There are also legal complications: the Medical Act 1971 specifies that a houseman is a government officer, so who will pay his salary?

And in the event of a mishap, who will bear the responsibility — the hospital, the medical officer or the specialist?

As such, the only viable option for now would be to accredit more government hospitals as training centres for housemen, including selected army hospitals.

This is something the Health Ministry is working on, according to Dr Ismail, who adds that they will open up more of the 100 government hospitals for housemen training over the next five years. It can’t be done at one go, he says:

“To be accredited for houseman training, hospitals must comply with certain criteria. For instance, they must have adequate basic specialities services, enough specialists, adequate hospital beds and cases as well as the right ‘case mix’.”

To achieve this, the government should consider allocating funds to improve facilities at hospitals not yet accredited, and look into specialists’ remuneration packages to entice them to remain in government duty.

Once the hospitals have the right specialists and facilities, the “case mix” will naturally flow in. That would also ease the present concentration of patients at the selected specialist hospitals.

This would also serve to meet the ministry’s doctor-population target of 1:600, as patients could go to hospitals closer to home, knowing that they are capable of handling specialised cases.

Another option the ministry is likely to consider, says Dr Ismail, would be to put housemen on flexi-duty.

This would surely be welcomed by most incoming housemen, especially as one of their perennial complaints is the workload and long hours on hospital duty.

jennifer@nst.com.my

Ballad Session 2009 artiste - thanks alot!