Where Have All the Doctors Gone?

In a  previous post (The Doctors’ Dilemma) we wrote about how the Ministry of Health’s (MOH) handling of the employment of young doctors might alienate those doctors from developing a commitment to their vocation. The focus of that piece was what appeared to be apparent discrimination of doctors from private medical schools in Malaysia. Recent reports of doctors resigning from the medical service suggest that the disaffection may not be limited only to young doctors but may have deeper extensions that could impinge on the government’s ability to meet its public health responsibilities in the future. There is already talk of a strike by doctors.

The flight of the doctors was disclosed by the top echelon of the ministry at a news conference that was reported in the news portal Malaysiakini (https://www.malaysiakini.com/news/584259.) on 23 July 2021. The Selangor Health Director revealed that since January this year, 163 medical officers had resigned from the service. But that was not all. As if to allay any concerns over the alarming figures of doctors exiting the service, the Health Ministry secretary-general, who was also present at the news conference, explained that the resignations reported were in line with those of previous years. According to him, nine hundred medical officers had resigned from the service from 2014 to 2020.

The alarming figures of doctors quitting the public service require a more carefully studied response than the flippant and cynical reasons offered by the Selangor Health Director. The reasons he advanced – of better pastures in photography and selling computers, inheriting family clinics and a loss of interest in medicine – makes it a problem of doctors exercising their choices without attributing any responsibility to the Ministry. Does the ministry conduct an exit interview of doctors leaving? Are there discernible patterns in the age and other profiles of those leaving? Has there been a study of the management of the service, especially the rotation schedule? Has the ministry acted to develop intervention strategies to curtail the trends? The problem most probably lies with the service and not those leaving. Statements that have gone viral in the social networks show deep and entrenched problems in the service which alludes to incompetence and racist decisions. Instead of making glib statements about inheriting family clinics, those paid to manage the system must start offering solutions to a problem that threatens the health service.

How doctors are treated by the medical service will have important ramifications on the supply of doctors to meet national needs. Students’ choice in selecting a career in medicine will be adversely affected if the news trickles down to them of the shabby way doctors are treated by the government. The employers of doctors must be mindful that ultimately it is the people who make the sacrifices to take up vocations such as medicine. These social processes cannot be nurtured through petty strategies that are currently employed. The ministry’s current placid attitude and reactions to the exit of doctors are probably encouraged by seeing the steady and growing number of doctors entering the service each year. If the current stewards of the medical service do not wake up to the duties entrusted to them, their legacy to their successors in the service will be despair.