Private clinics get final say on fees
Stakeholders: Advisories meant to help GPs find ways to cover rising operational costs
PETALING JAYA: Although some doctors' groups have proposed new service charges in retaliation against the newly enforced rule for displaying drug prices, private clinics can exercise their own autonomy in deciding their fees, says a private practitioners' group.
The Federation of Private Medical Practitioners' Associations Malaysia insists that the proposals made by some of its state affiliates were made in 'good faith', adding that they were meant to help GPs cover the rising operational costs.
Its president Dr Shanmuganathan Ganeson said while advisories were issued, it is not compulsory for clinics to fix prices accordingly, and clinics are able to exercise full autonomy in setting their charges.
He was responding to a Malaysia Competition Commission (MyCC) statement last Friday where the commission had cautioned private medical practitioners against introducing new service-related charges, as it could infringe the Competition Act 2010.
Dr Shanmuganathan revealed that medical practitioners had a dialogue with MyCC in December last year, during which a proposal for a RM20 regulatory compliance charge was considered.
Consequently, he said these state affiliates were mindful of not imposing fixed charges and opted to provide indicative ranges, but the move has since backfired.
'While the meeting with MyCC was constructive, the Competition Act now flags the decision to provide an indicative range as potentially problematic.
'At this point, we are compelled to ask: what are the government's real intentions toward private GP clinics?
'From where we stand, it appears the system is simply tolerating us until something more centralised and controlled is in place.
'Our profession is for patient care and the health of the rakyat,' Dr Shanmuganathan said when contacted.
'We want a sustainable, transparent GP ecosystem that patients can continue to trust.
'If there is no future for general practitioners in Malaysia's health system, we ask for honesty.
'Let us begin to responsibly wind down our practices so that our staff, medical suppliers, and patients are not blindsided when community-based private primary care collapses,' he added.
Dr Shanmuganathan said what was more disturbing was the regulatory imbalance where independent GP clinics are being scrutinised while corporate third-party administrators (TPAs) continue to suppress fees without equivalent oversight from the authorities.
GP Dr Roland Victor said it is not feasible for the price of medicines prescribed by clinics to be regulated as operating expenses may vary based on location.
'A shophouse in Mont Kiara will cost much more than (one) in Hulu Selangor.
'However, GP consultation fees have remained capped at RM35 for the past 30 years.
'Hence, GPs have no choice but to mark up medicine prices to manage their overhead costs such as rental, staffing and other facilities to sustain their clinics,' he said.
Dr Victor said he was not against the display of drug prices but GPs need to see consultation fees fairly revised for sustainability.
He agreed that TPAs contribute to the escalation of medical costs but they are not being monitored enough, nor are they regulated by the same laws imposed on GPs and clinics.
'These companies often dictate terms and conditions to GPs on how medical charges should be imposed,' Dr Victor said.
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