Malaysian Medical Resources

Seriously. The Ministry of Health, Malaysia’s health portal, MyHealth has recently launched some browser based games with health themes. You can check out Health Games for yourself.

Personally, I find the “games” rather lame and don’t see the purpose behind them. A truly interactive game which teaches the user in a subliminal fashion as he or she plays it might be more useful rather than inane “arcade type” games with some health theme which serves little purpose other than fill the time of those who are utterly bored.

The MyHealth portal is one of several Health Portal links in the MMR.

The big news yesterday, which came somewhat as a surprise, it that the Malaysian Medical Council, the governing body which maintains the medical register and also is responsible for overseeing medical standards and ethics, is to be corporatised according to the report in the Sun Daily

Health Deputy Director General (Medical) Datuk Dr Noor Hisham Abdullah told theSun recently that once the amendment is passed, the MMC will be a professional body responsible for maintaining medical standards in the country, and more significantly, for performance monitoring of doctors.
The amendment is expected to be tabled when the Dewan Rakyat reconvenes in March.
“The corporatisation of MMC is to emulate the General Medical Council (GMC) in the United Kingdom, where it functions not only to set and monitor standards of the medical profession, but also the competency of doctors registered with it,” said Noor Hisham.
GMC is a fee-based registered charity which maintains a register of its medical practitioners, and functions to protect public interests by ensuring compliance to medical standards.
Noor Hisham said the monitoring of doctor’s performance is the way forward for quality healthcare.
Health Minister Datuk Seri Liow Tiong Lai told theSun that the move is to make the council more efficient in its daily administrative work, as well as free it from government bureaucracy.
“MMC is growing by leaps and bounds, it has registered around 35,000 doctors now, so we have to look into making MMC more efficient and not tie it down with government bureaucracy or circular,” said Liow.
He added that corporatising the council will ensure that it operates as a stand-alone, independent professional body, akin to the Malaysian Institute of Accountants, the Bar Council and the Institute of Engineers Malaysia.
Under the purview of the Health Ministry, the MMC currently functions under the same principles as the GMC, and also acts as a disciplinary body for the medical profession.
A long serving member of the council, who is also a senior doctor in a public hospital, told theSun the move will resolve the occasional conflict between the functions of the council as the ‘whip’ of the medical profession, and its role as advisors to the Health Ministry.
“The very fact that the council is funded and run by the ministry, there will be some conflict of interest between the two,” the doctor, who declined to be named, said.
He said there were also occasionally some difficulties for the MMC to exercise its disciplinary roles, especially when involving ministry-employed doctors, though he did not give specific examples.
“The move has of course been welcomed by the MMC, and hopefully with its corporatisation it will receive more funding, be more efficient, and able to function independently and with professionalism,” he said.
Meanwhile, the Malaysian Medical Association also welcomed the move, although it admits that it was not consulted on the matter.
“However, the move is a good as it will make the MMC an independent body and there will be no potential conflict of interest, since currently the Health Ministry director general is also the chairman of the MMC,” said MMA president Dr Mary Cardosa.
She added that in the interest of good governance, the MMC must have representatives from all stakeholders who will be responsible for the registration of doctors and maintenance of standards of practice and ethics among doctors.
However, Cardosa disagreed that there may be an increase in fees paid for annual practising certificates (APC) with the corporatisation, and that it may be passed down to patients. Doctors in private practice currently pay RM50 per annum.
“Currently government doctors have their APC fees waived, but even if the APC fees are increased, it will not burden the patients as the fees are not high, and doctors’ fees are closely regulated by the law,” she said.

I am not really sure how corporatisation was entirely necessary in the first place if the MMC were to achieve the goals of registration of of doctors and also continuous monitoring of doctors’ performance. I guess the powers-that-be acknowledged that Government bureaucracy would be too much an obstacle for the MMC to progress in this direction. The article did not state where the funding of the corporatised MMC would come from but my guess is from it’s monitoring activities. I foresee that there will be:
- compulsory CME
- compulsory specialty registration
- compulsory re-accreditation
and all these exercises will require “fees” which will generate income for the MMC. I am not as confident as Dr. Cardosa on the APC fees – I suspect that there will be a substantial increase in this as well.
Together with the hefty subscription rates that Malaysian doctors already pay for medical malpractice protection (O&G doctors for instance have to fork out RM57,000 per year which is not even tax-deductible), practicing as a doctor in Malaysia will become increasingly expensive for sure.

Syed writes in to inform that he wants to become a bone marrow donor and asks for details on how to do so.
The country’s one and only registry is the Malaysian Bone Marrow Donor Registry (MBMDR) which is at the IMR (Institute of Medical Research) in KL.
We have covered this before in our previous post, Be a bone marrow donor. The US NMDP also illustrated the overall Steps of Bone marrow donation – basically it means joining the registry as a donor, and it involves providing a blood sample for Tissue Typing (also known as HLA matching). If one is ever found to be a suitable match for donation, one may in the future then be called up for either bone marrow or peripheral blood stem cell donation.

IMR’s MBMDR contact:
+603 26986033 ext 463
Email: mmdr@imr.gov.my
Location

Do note that the bigger the donor pool, the higher the possibility of finding a match. At the moment the MBMDR is quite small, at last count still under 20,000 donors. The country could do with a donor pool of easily over 100,000 so if you can help and be a bone marrow donor, that would mean so much for the large number of patients out there requiring a bone marrow transplant who do not have a donor.

Related posts:
A dying girl’s plea to the health minister
Aiming to be a marrow donor

The MMR would like to wish our readers a Happy and Prosperous Chinese New Year!

When medical students are stressed, nowadays they just go do a Youtube video

TakNak1Care is an initiative by the FPMPAM to educate the public on issues they see as problematic should 1Care and the proposed Social Health Insurance (SHI) programme be pushed through. The healthcare system in Malaysia will be radically changed from what it is today.
TakNak1Care voices legitimate concerns and the Government of the day must address these concerns in open dialogue rather than ram 1Care down the throats of the Rakyat.

To learn more and be informed about Tak Nak 1Care, you can connect to their presence in social media and do share and disseminate this information to your friends and family.

TakNak1Care in Facebook (you can “Like” their page if you have a Facebook account)
and
TakNak1Care in Twitter

We’ve also blogged a fair bit about 1Care. Malaysians, wake up! 1Care will soon be upon you before you know it, and it will be compulsory!!

Guest post by Dr. Lee Say Fatt (the article also appeared in Berita MMA December 2011 Vol 41 No 12 )

Mass Human Papilloma Virus (HPV) vaccination of women in the general population – a re-look at the real efficacy in preventing pre-cancerous and cancerous lesions of the cervix.

This article was written in response to the recent announcement by the Government of Malaysia regarding the allocation of RM 50 million for the HPV immunization program in 2012. It was subsequently reported in the Sunday Star (9 October 2012) headlines “Shot in the arm”. The headlines mentioned that at least 350,000 unmarried women aged 18 and above are expected to benefit from the free HPV immunization program to protect women against cervical cancer. Women, Family and Community Development Minister Datuk Seri Shahrizat Abdul Jalil further mentioned that no age limit has been set for the HPV vaccination and those who would qualify would be determined later.

Introduction
Cervical cancer is the second most common malignant disease in women worldwide. Similarly, in Malaysia, it is also the second most common female cancer, constituting 12.9% of all female cancers The Malaysian National Cancer Registry reported an average of 2,000-3,000 hospital admissions of cervical cancer per year in Malaysia, with the majority presenting at late stages of the disease.

It is now well established that human papillomaviruses (HPV) is the etiologic agent of almost all cervical cancers. Persistent viral infection with oncogenic types of HPV can lead to cancer of the cervix, anus, vagina, vulva, penis, mouth, and sinuses. In a study by the International Agency for Research on Cancer, HPV was detected in 99.7% of invasive cervical cancers from 22 countries. Although 15 high-risk HPV types have been shown to be associated with cancer, types 16 and 18 are responsible for two thirds to three quarters of cervical cancers worldwide.

The prevalence of genital HPV infection in the world is around 440 million. Epidemiological studies in the USA have reported that 75% of the 15–50 year-old population is infected with genital HPV over their lifetime. These are grouped into “high-risk” and “low-risk” types according to the degree of risk of development of cancer after infection with each genotype. Genital HPV infection is extremely common and most often causes no symptoms. A proportion of individuals infected with low-risk HPV types such as HPV-6 or HPV-11 will develop genital warts, whereas a subset of women infected with high-risk HPV such as HPV-16 or HPV-18 may develop cervical intraepithelial neoplasia (CIN), which can later leads to cervical cancer.
Read the rest of this entry »

An interesting article in Malaysian Insider by Dr. TK Khong, touching on the 1Care system the Government plans to implement.

While commendable in principle, SHI contributions are dependent upon financial ability. Means testing is fraught with difficulties, while the thresholds and variations for additional levy on the rich and healthy have not been defined, nor has the quantification of the “cross-subsidy” been finalised.
Most importantly, it is unclear how much administration of the SHI “organisation” will cost and where the funding for this will come from. Only if the consolidated fund is ring-fenced for healthcare will the public be able to enjoy the full benefit of a properly constructed SHI.
Otherwise, there will be a major adverse impact on the amount of money available for healthcare as management costs will divert significant amounts of funding

Read the full article at MI

Organised by the FPMPAM

Venue : Global Business and convention center, PJ, Section 19. (Map)
Date: 12th Feb 2012

Need to read more about 1Care? Read our previous posts on 1Care

Funny pic spotted in Facebook:

The MOH has just published on it’s website the Country Health plan for 2011-2015.
You can download the 3.3 Mb PDF file directly from this link

Trying to decipher facts amidst the bureaucrat-speak, I guess one can conclude that 1Care is well on the way.

In the first place, placenta injections are a highly dubious form of “beauty treatment”, rightly clarified by the Health Minister as Placenta jabs not allowed for beauty treatment
Secondly, this unfortunate woman, instead of placenta injections allegedly received silicon injections!

Ms Mandy Chong, a 35-year-old accounts manager from Petaling Jaya, Malaysia, paid RM8,180 (S$3,375) to a beauty centre for four injections in her buttocks.
The centre, which was not named, claimed that it was injecting sheep placenta imported from New Zealand.
Animal placenta is used in anti-ageing treatments, among other things, but experts are not convinced of its effectiveness.
But instead of placenta, Ms Chong claims the centre had injected silicone instead. Though liquid injectable silicone has been used for soft-tissue augmentation, some physicians say it posts risks such as causing inflammation and exerting pressure on nerves.
Ms Chong said she has developed side effects. She claimed: “When the injected area started swelling and I could not bear the pain. I went to a specialist hospital and discovered they had actually injected silicone.”
She had to pay over RM15,000 to rectify the damage caused by the beauty procedure, but claims that she still suffers pain.

Despite the Health minister reminding the public that “beauticians are not allowed to administer injections or perform any invasive procedures” I think his advice will fall on the deaf ears of vain women in the pursuit of “beauty”.

Related MMR posts:
Human Placenta and other “supplements” cited by FDA as a health risk
Rules on nip-and-tucks
Beauty at any price
Feedback: Questions on side effects of Placenta Injection