Sunday, 11 October 2009

Dissecting the brain… braindrain

“How old if Dr. F?”
“Oh, Dr. F is past his 50s already…”


That’s what I asked the nurse while I was at the nephrologist clinic during my last kidney check-up. Just to recapitulate, a “nephrologist” is a medical specialist for kidney function. It is a very rare discipline. When I first discovered my kidney condition, I had a hard time looking for one, let alone booking an appointment.

And it’s worrying…

If you’ve noticed; most medical specialists… or should I say, most “known-to-be-good” medical specialists are in the 50s, or late 40s. Hence, some friends and I share a common concern, i.e. when the current batch of good medical specialists finally retires, will there be a competent batch to take over?

Of all my friends who are doctors and are finishing or have completed their respective specialised discipline, none of them are in Malaysia. There are 2 surgeons, one in US while the other in Australia. There is an orthopaedic consultant and an A&E specialist, both in Singapore.

They were all top students during their educational years, who obtained entry into top notch medical school on credit (not on quota). And they have decided not to return to this country.

As of now, I know of 2 doctor-bloggers who are currently pursuing their respective specialised discipline overseas and they don’t sound like they will return “home”. Worse, some of my other doctor friends who are currently here are looking at migrating.

15 or 20 years from now, who will be the next batch of medical specialists looking after our health, or our children’s health? Will they be the top notch doctors who have gone through the right kind training? Or will they be the kind of
doctors who cannot even read simple x-ray films? If I am to stay, will I need to travel to Singapore every 6-month for my kidney check up in the future?

Brain-drain, is a big word… a very BIG word. It is so big, that I think most Malaysians have not fully grasp the frightening repercussions that come with it. If you think brain-drain is only going to cause the economy to crumble, please think again. You have no idea what is upon you.

I can go on and on, linking the economic elements to this worrying medical issue, clasped within an often over-looked concern. But I am sure you know what I am trying to get at.

But if you are unable to digest, or if you still believe that all these will not affect you; you better pray you can afford good private medical care when you have all sorts of medical problems from eating all the good nasi-lemak, bak-kut-teh and char-kuey-teow. That is, if there is still “good-private-medical-care” around.


1 year ago…
The chronicles of holes and poles

2 years ago…
Modern colonisation

34 comments:

Swee Ping said...

this indeed is a big concern, zewt. alot of specialists are aging and generally we have doubt on young specialists because we feel they have not 'seen' alot yet. when i visited this particular private hospital recently, there were so many young doctors which i doubted them and even have the thought that i would not want them to treat me. it's very stereotyping of me (however if it was my friends, i might not doubt it though) but when it comes to health, i rather not take the risk. tthis concern has been around for a long time. alot of them decided not to return for various reasons e.g. better pay, treated equal or at least better compared to home. and can we really blame them? no, we can't. in fact i remember there was an article when i was in secondary school, a guy who was doing successfully oversea in his medical field decided to return home because he want to serve his country. and guess what most ppl commented? this guy is dumb because he won't get what he deserved here nor will he be treated fairly in.. well you know what.

mun said...

Well, God has a plan for everyone of us so we should just have faith in Him. No need to worry about things that are out of our control.

But if one is really afraid of all these despite trusting the Lord, then help oneself by either migrating or work hard to earn money to buy the best medical insurance package.

Anonymous said...

Dont they miss our good ckt, nasi lemak and bkt ? Hahaha.Those who couldnt afford to migrate should really invest in insurance like mun said.

doc said...

relax, buddy! there are still quite a few good nephrologists who will be in service for the next 15 years or so - at least, these are the one i know.

should you want to change or get a 2nd opinion, feel free to email me. i know 3 in private practice & 1 still with govt service.

despite the brain drain, it's not the end of the world.

yet.

MKL said...

Well, I don't know if there is a god or not, but fact is, some countries pay their doctors well and some not. Some countries attract good doctors and from some countries doctors run away. And that IS a concern, especially if you have a condition, it becomes a real concern.

Great topic, Zewt and hope that people talk more about brain-drain. If a country wants to become developed, you have to keep the intelligencia at home. It's simple.

day-dreamer said...

You seriously got a point.

But how to keep those brains and talents in Malaysia when even most of us here are trying to seek a way out if possible? =X

LX said...

Zewt, I think I am one of the rare ones who can I dare say I am going back. I may not be the top student of my batch, but I think I would wanna work hard to be a good doctor! There is a lot to learn in the UK to bring back to our country. Kinda feel left out seeing most of my friends staying back in the UK to work, but I guess there is a reason for everything..

zewt said...

Swee Ping - perhaps there are some rare gem around whom we can rely on but i think from an overall perspective, the numbers are certainly declining. yeah, we just dont want to take chances when it comes to our health...

mun - hmmm... as much as i want to talk about God, bringing Him in will sorta create a lot of debates. it's a delicate matter. i try not to comment abou thim, besides, my pastor is a reader here :)

anon @ 12/10 12.02am - that's not the real solution my friend...

doc - hmmm... would definitely wanna know who are they...

MKL - i was watching grey's anatomy yesterday and there was a part where izzy said she barely earns USD30k a year, as a surgeon in US... i wonder if that is true.

day-dreamer - that is something we should really think about. and the solution is not to buy insurance.

LX - kudos to you!! hopefully there will be more like you. but i also pray that you will stay focus and stay energised becos this road is certainly one that is less travelled.

eiling lim said...

Gosh this is a rude awakening post. I guess, I have to start taking care of my food intake or else I need to fly to Singapore now and then for obvious reasons. Thanks for the waking up call. That's why I come here daily for a dose of the brutal honesty.

KoKo said...

easy only what, just pay up

j_yenn said...

hopefully nothing serious, your condition.

definitely a "worst case scenario" here. i think i should move out too :P

pablopabla said...

Of all my classmates (or schoolmates that I do know of), only one became a doctor. He went to study in Canada and became an anaesthesiologist. Nope, not coming back. Another 3 that I know studied dentistry. Only one working back home. The other two are overseas and not coming back.

neno said...

better save money!!spore medical expenses are not cheap..nothing comes free there..at least we gif free meds here..lol..

Anonymous said...

zewt,

you must be God...knowing all the nephrologist in malaysia and their records of treating patients. Only God with all the information at hand can come to that conclusion. You must be God.....

MKL said...

And you must be the devil, haha... As Zewt as it gets, Anonymous... as zewt as it gets ;)

pinknpurplelizard said...

Good and 'good' doctors...

Anonymous said...

Even private hospital, the doctors are not all great. I know one in Subang Medical Center who is not good.

And to the upper 2nd "Annoymous", you don't have to be God to know the real statistics.

HuntressMoon said...

i have no worries on the matter. i have finally decided to immigrate and will be soon, looking to settle stuffs in malaysia for 2 years or less.

blackjack said...

zewt, you now have a "hater" in your reader list haha!

zewt said...

eiling lim - yeah, you should... wine, meat, chocolates + so much cigars will take its toll at some point... do take care.

KoKo - you got so much money of cos can lah.

j_yenn - nah, this is not the worst... not yet...

pablopabla - is the other one looking to leave too? sigh...

neno - yeah, it's free here... but is it good? too much horror stories.

anon @ 13/10 12.19am - should you wish to worship me, you may do so. there is no need to refer me as God though.

MKL - cheers mate!

pinknpurplelizard - i know what you mean.

anon @ 13/10 9.53am - to be fair, there are also crap doctors in other countries...

HuntressMoon - well done!:)

blackjack - i welcome them with open arms...

5even11 said...

medical insurance package is a scam in the 1st place, we shouldnt even have to bother abt buying medical insurance IF we have a good healthcare system run by the GOVT. Public healthcare is run poorly (intentionally or not i dunno) so there will be more costly private healthcare, having more costly private healthcare will 'pursuade' healthy ppl to buy lots of medical insurance, just-in-case-mindset. Who benefit from all this? Urs truly insurance companies/bankers/tax collector...and who get to spend this collected tax money? ur guess is as good as mine, don worry, MSIA is not the only country practising this....

brain drain IS the end of MSIA, all natural resources can and will be drain, only human resources can be replenish, yes, MSIA is replenishing brain drain in other countries ie Spore/Aus/US....etc

I am not against good doctors pay package, i am just against a system of "good doctors migrating+public healthcare deteriorating+medical plan getting more costly +private healthcare gettin more costly + doctors standard deteriorating" vicious cycle...bcos this vicious cycle will lead to more brain drain n it will never end

msleepyhead said...

been reading your posts of late. good stuff indeed.

another term that should be used like your post on the quack doctor is 'brain hemorrhage'.

hopefully there will be enough good guys like you and your friend who will be serving the country.

The Envoy said...

Sigh.....the longer one's life is, the more problems there are....

Ju-Lian said...

YOURE SCARING ME!

Jun said...

if u come to melb thr will still be nice char kuay teow too-- as i have recently discovered! hehe..

Yvonne Foong said...

Hello Zewt, coincidentally two teenage college students came to interview me today. One of the questions they asked was whether I am happy doing what I do ie. being able to raise funds for myself and don't have to depend on other people.

I told them that I am very fortunate to be able to get the support I need. But I do wish to live in another country someday with a fair, welfare system so that not only I will get medical treatment, my peers too. There are still many NF patients in Malaysia so poor that seeking treatment at all is a luxury.

In a way, being able to get treated in LA is a blessing, but in another note, it's a pity that I have to go.

Siew said...

This is sad, isn't it? I, at the moment, travel to Singapore every 6 months because our country doesn't have a peadiatric nephrologist.

zewt said...

5even11 - i actually read somewhere that the diseases covered under medical insurance are actually very very very rare diseases. so when you are being hit with something, there may be chances that you will not be covered... scary... well said... all those factors put together... very scary for all of us.

msleepyhead - i am afraid people like me are all looking for a way out.

The Envoy - that's life mate.

Ju-Lian - hehe...

Jun - bring me when i am there!

Yvonne Foong - social welfare is something country is seriously lacking. it will be a long while more before things will improve... if it ever improves.

Siew - there you go... you should share your story...

neno said...

wakakaka..free..wat u expect??lol..

zewt said...

neno - but service quality if terrible leh.

neno said...

kekeke..nt if u meet me:p but then depends on my mood oso la..wakakaka..but u so leng chai (looks like justin) shud b no prob la..lol

zewt said...

neno - hahahahahaha... !!!!

h. said...

hey! great blog. i wanted to comment on the doctor-issue since i am doctor-to-be myself, in a developing country.

the thing is, there's a reason why you only see OLD doctors who are recognized, good, famous, [rich] and hard to get an appointment to:
1. it takes about 10 years to get your diploma (or a bit more if you're a lady who also wants to have children) -> you're older than 30 for sure
2. it takes another 5-10 years to get a real chance to prove yourself (depending on your status, knowledge, neatness and RELATIONS)-> over 40
and if you survive, you get where you wanted to, you're not gonna step down when you should,because you just got there,it's not worth it, this isn't why you worked so hard, abandoning, letting down your family,kids and friends night after night. you don't retire unless you can't stand on your feet anymore so the younger generation doesn't get a chance.
-> you're over 60 and you're still there

add all the hard work, sleepless nights, lonely days with a low paycheck and you understand why all the good doctors are leaving. if you're not going to have a nice family, at least you should get paid decently.
if you take a good look at famous professors, hosting international conferences, you'll realize there's something they all have in common: a missing wedding ring.

and if you think about how much time, effort and money does a doctor invest into his future, it makes sense that he expects his investment to pay back at some point, especially since this is a long term investment. right?

i'm not proud admitting this. but it's true.

zewt said...

h. - hello there. welcome! wow... the way you say it... it's like accountants hahaha... all old without a wedding ring, all in the name of success. i guess every profession has a story to tell. but this post though, is to remind people of the seriousness of braindrain...