Health White Paper: Specialists’ Role In Strengthening Primary Care – AMM

“There is a need to look at the positions offered by the MOH, besides the funding and pathways involved in training doctors to be specialists in their respective fields.” – Academy of Medicine of Malaysia.

The Academy of Medicine Malaysia welcomes the recent release of the Health White Paper (HWP), which provides a comprehensive overview with special focus on some of the key pillars of the country’s health system reform.

These include reducing inequity by increasing partnerships between public and private health care, the funding mechanisms and governance of the health care system, and the transformation of primary health care, all of which are crucial in reducing the overall cost
of care and the creation of a more sustainable health care system in the future.

The Academy of Medicine of Malaysia (AMM) will continue to advocate for the transformation of health care delivery by enabling the collaboration of primary care providers with specialists in order to provide and enhance promotive and preventive care.

The current ratio of population-to-specialist ratio in Malaysia is 10,000-to-3.88, which is alarming in comparison to the average population-to-specialist ratio in Organization for Economic Co-operation and Development (OECD) countries, which is 10,000-to-14.33 in 2020.

The training of health care personnel must be enhanced to address the lack of specialists as the country rapidly becomes an ageing nation, which will see an increase in non-communicable diseases (NCDs) and put further pressure on a health care system that is already strained.

The Ministry of Health (MOH) has enhanced the healthcare system by offering comprehensive services through facilities that include specialist and non-specialist hospitals.

However, inadequate medical and health care personnel posts, especially specialists in several disciplines, has negatively impacted the Malaysian public, as seen in the long waiting times in public hospitals.

There is a need to look at the positions offered by the MOH, in addition to the funding and pathways involved in training specialists in their respective fields.

The recent contract doctor issue is a major symptom of unresolved issues within our health care system, and this has pushed doctors to move out from the public sector.

The strengthening of the primary care system and better preventative medicine measures may reduce the burden on hospitals and specialists.

Existing technology may help in workforce training and be a force multiplier, further reducing variations in health care while also providing access to underserved and rural populations.

An example of such a programme is the University of New Mexico’s ECHO (Extension for Community Healthcare Outcome) model run by the University of Malaya in collaboration with AMM, which aims to exponentially increase the workforce capacity of community health care providers in order to provide best-practice care.

ECHO is a tele-mentoring platform which ensures the right knowledge exists at the right place at the right time. Such technology greatly facilitates health care specialists to conduct virtual training programmes and harnesses the power of knowledge by strengthening primary care through training and education.

The upskilled workforce will subsequently enable more equitable access to quality care, enables the transition of care outside of hospitals, and helps to reduce costs in the long term.

It is high time to address problems arising from inadequate specialist care in the country. We believe that a much more holistic approach, as proposed by the HWP, will address the challenges that exist within the health ecosystem, especially in primary care.

We call upon the specialist fraternity to support the pillars of reform espoused by the HWP, and to engage in the strengthening of primary care in their various capacities as providers, leaders of clinical practice, hospital administrators, and administrators both in public and private health care, in order to build a better health care system for the rakyat.

  • Academy of Medicine of Malaysia (Prof Dr Rosmawati Mohamed, master)
  • College of Anaesthesiologists (Prof Dr Marzida Mansor, president)
  • College of Dental Specialists (Prof Dr Lian Chin Boon, president)
  • College of Emergency Physicians (Assoc Prof Dr Shaik Farid Abdull Wahab, president)
  • College of Otorhinolaryngologists (Head and Neck Surgeons) (Dr Zahiruddin Zakaria, president)
  • College of Obstetricians and Gynaecologists (Prof Dr Siti Zawiah Omar, president)
  • College of Ophthalmologists (Dr Hajjah Nor Fariza Ngah, president)
  • College of Paediatrics (Prof Dr Thong Meow Keong, president)
  • College of Pathologists (Prof Dr Cheong Soon Keng, president)
  • College of Physicians (Prof Dr Paras Doshi, president)
  • College of Public Health Medicine (Dr Anita Suleiman, president)
  • College of Radiology (Prof Dr Norlisah Ramli, president)
  • College of Surgeons (Dr Siow Sze Li, president)

The Academy of Medicine of Malaysia, embracing 12 colleges and 23 chapters, is a registered professional, non-profit organisation representing medical specialists in Malaysia, and has gained recognitions as an organisation representing all medical specialists in the country. The AMM has been actively collaborating with the MOH and the Malaysian Medical Council in matters pertaining to medical specialist training and continuous professional development.

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

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