今日最新！太可怕！經濟不景氣，金飯碗也崩塌！過去三年全國總共有超過 500 家私人診所關門倒閉！連醫生都找不到吃！
這樣殘酷的事實，教那些擠破頭也要進入醫學系的大學生情何以堪？誰還敢說當醫生即使不發達也肯定衣食無憂？
這項驚人訊息，來自馬來西亞醫藥協會的調查報告；該協會擔心隨著大馬經濟情況越來越惡劣，倒閉的私人診所將會更多，後果將會更嚴重。
大馬醫藥協會主席拉文德蘭醫生表示，他們向全國1800間私人診所進行了調查，發現他們面對的問題非常嚴峻；最主要是在於醫藥費用年年大幅度提升，護士及診所助理薪金不斷提高；更重要的問題是上門問診的病患越來越少；許多診所平均每天上門的病患不足30人，根本入不敷出。
他說，根據調查顯示，馬來西亞的醫科畢業生如今已是供過於求，人才過剩。每年從大學醫學系畢業出來的見習醫生高達5000人；領取政府獎學金的都會在政府醫院實習4年。4年合約期滿之後，政府只能吸收最多一半，也即是2500名醫生，其餘的必須自尋生路；當中很多人都選擇貸款開設私人診所謀生。
但是，診所開得多，病人數目卻沒有增加，於是除了少數醫術精湛、公關手腕靈活、口碑很好的醫務所得以生存壯大之外，其他的都因為顧客不足、收入無法應付開支而不得不倒閉。
當然，一些友族的醫生看診不認真，醫術平庸，還有更多馬來醫科畢業生連簡單的英文英語都不會，導致很多病患喪失信心不再登門問診，也是主要原因之一。
大馬醫藥協會因此建議政府雙管齊下，首先限制大學招收過多醫科學生；同時建議國內所有附設醫學系的大專院校都必須擁有本身的專科醫院，自行吸納本院畢業的見習醫生及藥劑師；如此方能有效解決醫生過剩的問題，為國人提供更多治病管道選擇。
Clinics closed due to poor business
PETALING JAYA: As many as 500 clinics run by general practitioners (GPs) were estimated to have closed between 2014 and 2016 due to poor business.
And the Malaysian Medical Association (MMA) is worried that the situation may worsen.
Its president Dr Ravindran R. Naidu said a study involving 1,800 GPs revealed widespread concern over the financial sustainability of their clinics.
The findings from Study on the Health Economics of General Practitioners in Malaysia: Trends, Challenges and Moving Forward in 2016 revealed that the expenses for managing GP services had increased over the years due to changes in policies as well as the involvement of the unregulated third party administrators (TPAs), said Dr Ravindran.
The findings showed almost 70% of clinics saw fewer than 30 patients a day, while the operating cost of a clinic in an urban area ranges from RM50,000 to RM60,000 a month.
「With the drop in number of patients and increasing cost, it will eventually lead to the natural death of the GP practice,」 said Dr Ravindran, adding that prior to this, instances of clinics closing down were rare as they would typically be sold or passed on to others to run should the doctors retire or migrate.
Dr Ravindran argued that TPAs must take the main share of the blame as they had removed some patients from GPs.
「They negotiate with companies and take away patients from one clinic and pass them to other clinics,」 he said, adding that TPAs place restrictions on consultation fees, types of medication prescribed, while charging GPs a fee for every patient they see.
Contributory factors, said Dr Ravindran, include the overproduction of doctors and the introduction of the contract system for those in public service.
He said as the Government would only take 50% of the doctors after a four-year contract, the rest are likely to become GPs, thus saturating the sector even further.
The solution to this, argued Dr Ravindran, is that the Government has to cut down on the number of students studying medicine as there were 5,000 medical students graduating each year.
「The other alternative is to build more hospitals while all medical colleges should have their own hospitals,」 he said.
The vice-president of the Medical Practitioners Coalition Association of Malaysia, Dr M. Raj Kumar, agrees that clinics seeing below 30 patients a day were unsustainable.
「A clinic needs at least 30 patients, depending on locality,」 he said, adding that operating costs have skyrocketed in recent years such as the various licences needed for the practice, medicine costs that increase every six months, the introduction of GST, and rise in wages for nurses and assistants.
「The poor economy is also forcing the public to visit government clinics,」 he said.
Many doctors, especially solo practitioners, end up joining emergency rooms in hospitals, take up locum stints or join pharmaceutical companies.
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