The Death Knell For GPs and The Emergence of Micro-Specialists — Dr John Teo

Drug price controls may kill GP practice after the Cabinet refused to raise GP fees.

April 24th 2019 marks an important day for the health care landscape in Malaysia for it’s the day the Cabinet of Malaysia turned down the request for General Practitioners’ (GP) fees harmonisation after 27 years of static GP fees.

Your friendly neighbourhood GPs, who had been providing daily health care for decades to generations of Malaysian families at very reasonable and accessible costs, had been surviving all these while with the low fees that are never adjusted over a quarter of century with cross profit from drug sales.

In so doing, many Malaysians are able to see them easily, quickly and at affordable costs. Despite these, many GPs are increasingly finding survival tough and many are struggling or on the verge of closing down.

The final nail on the coffin is of course with the stroke of a pen, the Cabinet had approved the drug price control to be implemented soon. This signals the start of the possible annihilation of GP practice in this country with no way to absorb the rising costs of operating clinics that they can barely contain in the last 27 years.

A cup of coffee in the kopitiam 27 years ago cost 50 sen and today it is 2 ringgit, representing a 400 per cent increase, yet GP consultation fees have a zero per cent increase! Maybe GPs don’t need to drink coffee perhaps.

It is my prediction that GP practice will slowly and surely disappear one by one, aided and coaxed to its natural death with the ever increasing and strangulating regulations that the government is hell bent on implementing.

That’s the only aspect that there is true political will power to act on.In place of family GPs will be the nutritionist GPs specialising in nutritions, the supplementionist GPs specialising in supplementations and product distributions, the beauty GPs specialising in beauty and fashion! Etc, Etc!

Less and less doctors will want to be family GPs, the bedrock of family health and primary care and many doctors will clamour for specialisations and super-subspecialisation as suggested by one CEO of a large private hospital recently.What does this all mean to the average Malaysian?

Well it means that if  you have a normal cough and cold or a bout of diarrhoea, you may have to go to the government health clinic and wait for hours and be seen for only a few minutes because the government health clinics are overburdened with hundreds of patients per day or wait in the casualty for the whole day to be seen or off course consult Mr Google and self medicate.

Alternatively you may want to go to private facilities with specialists and super-subspecialists and end up with multiple investigations and procedures because there are simply no GPs available to screen you and refer you to the appropriate specialists or not at all as it can be simply treated with simple medications.

I shudder to think of how health care will be in the very near future and the government of the day knowingly or unknowingly had dealt the final blow and the eventual total elimination of decades of GP practice in this country.

Dr. John Teo is a medical practitioner based in Sabah

  • This is the personal opinion of the writer or publication and does not necessarily represent the views of CodeBlue.

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