PRIVATE PRIMARY HEALTHCARE ISSUES AND CHALLENGES

According to WHO (2021), primary health care (PHC) is a whole-of-society approach to health that aims at ensuring the highest possible level of health and well-being and their equitable distribution by focusing on people’s needs and as early as possible along the continuum from health promotion and disease prevention to treatment, rehabilitation and palliative care, and as close as feasible to people’s everyday environment.  PHC is the most comprehensive, equitable, cost-effective, and efficient strategy to improve people’s physical and mental health, as well as their social well-being. Currently, PHC is delivered simultaneously in Malaysia by parallel public and private sectors that are wholly separate in terms of structure, finance, and governance. In the private sector, there are now 7,500 General Practitioner (GP) clinics, the bulk of which employ little more than six people. These general practitioner (GP) clinics are crucial in assessing acute sickness episodes and providing ongoing treatment for patients with non-communicable diseases (NCDs) such diabetes and high blood pressure. About 40% of Malaysia’s primary care patients visit them. PHC services are provided in the private sector by a variety of competing, independently operated clinics that are neither coordinated or integrated. They are governed by the Private Healthcare Services and Facilities Act, which mainly focuses on operational requirements and organisational structure.

As a result, private GP clinics face numerous unforeseen managerial and operational challenges including unchanged consultations fees since 1992, doctor hopping, inadequate staffing, insurance schemes and third party health administrator policies discouraging long term and preventive care, lack of vocational training, varying levels of competency and quality of care provided, lack of incentives to upgrade computer systems to enable better patient follow up, lack of support from the government for clear policies and guidelines as well as pharmacies that provide over the counter medication which are similarly sold by the clinics. 

Another aspect of management of GP clinics which is relatively new is healthcare marketing. A large percentage of services that GP clinics provide is tailored to providing holistic health care for families in the surrounding vicinity and building a connection with the community. Thus, reaching out to prospective patients through collaboration with local NGOs, community leaders besides social media marketing plays an important role in standing out from other competitors. 

It is crucial to provide assistance to private GP clinics as they navigate the challenging task of providing accessible health care for the Malaysian population while staying profitable. Providing opportunities to better understand the running of GP clinics especially to the younger generation of primary care physicians will prepare them for a more sustainable and rewarding employment.

Dr Lee Xiu Xian, Eunice

Dr Muhammad Syafiq Bin Hairudin