I still remember when I'm doing my foundation at Kolej Teknologi Timur(KTT) in Sepang, my lecturer asked everyone, a simple question " Why you want to be a doctor?", but yet it is a difficult question for me.
Sample answers :
- help others who in difficulties
- i have experience with one of my family who have cancer, so I wanna help him
- family order
- its run in my blood
- my bestfriends choose it
- money, money, money
- popular and be respected by the tittle "doctor"
- no need to find work, for sure there is job for a doctor after grad
- prove that i can overcome my fear toward blood
- straight A's student always choose medicine, so do I
- i've been doctrine
- i just apply scholarship for it, i get it, so just try it
Actually there are a lot of answers for that simple question. So, what you or me set in our mind at the beginning... the beginning of our pathway to become a doctor? Have you heard about this " you are what you're thinking". What you think, will control your action, your deed and make what you are now. So, think about it again.
which type of doctor you wannabe?
Brain Drain
Is a migration of trained and talented individuals from one institution, or from one country or part of a country to another in search of better working conditions, a higher uality of life and/ or a less hostile environment.
- external - when trained and skilled human resources leave their country to go and work in developed countries or to work in developing countyies
- internal - when trained and skilled human resources are not employed in the fields of their experties or when human resources move from the public sector to the private sector or within a sector of a particular country.
so, why we bother bout this brain drain? because brain drain is a phenomenon prevalent in all industries in every nation, especially IT and healthcare. Migration of trained professionals from these fields has created an acute shortage of professionals in countries.
Reasons for brain drain
1. WHO report, 2006
- developed countries - A growing aging population and increasingly high-tech health care are exacerbating the demand for health care workers. In addition, poor planning and underinvestment in health worker education has left developed nations with too few domestic health workers to meet the demand, according to the WHO report.
- developing countries - economic policies limit investment in public-sector health care and reduce funds for health worker education. At the same time, according to the WHO, the AIDS epidemic has placed unprecedented burdens, including high rates of HIV-related illness and death among health workers, on these already stressed health systems. Faced with poor working conditions and limited economic prospects in their home countries, many health workers choose to migrate to fill the demand in wealthier nations.
2. Aljunid, WP Sh Ezat, Ismail A. (2004)
- Better remuneration in private sector
- Less favorable working environment in public sector
- Location of private facilities in towns and cities
- Bureaucracy in public sector
- Heavy workload in public sector
shortage of healthcare provider (NEJM, 2007)
In Malaysia, 25% of all doctors are specialist. From this, 75 % work in private hospital, ironically, 70% of complex cases treated in public hospital. As a result, the good people just keep leaving government posts for other jobs.
As Aid Thoughts puts it, “When the top of that ladder ends at the UN, not the government, ambitious civil servants will feel less motivated to excel…Even when the few bright stars do bother to overachieve, they’re quickly snapped-up into the development sector.”
Medical tourism
Medical tourism is like having a vaccation while having a medical treatment in other countries which offer more cheapers treatment for your own countries. For example, Mr John Smith, from US need to pay 23.938 US dollar for by pass surgery. If he use that same amount of money and get treatment in Malaysia, he only need to pay for 6.315 USD and the remain he can use it to go vacation in Malaysia (exclude payment for room).
The boom in medical tourism has already brought about fierce competition in the private sector. Late prime minister of Thailand, Thaksin Shinawatra in 2003, aims to attract foreign patients to high-end medical services and facilities on offer at private hospitals, and to support these hospitals in competing with medical services in other countries in the region like Malaysia and Singapore.
Of course the foreigner will go to the private sector because they're not the citizen of that country. This cause internal brain drain, with high payment, less workload, more comfortable working place and mingle with high-income patient.
medical tourism
Conclusion
So, as a doctor to be, where we gonna work, rural or city area, private or public hospital? Let us sit down, forget about big things, about pathophysio, about mechanism and what so ever. Lets think about small things but yet it count for a big move, about ourself. Which type of doctor will we be?
refferences :
3. Lecture note, Malaysian health Care System : Current Issues and Future Challenges, by Dr. Sharifa Ezzat Wan Puteh
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