LETTER | For generations, our one-stop general practitioner (GP) clinics have been the cornerstone of healthcare for all Malaysians.
GPs have performed a multitude of duties from treating everyday illnesses to supporting families through difficult times and serving on the frontline of major public health crises such as the Covid-19 pandemic.
Our nationwide community-based medication-assisted therapy programme by GPs for heroin addicts started in 2002.
By 2006, it had contributed to the national effort to successfully stop the rising epidemic of HIV deaths among IV drug users. And by 2016, this programme had taken more than 30,000 heroin addicts off the streets and reconnected them with their families and community.
Thus, the role of GPs in the health of all Malaysians should be duly appreciated and recognised.
In fact, Malaysia’s GP system is widely recognised as one of the most affordable, efficient, and patient-centred in the region.
However, this vital healthcare pillar now faces increasing pressure from unnecessary and disruptive regulatory proposals. These efforts, often driven by large corporate interests, risk compromising both the safety of patient care and the integrity of our medicine supply chain.
A recent reference to a 2022 survey cited by the Federation of Malaysian Consumers Associations (Fomca), which reported “medicine price mark-ups of up to 900 percent and price variations exceeding 400 percent for the same drugs at different private clinics” is mischievous.
The study warrants critical scrutiny. Blanket interpretations of such data, without context, can be misleading and serve only to create a toxic environment and to generate mistrust of the very system that delivers reliable, affordable care to successive generations of Malaysians, including many of our present leaders and cabinet members.
Doctors do not condone any unethical practices by unprofessional colleagues, but when we want to throw away the dirty bathwater, we should be careful not to throw away the bathtub and the baby as well.
It must also be emphasised that GPs already operate under robust regulatory oversight. The Good Dispensing Practice Guidelines of the Malaysian Medical Council govern the ethical and evidence-based choice and dispensing of medicines within clinics. Patients’ rights and choice are also clearly stated.
Among others, these guidelines state that, “in all registered medical clinics with dispensing facilities, it is recommended that a notice be displayed in a prominent area of the registration counter to inform patients that the clinic has a pharmaceutical service and that patients have the choice to have their medication/drugs dispensed at the clinic or at any pharmacy. Patients who do not wish to have their medication/drugs dispensed in the clinic should request to indicate so at their time of registration, and will be provided with a written or printed prescription.”
This is a testament to the medical profession’s self-regulation and ongoing commitment to transparency, patients’ rights, choice, patient safety and ethical care.
It is important to reaffirm that GP clinics are not retail outlets. Treating the sick is not a commercial transaction.
Doctors and their practice of medicine are a strictly licensed profession, governed by a social contract of trust, statutorily mandated ethical responsibility, duty and continuity of care between the doctor and the patient. It is not a trade.
If the Domestic Trade and Cost of Living Ministry intends to bring doctors’ professional services under the scope of the Price Control and Anti-Profiteering Act 2011, then proper procedure must be followed.
This includes the gazettement of the medical profession as a trade - a move which would have far-reaching future implications, including the formation of trade unions and trade protective practices.
Thereafter, the one-to-one personalised patient-doctor encounter of today will be a thing of the past. Union rules and business-oriented standard operating procedures will prevail, much to the detriment of today’s tailored patient-centred clinical care.
The public and the ministry can rest assured that our doctors remain steadfast in their commitment to treat the sick and to do so in the most cost-effective, caring, and responsible way.
Additional layers of regulation will only drive up healthcare costs and run counter to national efforts aimed at controlling the cost of living.
This letter is signed by:
Dr Steven KW Chow, founding chairperson of DRSFORALL/FPMPAM
Robert Phang Miow Sin JP, founder and chairperson of Social Care Foundation, exco of Malaysian Crime Prevention Foundation
Professor Dr Sharifa Ezat Wan Puteh, chairperson of MSHR
Professor Dr Mohamad Hussain Habil, fellow of Malaysian Psychiatry Association
Dr Khafidz Ishak, president of Persatuan Insaf Murni Malaysia
Associate professor Tan Wooi Chiang, president of Dermatological Society of Malaysia
Addiction Medicine Association of Malaysia
Association of Specialists in Private Medical Practice
Medical Practitioners’ Coalition Association Malaysia
Penang Medical Practitioners’ Society
Perak Medical Practitioners’ Society
Private Medical Practitioners’ Society Kedah/Perlis
Private Medical Practitioners’ Society Selangor/Kuala Lumpur
Pahang Private Medical Practitioners’ Society
Association of Private Practitioners Sabah
The views expressed here are those of the author/contributor and do not necessarily represent the views of Malaysiakini.
