MORE money and a lighter workload are the reasons behind the exodus of government specialist doctors to the private sector.

Many of these doctors are stuck in lower salary grades with no promotions despite serving the government for many years, said the Malaysian Medical Association (MMA).

Dr Muhammad Redzwan S. Rashid Ali is one of the specialists who left government service to join the private sector.

He told The Malaysian Insight there were other push factors in his decision to leave the service but money was a primary consideration.

“It is expected that more doctors will move to the private sector because even though the government has tried to retain their doctors, it is still not enough,” Dr Redzwan told The Malaysian Insight.

The gross salary for doctors in the private sector is four to five times more, depending on experience and specialty, he said.

Earlier this month, Health Minister Dr S. Subramaniam said the number of government healthcare professionals quitting is increasing every year owing to the remuneration gap between the government and private sector.

Last year alone, 170 healthcare professionals quit the government. This is an increase compared with 158 professionals who quit the previous year.

Dr Redzwan is one of the many who took the leap of faith to move over to the private sector after serving in the government for 12 years.

“On average, senior professionals will decide to move over when they are 40 to 45 years old, after working for the government for 15 to 20 years.

“A lot of them move due to financial factors which involve their children’s studies,” said the 37-year-old doctor.

This was the same for another general and chest physician, Dr Mustafa Kamal, 46, who gave up government service for the private sector three years ago.

“I need the money… my five children are already in university. I also have to take care of my parents and a brother whose medical bills come up to RM5,000 monthly.”

He had been working in a government hospital for 18 years and said the difference between what he earned in the government sector and private sector is six times the amount.

Killer workload

The workload in the government sector is heavy and doctors are expected to do more in a short time, Dr Mustafa said, without a commensurable salary.

“As a head of the respiratory department, I only had one medical officer under me. I had to look after four wards with 12 assistants, 10 doctors and 100 nurses to monitor.

“I also had to visit 10 district hospitals throughout Kedah and Perlis. The workload was high… but the salary wasn’t.”

He said he did not see any difference in challenges for both sectors.

This was different from Dr Redzwan’s experience, who said he was always busy and stayed up late, and was always “on-call”.

“(The) working hours are actually longer and busier in the private sector.

“So we need to be very disciplined and plan our time well for personal or family matters. To get a holiday is also very difficult.

“This is coupled with patients who sometimes place very high expectations and this can be very stressful.”

His income in the private sector, however, makes up for the trouble.

He added that the efficiency in a private hospital can also be significant when treatments are carried out smoothly.

On the other hand, in government hospitals, because medical costs are subsidised, there will be a long waiting list for treatment.

“In the private sector, it is more independent, more comfortable and faster when it comes to doing work and treating patients as there is no delay and more financial freedom.”

They are not constrained by other factors like the lack of funds, budget, medicines and delays in the investigation and treatment of a patient, Dr Redzwan said.

Promotions take a long time

Other factors that contribute to doctors switching sectors are limited opportunities and the time it takes for promotions.

“Experts in government hospitals get fixed payments with allowances depending on rank.

“In the private sector, there is no concept of rank for medical specialists as all specialists in private hospitals are consultants. And the salary or payment received by the consultant is higher due to consultation and procedural fees,” said Dr Redzwan.

Dr Mustafa also agrees with Dr Redzwan, saying that promotions take too long and the workload too heavy in public service.

MMA president Dr Ravindran R. Naidu, who supports government doctors, said many are still stuck in lower salary grades.

Apart from the issue of rank, bureaucracy, limited prospect of promotion and the probability of being posted in outstation and low salary also contributed to government doctors switching sectors, Dr Ravindran said.

“Mostly, specialists are the ones leaving the government service. There should be more promotions, especially for those who have been serving for years.

“Right now, we have a shortage of specialists and it’s worrying,” he told The Malaysian Insight.

To address the existing problems, he proposed upgrading hospitals in areas where there are no specialists and offering more training places for postgraduates. – January 19, 2018.