Health Minister Datuk Seri Liow Tiong Lai said the government is studying the possibility of shortening the doctors’ compulsory service in public hospitals. He said the ministry was hoping to come up with the decision by this year.
“The ministry is looking at four years of service (two years of housemanship and two years of compulsory service) compared to five years (three years of housemanship and two years of compulsory service) now,” he told reporters after launching B-Nes Sdn Bhd, a company specialising in birdnest products, near here, today.
He was commenting on a statement made by Deputy Minister in the Prime Minister’s Department Senator Datuk T. Murugiah on Jan 27 that the government was looking at increasing doctors’ compulsory service in public hospitals to between five and 10 years to overcome the shortage of doctors.
He said the idea to extend the compulsory public service for doctors to five or 10 years from the current three in order to overcome the annual shortage of doctors in government hospitals, was not practical.
“We are looking at cutting it (the compulsory service) and making it more attractive for doctors to practice voluntarily in the sector. Forcing them to do so is not good,” he said.

What’s behind the politico-speak I wonder? Perhaps the crux of the problem is the massive number of medical graduates which will be coming out over the next few years, meaning there won’t be enough government jobs for doctors and thus the government won’t “force” you to stay on. At this rate, I think the Government in 5-10 years time will be hiring doctors on a competitive annual contract basis and no more “permanent” civil service jobs!

Spotted in the blogosphere:
Another U-turn
My Health Matters (Dr. David Quek’s blog)

from the Malaysian Medical Resources

Doctors’ compulsory service may be reduced?

from the Malaysian Medical Resources

Condolences

Related MMR posts on Organ Donation

from the Malaysian Medical Resources

Unrecorded leave for organ donors

* Stop tobacco use and avoid exposure to second-hand smoke
* Limit alcohol consumption
* Avoid excessive sun exposure
* Maintain a healthy weight, through eating healthily and exercising regularly
* Protect against cancer-causing infections

Other than prevention, many cancers are curable if detected early, and some (e.g. colorectal, cervical, and breast cancer) are detectable at an early stage if appropriate screening is done.
See MMR posts on Cancer screening

from the Malaysian Medical Resources

Cancer can be prevented

One of the worst ones I recall is a chap who I suspect learnt only one thing from his surgical posting. IV drip regime = 6 hourly pints of fluids. So in his next rotation in paediatrics, for a four month old baby, he also ordered 6 hourly pints. Luckily this was stopped in time by the MOs. Needless to say, one wonders how these people got through medical school!

from the Malaysian Medical Resources

Beware of HOs

SHAH ALAM, Feb 2 — Selangor health officials are bracing to contain an anticipated sharp increase in dengue cases following 11 deaths, eight of which happened in the state last month.
“According to the World Health Organization (WHO) the number of dengue cases spike in two year cycles and the situation this year may get out of control if not contained.” state health executive councillor Dr Xavier Jayakumar told The Malaysian Insider.
Dr Xavier, who disclosed that 1,895 cases of dengue were reported in Selangor for January, chaired an emergency meeting with state and local government health officials where he described the situation as alarming.
It is understood that changing weather patterns were among factors which cause the cyclical spike in dengue cases but Dr Xavier said authorities had a window of about a month to contain it before it peaks in March and April.
“The spike started in the last week of December and is steadily increasing.”

Related MMR posts on Dengue

from the Malaysian Medical Resources

WHO warns cyclical spike in dengue cases, 11 now dead in Malaysia

Some herbal remedies may increase the potency of prescription drugs for heart disease or make them less effective, a team of experts concluded.
Mixing herbs and drugs also could cause serious heart rhythm problems and bleeding, according to the review published in the Journal of the American College of Cardiology.
Use of herbal supplements among elderly patients is especially concerning because they typically have more than one disease, take multiple medications and already are at greater risk of bleeding, the report said.
Previous studies have sounded alarms about use of herbal supplements which are not regulated like traditional medicines. This review examined how supplements and cardiovascular drugs may interact.
“We can see the effect of some of these herb-drug interactions — some of which can be life-threatening — on tests for blood clotting, liver enzymes and, with some medications, on electrocardiogram,” Dr. Arshad Jahangir of the Mayo Clinic in Arizona said in a telephone interview.
Many patients fail to disclose their use of herbal remedies so healthcare providers should be more probing, Jahangir said in a telephone interview.

This applies especially to herbal drugs like Ginkgo which also “thin the blood” so be warned.

from the Malaysian Medical Resources

Caution regarding mixing herbal remedies if you are on heart medication

This reminds me of a little joke I recall from my medical student days. While the origin of the name AO Foundation stems from the German , Arbeitsgemeinschaft für Osteosynthesefragen (German for Association for the Study of Internal Fixation) the operative recommendations for fracture treatment also leads one to assume AO stands for “Always Operate”!

from the Malaysian Medical Resources

Free AO Surgery Reference available

via The Efficient MD

from the Malaysian Medical Resources

Practicing Medicine in the Web 2.0 era

I am a medical doctor who was educated overseas and worked in Australia for several years and recently decided to return to Malaysia to serve the country.

As a professional working overseas I heard about the ‘Program bagi mengalakkan warganegara Malaysia yang berpakaran yang bekerja di luar negara pulang ke Malaysia’ and therefore applied for it. I was very disappointed when they rejected my application on the grounds that it was sent after I returned to Malaysia. Apparently it was meant to be sent whilst I was still in Australia.

I find this a very poor excuse given the fact that Malaysia is trying to lure back its citizens to work for them. It discourages professionals such as me from having to bear the burden to return but not have any perks or encouraging incentives. Furthermore, my parents bore my exorbitant medical tuition fees and I did not receive any governmental loans whatsoever. The “least” is something anyone would
expect.

Besides that, it took me a great deal of an effort to locate the above mentioned application form which was hidden in the catacombic archives of one of the governmental websites.
Talk about purposeful inconvenience or perhaps voluntary neglect.

I can see why many of my colleagues are hesitant to return and serve the government given the unimpressive, unattractive attitude and to top it off the obvious suboptimal remuneration and working conditions. Now, thankfully I still have the option to return to Australia and am reconsidering my intentions to continue here thanks to the above. Job well done in luring professionals back.

I agree with Disappointed Doctor. It sounds typical of bureaucrats who can’t seem to exhibit an iota of flexibility. So the applications must come from overseas and not from those who returned from overseas to Malaysia first? Absolutely ridiculous you might say but in Bolehland I am not surprised.

Related MMR posts:
Malaysian Doctors abroad not coming back? Who’s to blame?
Training abroad: are you coming home?
Turning away the brains

from the Malaysian Medical Resources

Feedback: Disappointed Doctor

People with epilepsy should be warned that using a popular herbal remedy may increase the risk of seizures, researchers say.
German scientists, writing in the Journal of Natural Products, said they had found 10 written reports of seizures linked to ginkgo biloba.
They said they were convinced the herb could have a “detrimental effect”.
A leading UK epilepsy charity said the evidence was not yet compelling, although it said care was needed.

Related MMR posts on Ginkgo:
In a GEM of a study, another alternative treatment bites the dust
Another unclear study on Ginkgo
Gingko may not aid memory in healthy older adults
Ginkgo and Bruising

from the Malaysian Medical Resources

Ginkgo biloba’s epilepsy seizures warning

One of the country’s most commonly prescribed anti-obesity drugs has been banned across Europe after it was blamed for increasing patients’ chances of suffering a heart attack or a stroke.
The European Medicines Agency (EMA) ordered doctors across the continent to stop prescribing sibutramine and told pharmacists not to dispense the drug, which is marketed in the UK as Reductil.
The watchdog’s Committee for Medicinal Products for Human Use (CHMP) acted after a study of 9,800 patients said the risks of sibutramine outweighed its minimal benefits.

Contrast this with the situation in Malaysia where the NST reports the drug is Easily available

REDUCTIL is a drug that can only be bought with a doctor’s prescription.
Nobody seems to have told pharmacists about this though. Checks by the New Straits Times yesterday revealed that the medicine, in its 10mg and 15mg form, could very easily be obtained over the counter.
The outlets that sold them included large chain stores as well as neighbourhood pharmacies. No questions were asked and no prescriptions were required when the product was sold.
The 10mg boxes went for RM130 and RM150 respectively at two pharmacies in Lucky Garden, Bangsar. A 15mg box, on the other hand, cost a princely RM225 at a pharmacy in Suria KLCC.
When asked about potential health risks, though, the pharmacists listed out dry mouth, constipation, insomnia and heart palpitations as possible side effects.
Health Ministry pharmaceutical services senior director Eisah Abdul Rahman was shocked when informed.
“This shouldn’t be happening. It’s a prescription medicine,” she said, adding that she would alert the ministry’s enforcement division.

I wonder how come Puan Eisah should be “shocked”. Is she not aware that abuse of presciption-only items by pharmacies in Malaysia is not an unknown phenomenon? For example, I had a patient declare to me she could buy Tamiflu on her own (without prescription) and stockpile for her and her family’s use “just in case” at the height of the H1N1 scare last year. I am sure many of you would be aware of similar flouting of the law, and one really wonders how widespread this is.
In Bolehland lack of enforcement is the order of the day, rather than strict enforcement.

from the Malaysian Medical Resources

Reductil banned in Europe, but widely available “OTC” in Malaysia