Materia Medica Malaysiana

Rural doctors

THE Health Ministry is banking on the desire of many senior doctors to continue working past the mandatory retirement age to provide partial relief to the doctor shortage which has hit rural Malaysia the hardest.

Indeed, many are in their prime and are not broken-down old horses ready to be put out to pasture. The Health Minister says 34 retired doctors have already accepted re-employment in rural health centres and hopes to persuade even more to follow in their footsteps. However, unless country life rather than city living is their old-age idyll, and they have established roots in rustic communities, it remains a moot point whether the pastoral charms of rural medicine will prevail over the pragmatic enticements of urban private practice. In the Malaysian medical scene, when doctors decide to move, it has always been in the direction of the private sector and to towns and cities. There has been a steady and continuous exodus at the rate of one doctor per day for the past 10 years.

What this means is that while there has been no shortage of stop-gap measures — hiring retired doctors and foreign doctors, getting private practitioners to put in a number of hours in government clinics, etc — these will be insufficient to mitigate the losses, let alone replenish the stock. It is not because we are not training enough, although, of course, we need to increase the number of medical students. The fact is we don’t pay government doctors enough. The antidote to the haemorrhage lies in a pay-and-perks package potent enough to immunise them against the allure of the private sector and strong enough to attract and retain them in public service.