New doctors or new hospitals: Did Liow get it wrong?
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| Liow - bad planning? |
Yesterday’s news report that Malaysia suffers from an excess of new doctors takes us by surprise. This in sharp contrast to previous announcements (Star, 15, 21 November 2010), by Health Minister Liow Tiong Lai that the government was hiring more doctors from abroad including from Egypt and Pakistan, to overcome the shortage of doctors.
So have the planners in the Ministry of Health got their numbers for the future intake of doctors wrong?
It appears that although most government hospitals received more medical housemen for clinical training, they were however, not receiving sufficient work experience.
Every year, the country would see about 4,000 Malaysian medical students graduating from a combination of local medical schools with lower fees, and doctors graduating from 350 universities worldwide.
Liow also said that there were 700 foreign doctors or medical officers on contract with government hospitals nationwide.
This must sound very confusing to the man in the street. Have we or have we not got a shortage of doctors?
If we are referring to a shortage of experienced doctors, why aren’t the foreign doctors not helping us train the new doctors? It seems we are in a vicious circle.
Senior Hospital Kuala Lumpur consultant physician Dr S. Jeyaindran said each specialist was supervising four times as many housemen compared to a decade ago.
“Five years ago, one houseman looked after 10 patients in hospital wards at any one time but now it is one to four patients. The concern is that these interns are seeing fewer patients and hence, have fewer opportunities to carry out adequate procedures. In some hospitals, there are more housemen than patients.”
Malaysian Medical Council ethics committee chairman Dr Abdul Hamid Abdul Kadir said several specialists were overburdened by the workload and training hospitals were experiencing difficulty coping.
Abdul Hamid said, “In the past, it was five housemen in each department but now it could be 20 to 30 for each department.”
Health Minister Liow said the ministry was aware of the issue and would be increasing the number of training hospitals.
So will the planners get it right this time and build more hospitals, or will we be told of another type of shortage in the months to come?
The proliferation of local medical schools was presumably to address the shortage of doctors in the country.
In addition, students were sent to medical schools in a variety of countries, even to the lesser known ones, in an effort to boost our numbers of doctors. Or perhaps these had entry qualifications that were not as stringent as the more famous and established medical schools of UK, Ireland, Australia and India.
But increased numbers is as worrying as the attitude of the doctors.
Dr Jeyaindran said, “Some lack responsibility towards their patients,” and gave examples of ‘….those who did not know how to give an accurate diagnosis and relied too much on investigative tools instead of clinical skills and getting the proper patient history’.
In addition, there are unsubstantiated reports that some underworked and unsupervised housemen in a Klang Valley hospital would watch movies during their shift. A medical officer who wished to remain anonymous said, “It was because they knew that the medical officers (senior doctors) would just do the work instead.”
She also said that some specialists and heads of department were reluctant to give more work to housemen.
Have we churned doctors out of medical school as fast as possible, simply to satisfy a government target? Have we compromised quality for quantity?
All that money and time spent on training doctors could have been used to build ‘proper’ hospitals ie those not implicated in corrupt acts.
So do we really have too many doctors? Many of us have witnessed clinics and hospitals, both government and private ones, in cities, towns and in the rural areas, like kampongs and longhouse settlements, with long queues of people desperate to see a doctor.
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