Professional Documents
Culture Documents
It is said that in order to live a full, fruitful life, a person should write a book, have a child, and plant a tree.
We want to help you start.
Our sense of Corporate Social Responsibility doesn’t just stop at shaving millimetres off of every single
screw to consume fewer raw materials, or at producing calculators made from 100% recycled materials. No.
We start movements that see an entire community replanting a forest.
So, no more corporate social responsibility, just responsibility. And to see how deep our sense of responsibility
goes, visit us at www.canon.com.my
CANON MARKETING (M) SDN BHD (158419-H): CANON LIFESTYLE CONCEPT STORES:
HEAD OFFICE & SHOWROOM: Block D, Peremba Square, Saujana Resort, Section U2, 40150 Shah Alam, Selangor s 352)! +,## Tel: 03-2166 2382 s -)$ 6!,,%9 Tel: 03-2282 7037 s 0!6),)/.
Darul Ehsan, Malaysia. Tel: 03-7844 6000 Fax: 03-7845 0505 Customer Care Centre: (Monday – Friday, 8.30am – Tel: 03-2144 6200 s 5 .%7 7).' Tel: 03-7726 8861 s 35.7!9 092!-)$
7.30pm) Customer Careline: Tel: 03-7844 8333 (Monday – Friday, 8.30am – 6.00pm), (Saturday, 9.00am – 1.00pm) Tel: 03-5633 1818
E-mail: helpdesk@cmm.canon.com.my Website: www.canon.com.my CANON BRAND STORES: s 0,!:! ,/7 9!4 Tel: 03-2141 8188
4 President’s Page
The First 100 days…
8 Secretary's Page
From the Desk of the Secretary
10 PPS Column
Quality in General Practice
Message from the
12
14
From the Desk of: Tan Sri Dato’ Seri Dr Mohd Ismail Merican
Better Prospects for Doctors Working in the Ministry of Health
SCHOMOS
EDITOR
SCHOMOS Meets Director-General of Health Medical Tourism: Are we ready for it?
Medical tourism is described as a practice of traveling across
16 Insurance international borders to obtain healthcare. This happens when citizens of
Update on Hospitalisation Plans for MMA Members other countries find quality healthcare cheaper in another country.
Singapore and Thailand have been in this business for a few years and
17 Press Statement Malaysia seems to be slowly catching up on its own bit in promoting
Australian Park Named After Malaysian Doctor medical tourism. We are more conducive to attract a bigger medical
tourist crowd but are we doing enough and do we have the correct focus?
18 Book Review One of the main concern is the brain drain from public hospitals to private
Clinical Atlas of Nasal Endoscopy hospitals. Doctors are fully aware that medical tourism flourishes well in
private hospitals especially when payment is in cash without any hassle
19 Letter to Editor from the local MCOs. Limited private practice in government hospitals,
1st MMA/MAAH Urban Outreach - Programme at SMK Sri Sentosa KL which was initially aimed for foreign patients, seems to have failed
miserably.
20 Mark Your Diary
Medical tourism promotes foreign exchange income and elevates our
21 Classified Advertisements standards, as we have to compete to be the best. One of the serious
constrain is lack of medical manpower particularly doctors and nurses.
24 Report Though we may have the highest number of medical schools per capita
Introductory Plantation Health Seminar in the world [23 medical faculties for a population of 27 million], we are
still running low in numbers of doctors in public hospitals. We also know
26 CME Update that the bubble will soon burst as the medical graduates are soon going
- Limbal Stem Cell as Potential Therapy to Blinding Corneal Conditions to graduate and will fill up all the empty post right up to the interiors of
28 - Colour Blindness East Malaysia. Maybe then we can promote medical tourism with
enough doctors for our rakyat and medical tourists.
30 Branch News
- MMA Wilayah Activities Our worries will not end with increase foreign patients [medical tourists]
32 - Briefing to the Private Sector on Influenza A (H1N1) in Penang in the next few years as we also may face challenges from foreign doctors
33 - MMA Perlis Pain Workshop having their practices in Malaysia after the AFTA comes into effect. It will
- MMA Perlis Dinner 2009 be rough turf for local doctors to keep up with this competition.
Malaysian doctors will be allowed to work within our region but how many
34 SP’s Korner of us will do so? I foresee tougher times in the future for doctors and
maybe the medical profession will not be a favorite choice anymore within
the next decade. Some serious proactive steps should be initiated now.
MMA EXECUTIVE COMMITTEE MEMBERS: 2009-2010
DR DAVID K. L. QUEK DR KULJIT SINGH Regulatory Requirements
President 2009-2011 Honorary Deputy Secretary Do we need more agencies, societies or associations to regulate doctors
and their practices? Are we not frustrated enough with By-laws and
DATO’ DR KHOO KAH LIN DATO’ DR SARJEET SINGH SIDHU Acts? We do not need any more governing instruments on our practices
Immediate Past-President Honorary Deputy Secretary
in the name of quality. It is often ridiculous to register in so many different
DR MARY SUMA CARDOSA DATO’ DR MOHAN SINGH PANNU registers, government agencies and societies, which portray quality
President-Elect Member control. The medical practice itself has its difficulty in managing MCOs,
insurances and ‘consulting’ pharmacies. It is not at all acceptable for
DATO’ DR N.K.S. THARMASEELAN DR HARVINDER SINGH doctors to face additional burden of complying with quality control
Honorary General Secretary Member societies. We should stand strong to reject any more regulating
instruments into our practice. Doctors are noble enough to self-regulate
DR HOOI LAI NGOH and practice within the domain of medical ethics and best patient care.
Honorary General Treasurer
My best wishes to all like always, and let us work out a better future for
EDITORIAL BOARD doctors.
Editor: E d i t o r i a l B o a rd M e m b e r s :
Dr Kuljit Singh Datuk Dr N. Arumugam Dr Kuljit Singh
Dr Mary Suma Cardosa
Dr Chen Wei Seng Editor
E x - O ff i c i o :
Dato’ Dr N.K.S. Tharmaseelan Dr Saraswathi Bina Rai
Dr Andrew, Tan Khian Khoon
Dr Harvinder Singh
A d m i n i s t r a t i v e O ff i c e r DISCLAIMER:
Dr Krishna Kumar
(Publications): The views, opinions and commentaries expressed in the BERITA MMA (MMA News)
Matilda Cruz do not necessarily reflect those of the Editorial Board, MMA Council or
MMA President, unless expressly stated.
Anyone who aspires to be an MMA leader must be aware of the 2. What are your issues/plans for the MMA in the near and
responsibilities and tasks ahead. He or she must necessarily wish longer term?
to do more, to represent the profession more robustly and with Many of the issues that have arisen during the first 100 days of my
fullest attention to details of the multifarious issues, which pertain presidency are not all new. However, these have been raised and
to the medical profession and healthcare scenario in the country are now under discussion, with the view to some degree of
and beyond. resolution or action. Among the most pressing issues include the
following:
Not surprisingly, much is expected of the President as the a) R e v a m p a n d r e j u v e n a t e o u r M M A S e c r e t a r i a t and motivating
presumed spokesperson and the recognised opinion leader of what our staff to be more productive and professional;
must be the most respected association in our society, especially b) E n c o u r a g e o u r m e m b e r s t o r e c o g n i s e t h e i r o w n i m p o r t a n t
when the MMA is seen to represent the interests of the largest i n d i v i d u a l r o l e as well as collectively, and instill increased
number of our doctors. participation in the affairs of the medical profession, to remind
physicians about their calling, their vocation, their kindlier more
I think many among the public are aware that we still represent the caring nature, as well as to remember to be our patients’
rational voice on healthcare issues in the country, and would like greatest advocate;
very much to listen to our viewpoints, although increasingly with c) E n c o u r a g e o u r M M A l e a d e r s h i p ( E x c o a n d C o u n c i l
more and more skepticism and mounting mistrust. m e m b e r s ) t o t a k e u p m o r e r e s p o n s i b i l i t i e s, more in-depth
interests, develop and acquire training and leadership skills, so
Certainly many officials in the MOH and the Health Minister himself that together we can better plan for more concerted policies and
regards us highly as an important sounding board on all aspects of a more meaningful, more participatory and influential role for our
health, which impinge on our Malaysian healthcare scene. I was august association, vis-à-vis healthcare and professional issues
pleasantly surprised that a recent Malaysian public survey found in our country;
that doctors are widely regarded as having the second most d) E n g a g e w i t h t h e M a l a y s i a n P h a r m a c e u t i c a l S o c i e t y ,
stressed profession! A few years back, some 72% of the public pharmacists in general and their leadership to move towards
polled also found us to be the most trusted among all other greater professionalism, cooperation and collaboration;
professions! This gives us hope that we can still offer meaningful e) W o r k w i t h o t h e r p h y s i c i a n g r o u p s towards greater unity of
and beneficial services to our rakyat, despite mounting grumblings purpose and direction, e.g. FPMPAM, Academy of Family
of physician carelessness and callousness. Physicians of Malaysia (AFPM), Academy of Medicine, MOH;
f) R e v i s i t t h e d i r e c t i o n a n d p o l i c i e s o f t h e M M A ’ s n a t i o n a l
Journalists, news editors and health officials expect the MMA to h e a l t h p o l i c y c o m m i t t e e, including re-establishing an updated
have an opinion on myriad issues no matter how esoteric or fatuous blueprint for ‘Health for All’ Malaysians, including equity and
they might be (e.g. what do I think of so-and-so’s inane comment access issues;
that “masturbation may predispose to the H1N1 flu”?!!). Curiously g) R e - e n g a g e a n d c r i t i c a l l y r e v i e w t h e i s s u e o f s i n g l e - p a y e r
they all appear to believe that the President should readily have all N a t i o n a l H e a l t h I n s u r a n c e S c h e m e for our Malaysian
these information, ideas and opinions at his or her fingertips! The healthcare system revamp, the continuing role of our private
President must be able to respond nearly immediately and clearly— sector, its possible integration or greater assimilation with the
often with an impossibly unrealistic black-and-white certainty. public sector, reconsider other financing options, e.g.
DRGs/case-mix, catastrophic coverage/safety net, etc.;
He must also be the know-all with regards any health issue, no h) L e a d d i s c u s s i o n s o n t h e i n a p p r o p r i a t e n e s s o f u n p o p u l a r
matter how remotely connected! Perhaps this underscores the a n d u n n e c e s s a r y r e g u l a t i o n s on the private medical
respect and the expectation that the MMA is the de facto body practitioner, especially with regards the possible extension of
where our opinions matter and ought to be sought… We are M S Q H a c c r e d i t a t i o n of private clinics, repeal of agreed-to
flattered, but at the same time bemused at the hysterical unpopular arbitrary regulations of the Private Healthcare
approaches of some of these media people, anything to stoke the Facilities and Services Act 2006, working with the AFPM to
interests of the readers! further strengthen primary care services and standards;
i) R e c o g n i s e t h e i m m i n e n c e o f n e w A F T A a n d M R A p o l i c i e s
It is with this in mind that I have felt compelled to try and actively when they come into play in 2010, and how they impact upon
engage with as many organisations and authorities as possible, i.e. our profession and our members, engage with the authorities
any influential body that requires our input and ideas. How much (MITI, MARTRADE, BIM, EPU) to mitigate the possible
we have managed to impart in terms of influence or suggestions, professional implications on some sectors of our healthcare
remain to be seen. But it is clear that if we had not been there, then providers;
our doctors’ interests might not have been represented at all.
cont’d...pg 5
• MALAYSIAN MEDICAL ASSOCIATION • SEPTEMBER 2009
President’s Page (cont’d)
5
cont’d...from pg 4 4. Do you think that MMA should be THE provider for CME /
CPD, or like the specialist register this should be given to the
j) A d d r e s s l o c a l c o n d i t i o n s o f h e a l t h c a r e, particularly the
Academy of Medicine or MMC?
concern of too m a n y m e d i c a l g r a d u a t e s in the immediate
There is no doubt that the MMA remains the best organisation to
future where training, supervision and experience may be
administer and coordinate the CPD mechanism for doctors in the
compromised. More than 2,000 new doctors now enter the job
country. Our approach has been simple and well documented, and
market annually, and with the new scheme of 2-years of
has served to ensure that doctors can keep track of their continuing
housemanship, followed by another 2 years of compulsory
professional development efforts, when they register for such
service (recently just revised downwards by the MMC and
activities. Of course we can further strengthen this mechanism to
MOH), these may be shortchanging our future doctors and their
include web-based learning and documentation and therefore more
professional skills and competency. There have been concerns
accurate logging in of CPD points.
that our training positions may be inadequate for this larger
influx of recent years.
At this juncture, the MMA believes that the Academy and/or the
k) P u b l i c s e c t o r p r o f e s s i o n a l i s s u e s t o b e s t r e n g t h e n e d. At the
MMC do not have the logistical, secretarial or manpower support to
same time SCHOMOS will continue to fight for better and better
administer this duty. However, the MMA also hopes that we can be
working conditions, fair and appropriate remuneration and
offered greater incentive to continue this function, which we are
career prospects for our doctors in public service.
now performing without any due recognition or financial support.
l) Too many Medical Schools. In the light of the above scenario,
MMA joins other bodies concerned as to the possible glut and
While the specialist register is now within the purview of the
redundancy of future medical graduates. Too many are now
Academy of Medicine, its implementation is now incomplete and
being produced or are returning. Medical schools and colleges
delayed because of its requirement for registration fees, which we
locally should be scrutinized so that the ‘mass production’ of
understand is time limited. If the administration of CPD function is
more graduates does not undermine the standards and the
to move anywhere, it should not further burden the practicing
needs of the country.
physician. The fact that GPs and family physicians are making
MMA subscribes to the view that there should be a moratorium efforts for continuing education and professional development
on new medical schools and that existing medical schools should be sufficient to ensure that the MMA continue to support
should not be allowed to exceed their capacity to churn out their endeavours, ultimately for our patients’ benefits.
more graduates than have been agreed upon, without adequate
minimum standards of necessary skilled teacher-student ratio, 5. Should it be compulsory for all doctors to have a certain
the availability of medical student clinical clerkship opportunities number of CPD/CME points over a certain period to continue
in our overcrowded training hospitals, and the ‘needs’ basis for obtaining their APC?
the country. With the implementation of the revised Medical Act some time in
m) M e d i c o - l e g a l c h a l l e n g e s. This will continue to escalate as 2010 (?), we expect that the practicing license will be linked to proof
more and more of our patients are increasingly empowered, of CPD for physicians, the final quantum has yet to be finalised, but
become more knowledge-savvy, as well as expect a lot more. is in the order of some 50 to 60 CPD/CME points over 2 years. This
Medical errors and mishaps are now tolerated poorly and then will mandate that doctors take greater responsibility to update
often are met with more medico-legal challenges and themselves on a regular basis.
complaints. With the rising costs in medical care, there is also a
tendency to expect greater clinical results, failing which disputes It is estimated that thus far only some 10 to 20% of our doctors
on charges are rising, with mounting threats of litigation and attend any sort of CPD programmes, and then only sporadically at
threats of professional complaints to MMC and the mass media. that! This expected rise in registration and collection for CPD
n) E n g a g i n g w i t h o t h e r h e a l t h a n d m e d i c a l p r o f e s s i o n a l b o d i e s programmes/points will stretch our administrative function and
o n t h e i n t e r n a t i o n a l l e v e l (WMA, CMAAO, MASEAN, IPPNW) capacity, and thus we hope to be able to perform this with
to spearhead consistent policies of common concerns, e.g. adequate and fair support from the MOH or the MMC. Otherwise
global warming-climate change initiatives, human rights in this exercise may hit stumbling blocks of gridlock and missed
conflict or state-controlled nations, custodial torture and deaths, opportunities. Ensuring that more than 25,000 doctors get their
nuclear disarmament, ‘orphan’ communicable diseases control, CPD registered points will be a definite challenge, but I believe we
global poverty eradication (Millennium Development Goals), are up to it. We are in the midst of streamlining registration
healthcare equity and access for all, etc. techniques such as the use of ID card readers and automatic data
capture/entry, but cost constraints are real issues.
3. What is MMA's role in outbreaks like the A/H1N1 influenza
pandemic? 6. When or should Malaysian doctors give up their role in
The MMA has under my lead chosen a cooperative and engaged dispensing medications?
approach with regards this recent outbreak. We have taken the The short answer to this, is ‘NO’, not yet anyway. In my view, I think
lead to disseminate patient education and defuse public panic as we are still far from yielding our rights to dispensing medicines and
well as to support the MOH’s directives and plans to cope with this therefore separate prescription from dispensing. I urge the Minister
novel pandemic. of Health to seriously avoid making any arbitrary and hurried action
with regards this contentious issue. This viewpoint persists despite
We have also voiced our concerns as to the limited and frustrating our continuing dialogue with the MPS and their continuing lobbying
role of private sector doctors during the earlier phase of this for such a move.
pandemic, the lack of consistent downstream transmission of
timely information, inadequacy of algorithms of clinical approaches Perhaps the most important reason against such a move is the fact
and therapies, confusing access to referral, medicines and that our citizens have yet to learn the difference between what it
appropriate testing, etc. Happily, most of these have now been means to be a doctor and what the pharmacist’s role is. For too
ironed out and are much better understood and practiced. long, our rakyat have come to assume that consulting with a doctor
for a health ailment meant being accompanied by some given
We have also managed to successfully convene an urgent medicines for the healing process—no medicines, no charge, many
Pandemic Flu Conference with the full cooperation from the MOH, still feel and expect.
which was well received and actively attended by over 700
participants. We will continue to help voice our input and That the patient-doctor consultation process is a professional
suggestions to further improve the approach towards this still exercise is rarely accepted as a means of fair remuneration for the
unraveling pandemic, so that our public can be best served, and doctor, although increasingly more and more are accepting
our doctors better protected and empowered. specialist visits as such. Thus, the recognition of appropriate fees
cont’d...pg 6
Main Committees 3
Other Committees 28
Total Number of Committees 31
Definition of Quality
Donebedian, an American writer on medical quality talks about
The Institute of Medicine defines quality as: quality in healthcare as examinable using the concepts of
structure, process and outcome.
“…….the degree to which health services for
Structure
individuals and the population increase the This refers to the systems you have in place to deal with aspects
likelihood of desired health outcomes and are of running the practice. If you bulk bill all your patients or are a
cash only practice, you can get by very easily with a manual
consistent with current professional knowledge.” accounting system. If you have multiple surgeries, issue
accounts to all your patients and have several categories of fee
Donabedian argues that ‘every healthcare practitioners and every level, your accounting needs may be better handled by a
healthcare institution has two major objectives: (1) to provide computerized accounting system. The structure of your practice
care of the highest possible quality, and (2) to provide care at the will determine how you may best deal with patient accounts.
lowest possible cost. He identifies three components:
• S t r u c t u res: material resources, facilities, equipment and the Process
range of services at the practice level. Process refers to how the structures you have in place function.
• P ro c e s s e s : what is done in giving and receiving care. Let us assume you are bulk billing all your patient contacts.
• Outcomes: the effects of care on the health status of the Process issues would include items such as:
patient and the community. • Do you get vouchers signed for all your patients?
• Are the vouchers correctly filled in?
The ‘Health For All’ policy outlined a quality framework for
advancement of health promotion internationally. Colloquially Outcome
known as the Ottawa Charter, the framework identifies a series of Outcome refers to what happens after an event occurs. In
principles and strategies. The principles are: financial terms this is the amount of money you take home from
• The prerequisites for health such as peace, shelter, education, the practice. In other areas of practice performance, outcomes
food, income, stable ecosystem, sustainable resources, social may be more difficult to measure readily.
justice and equity.
• Advocacy within political, economic, social, cultural, (Source : www.racgp.org.au/runningapractice/evaluation)
environmental, behavioural and biological systems.
• Enable equity in health care for all; and
• Coordinated action by all concerned to promote health. Seven Steps to Patient Safety in General Practice
The strategies are: S t e p 1 : B u i l d a S a f e t y C u l t u re
• Building healthy public policy; • Carry out an audit to assess your team’s safety culture.
• Creating supportive environments; • Highlight successes and achievements in improving safety,
• Strengthening community action; and be open and honest when things go wrong.
• Developing personal skills; and • Apply the same level of rigour to all aspects of safety,
• Reorienting health services. including incident reporting and investigation, complaints,
health and safety, staff protection and clinical quality
The six dimensions of quality: assurance.
1. Safe – avoiding injuries to patients from the care that is • A strong safety culture requires – leadership, teamwork,
intended to help them. accountability, understanding, communication, awareness of
2. Effective – providing services based on scientific knowledge workload pressures and safety systems.
to all who could benefit and retaining from providing services
to those not likely to benefit (avoiding under use and overuse, Step 2 : Lead and Support your Practice Te a m
respectively). • Talk about the importance of patient safety and demonstrate
3. Patient-centred – providing care that is respectful of and you are trying to improve it by including an annual patient
responsive to individual patient preferences, needs and values safety summary in your practice report or your Practice
and ensuring that patient values guide all clinical decisions. Quality Report.
4. Timely – reducing waits and sometimes harmful delays for • Include patient safety in in-house staff training, including the
both those who receive and those who give care. use of improvement methods, and ask for it to be part of
5. Efficient – avoiding waste, including waste of equipment, continuing education outside of the practice.
supplies, ideas and energy. • Promote safety in team meetings by discussing safety issues
6. Equitable – providing care that does not vary in quality and making it a standing agenda item.
because of personal characteristics such as gender, ethnicity,
geographic location or socioeconomic status. Step 3 : Integrate your Risk Management Activity
• Regularly review patient records (e.g. using case note review
(Source: A Quality Framework for Australian General Practice,
Background Paper July 2005, The Royal Australian College of General
tools) so that areas of common harm such as delayed or
Practitioners) missed diagnoses/treatment can be identified.
cont’d...pg 11
cont’d...pg 13
T
h e re h a v e b e e n m a n y l e t t e r s a n d c o m m e n t s best healthcare to the public. In 2008,
m a d e a b o u t t h e ro l e o f t h e M i n i s t r y o f H e a l t h government doctors provided services to 2
( M O H ) i n i m p ro v i n g t h e l o t o f d o c t o r s w o r k i n g i n million in-patients and 62 million outpatients
t h e p u b l i c s e c t o r. It is obvious that many do not know in 2008. This year the number of patients seen has escalated
how the gover nment machinery works. While the significantly following the current economic downturn and the
Influenza A (H1N1) pandemic.
MOH can come out with brilliant ideas and innovative
strategies, these may not mean much if the central
To complicate matters, in 2008, only 60% of doctors are in the
a g e n c i e s a re n o t s y m p a t h e t i c o r u n w i l l i n g t o d i g e s t t h e public sector although they are responsible for serving 77.4% of
a r g u m e n t s w e p u t f o r w a rd. You may sense that I the total hospital beds in Malaysia. The remaining 40% of
sound disappointed or frustrated but that is the re a l i t y. doctors are in the private sector and are responsible for the
Granted, the central agencies have done a lot under remaining 22.6% of hospital beds.
t h e p re s e n t C h i e f S e c re t a r y, Ta n Sr i Mohd Si de k
Hassan and the Dire c t o r-General of Public Services Our doctors and other allied health professionals have been
D e p a r t m e n t , Tan Sri Ismail Adam. Indeed, you cannot working very hard to provide the best of care for our patients
get better supporters than these two fine gentlemen. despite the many constraints, challenges and risks they face
O u r S e c re t a r y - G e n e r a l o f H e a l t h , D a t o ’ S r i M o h d N a s i r everyday.
Mohd Ashraf, is also very supportive but what I find
The Ministry of Health has been working very hard to improve the
disconcerting sometimes is the lack of urgency of the
terms and conditions of service, remuneration and working
i m p l e m e n t a t i o n o f i n s t r u c t i o n s f ro m t h e t o p . S o m e o f conditions of the doctors. Various measures have been taken
o u r t h e m i d d l e m a n a g e r s e i t h e r re s p o n d s l o w l y t o and will be further implemented to ensure doctors continue to
i n s t r u c t i o n s f ro m t h e t o p o r p u t i n c o n d i t i o n s u n k n o w n serve in the MOH. These include the creation of new allowances,
t o t h e i r b o s s e s t o e n s u re t h a t a l l d e c i s i o n s m a d e a re improving current allowances such as the critical and on-call
‘ c o r re c t ’ a n d ‘ f o l l o w p ro c e d u re s ” . T h e re i n l i e s t h e allowances, providing incentives for those working extended
b u re a u c r a t i c t r a p . P e r h a p s t h e y m e a n w e l l b u t t h e y hours (RM80.00/hr) and those operating on Saturdays
s e e m c o m f o r t a b l e b e i n g e n s l a v e d b y t h i s b u re a u c r a c y (RM200/hr), allowing locum in private healthcare settings and
and because of this and the fact that they thrive on servicing private patients after office hours or during weekends
orthodox practices, decisions made collectively at the (full paying patients) and many more. In addition, the MOH has
created more opportunities for doctors to get promoted to higher
t o p m a y s o m e t i m e s b e i m p l e m e n t e d m o n t h s l a t e r, that
grades to retain them in the public health system even though the
t o o a f t e r s e v e r a l re m i n d e r s .
monetary gain is relatively lower than in the private sector.
Efforts have also been made to improve the working environment
The Ministry of Health (MOH), as the primary government agency
by providing conducive examination rooms for doctors especially
responsible for providing healthcare to the public, is committed
those in new hospitals with IT facilities. Those working in older
to providing equitable, accessible and affordable healthcare
hospitals, sadly, are sharing rooms, making it difficult for them to
services to all Malaysians. The role is all the more daunting,
protect the privacy of their patients. The MOH has already made
taking into consideration the mounting challenges in the planning
an urgent appeal to the government to provide more resources to
of optimum and acceptable services including changing disease
upgrade these older hospitals in terms of renovations and
patterns, a well informed and demanding public, rising costs of
refurbishments, providing more ICU beds and examinations
healthcare, new medical technologies and globalisation and
rooms, modern equipments and others. The Government is
liberalisation.
sympathetic and we hope to get clearance soon to be able to do
this in many of our older hospitals, some of which are more than
One of the most important components in improving the
20 years old.
effectiveness of the healthcare delivery system is an efficient and
competent medical workforce. As such, the MOH is working
We do appreciate the sacrifices of our house officers and
tirelessly to address the shortage of skilled medical and health
doctors. We are doing everything in its power to fight for better
personnel, especially doctors. For this purpose, 24,135 posts of
remuneration, allowances and better promotional prospects.
doctors have been created. However, as of December 2008, only
We have also made a proposal to set up the Medical Services
57% (or 13,762 posts) have been filled. Only 2,545 of the posts
Commission. Many of our recommendations need the support
filled are specialists from various disciplines and grades (UD 41
of central agencies in the government. We are also mindful of
and above).
the sacrifices of parents in funding medical education for their
children and has recommended to the Malaysian Medical
Even though the current number of healthcare workers is far from
Council (MMC) to reduce the compulsory service from the
satisfactory, the Ministry of Health is commited to providing the
present 3 years to 2 years.
cont’d...pg 13
Housemanship training program, to me, is the most important The MOH, despite the many constraints, challenges and limited
part of a doctor’s career. It moulds the housemen to become resources, will strive to deliver the best medical and healthcare to
good and safe doctors. It is also the first big step for them in the the public. We have a great team that is overworked and
long journey of the medical profession. But for training to be stressed. We hope the central agencies will respond favourably
effective there has to be mutual respect between our younger to all our many requests to improve the working conditions,
colleagues and the more senior ones. The senior doctors must remunerations and career propects of our healthcare personnel.
fulfill their responsibilities as service providers, teachers, trainers They certainly deserve better.
cont’d...from pg 11
Prevention is often defined as having three levels: o Tertiary – reducing impairments and disabilities, minimizing
o Primary – the promotion of health and the prevention of suffering caused by existing departures from good health or
illness, e.g. immunization and making physical environments illness, and promoting patients’ adjustment to chronic or
safe. irremediable conditions, e.g. prevention of complications by
o Secondary – the early detection and prompt intervention to self monitoring of defined parameters supported by their GP.
correct departures from good health or to treat the early signs
of disease, e.g. cervical screening, mammography, blood GPs provide comprehensive, holistic health care to patients,
pressure monitoring and blood cholesterol checking. including preventive, curative and rehabilitative care on a
continuous and long term basis to all member of a community. A
key role of general practice is to prevent disease.
Prevention Services
by Dr Harvinder Singh
National SCHOMOS Chairman
CHOMOS with MMA Exco were fortunate to have met up with Tan Sri Dato’ Sri Dr Ismail Merican,
Many issues were brought up during this informal meeting and DG was kind enough to listen to SCHOMOS
and update us on many important issues. Below is a summary of the issues discussed.
SCHOMOS will also be organising a second seminar on “Rights and Responsibilities of Government
Doctors” on 5 December, 2009 in Penang. The first such seminar was held last year in Kuala Lumpur with
overwhelming response. DG has consented to deliver the keynote address at this seminar. It is hoped that
many government doctors will take this opportunity to attend this one day seminar.
Order of Australia Medal on the Queen’s work done in this area by Dr Harry Ratnam.”
Australian Park birthday honours list for service to medicine
Queensland multimillionaire Maha
Named After in Ipswich.
Sinnathamby, formerly of Rembau, Negri
Sembilan said Dr Ratnam should be “very
Malaysian Doctor “I never dreamed in my life that I would get
an Order of Australia and then a park proud of his achievements.”
named after me,” he said. “I never expected
M E L B O U R N E : The city of Ipswich, about “The whole community of Ipswich loves
to be rewarded in this way.”
40km from Brisbane, has dedicated a new this man. He has done a lot for them,“ said
18ha park in Redbank Plains to a much- Sinnathamby, who has a boulevard named
Dr Ratnam, who had his early education at
loved Malaysian doctor who has served the after him.
St John’s Institution, Bukit Nanas, Kuala
local community for nearly 30 years.
Lumpur completed his schooling in Dublin,
Ireland. He then entered the Royal College Most of the 200 people who attended the
Mayor of Ipswich Paul Pisasale said the launch of the park at the weekend were Dr
of Surgeons and Physicians in Dublin,
park was named after Dr Kamalakaran
graduating in 1977. Ratnam’s patients. -- Bernama
‘Harry’ Ratnam “to celebrate his
professionalism, dedication, loyalty and Published: The Star Online Tuesday
Since coming to Ipswich, Dr Ratnam has
compassion to the Ipswich community.” August 18, 2009
served on many health and welfare
committees, especially with the elderly.
“Dr Ratnam, who arrived in Australia, and
in Ipswich in 1981 with his wife Raji after
It even prompted Jo-Ann Miller,
an invitation from the Agent General of
Queensland State Parliamentary Secretary
Queensland in England, has served the
to the Minister of Health, to refer Dr
community ever since, and I believe it is
Ratnam as “an absolute hero” in
fitting for this magnificent park to be
Queensland State Parliament in April 29,
named after him,” he said.
2004.
In 2007, Dr Ratnam, who is the younger
Ipswich city councillor Victor Attwood, who
brother of former judge R.K. Nathan and a
proposed the park be named after Dr
first cousin of billionaire Tan Sri T. Ananda
Ratnam, said he did it “in celebration of the
Krishnan, was awarded the prestigious
(Picture sourced from the Star Online)
Book Review
18
T
he technological advancements in the expanding
field of rhinology has expedited the publication of
this Malaysian contribution entitled “Clinical Atlas of
Nasal Endoscopy”. In addition to his numerous academic
clinical publications, Prof Dato’ Dr B.S. Gendeh has
previously published two other books in his keen interest
to keep Malaysians updated in his subspecialty of the
nose. His two previous book publications were on “Sinus
Surgery: State of the Art Technique” in 2004 and
“Otorhinolaryngology” in 2006. Generally, books in
selective specialized fields tend to be expansive, but his
kind contribution towards rhinology may make this
knowledge more easily available to the local medical and
surgical fraternity. This vast collection of his own
descriptive clinical photographs and facts viewed through
the end of an endoscope, introduces the common man to
the fascinating world of rhinology. Moreover, nasal
endoscopy is a cousin to keyhole surgeries and similar to
developments in gastrointestinal endoscopy in opening up
new horizon in the state-of-the-art Minimally Invasive
Surgery.
In response to a complaint received Association for Adolescent Health will be more than happy to involve you in
from a concern doctor as to why (MAAH). All the facilitators had our future activities.
General Practitioners located around undergone training sessions to equip them
Sri Sentosa were not invited to with the necessary skills. Together we can make things happen.
participate in the above programme,
below was the REPLY received from Since studies have shown that adolescents Thank you.
Dr Nazeli Hamzah, Chairperson of communicate better with their own peers
the Adolescent Health Sub- than with adults, we have always found that
Committee. youths make great facilitators with Dr Nazeli Hamzah
supervision from adults. We are training a Chairperson
Sir, pool of youths to be drawn upon when we Adolescent Health Sub-Committee
have similar projects. Email: nazelihamzah@gmail.com
The target participants consisted of 100
`selected` students who went through a As this was our first project in an urban
specific module to increase their resilience area we have not invited other doctors to be EDITORIAL NOTE: All ‘Letters to
so they are more able to be in control of involved. We will be happy to invite you to Editor’ must have full name of the
their actions and not be so easily influenced join us for our subsequent programs. authors and their membership
by negative elements. number. The Editorial Board reserves
I take this opportunity to invite all doctors the right to decline publishing any
The facilitators were members of the who have interest in Adolescent Health letters/articles without names of
Adolescent Health Committee of MMA and issues in their community to please contact authors clearly spelt out.
youth members of the Malaysian the Adolescent Health Sub-Committee. We
The course delivers high level teaching materials covering all subject areas of interest to General Practitioners. With the Online tutorial support,
Online assignment and MCQ test system, the students will be exposed to information technology and update their professional skills via the
cyberspace community.
The next academic year will start on January 2010 and it is open to all General Practitioners in Malaysia. The first semester will commence with
a workshop to be held on the first week of the semester followed by the first four modules, which are to be completed each month over a
period of six months.
Upon completion of the DFM Programme, the candidate may continue studying by enrolling on the Advanced Vocational Training Program for
two years to prepare for Membership Examination of the AFPM and the Fellowship Examination of The Royal Australian College of General
Practitioners. (MAFP/ FRACGP)
OCTOBER 2009 Contact : Cik Natasha Alia bt Md Yusof University (UNU), Asia-Pacific Academy Consortium
Email : natasha@ummc.edu.my for Public Health (APACPH), World Health
AOEMM 11th Technical Update Contact : Prof M. T. Koh organization (WHO), The United nations Children's
“Health Impact Assessment” Email : kohmt@ummc.edu.my Fund (UNICEF) and Malaysian Public Health
Date : 10 October 2009 Specialists.
AOEMM 12th Technical Update Occupational Health Course for Medical Date : 23 - 25 November 2009
“Work Related Occupational Musculoskeletal Practitioners Venue : Dewan Kuliah UMS dan
Disorders” Date : 13 - 15 November 2009 Pusat Pendidikan Perubatan Desa
Date : 11 October 2009 Venue : To be determined Sikuati Kudat
Venue : To be determined Tel/Fax : 03 - 4044 6030 Email : franny@ums.edu.my
Tel/Fax : 03-4044 6030 Email : aoemm@aoemm.com / For further info: http://www.ums.edu.my/conferences
Email : aoemm@aoemm.com/ shafienaz@gmail.com
shafienaz@gmail.com Website : www.aoemm.com
Website : www.aoemm.com DECEMBER 2009
Second Seminar on Postgraduate Medical
9th World Congress International Association for Education in Malaysia Nutrition Communication Workshop
Adolescent Health (I.A.A.H) Date : 14 November 2009 Date : 3 December 2009
“Private Lives, Public Issues: Global Perspectives Venue : Grand Seasons Hotel, Kuala Lumpur Venue : International Medical University,
on Adolescent Sexual Health” Contact : Ms Alice Joseph/Ms Hema Bukit Jalil, Kuala Lumpur
Date : 28 - 30 October 2009 Tel : 03 - 4041 1375 Contact : Ms Danielle Ho / Ms Lee Ching Li
Venue : Shangri-la Hotel Fax : 03 - 4041 8187 Tel : 03 - 2731 7358 / 7249
Kuala Lumpur Email : info@mma.org.my Fax : 03 - 8656 7299
Contact : Datin Saadiah Ahmad Reg fee : RM100.00 (MMA Members) and Email : danielle_ho@imu.edu.my /
Tel : 03 - 2691 5379/ 03 - 2698 9966 RM150.00 (Non MMA Members) chingli_lee@imu.edu.my
Fax : 03 - 2691 3446 Website : http://www.imu.edu.my
Emails : mpaeds@gmail.com or AIDS After HAART
2009iaah@gmail.com Date : 14 November 2009 40th Union World Conference on Lung Health
Website : www.iaah2009.com Venue : Hospital Sg Buloh “Poverty and Lung Health”
Contact : Prof Suneet Sood Date : 3 - 7 December 2009
Email : suneetsood@yahoo.com or Venue : Cancun , Mexico
Health Wellness Workshop
Contact : Dr Noor Sham Yahya Luddin Online Reg : www.worldlunghealth.org
Healthy Weight, Healthy Life
drnoorsham@salam.uitm.edu.my
Date : 31 October 2009
Contact : Puan Ruhi Rights and Responsibilities of Government
Venue : International Medical University
Tel : 03-6120 3420 Doctors
Bukit Jalil, Kuala Lumpur
Fax : 03-6120 3423 Organised by Malaysian Medical Association and
Contact : Ms Danielle Ho / Dr Low Bee Yean
Website : http://mhr.uitm.edu.my Ministry of Health
Tel : 03- 2731 7358/7533
http://medicine.uitm.edu.my Date : 5 December 2009
Fax : 03 - 8656 7299
Venue : Auditorium, Ambulatory Care Centre
Email : danielle_ho@imu.edu.my /
Plantation Health Committee MMA Hospital Pulau Pinang
beeyean_low@imu.edu.my
“Introductory Plantation Health Seminar” Contact : Ms Azlin (SCHOMOS Secretariat)
Website : http://www.imu.edu.my
Date : 14 - 15 November 2009 Tel : 03 - 4041 1375
Venue : Jenderata Estate Fax : 03 - 4041 8187
38th MMA Perak Installation 2009
United Plantations Email : schomos@mma.org.my
Date : 31 October 2009
Teluk Intan, Perak
Venue : Royal Perak Golf Club
Contact : Ms Punitha Asia Pacific Primary Care Research Conference 2009
Tel : 05 - 2436543 / 016-5209022
Tel : 03 - 4041 1375 Date : 5 - 6 December 2009
Contact : Ms Malar
Fax : 03 - 4041 8187 Venue : City Bayview Hotel, Melaka
Email : mmaperak_2c@yahoo.com
Email : planthealth@mma.org.my Website : http://www.afpm.org.my/appcrc2009.htm
Website : www.mma.org.my
First Johor Medical Conference in Primary Care
Target Group : Doctors, Estate Hospital Assistants, 7th Asian Angle Closure Glaucoma Club Meeting
Jointly Organised by MMA Johor Branch and
Plantation Management (Managers Organised by Malaysia Society of Ophthalmology
Monash University
and Assistant Managers) & Malaysian Medical Association
Date : 31 Oct - 1 Nov 2009
Reg Fees : RM100.00 (MMA Members) Ophthalmological Society
Venue : Monash Clinical School Johor Bahru
RM150.00 (Non-Members) Date : 5 - 6 December 2009
Contact : Dr Kamarudin Ahmad
(2 breakfast and 2 lunches included) Venue : Crowne Plaza Mutiara Kuala Lumpur
Tel/Fax : 07-2364148
Contact : Majmin
H.P. : 012 - 7761061
25th Malaysia-Singapore Ophthalmic Congress 2009 Tel : 03 - 42517032
Email : kamaldr@yahoo.com
Theme: “Ophthalmology Today and Tomorrow” HP : 017 - 8821680
Organised by MMA Ophthalmological Society Email : majmin8@pd.jaring.my
(MMAOS) Website : www.aacgc.org
NOVEMBER 2009
Date : 20 - 22 November 2009
Venue : Renaissance Hotel, KL Occupational Health Course for Medical
Seminar and Technical Workshop
Contact : Ms Begum Practitioners
Mammalian RNAi and qPCR
Tel : 03-4041 1375 Date : 11 - 13 December 2009
Date : 3 - 4 November 2009 (Seminar)
Contact : Dr Jelinar Mohamed Noor Venue : To be determined
: 3 - 5 November 2009
(Hon Secretary) Tel/Fax : 03 - 4044 6030
(Technical Workshop)
Email : ophthal@mma.org.my Email : aoemm@aoemm.com /
Venue : International Medical University,
shafienaz@gmail.com
Kuala Lumpur
College of O & G Teaching Conference Website : www.aoemm.com
Contact : Ms Danielle Ho / Dr Leong Chee Onn
Date : 20 - 22 November 2009
Tel : 03 - 2731 7358 / 7528
Venue : One World Hotel Calling all Medical Graduates from KMC Manipal,
Fax : 03 - 8656 7299
Bandar Utama City Centre KMC Mangalore and Melaka Manipal Medical
Email : danielle_ho@imu.edu.my
Petaling Jaya College to join Annual Alumni Meet
cheeonn_leong@imu.edu.my
Tel : 03-4041 7088/4041 7541 Manipal Alumni Association Malaysia Annual
Website : http://www.imu.edu.my
Fax : 03-4041 9722 Convention
Email : dronghc@myjaring.net Date : 11 - 13 December 2009
Post Graduate Course on Paediatric Infectious
angeln@pd.jaring.my Venue : Rennaisance Hotel, Melaka
Diseases
Contact : Mr Kulen
“Paediatric Infectious Diseases”
2nd International Conference on Rural Medicine, Tel : 03 - 2282 7355
Date : 12 – 13 November 2009
ICORM 2009 Email : manipala@streamyx.com
Venue : Dewan Jemerlang
Organised by Sekolah Perubatan UMS, Persatuan Website : manipal.org.my
University of Malaya
Perubatan Desa Sabah (PERDESA), Kementerian
Tel : 03 - 7949 2065/7949 2732
Sains Teknologi dan Inovasi (MOSTI), United Nation
Fax : 03 - 7955 6114
ANNOUNCEMENT
PUBLIC HEALTH SOCIETY OF MMA CONGRATULATIONS
The Public Health Society of MMA has been in existence with the MMA
since the last few years. It has engaged in public health activities and The MMA congratulates the following
has worked very closely with other public health bodies, Ministry of
members:
Health and the public health departments of the various universities in
Malaysia. In the recent years there has been a decline in membership
from members of MMA who work in public health areas and other
MMA members who have interest in public health issues. DATO’ DR TEH LEI CHOO
Darjah Setia Pangkuan Negeri (DSPN)
The PHS now needs to hold an AGM to elect its office bearers. Through
this announcement, the PHS invites all MMA members/ Public Health
Specialists who have interest in public health issues to inform the
DR SANTOKH SINGH
secretariat regarding their contact address to assist them to join the PHS. DR REVATHY NALLUSAMY
DR LIM LAY HOOI
For further information please contact: DR ANITA BHAJAN MANOCHA
Puan Jalina at MMA House DR BALANATHAN KATHIRGAMANATHAN
Tel: 03- 4041 1375 Darjah Johan Negeri (DJN)
Email: publichealth@mma.org.my or
Dr S. Elangovan
H/P: 012-526 3293 DR TAN CHONG GUAN
Email: esgeron@gmail.com. Bintang Cemerlang Negeri (BCN)
The AGM will be held as soon as possible to elect the new committee.
Your urgent attention to this matter is highly appreciated. On being conferred the recent award by the
Yang di-Pertua Negeri of Penang
Thank you.
in conjunction with his
71st birthday celebration.
Dr S. Elangovan
Secretary, Public Health Society, MMA
SCHOMOS SEMINAR
‘RIGHTS AND RESPONSIBILITIES OF GOVERNMENT DOCTORS’
Anjuran Bersama
Persatuan Perubatan Malaysia & Kementerian Kesihatan Malaysia
Perasmian oleh:
YBhg Tan Sri Dato’ Seri Dr Hj Mohd Ismail Merican
Tarikh : 5 hb Disember 2009
Masa : 8.30 pagi - 5.00 petang
Tempat : Auditorium, Ambulatory Care Centre, Hospital Pulau Pinang
Objektif:
• Menyampaikan maklumat-maklumat penting berkenaan keperluan perkhidmatan dan kebajikan pekerja kepada para doctor;
• Menyampaikan tugas dan tanggungjawab para doctor yang berkhidmat dengan kerajaan;
• Membantu usaha Kementerian Kesihatan Malaysia untuk meningkatkan tahap perkhidmatan kesihatan di Negara ini.
Yuran Pendaftaran:
MMA Member: Percuma
Non-MMA Member: RM50.00
P
UTRA MEDICAL CENTRE IS A 145 BEDDED
HOSPITAL strategically located in the Centre of
Alor Setar. We are expanding and growing with
a 8th Level New Wing. In line with our expansion, we would like to
CIRCUS invite applicants for the following Resident positions:-
I am a consummate performer, Please send CV, Certificates, Testimonials and Photo (n.r) to:
Everybody loves me. Every night E-mail: pmc@puramedicentre.com.my
My saw-dust dread is exchanged
For star-dust dreams. Every morning
I wake, vowing never again For enquiries contact:
To be a clown. Mdm Shanti Kandaiyah: 017-5081658
But then the Ringmaster cracks Mdm Gan: 012-5820528
His whip, shouts, “The show Must go on!” Tel: 04 - 7342888 Fax: 04 - 7348882
Website: www.putramedicentre.com.my
by Dr Ng Kian Seng
www.adeg.com.sg
The medical practitioners need to be armed with basic knowledge on aesthetic dermatology
which are not taught in medical school so that they will be able to advise their patients on
various skin rejuvenation procedures and also carry out some of the more simple procedures
ADEG workshops are designed to equip medical practitioners(GPs and specialists) to gain
basic and practical knowledge on evidence based skin rejuvenation procedures on Asian skin.
For detailed formation on ADEG workshops, please visit www.adeg.com.sg
Please sign up for the workshop to be held in Kuala Lumpur immediately if you wish to gain
knowledge on aesthetic procedures.
or via e-mail
kamil@ish.kpjhealth.com.my
Introductory Plantation
Health Seminar
We would be also discussing the problems faced by the medical
team and the management in maintaining good health among the
plantation workers. There would be a question and answer
section at the seminar which we hope will benefit all participants.
by Dr J. R. Prushothaman
Committee Member, The topics of discussion are as follows:
Plantation Health Committee, MMA 1. Role and Responsibilities of Visiting Medical Officers
2. Role and Responsibilities of Estate Hospital Assistants
3. Chemical Regulations
he Plantation Health Committee headed by Dr Ravindran 4. Noise Regulations ( Oil Palm Mill)
Presenter positions would suit either full time or part time clinicians looking for
regular weekend or mid week work.
Doctors who are interested in applying should review the position description on www.medicalprotection.org/uk/careers
All applications must include a letter detailing how they meet the minimum requirements, necessary experience and profile description
outlined in the position description.
Applicants who are shortlisted will need to be available for a video or teleconference w/c 26 October 2009 and a selection interview in
Singapore on 13 November 2009. All travel costs to this event will be met by MPS in accordance with standard policies.
T
he surface epithelium of the eye glaucoma and total blindness are conditions suffered by
comprises of conjunctiva at the these patients which reduce their quality of life.
p e r i p h e r y, l i m b u s a t t h e t r a n s i t i o n
The principle of treatment for limbal stem cell deficient
zone and the cor neal epithelium. Cor nea is conditions include the use of amniotic membrane graft,
a s t r u c t u re a t t h e f ro n t o f t h e e y e w h i c h conjunctival-limbal autograft and penetrating keratoplasty.
a l l o w s l i g h t t o p a s s t h ro u g h t o re a c h re t i n a , Amniotic membrane grafting on its own usually fail to
regenerate the epithelium. Conjunctival-limbal autograft
which then transmits signals to the brain.
needs a large size graft taken from patient’s other healthy eye
To p e r f o r m t h i s f u n c t i o n , c o r n e a m a i n t a i n s which would render the donor eye of developing secondary
i t s t r a n s p a re n c y b y p h y s i c a l l y b e i n g d e v o i d limbal stem cell deficiency. If an allogenic source is used, the
of any blood vessels. cont’d...pg 27
S t r u c t u re s o f t h e e y e
Day 20
Autologous graft c u l t u re d with amniotic membrane re a d y for Limbal stem cell deficiency in the right eye of patient with chemical
transplantation injury
COLOUR BLINDNESS
Clinical Features
Contrary to popular belief, people with colour-blindness
seldom see things in black and white or shades of grey, they
are still able to see colours, though they may have a hard time
distinguishing between colours, say between red and green,
or blue and yellow, especially when they are presented with a
mix of many colours.
Treatment
Recently, there were various experiments done in the United
Colour blindness cannot be cured, nor prevented - except by
States in laboratory animals that suggested gene therapy in
genetic counselling. (Though possibility of using genetic
adult animals may be useful in treating colour blindness,
engineering to repair/modify the colour blindness gene may
which will greatly give hope to people affected by this
be a possibility in the future).
condition in the future.
It was felt that since this Consensus Guideline is meant for the
use by Primary Care Doctors, an input is required from this group
of medical practitioners. Hence, the role of MMA Wilayah in the
formulation of this Consensus Guideline by the provision of input
by our Wilayah Primary Care Doctors.
A
nother briefing on Influenza A (H1N1) was held in Penang State Epidemiology Unit. The session was chaired by Dato’ Dr
(for the 3rd time this year in the state) to the private sector. Lim Yu Hoe, Consultant Physician at Penang General Hospital.
The idea was mooted by the State Health Director, Dato’ He had been given the task of taking the role as the State Liaison
Dr Teh Lei Choo following a request by a private practitioner in Officer for Flu A. Personally, I believe it’s an excellent move.
Penang to have such a session. There had been two such Penang is a great place to work as there always has been great
briefings before this year and both were held on a Sunday but the cooperation between the private sector and Government and
attendance was never as envisaged. The State Health Director between the Health and Hospitals and this has never been an
planned the date with the Chairman of Penang Branch MMA and issue here. However, we do need someone to champion our
PMPS President and a Saturday morning was agreed upon – 5th cause and Dato’ Lim may be the most apt person. He pointed
September, 2009. It was very timely indeed as over the week out that patient education was not effective enough and each
prior to the event, there were some changes in the management and every health personnel had a role to play in this. The public
of Influenza A (H1N1) and we were able to update the was still not interested and there is lack of knowledge. It is every
participants accordingly. health practitioner’s task to treat, prevent and to allay anxiety and
he stressed upon these simple but crucial messages.
To ensure all the private doctors were aware this time around,
flyers were sent through MMA and PMPS to all their members; There were hitches at the start of this briefing that was held at the
letters were sent individually to the private hospitals; In addition Auditorium of Hospital Pulau Pinang. The air-conditioning went
emails were sent to about 400 private doctors, dentists (Yes, we on strike and the hall projector refused to work (as always:
decided that dentists too should be informed) as well as to the Murphy’s Law). Anticipating the worst, we had brought our own
private hospitals. Not all doctors are members of MMA or PMPS LCD and notebook as well, so were able to rectify the situation,
but we tried to reach as many as possible. We were quite and started right on schedule. Hence, albeit a tilted screen and
confident that most of the private doctors were aware of this a few stiff necks it was a very fruitful morning and it’s a pity that
briefing but the decision to attend is a personal choice. The more doctors did not attend.
Penang Branch of MMA was represented by Dr Praveen, the I believe it is their loss.
Vice-Chairman; Dr Patrick Tan, the President of PMPS was
present as well (in between his surgeries); the State Health At the end of this very stressful
Department was well represented by the Director - Dato’ Dr Teh morning, sitting at home with a
Lei Choo, Dato’ Dr Rosenah - the Consultant Physician, and the book, I texted my appreciation to
District Health Officers. Yours truly wore the hats of MMA all those involved in this
Penang Branch and the State Epidemiology Unit – the unit to organisation and made this
receive all brickbats. happen. Maybe the reply from the
Health inspector from the Epid
There were three presentations – Dato’ Teh took the lead and Unit sums its all: “Satu Pasukan,
gave an overall situation of the disease. This was followed by an Puan”. One team! Yes, it’s nice
excellent presentation on the Medical Management of Influenza to be a part of this team!
The first was a Pain Workshop held at Putra Palace Hotel at 2.00pm. The speakers were Mr. Jaya Prakas Rao, General Surgeon, HTF,
Mr. Yeap Ewe Juan, Orthopaedic Surgeon HTF and guest speaker was Dr Mary Suma Cardosa, Consultant Anesthesiologist, Hospital
Selayang. The Workshop was attended by about 30 doctors including GPs and ended at 6.00pm.
TO PLACE ORDER:
Contact: Ms. Hema @ Tel: 03- 40411375 Email: soem@mma.org.my
Cost: RM88.00 (inclusive of postage within Malaysia)
Cheque payable to: Malaysian Medical Association
SP’s Korner
34
SP’s Korner 10.00pm news was on. The news crew was covering a story of a man
on a ledge of a tall building preparing to jump. Vella looked at Bob
and said,“Do you think he’ll jump?”
Bob said,“You know, I bet he’ll jump.”
by Dato’ Dr S. Pathmakanthan Vella replied,“Well, I bet he won’t.”
Ipoh, Perak Bob place a RM10 bill on the bar and said,“You’re on!”
Just as Vella placed his money on the bar, the guy on the ledge did a
swan dive off the building, falling to his death.
This is my 200th contribution to this Korner. There was a Vella was very upset, but willingly handed his RM10 to Bob saying,
“Fair’s fair. Here is your money.”
time in September 1985 when I got this queer urge of
Bob replied,“I can’t take your money. I saw this on the 5.00pm news
propagating humour in a written form. I was then and so I knew he would jump.”
encouraged by friends and colleagues. I particularly like to Vella replied, “I did too. That really must have hurt!! I didn’t think
single three of them – Dato’ Dr Joginder Singh and the late he’d do it again!!”
Dato’ Dr Lim Say Wan both of whom were Editors of Berita Bob took the money.
MMA during that period and Dato’ Dr Abdul Hamid.
REAL DISPUTE – PRE – DNA STORY
And for some of the early years, I had to progress against A young boy comes running down the street looking for a cop. He
finds one and then begs, “Please, officer, come back to the bar with
some prevailing odds to keep the budding voice of humour
me, my father’s in a fight.”
growing in a conservative and mundane society where Well, they get back to the bar and there is three guys fighting like you
mirthology is strictly controlled by theology and ethnicity. wouldn’t believe. After a while the cop turns to the kid and says,
“Okay, which one is your father?”
After a span of 25 years, some humour is still taboo and can The kid looks up at the cop and says, “I don’t know, officer. That’s
only be nervously mentioned in isolation and in “silence” in what they’re fighting about.”
our “fragmented but one” society.
LYRICS OF INDIA
TALK, TALK!! Surinder’s granduncle was booked into an SIA flight to Bombay. But as
A husband, proving to his wife that women talk more than men, this was his first time in an airplane, he made a few preparations that
showed her a study which indicated that men use, on the average, were out of place. When the stewardess came around to take orders for
only 15,000 words a day, whereas women use 30,000 words a day. the in-flight meal, the granduncle declared loudly, “I have brought my
She thought about this for a while and then told her husband that own lunch. Make sure you don’t charge me for food and drinks!”
women use twice as many words as men because they have to repeat So, as everybody was given their in-flight meal, the granduncle
everything they say. began spreading out his own home-cooked meal. The man sitting
He said,“What?” next to him was an American history researcher, who was curious
about the food.
WHAT IS IN A NAME – ANATOMY “Excuse me, what is that drink?” he asked.
The pastor asked if anyone in the gathering of the Church Hall would The granduncle picked up the yogurt-based lassi drink and said,
like to express “Praise for answered prayers”. “Milk of India!”
A lady stood up and walked to the podium. The granduncle took out several pieces of chapattis and started
She said,“I have a Praise. Two months ago, my husband, Marvin, had feasting.
a terrible motorcycle wreck and his scrotum was completely “And what is that dish?’ asked the curious American.
crushed. The pain was excruciating and the doctors didn’t know if “Wheat of India!” replied the granduncle proudly.
they could help him.” Finally, the granduncle took out some desserts. He offered some to
You could hear a muffled gasp from every man in the congregation the American.
as only they can imagine the pain that poor Marvin must have “What is it?” asked the American.
experienced. “Sugar of India!” replied the old man.
“Marvin was unable to hold me or the children.” She went on. “And After the meal, everyone was settling down when there was a loud
every move caused him terrible pain. We prayed as the doctors “Pooooooooot” from the granduncle.
performed a delicate operation and it turned out they were able to “What was that?” asked the American in disgust.
piece together the crushed remnants of Marvin’s scrotum and wrap The old man replied coolly,“That’s air of India!”
wire around and through it in places to hold it in place.”
Again, the men in the gathering were unnerved and squirmed MINI – BITES
uncomfortable as they imagined the terrible surgery performed on (1) You know that children are growing up when they start asking
Marvin. questions that have answers.
“Now,” she announced in a quivering voice,“thank God, Marvin is out (2) “If stupidity got us into this mess, then why can’t it get us out?”
of hospital and the doctors say that with time his scrotum should - Will Rogers
recover completely.” All the men sighed with obvious relief. The (3) “Any government that robs Peter to pay Paul can always depend
Pastor rose and tentatively asked if anyone else had something to say. upon the support of Paul.”
A man stood up and walked slowly to the podium. - Rings a bell, eh!
He said,“Hi, I’m Marvin.” The entire congregation held its breath. “I (4) The more you observe politics, the more you’ve got to admit that
just want to thank you all and also explain to my dear wife again that each party is worse than the other.
the word is STERNUM.” - Will Rogers
(5) An amateur golfer is one who addresses the ball twice: once
GOVERNMENT before swinging, and once again after swinging.
A small boy was asked by his teacher, “What is the size of the (6) “We don’t want to go back to tomorrow, we want to go forward.”
Government?” - Dan Quayle
“About 5 feet 2 inches,” he replied promptly. (7) Terrorists pollute the nation’s water supply with truth serum.
“No, no, no,” said the teacher, “I mean how many members the Society is rocked to its foundation as everyone including lawyers
government has? How did you get 5 feet 2 inches anyway?” and politicians start speaking honestly. Doctors were status quo.
“Well,” replied the boy. “My father is 6 feet tall and every night he
puts his hand to his chin and says,“I have had it up to HERE with the Marvin murmurs:- “Two is company. Three is bad control.”
Government!!”