Saturday, May 13, 2006

Private Healthcare Facilities and Services Act and regulations

A small posting about the business of medicine and cardiology, for those of us in private practice. As of the 1st May 2006, the new PHFS Act/Regulations comes into force. It is obvious from the Act that the government would like to control and punish the few bad hats that we have in our midst, at the expense of inconveniencing all private practitioners and increasing the cost of private healthcare, and yet not necessarily solving the problem.

This new Act ask that all medical and dental clinics be registered, with an attendant price tag, of course. There are many details in clinic practice that have to be registered including the size and floor-plan of the clinic, the type of resuscitative equipments available, the staff situation and their training, the cost of treatment, the degree of advice and counsel given to patients, the case mix seen and many other details which are indeed too many to detail out here.

Besides this, there must also be a grievance mechanism, so that should patients complain, how is the complaint to be address. The life of the private practitioner has now become more stressful. I suppose the stated aim of the Act seems proper, but surely, there are many other ways this aim can be achieved.

For example, the poor GP has now to learn how to set an IV line and how to intubate. Would you trust the GP, who has not intubated for the last twenty years to do it in an absolute emergency?

Grumble and protest as much as we want, the Act is law. As usual, consultation was non-existant, before the law was passed. One thing is ceratin. With so much more paper work and bureacracy, the cost of care will go up. Some small practices may also be unable to sustain the cost of paperwork and have to sell their souls to larger group practices just to carry the documentation cost. What of the little clinics in rural areas? Well clearly no provisions have been made from them and Pak Ali, the rubber tapper will certainly have to be a newly minted Felda millionaire to pay for his next cough and cold at the local GP.

For those who chooce to ignore this act and focus on helping the ill (still amazingly one of the reasons people practice medicine), fines and jail terms are threatened. Of course, with the jail term comes automatic suspension from practice of medicine.

This Act also makes the minister of Health the "grand supremo". He holds tremendous power under this new Act. Wearing my other hat as the President of the Private Medical Practitioners Association of Selangor and Kuala Lumpur, we are due to meet with YAB on the 19th May 2006 for further discussion, after the fact.

Well, we have to live with this new Act. This poor private cardiologist will try not to raise the cost of care. Time are hard enough for everyone as it is. Well at least for this poor cardiologist, cardiac resuscitation is part of life.

Life surely is tough and getting tougher in private practice. Maybe early retirement to fulltime blogging is a good alternative. After all, it's surely more enjoyable to write blog posts than write the documentation to fulfill the legal burden of the act.

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