MEDICAL / HEALTH TOURISM. THE PROS AND CONS FOR MALAYSIAN HEALTHCARE

Lately, we have been hearing much about Tourism and in particular Medical / Health tourism. It may be because we have a very active Minister of Tourism, trying to make more money for the government coffers. This is of course not wrong. It helps our country's bank account. But are there any downside? What are the pros and cons?
Let me share with you the perspective from a private medical practitioner, quite senior in service. Firstly, let me begin by differentiating between health tourism and medical tourism. Health tourism is providing healthcare to foreigners who are not " SICK ". These are all part of wellness. A good example is cosmetic surgery ( lifts, nips and tugs ). Medical tourism on the other hand is giving medical therapy to a foreign patient. These are people who are not well ( patients ) who either find the waiting list is their respective countries unacceptable ( e.g UK ), or find the cost of treatment too high ( e.g USA )., or both. Labour cost being cheaper in developing countries, we can hopefully provide "equivalent " healthcare or medical care at perhaps half the cost. Why do I put " equivalent " in inverted commas? Because it is perceived that way. The so called equivalent standards of care is all marketing and market driven. Private hospitals will pay money ( quite alot ) for certain international companies, for example JIC, to come and evaluate their hospital. Should they pass, they are awarded a JIC certificate and this allow them to go to USA and UK and advertise that they have good facilities and good doctors. But wait a minute. All that JIC or equivalent bodies do is to evaluate the standard operating procedures ( SOP ) of a hospital, and their facilities. As for the medical personnel ( which is one third medical care ), they only ask for a list of the medical personnel on staff and their CVs. Everything is on paper, not on expertise and experience. So, if you have a fresh FRCS, he is on paper as good a surgeon as an FRCS practising for the last 20 years. Hospitals are always recruiting new graduates, so that their hospital is full of " specialist ", of whatever calibre. Medicine has become a business, and doctors are also beginning to feel that they are a pair of hands in this business cycle, and so some of them are also beginning to behave like businessmen, and can you blame them.
One of the good thing coming out of this push to medical / health tourism, is that doctors will get an increase in fees. I could not understand why the MOH ( ministry of Health, Malaysia ), wish to enact a bill to control doctors fees. In the light of health tourism, and the government attempt to encourage our own doctors working or training overseas to return. They have to increase doctors pay and fees. Which doctor, with a cushy job overseas, will wish to come back, go on call and take off a gallbladder at 1am in the morning for 600 UK pounds? or USD 1,000? We have always asked the government to remove the fees schedule, and this push towards medical tourism, may just help us to do just that. Maybe that is why, at the last fees schedule Task Force, committee meeting, we were told that the PM feels that doctors fees must be increase quickly.
The other problem with medical / health tourism is that, there may come about two standards of care. One for the full paying foreigner and one for the locals. Hospitals will become 6-7 stars, and charge 6-7 star fees, where the average locals will not dare to tread. All the specialist, who feels that they are 6-7 stars will gravitate there, is it a business mah, so who will be left to care for the deserving locals in their own country?
Of course doctors / specialists are also worried. Should they do a procedure on an American, and the procedure goes sour ( patient suffers a complication ), he can be sued in US courts and be awarded damages in US courts. That will be a small catastrophy for the specialist. His whole life work could be wiped out in one go, so he will buy more medical indemnity insurance to protect himself. Medical indemnity fees will climb till US proportions, and the cost will be passed on to the patients. So cost of care will go up.
Yes, the Thais, especially the Bumrungrad hospital I am told is doing very well, so everyone here would like to imitate them. Not so easy. That can form another story.
Finally, the government has announced that they wish to have a Public-Private Partnership to start an Academic Medical Center? I suppose it is a private corporation ( probably GLC ), forming a partnership with John Hopkins - College of Surgeons, Ireland. We have heard painfully little about this. Nice idea. As usual, it is the working out that is the more difficult part. I must say, the tune has changed. Last February, when we were gathered together for three days to hear the Minister ( MOH ) launch the 10th Malaysia Plan Healthcare Transformation and Re-structuring, we were given briefings by all the DG and Deputy DGs on this subject, and there was no mention anywhere of an Academic Medical Center. I suppose, should it come about, we should see many retired overseas " experts ", here partly for the " Malaysia my second home - silver hair " program and also to teach some courses. Well lets see what happens? Is it another flash in the pan idea, or are there any substance in it. They lend their names. It is always nice to say that John Hopkins is here ( borrowing their name ). I hope it does not lead to them testing ( ideas / drugs / procedures ) what they cannot test in USA, here. That would be a shame.
Interesting what the future holds? As for me, it is cardiology as usual.