3.1 General Practitioner Clinics
Importantly nationwide, private clinics cater to most of
the fee-for-service self-paying public, which include:
private sector employees through panel doctor
contract/insurance arrangement; thus relieving the already
overloaded Ministry of Health’s public clinics. In general,
the choice for such private clinic consultations and
treatment is due to easier access, simpler registration and
appointment, and shorter waiting times. There is also
possibly greater continuity of care with better personal
attention from one’s own family physician or general
practitioner—i.e. superior personal touches and closer
encounters are the added values in private clinic visits,
despite greater fees for consultation and medicines, which
are frequently bundled together.
Some crossover of services however exists. Depending
on patients’ demands or choices, these generally
complement each other for the greater benefit of the
patients concerned. Dissatisfaction or uncertainty with
services from either sector has on many occasions led to
patients seeking second opinions and/or therapies from the
opposite sector, and vice-versa. Although there have been
counter-accusations of poor and/or unprofessional care, or
mismanagement issues, each sector does cater to the
differing demands and expectations of the public. In
economic terms there is some duplication of services, and
possibly over-utilisation and wastage of resources, but
patient choice is preserved as a right.
Thus, urban GP clinics provide easy care for common
ailments and simple trauma/injury management, at very
reasonable costs, especially for areas outside the main
capital city—Kuala Lumpur-Klang Valley, and
complement the public sector in helping alleviate the
patient crush on their severely overloaded outpatient
clinics.
However, of late, with the mushrooming of many GP
clinics in close proximity to one another, competition for
patients has become keener, and many clinics are simply
eking out a living, struggling to keep afloat. Some have
resorted to creative complementary alternative medicine or
aesthetic/beauty health care shifts to supplement or even
revamp their practices. Still the MMA continues to receive
complaints of there being too little work and income for a
sizable number of clinics in larger urban centres.
This underutilisation of many urban clinics is wasteful,
and could perhaps be one mechanism to help out the
overcrowded public sector outpatient clinics.
Redistributing public sector patients who sometimes
have to wait several hours, to a panel of urban or suburban
private clinics nearer their home, can be a real option for
better patient care and attention. A payment mechanism can
be worked out to address this purchasing of services, which
will generate a win-win scenario for all concerned.
However, logistics and bureaucratic red tape and
registration exercises have made this approach of sharing of
services impossible to carry out at the present moment.
3.2 Private Medical Centres & Hospitals
For more serious illness and injuries, hospital care
through well-equipped emergency departments (EDs) is
now the expected practice. These medical emergencies are
previously offered only at larger public sector general or
district hospitals. These days however, most private
medical centres boast of state-of-the-art emergency care at
more luxurious settings and costs. Personal and more
attentive specialist care are now demanded and offered at
many of these private EDs, where many orthopaedic
surgeons and neurosurgeons now practice privately.
However, private medical centres are not simply for
emergency and/or trauma care. Most are now developed as
competitive consumer-driven full-fledged healthcare
facilities to cater for the more discerning public who would
pay more to obtain perhaps better (perceptibly), more
personalised, faster (less or no waiting time) and possibly
more comfortable and/or luxurious medical care.
Health insurance or maintenance organisations have
also bought into this system to offer more premium benefits
to their clients, particularly those of the corporate world,
where risk-averse and delay-averse market-driven results
are expected. Executives and staff are offered contracted
quicker and direct access to possibly more expert
specialised care, with faster turnaround times and earlier
return to work expectations.
Of late, the entry of different national and transnational
capital flow into the private healthcare system has further
developed the service capacities of this sector. Healthcare
industry players such as the state-owned KPJ group (Johor
State Development Board), Parkway Holdings (Singaporebased,
American-invested), and latterly Khazanah National
Berhad (a Ministry of Finance Malaysian GLC) have
greatly influenced the direction and expansion of these
private services, while at the same time inflating the cost of
private health care services by offering more sophisticated
amenities and newer technology-driven expert care.
Together with the Association of Private Hospitals