Over the last 2 weeks, I have been receiving numerous emails and blog queries about which university he/she should choose to do medicine. It is rather surprising to see that each student seem to be have received at least 3 university/college offers to do medicine ! This is what happens when you have close to 36 medical schools with almost 45 medical programs. It is surely an Air Asia theme like scenario “Now, everyone can become a doctor…….” This does not include those who go to various other countries to do medicine. Shockingly, after writing so much about medicine in this blog, I still get questions that I find rather irritating at times. There are many students out there ( some are already 4th/5th year medical student) who still do not understand about degree recognition issue and post-graduate educations. They still think they can go to another country and easily get a job! They still think that postgraduate education is as simple as reading books and sitting for exams. Gosh, what do our schools teach the current generation of students ! They really fulfil the criteria of “katak bawah tempurung” .
As I have been saying many times over the last 3 years, just imagine the glut of doctors that we are going to face in 3-4 years time. When the market is saturated, the income of all doctors will decline. Even now, I see new clinics being open just few doors away from another clinic. That is how competitive it has become. In fact, I was just informed that some insurance companies have started to reduce their consultation fees for doctors by at least half ! If you don’t agree, they will go to another doctor who will ! The newer GPs will obviously agree, to get some income, rather than nothing. To add salt to the wound, our Health Ministry is planning to open another 40-50 1Malaysia clinics throughout the country as mentioned here and below. The 1Care system is still being kept under the carpet till further announcement.
In January 2012, I wrote an article on how doctors in US are going broke. Well, the situation has not changed much. The latest news from US says that many private practices are being closed/sold due to poor income (insurance companies have started to slash the payment), increasing litigation rate and high maintenance cost. Thus, many of the specialist are running back to hospital based practices with a fixed income. The situation is the same in many other countries as well. Even in Malaysia, some of the private hospitals have started to employ doctors compared to “self-employed version” which use to be the norm for a long time. This clearly shows that we are now at the mercy of the private hospitals and they can now demand what they want. A fixed income means that your income will be generally lower with higher tax, since you can’t play around with your tax. Furthermore, your income will not be much of a difference from what a government consultant earns.
The declining income has increased the amount of unethical practices. Whatever said , a private practice is a business to earn income for a living. Once you are used to a specific amount of income, you will try to achieve it no mater what. Thus, unethical practices will surface. That’s why I alway tell people that,never let money to buy over you. Keep your commitment low and earn a decent living. Medical business is a “one man” show. If anything happens to you, your income is ZERO!
Doctors bail out on their practices
By Parija Kavilanz @CNNMoney July 16, 2013: 9:18 AM E
Dr. Patrick Cobb sold his private oncology practice in December 2012. “It just wasn’t feasible for us to stay in practice,” he said.Doctors who own private practices are looking for a way out. Fed up with their rising business expenses and shrinking payouts from insurers, many are selling their practices to hospitals.
It’s happening nationwide and has picked up pace, said Tony Stajduhar, president at Jackson & Coker, a physician recruitment firm.
Experts say the number of physicians unloading their practices to hospitals is up 30% to 40% in the last five years. Doctors who sell typically become employees of the hospital, as do the people who work for them.
The reasons for the trend vary. Doctors are tired of the hassle of filing insurance claims and collecting payments from patients and want to only focus on medicine again, Stajduhar said.
Obamacare has also created more fear of the unknown. Doctors are worried that new regulations will add to their administrative work and require them to pour more money into their businesses, Stajduhar said.
Related Story: One doctor gave up on health care in America
Dr. Patrick Cobb, an oncologist in Montana, sold his 30-year group practice Frontier Cancer Center to a hospital in December. His practice was struggling for years even before health reform passed.
Changes in chemotherapy drug reimbursements badly hurt the business, he said. In cancer treatment, patients don’t buy the drugs themselves. Oncologists buy the drugs and then bill insurers for the cost. Medicare significantly reduced reimbursements in 2003 for chemotherapy drugs.
That was a turning point, said Cobb. “We spent millions on drugs that we bought directly from distributors. When reimbursements fell, our costs went up,” he said. Cobb and four other oncologists at the practice took pay cuts to offset declining revenues, but it wasn’t enough. In 2008, the practice closed one of its four locations.
Cobb and his partners looked for a buyer in 2012 and found one in Billings, Mont.-based St. Vincent Healthcare. The hospital system hired Cobb and the rest of the practice’s staff. “It just wasn’t feasible for us to stay in practice,” said Cobb.
Related Story: Doctors driven to bankruptcy
The cycle of hospitals buying private practices has happened before. In the early 1990s, hospitals went on a buying spree as a way to get access to more patients, said Thomas Anthony, an attorney with Frost Brown Todd in Cincinnati. At the time, it was a sellers’ market and the deals were financially rewarding for doctors.
This time, the market dynamics are different. Doctors are eager to sell and might not be able to make as much as they did in the first wave of acquisitions, said Anthony.
But, for sure, hospitals are buying.
As more of Obamacare is put in place, hospitals are rushing to increase their market share in anticipation of millions more Americans getting access to health care. Buying practices is a quick way to do that, Anthony said. And more private practice doctors want to enjoy steady salaries and hours again as hospital employees.
Dr. Dwayne Smith, a bariatric surgeon, sold his group practice to a hospital two years ago. His practice was profitable but costs were creeping higher in recent years because of shrinking reimbursements.
Related Story: Why doctors can’t stay afloat
One big cost coming down the pike was tied to electronic medical records. Federal law gives physicians until 2015 to implement digital records technology or face a 1% reduction in Medicare payments.
“This would have been a very difficult investment for us,” said Smith.
Smith’s practice approached Cincinnati-based St. Elizabeth Healthcare in 2011 with an offer to sell. The hospital bought the practice and Smith became a hospital employee. He’s happy with the decision even though he has had to adjust to the loss of autonomy.
“My hours are better. I’m not spending hours on administrative work or worrying about my business,” said Smith.
The private practice model is very expensive to operate, said John Dubis, CEO of St. Elizabeth Healthcare. “That’s why it’s diminishing,” he said. Most of the 300 physicians employed by the hospital’s specialty physicians group have come from private practices.
Said Cobb, the oncologist: “We have a joke that there are two kinds of private practices left in America. Those that sold to hospitals and those that are about to be sold.” 
40 To 50 More 1Malaysia Clinics To Be Set Up From Next Year
“Despite grumblings from the operators of private clinics when K1M was set up, K1M still receive encouraging response from the people because of the low charge imposed.
“It is a successful 1Malaysia product and can benefit the people by ensuring a good level of healthcare,” he told reporters after attending a gathering, here, Thursday night.
There are now more than 200 K1M nationwide serving about 1.5 million people with the minimum charge of RM1 for citizens and RM15 for non-citizens.
K1M is one of the initiatives under the 1Malaysia concept mooted by Prime Minister Datuk Seri Najib Tun Razak.
— BERNAMA
Pagalavan's Avatar 
hello dr,do you mind sharing your knowledge about “Ijazah Sarjana Muda Kejuruteraan Teknologi(Farmaseutikal) at UMP? This is a new course in UMP and I will be the very first batch of student if I take up this course. I am in dilemma whether to take up the offer or not. What I worry is its future job and does it have any master programme if I wan to proceed my study after degree? Will you suggest me to go for this course? Hope dr can share your precious opinion with me.
THis degree is for people who are going to be involved in drug manufacturing. Will your degree be recognised in Singapore ? I am not sure about job prospect but Singapore do have some drug manufacturing industries. Malaysia do have some generic companies manufacturing drugs over here.
hmm,this course is actually technology engineering. After this degree, we will not be an engineer or a pharmacist but come out to be a technologist. FYI, UMP has signed a memorandum of agreement (MOA) with the Republic of Ireland’s Institute of Technology Tallaght (ITT), and another memorandum of understanding (MOU) with The Malaysian Organization of Pharmaceutical industries (MOPI), to jointly offer a dual degree programme in Pharmaceutikal Technology Engineering. Do you think this is a good course to be taken up? Any risk (as this is a new new course in Malaysia and they only take 30 students for the first year) ?
Being in the pioneer batch do have some advantage but you need to talk to the university management whether they have any arrangement for job with any companies
Hai..i got the same degree as you are..so nak tnya mudah tak nak dapatkan kerja??
https://polldaddy.com/js/rating/rating.js
Hye..i believe u already pursue your study in farmaseutikal .i hope.do you mind share ur knowledge about the difference between pharmacy and farmaseutikal?
they say their uni will arrange the internship for us after graduating. So is this course safe to take up?
difficult for me to say for sure but sometimes new courses are the field that is in demand in the future.
hmm…actuali I have another offer of M.D from UCSI and I have already passed the inteview . WHich course will you recommended me to take up?
do what you are interested in. Even doctors may become jobless in another 2-3 years!