Doctors in Malaysia Unemployed?

Globally, WHO estimates a shortage of 4.3 million physicians, nurses and allied healthcare workers. Many developed countries report doctor shortages- U.S, Canada. United Kingdom, Australia, New Zealand and Germany. Developing nations often have shortages due to limited numbers and available supply capacity. But not Malaysia, we are in “surplus”.

The WHO has a ratio of 1 doctor to every 1,000 people, to meet basic needs of a developed country. For Malaysia, it was 1 doctor for every 625 citizens in 2018. The government’s target is one doctor to 400 citizens. How was this target arrived at? And whose agenda is this?

Dr Khor Swee Kheng in an article (Star Online, Nov 6 2019) reported that between 2011-2016, the annual number of new doctors graduating rose rapidly from 3,710 to 6,238. That’s close to double! And it was 10.3% (CAGR) for the period. We are graduating 1.7 times more doctors per capita than even the OECD.

If these numbers continue uncontrolled we may hit the target of 1:400 by 2021 or sooner. We have the quantity but what about quality, distribution, utilization, career or life expectations of those who are now doctors? Sure it increases social mobility and reduces inequality. But that presumes they have a contract with the Government. And contract staff earn less than a permanent one. And what the above exercise basically shows is that we are obsessed with a ratio.

The pursuit of which was probably to attain a developed nation status. But there are also other ratios that we need to consider. The inequality (Gini coefficient) and poverty ratios. In fact, if we had reduced poverty significantly then medical services will be less taxed, less budgeted and less bloated.

In the longer-term, we need a roadmap or masterplan for medical services to place it on par with more developed nations. That means quality and not quantity. Excellence not mediocrity. Diversity not homogeneity. And that may require massive political will and discipline. Are we ready for it?

In the meantime, it is best for “new” doctors to secure their experience in developed nations or private hospitals in Malaysia. Second we need to close some of the supply taps – de-recognise selected overseas medical schools and shut (or amalgate) 50% of local medical schools. This is done over a period of 5 years. That’s the view of Dr Amar Singh, HSS in an article (FMT) on November 9, 2019. Third, we may need mini or district hospitals in rural districts, including Sarawak and Sabah. Then existing supply is better utilised.

In the future, we need to focus on quality and disciplines that may be required soon for example, Geriatrics.

Reference:

1.     Dr Amar-Singh HSS, Don’t treat our young doctors so unfairly, 9 November 2019;

2.     Dr Khor Swee Kheng, Star Online, How many doctors does Malaysia really need? 6 November 2019;

3.     Wikipedia, Physician supply.