Government Doctors Claim Meetings Keep Them From Patients

KUALA LUMPUR, Oct 6 (Bernama) -- Last year, 374 doctors left the government service--an average of about one per day, according to statistics from the Malaysian Medical Association (MMA).
Many joined the private sector because they wanted better pay and better hours.
But some could be quitting because they are frustrated that administrative duties, meetings, examinations and seminars are keeping them from their "core business" of treating patients.
The MMA's deputy secretary Dr Kuljit Singh estimates that at least 20 to 40 percent of a government doctor's time is spent in departmental, hospital, state and Ministry of Health meetings as well as courses and seminars.
"I get taken away from clinical work and have to leave the afternoon clinic with juniors," the government doctor told Bernama.
If there is a delay in tackling this problem, he predicted, "Government doctors will move to greener pastures where they can get at least four times the salary and see patients from 8 to 5."
In the private sector they have no administrative work or courses and not as many meetings, he said.
Heads of departments have to attend more meetings, said MMA's Section Concerning House Officers, Medical Officers and Specialists (SCHOMOS) vice-chairman Dr Mastura Ismail.
"As a boss, you have to go to technical, management and scientific meetings," she explained.
As a family medicine specialist, she attends perinatal meetings once a month and whenever there is a maternal death, she has to attend a meeting held within one month of the death.
In addition, she attends district level management and finance meetings once or twice a month.
"But sometimes you can delegate some meetings to your subordinates and ask them to come back and report to you," she said.
Some doctors have also complained about the Penilaian Tahap Kecekapan (PTK) or the Efficiency Level Assessment under the new remuneration scheme (Sistem Saraan Malaysia) introduced in 2002--which includes in-house evaluation, courses and examinations.
For example, noted Dr Kuljit, doctors need to go for courses on government regulations and circulars--such as how to apply for leave. Instead of doctors spending time on such courses, he suggested, the Human Resources Department in their organisation could advise them.
If doctors don't take the course, they cannot be promoted, he said, questioning whether the assessment measured their efficiency as doctors.
"Looking at the number of patients seen, the number of teaching sessions and the number of presentations would be more logical," said Dr Kuljit.
But he welcomed the Ministry of Health's plans to integrate continuous professional development with PTK and suggested that points could be awarded for doctors taking related medical courses--perhaps once a year.
"We encourage doctors to go for continuous professional development," MMA's immediate past president Datuk Dr N. Arumugam said, quoting studies which indicated that within a five year period, 30 to 50 percent of medication and techniques would have changed.
Between 10 days to two weeks per year spent on relevant courses would be time well spent, he said.
To attend such courses, doctors need permission from their head of department, stressed Dr Mastura.
She said doctors have to select courses which are pertinent, important to their discipline and to which they also can contribute.
"The Ministry of Health encourages this as long as we know how to manage our time and be fair to our colleagues and take turns," she said.
"At the end of the day, patients come first," said Dr Mastura.