In my earlier 2 posts , http://pagalavan.com/2012/06/17/for-future-doctors-the-deppresing-side-of-being-a-doctor , http://pagalavan.com/2012/06/22/for-future-doctors-the-depressing-side-of-being-a-doctor-part-2/ I wrote about how difficult our life as a doctor has become; Ungrateful patients, patient who shout and scolds you, patients who demand certain things to be done with no proper indications and the ever-increasing litigation rate in this country and all over the world. The real art of medicine is slowly dying due to these issues.
The doctors on the other hand have started venturing into unethical practices and trying to earn as much money as possible. The competition is getting so tough that many doctors are finding other ways to make money. I know many private doctors who do so many unethical practices to make money. I had mentioned about this before in some of my earlier postings. One of my friends in private sector told me that doctors are the BEST businessmen. This is because patients trust that their doctors will do the best for them and thus they do not question what you do. So, patients get cheated all the time. Most ethical doctors don’t earn much in private sector in comparison and will be labeled as useless doctor by patients themselves. Imagine when you tell a patient that he does not need to remove his incidentally found asymptomatic gallstone but another doctor tells him that it must be removed and does the surgery? The doctor who does the surgery becomes the good doctor as far as the patient is concerned. In fact there are also patients who are unhappy when you tell them that they do not have any illness and do not need any treatment!!. These are the issues that an “ethical” doctor needs to face on a daily basis. BUT the unethical doctors are laughing to the bank by earning money cheating the uninformed patients! Sometimes I laugh at people who tell me that “so and so” relative of theirs are earning more then RM100K in a private hospital. Have they bothered to find out what unethical things that this doctor is doing? I know of cardiologists who do angiogram on anyone who walks into their clinic and puts a stent into everyone despite having only 10-20% stenosis!! I am not saying that all private doctors are doing this but it is becoming more and more common due to stiff competition and wanting to keep their income at a certain level! That’s how money can corrupt people!
Another new trend is beginning to appear recently. Many doctors, especially general practitioners(GPs) are cheating patients with the incorporation of traditional and complimentary medicine (TCM) into their practices. It is wrong ethically and legally from MMC’s point of view. I just saw a Rheumatoid Arthritis (RA) patient from a district in Johor who has been suffering from RA for atleast 7 years. For the last 2 years, she has been seeing a clinic near her house, which is run by 2 MBBS doctors ( the patient quoted this). However, these doctors are also practicing TCM. The patient’s blood is taken on every visit and even her saliva is taken to send to India for development of specific “drug” for her disease!! None of these results were ever informed to her despite requesting for it (which is obviously against the Private Healthcare Facility Act). I saw some of the treatment that was given to her and I noticed that except for 1 drug, the rest are traditional medicine. The drug that I can recognize is Prednisolone! The clinic also refused to tell her the names of the medications. AND you know how much they charge her for every visit? A whooping RM 500-1000/visit, so much so, she now owes the clinic more then RM 1000!! This is what I call daylight robbery! The patient’s disease has progressed tremendously to the extent that her joints are severely damaged now.
Then I saw another patient who has been suffering from Psoriasis for many years. He saw this doctor in his hometown who offered him Ozone therapy which the doctor claim can cure his psoriasis!! This patient was also given Prednisolone!! I know many doctors who are practicing Ozone and chelating therapy. Some of these doctors are claiming that they can cure your ischemic heart disease (confirmed stenosis by angiogram) with this form of treatments. Mind you that these treatments are expensive and not regulated by the government unlike doctor’s charges. The therapy can cause RM 1000-2000/session and the patient will need about 10-20 sessions depending on their disease. Infact, I had a GP who even promoted this directly to me. I just laughed at him! I asked for evidence and the only evidence he could give is that the patient’s symptoms have improved! NO repeat angiogram evidence! Everyone in medical field will know of placebo effect!
MMC has issued a warning last year about doctors practicing complementary medicine, especially ozone and chelation therapy http://thestar.com.my/news/story.asp?file=/2011/10/18/nation/20111018134806&sec=nation. Actions can be taken against these doctors including revoking their license to practice if they are found promoting TCM by claiming that it can cure the patient’s disease. The patient’s are vulnerable to whatever the doctor says, as patients trust doctors will always do their best for them. Unfortunately, I am sorry to say that doctors are becoming the best robbers and conman in this country with the poor enforcement of law.
The other money-making business that doctors are flooding into is aesthetic medicine. Even though aesthetic medicine is recognized as a branch of medicine and is allowed to be practiced by medical councils around the world, it has to be done properly. At the moment, there is no guideline in Malaysia on how an aesthetic physician is going to be recognized. MOH did issue a guideline in 2008 on the practice of aesthetic medicine http://mmc.gov.my/v1/docs/Aesthetic_Medicine.pdf but no concrete registration was implemented. Today’s Star reported that soon, all aesthetic medicine practitioners will be required to be registered and show proof of their training http://thestar.com.my/news/story.asp?file=/2012/7/15/nation/11667960&sec=nation . So, from now onwards you can’t claim yourself as an aesthetic medicine practitioner without proper training. I know it is a money making business as a glorified beautician but also remember the high litigation rate involved. The indemnity insurance rate is only second to O&G: http//www.medicalprotection.org/Default.aspx?DN=c3681b59-1313-41ab-9fd5-dd11fe97c622. The rates are lower for GPs who are only doing part time aesthetic but always remember that you can get sued anytime for any unsatisfactory work.
Whatever passion and interest you have in medicine will eventually disappear as the time passes by. I know many of my friends who said the same when they entered medical school but I know what they are doing now. At the end of the day, it is all about earning money as a profession and to feed your family. There are very few doctors who really have the passion after some time. With the oversupply and over flooding of doctors soon, the situation will only get worst. That is the reality.
BUT how much money is enough? Don’t let money buy over you…………. Money can’t buy you everything as what Dr Koh has admitted after the death of his son, yesterday http://thestar.com.my/news/story.asp?file=/2012/7/14/nation/11660162&sec=nation
Guidelines soon on aesthetic treatment, says Liow
KUALA LUMPUR: Guidelines on aesthetic medical practice are being drawn up to protect the public from botched jobs.The draft is expected to be completed this month, which would lead to the setting-up of the National Registry of Medical Practitioners Practising Aesthetic Medicine next month.
Health Minister Datuk Seri Liow Tiong Lai said a committee comprising government and private practitioners had been selected to oversee the maintenance of the registry.
He said the registry would have three different categories of medical practitioners providing aesthetic medical services – general practitioners (GPs), dermatologists and other specialists and surgical specialists and plastic surgeons.
“We welcome GPs to practise aesthetic medicine but they need to take courses and be regulated by the ministry,” he said after the 1st Malaysia-Singapore Conference of Aesthetic Medicine opening ceremony here.
The minister said GPs would have to take up a course requiring up to 56 hours of study before they could be validated by the committee to be included in the registry.
Malaysian Society of Aesthetic Medicine president Dr Louis Leh said the main aim was to promote safe aesthetic medicine and cut down on people turning to fly-by-night operators.
“Many don’t know where to go for such treatment and they end up with botched jobs,” he said, adding that beauty consultants were not supposed to handle tasks that required the use of needles or knives.
On whether beauty consultants could hire trained aesthetic doctors to do minor procedures at their centres, he said doctors were not allowed to do so because the Private Facilities and Services Act required them to practise in a proper medical set-up