Forum script

SERVICE MANAGEMENT IN PUBLIC AND PRIVATE HOSPITAL

MC: assalamualikum and very good morning to all, I’m Muhammad nizam as your moderator
today.
Today we will talk about the service management in public and private hospital.
As we all know, Customer service is the provision of service to customers before, during and
after a purchase. The perception of success of such interactions is dependent on employees
"who can adjust themselves to the personality of the guest”. Customer service concerns the
priority an organization assigns to customer service relative to components such as product
innovation and pricing. In this sense, an organization that values good customer service may
spend more money in training employees than the average organization or may proactively
interview customers for feedback.
From the point of view of an overall sales process engineering effort, customer service plays
an important role in an organization's ability to generate income and revenue.[2] From that
perspective, customer service should be included as part of an overall approach to systematic
improvement. One good customer service experience can change the entire perception a
customer holds towards the organization.
Before we going further, let me introduce to all of you our special panels. Let me introduce our
first panel. First is Dr Mohamad Saiful Hizam Taib CEO of hospital queen elizabeth kota
Kinabalu, our representative from public hospital.
WORKING EXPERIENCE: 20 years in service with General Hospital and currently Director of
Sarawak General Hospital.
SPECIALTY:
Paediatrics – General. the branch of medicine dealing with children and their diseases .
QUALIFICATIONS
MBBS (Mal) - professional degrees in medicine and surgery
MRCP (UK) - Membership of the Royal College of Physicians
Our second panel is PROF DR. mohd faizul fazwan bin abd Rahman. GENERAL HEALTH
DIRECTOR OF MINISTRY OF HEALTH MALAYSIA
Background:
His name is Mohd Faizul Fazwan Bin Abd Rahman. He was a former medical practitioner and
now he has held the post of General Health Director of Ministry of Health Malaysia since 2010.
He has PhD in Bioinformatics and Genetics from Kadir Has University of Turkey. Have
experience in medical field for more than 30 years. Served in several government hospitals
and private hospitals in Malaysia and has served in medical administration in the United
Kingdom for 5 years and in Australia for 3 years. Be a health professional health consultant to
the Malaysian health ministry for more than 10 years.

Our third panel Her name DR Nyla Edol, Deputy CEO of Gleneagles. Our representative from
private hospital. she study medicine in the United Kingdom and graduated as a doctor in July
2007 from the University of Edinburgh. During her time at university she has also gained an
intercalated degree in Pharmacology which awarded her as a Bachelor of Medical Sciences
(Pharmacology).
She had worked as a junior doctor in Cambridge and did her Masters of Philosophy (MPhil) in
Translational Medicine and Therapeutics (TMAT) at University of Cambridge. After completing
her master's degree with First Class Degree in mid 2009, she continued her stint at Imperial
College London as a Trainee Surgeon with the support of NHS Health-care Trust. Her
specializations are general surgery and trauma/emergency. At the same time, she had served
at St Mary Hospital, Royal London Hospital, Chelsea & Westminster Hospital and Charing
Cross Hospital.

And our last panel is DR mimi .specialist doctor at UNITED KINGDOM, 1 of the best hospital
in the world. She graduated as a doctor in July 2013 from the University of Edinburgh.[5]
During her time at university she has also gained an intercalated degree in Pharmacology
which awarded her as a Bachelor of Medical Sciences (Pharmacology).

She had worked as a junior doctor in Cambridge and did her Masters of Philosophy (MPhil) in
Translational Medicine and Therapeutics (TMAT) at University of Cambridge. After completing
her master's degree with First Class Degree in mid 2015, she continued her stint at Imperial
College London as a Trainee Surgeon with the support of NHS Healthcare Trust. Her
specializations are general surgery and trauma/emergency. At the same time, she had served
at St Mary Hospital, Royal London Hospital, Chelsea & Westminster Hospital and Charing
Cross Hospital.

QUESTION 1
MC : lets move to our topic today. My first question is for Dr Mohd Faizul, first and foremost, if
I may to ask, what exactly is the main difference between a public and a private hospital?

DR MOHD FAIZUL :
The prime difference between a private hospital and a public hospital is the ownership. A
private hospital is one which is owned and governed by a person or many people who are
managing the whole finances on their own. A public hospital, on the other hand, is completely
and entirely run by the government’s funding and money. Everything from the construction to
the fees of the doctors to the equipment, medicines are based on the government budget.
Hence, each and every single thing is being taken care of by the local government body. A
public hospital is considered to be a preferable option for the not-so-rich lot of people who,
despite acute illness, cannot afford the heavy fees of a private hospital. It is very ironical to
see that a hospital that is governed by the government, which has obviously more funds than
a group of people or one person alone, does not offer that level of service that can be
counted on in most of the times. However, this can be due to the fact that a government has
a limited budget allocation to health care as it has many things in its hands such as defence,
education, economy, etc.
The fees of a private hospital are higher than that of a public hospital. It should be noted that
most of the time public hospitals offer their services free of charge or for reduced rates. In a
public hospital, since the services are mostly free, waiting time is longer. For some operations
patients have to wait for years until they get their place. In a private hospital, waiting time is
less. If you have money, you can get you operation done very quickly. Private hospitals have
the most modern equipment and the equipment last longer too. Public hospitals have good
equipment, but due to the extreme use they can get damaged more often than those in a
private hospital. Number of patients per doctor is higher in public hospitals. It is not good as
the attention is too much divided. It is also exhausting for the doctor. Since private hospitals
are a kind of a business they earn a profit like any other business. However, that is not the
case with a public hospital. Governments operate public hospitals for the health of their people,
and not to earn a profit.

QUESTION 2
MC: my second to DR faizul . How cost dimension can be included while evaluating the
service quality of public and private hospitals using survey method?
Basically what we can as the government or even the public evaluating is how the healthcare
services are actually delivered. Generally it is assumed that quality is better in private sector
as clients are charged fee for availing the services. However in public sector costs are in the
form of expenditure by government on equipment, salary, infrastructure and so many other
things. So, it is not fair to use it as the measurement of comparison for both sectors. Actually
there are available for certain mechanism to estimate the costs for both sectors, so that
genuine comparisons could be made between the service quality deliveries of both the
sectors. In our department, we have worked on the development of different kinds of
performance and productivity metrics for health facilities mainly in developing countries as
Malaysia can be assumed as one of it, in which it is also covered cost aspects. We proposed
a study of costing for our national health insurance system that would consider, just like in the
private sector, all costs direct and indirect of health services. For example, for a case of
appendicitis, operating room cost should include direct costs as well as indirect costs such as
electricity, water, depreciation of equipment, labour costs and etc. This would give us an idea
of the actual comparison cost of the services in both sectors that strongly affected on the
efficiency of the services provided in these sectors. There are many studies that compare the
quality of services between private and public hospitals. Most do not show that the quality of
services is better in private hospitals, at least for the developed countries. I think it might be
different for developing countries as the difference in the level of resources might be higher
between the private and public sector. If you want to see an overview of the evidence up to
2010, you might take a look at the first chapter of Patrick Jeurissen dissertation: for-profit
hospitals in Western countries. Best long essay written as a requirement for the Doctor of
Philosophy degree by Patrick Jeurissen. You can find your answer in it.

MC : tq for your answer DR.

QUESTION 3
HANDLING CUSTOMER COMPLAIN
MC : we proceed to the next question. Its about handling the customer complain. Before we
ask out special panel.
let me share with all of you, about complaint. It happens When a customer feels strongly
enough that his or her expectations have not been met, he or she may make a complaint.
A complaint is when a customer brings a problem to the attention of the organization and
expects some redress, probably over and above simply supplying the original product or
service that was the cause of the complaint.
Complaints are often used by regulators as one measure of the success of the organization’s
customer service specially in healthcare industry.
This question will be ask to our two representative from public and private hospital. DR. mohd
Saiful ? how the public hospital handling the customer complain ? can u elaborate to us ?

DR (PUBLIC) :
Tq MR nizam. There are real benefits in prioritising and improving complaints handling:
nearly all customers would recommend a to their friends if a complaint had been resolved
efficiently, four out of five customers would spread the word if a complaint had been handled
badly still not many companies seem to be listening to this key customer service point, so
there are advantages to starting now despite the rise in complaints, only one in four employees
feel qualified to deal with them only one in three customer-facing staff are actually trained to
deal with angry customers. Most customers would pay more for excellent service
The 5 rules of complaints handling for organizations, especially in our public hospital, which is
:
1. Have a strategic plan
Have a clear, flexible welcoming and open policy on complaints. A complaint is a gift when a
customer gives up their time to help you improve your organization.
2. Train your staff and management in complaints handling
Give them confidence to tackle the difficult customers and support in their actions. Excellent
complaint handling isn't easy and can sometimes be stressful and feel unrewarding. Confirm
its importance in providing great customer service.
3. Give complaining enough priority and authority
Staff should be aware that complaints are a top priority item for your operation, and anyone
who deals with them must have sufficient authority to resolve them completely.
4. Ensure that you can process complaints from all sources
There are 4 main ways to complain – in person, by telephone, by mail, by email/internet. Your
organization must be able to handle all of these efficiently.
5. Set up processes to log and analyses all complaints and share with everyone
You can learn a lot about problems with internal processes, training, specific
employees/managers, and product for free.
MC: TQ DR MOHD SAIFUL, what about private hospital? DR nyla can u share with us how
your hospital handles the customer complain?
DR (PRIVATE) : tq MR nizam. I think the point that DR Saiful said early actually is same to
private hospital as well. We also using that method, but I want to add something which is. The
process and action for setting up complain handling, there are 10 point we can focusing.
1. Thank the customer for complaining
Say that you are sorry that the problem has happened. This is not an admission of guilt and it
does demonstrate respect for the customer.
2. Put yourself in the place of the customer
This will instantly give you an advantage, as you not only will have more empathy with the
customer, but also you know your business better than them and so can hopefully see the
solution quicker.
3. Start with the view that the customer has a valid point, not that he/she are trying to rip you
off
It is true that there are some professional complainers, but they are in the minority. if you are
a local store, you probably know them anyway. Accepting the customer may well have a point
can trigger ideas for an acceptable resolution.
4. Get all the facts first
Let the customer give you all of the information. This will help you fully understand the situation
and, if the customer is emotional, this will give them time to calm down. Don't offer the
complainant a free gift straight away. It's very tempting to give the customer a gift, or vouchers.
In many cases it is good service, but too often it is done instead of solving the problem, which
can lead to more complaints about the same thing because it hasn’t been fixed.
5. Correct the mistake
All of the other suggestions are pointless if you don't fix the problem. Make sure that your
definition of the right fix is the same as the customer's.
6. Learn from every complaint
Fix the process: Train staff in the issue and eliminate the fault. Wherever possible let the
complaining customer know that they have helped you resolve a problem. They'll come back
again and again and will probably spread the word.

7. Minimise reasons for complaints

Do you have a continuous improvement culture? Do you check customer (and employee)
satisfaction regularly? Do you check the quality of the goods sold in your organisation?It costs
at least 5 times as much to gain a new customer than keep an existing one, and takes 56 days
on average. Keeping this complaining customer should be the top priority, and at these cost
ratios you can afford to be generous in your time and effort.
8. Always respond
In person complainers hopefully always get dealt with, but make sure that everyone who
complains on the telephone, by letter, or by E-mail gets a rapid and appropriate response.
9. Listen to your staff
They nearly always care about your company and doing a good job and are much closer to
the customers than you are. Ask their views regularly and make changes when they are
sensible. Make sure their complaints are handled too.
10. Lead by example
It's not that your staff don't listen to what you say, it’s that they do listen, so make sure that
you are always setting the right example, and giving complaints your personal priority. Reward
good complaints handling.

QUESTION 4
TRAINING AND DEVELOPMENT
MC : the next question I would like to ask our specialist doctor from UK, DR MIMI AZUREEN.
About training and development. For your information, dr mimi was in charge in giving training
and development for the doctor in UK. she has many experiences in this term. Maybe DR you
can share with us your experience ?
DR MIMI :
As healthcare provider shortages loom, hospital and health system training and development
programs become increasingly important. Such programs can help retain current employees,
improve their skills and positively impact the overall quality of a health system — something
that is increasingly important in a value-based world.
Yet, training and development initiatives aren't often a top concern for health system leaders.
This, of course, is not surprising given that leaders are faced with more pressing issues, such
as reimbursement, compliance, clinical quality and beyond. However, training and
development is an important area that leaders should assess often.
few best practices that can help ensure any given training program meets its goals without
overextending a health system's resources.
1. Create training programs for different learning styles. Training programs should include
material that appeals to various learning styles: verbal, visual, hands-on, etc.
Training programs also need to reflect the multilingual employee population in so many
hospitals today. "We often make the generalization that if this is in English and it is simple
enough then everyone's going to get it, and that may not be the case," notes Ms. Horseman.
"You need to ensure all of your different employees in their different roles — from the
housekeeper to facility worker all the way through the CEO — can comprehend the
information."
2. Make programs interactive. Group work, quizzes and other activities can help make training
programs less lecture-based and more interactive — something that not only helps employees
retain information but also makes the training more enjoyable for them.
"You have to make it as interactive as possible; the more involved [employees] are, the more
they retain," explains Ms. Horseman.
3. Embrace computer-based training modules. While certain types of trainings may be better
suited for face-to-face training, many others can be completed online. Computer-based
training modules are often more convenient for employees as they can be completed from
various locations, at different paces and at times that work within an employee's schedule.
4. Personalize information so it is specific to your hospital or health system. Another reason
develop training programs is because, in addition to being cost efficient, information within the
training can be specific to facilities and procedures.
5. Ensure training reflects changing skills. Hospital training programs have always covered
issues such as compliance and clinical competency, but increasingly hospitals are developing
programs around newly sought-after skills, such as customer service and patient-centered
care.
"What we've seen more than anything else because of value-based healthcare is that we're
putting more focus on the patient experience and balancing it with quality and cost,"
. "We've always covered customer service in orientation, but it's certainly more in depth than
before. As the patient experience plays more into our reimbursement, we have to get across
to staff what this means and how the employee can impact it."
6. Consider employee demands beyond training. Employees at hospitals have multiple
responsibilities, and training should be designed so that it can be completed without taking
away from those responsibilities.
"One of the things that makes healthcare unique is a large part of our employees are nurses
or physicians who are caring for patients,". "We really need to make sure we're putting together
training that is effective for them. Not everyone is at a desk, so training they can do between
daily activity is ideal."
7. Evaluate the effectiveness of training programs. Finally, hospitals should always assess the
effectiveness of their training programs through surveys and testing of skills. After all, a training
program that doesn't effectively improve some skill or competency is a waste of health system
resources and employees' time.
MC: a very detail explanation I guess DR mimi. I think that kind of method our public and
private hospital can follow to be a better hospital as well as produce best employee in the
future. tqsm
QUESTION 5
PROMOTING SERVICE & EDUCATING CUSTOMER
MC: the next question is about promoting service & educating customer. For your information,
A business has immense benefits to reap from educating customers, if it fails to do so, the
customers will find the information themselves anyway, but the business loses valuable points
it could have scored with the customers, or worse – the customers switch to a competitor that
empowers and teaches them how they can get the most out of the product at hand.
Can our 4 panel share with us the way and how promoting service & educating
customer/patients ? we start with DR Faizul ?
Dr faizul: Here are 3 benefits I will share with you of educating your customers –
1. It Builds Customer Trust
In an era where companies use various marketing ploys to lure as many prospects into using
their products. Customers are more likely to trust those brands that make effort to enhance
their knowledge about the nature of its products. Research has shown that educating
customers strengthens their trust in an organization, and it can act as an important service
differentiator for brands.
The smart consumer will opt to get service from the company/hospital that’s educated him on
the issue and presented him with multiple solutions. That company’s selflessness has built
trust — and its ability to teach him has bought his loyalty in the future
2. It Reduces Complaints
Besides building customer trust, educating customers will lead to a reduction in complaints as
the customers become more adept at solving a good number of problems related to the
product(s) on their own. This eases pressure on support channels and enables support staff
to handle other issues.
When support staff can pay more attention to other tasks, they become more productive. This
is possible since fewer customers are calling or emailing them for assistance on basic issues.

3. Enhances Customer Loyalty

When customers know and understand a product, it’s features, capabilities & limitations, it
gives them realistic expectations on what they can achieve with the product. This deep
understanding of a brand’s product or service is very important for building trust.
Educating your customers helps them understand your products better and build trust with
your brand. Without this trust, loyalty will not be possible.
MC: how about DR Saiful ?

DR Saiful:
3 Ways To Educate Customers
#1. Create Hands-On Experience
Educating Your Customers - Hands-on Experience
Create opportunities for customers to touch, watch or experience your product with live demos
or samples for them to test out. Remember that most people are visual or kinesthetic learners
– they need to see, feel and have their hands on something to really learn and understand
how it works.

#2. Organize Workplace

Depending on the nature of your business, your customers might find workplace very helpful
in utilizing your product efficiently.This sort of engagement can be used as a differentiation
tool and also as a means to connect emotionally with the customer while creating more value
for them.

#3. Create & Share Useful Content

Create and put out content where the customers can easily access them, it could be on your
website, via email or social. In your content, tell them exactly how to use the products in very
simple terms.
Share the facts and DIY hacks that empower the customers to meet their needs faster or more
efficiently using the product. Content could take the form of blog posts, videos or graphics.
Share it on social media and try to reach as many customers possible
QUESTION 6
CHALLENGES OF SERVICE MANAGEMENT IN PUBLIC/PRIVATE HOSPITAL
MC:next question in on challenges of service. Field service management is a serious
challenge that involves multiple levels of coordination. companies need effective strategies to
meet customer expectations, balance the workplace, and stay profitable. In the digital age,
that almost always means adopting new technology.
Every business tries its best to overcome the challenges, but it’s a herculean task for field
service managers to hit their targets and achieve results in all directions. It’s important to make
every tactical and strategic decision based on accurate data, and in such a way that your
whole team will comply.
Let hear the view of our public and private representative DR SAIFUL & DR NYLA ?
DR saiful: Irrespective of healthcare industry, field service organizations face many of the
same challenges. Here are few point of the most common and explanation of how technology
can make a difference.
1. Schedule Adherence
Customers expect your company to deliver the products and services they pay for, and your
company relies on its employees to meet these expectations. That means it’s important that
field workers maintain their assigned schedules. It’s helpful to know your technicians’ real-time
location, their performance, and their adherence with assigned jobs and hours. Tracking your
workforce while they are in the field also means you can allocate work orders faster and
manage task distribution on a daily basis.
A field service management application that lets workers to coordinate with the back-office
using a service desk can solve this problem. You can see your workers’ location, schedule
and dispatch jobs, track hours, and monitor incoming customer requests with ease.
2. Performance Management
What are the best KPIs for measuring service efficacy?
Every company needs precise and clear data to compare their performance against goals and
make decisions that move the business forward. Do manual methods (like spreadsheets,
paper documents, and calculators) provide accurate analytics? Maybe, but only after a
mountain of manual data entry and research.
Dashboard and reporting modules contained in many field service apps can help decision-
makers monitor trends and performance without adding hours of labor to their already full
schedule. Plug and play reports are also a great way to analyze product demand and monitor
the growth of your customer base.

2. First-Time Fix Rate

Budget directives demand that every field service manager make a profit for the business
while maintaining a balance between quality of service and number of employees. For larger
businesses with more employees, underused resources can quickly compromise the bottom
line.
To achieve a high first-time fix rate, it is a wise move to employ field service management
software that comes with intelligent automation. This automation enables skill-based task
distribution. And having complete details before the service call helps the technician succeed
the first time.
DR nyla: for my view .
3. Communication with Customers
Customers like to stay in the loop about their service calls. If your truck is running late, or if
you have to cancel, or if you have to order a part and come back on a different day, it helps to
have a mechanism in place that extends visibility to the customer.
Customer relationship management practices adopted by any organization have a huge
impact on the success of the business, and field service is no exception. Retaining customers
and gaining new ones requires attending each of them with equal consideration. But what if
your representatives spend most of their time answering the same questions over and over
again, and someone with a different question goes unnoticed? Negative feedback on social
media and review sites can prove to be a major setback.
The solution, in this case, is the integration of customer relationship management with field
service. If you want to go the second mile, a branded customer facing app with a self-service
portal can reduce the number of calls and increase customer satisfaction.

QUESTION 7
Q&A FROM AUDIENCE (FACEBOOK LIVE/GUEST)
On our forum today, we will have Q & A from our guest and people who watch our live today
(facebook/tv) and will be answered by our panel. Ok everyone we already received 5 question
which is from MR ALI MEDICAL student from UMS , the question is HOW TO RECRUIT
DOCTOR AND STAFF AT THE HOSPITAL ?
This question is addressed to DR faizul. How actually the hospital government or private
recruit doctor or staff in healthcare industry ?
DR: FAIZUL:
 How to recruit staff/doctor in hospital
The market for recruiting physicians to hospitals has become competitive due to the shortage
of physicians and the push to align with physicians for accountable care organizations, patient-
centered medical homes and other collaborative models. Hospital leaders may have to be
creative in how they attract specialists to their programs to get the candidate they want. Tom
Florence, senior vice president of recruiting at Merritt Hawkins, offers seven steps hospitals
can take to successfully recruit specialists in a competitive environment.
1. Verify the need. "The first step a hospital should take before embarking on recruitment is to
verify the need. He suggests assessing current hospital programs' volume to ensure that any
specialist who is hired would be busy. He also recommends consulting with primary care
physicians to determine which specialists have waiting lists and would thus offer enough
business to sustain a new physician.
2. Understand the market. The next step hospitals should take is studying the marketplace to
gain an understanding of the number of candidates available for a specific specialty. For
example, there are fewer oncologists than family practitioners to choose from,
3. Develop a competitive financial package. After studying the market, hospitals should create
a competitive financial package that includes a base salary, potential bonuses and benefits.
The financial package should be competitive not only locally, but nationally to attract a greater
pool of people. In addition, a hospital should prepare the contract before inviting a physician
for an interview to show the physician upfront what the hospital is offering in writing.

DR MIMI: I also want to add few point, in my country in UK we :

1. Provide staff and technology support. Hospitals may be more likely to successfully recruit
specialists if they offer adequate staff support and the kind of technology the specialists want.
Some specialists, however, may come with their own support. Hospital leaders may need to
sign physician assistants and other personnel specialists have to make them feel supported
in their position.
Having modern technology is also important when recruiting specialists, especially for
hospitals in smaller communities. "Most specialty training is done in larger cities. "There's a
perception of fear when a candidate considers an opportunity in a smaller town, a perception
that [the hospital] might not have back-up or that the equipment will not be on par."

Mc: SECOND QUESTION IS

Why we lack of professional or specialist doctor at the hospital?

Dr faizul: LATELY, our newspapers both online and print have been flooded with letters from
the public highlighting the plight of housemen. Little do the public know that medical officers
who have completed their housemanship also face hurdles in their struggle to improve
themselves, spending money to further their studies and be of better service to the nation.
Very often, we hear the authorities lamenting over the persistent shortage of medical
specialists in our public hospitals. To overcome this problem, the government is encouraging
the training of potential specialists through the medical masters programmes at local
universities and allowing alternative pathways for serving doctors to be qualified and gazetted
as specialists, apart from hiring foreign specialists.
The alternative or parallel pathway has been the traditional route for our doctors to become
specialists well before the introduction of the local masters programme where doctors can sit
for one of the international professional examinations from a number of established bodies
such as the Royal College of Physicians, United Kingdom (MRCP).
Currently, on passing the MRCP examination, a young medical officer (MO) who aspires to
specialise in, for example, internal medicine, is required to have three years experience and
undergo another 18 months of training at a number of designated hospitals before being
gazetted as a specialist. This is equivalent to a medical master’s degree of four years followed
by six months of training before gazettement. Doctors undertaking the masters programme
are usually funded by the government (Hadiah Latihan Persekutuan) while those opting for
MRCP are self-funded.
However, several problems were encountered by doctors taking the parallel/MRCP pathway.
Firstly, many were told they have “insufficient” service experience in the required fields. As an
example, some MRCP holders found out to their disappointment that their years of general
medical service at district health clinics (Klinik Kesihatan Daerah) were not considered.
This is due to hazy guidelines requiring a minimum of three years’ exposure in specific/relevant
fields as a pre-requisite for entering pre-gazettement training. As such, these doctors have to
spend extra years to make up for the “lost” period at district clinics before they can embark on
the pre-gazettement training programme.
This is very unfair to the young doctors because the majority of them were posted to the district
clinics through no choice of theirs. At a time when there is severe shortage of staff at rural
clinics, they rendered their services, hence it would be a great injustice not to take into account
these years as part of the entry experience required for gazettement.
Secondly, a log book system was introduced recently to record the experiences of the MOs
with MRCP qualifications in handling certain procedures. It was introduced abruptly and many
doctors were not properly informed.
This new system requires all relevant experiences/procedures to be logged and certified by
the senior doctor in charge. However, this certification task has not been assigned under the
annual KPI or SKT of the senior doctor to make it mandatory. Thus, some senior doctors do
not want to certify for procedures that they could not remember, more so if they have the habit
of delegating work to their juniors.
The new system also requires the supervising specialist to regularly assess the young MOs
before certification. This is a noble move indeed, at first glance. However, in reality, many MOs
encounter senior doctors delaying or postponing assessments due to all sorts of reasons. To
the young MOs, this is really frustrating and demoralising.

DR SAIFUL: Additionally, the aspiring doctors have a hard time searching for their supervising
specialists as they could have been transferred or resigned or retired. Sometimes, the MOs
themselves are transferred, and searching for a particular supervising senior doctor for a
particular period of their training can be problematic. As such, the time spent and exposure
gained during these uncertified periods are not counted and have to be offset by additional
new experiences to be acquired.
difficult to standardize markings and time-consuming to do multiple assessments for both the
assessor and the MOs. When this assessment work is not counted under their SKT/KPI, many
senior doctors see it as a goodwill effort and tend to skip the assessment altogether, relying
on their daily interactions to allocate marks for the MO.
Hence, an MO who is newly transferred into a hospital may face a biased assessor, exposing
him/her to favouritism and power abuse.
In fact, some new assessments have been added in the log book which are redundant. Certain
components have already been assessed during the MRCP PACES exam ( a standardized
international assessment) and there is no necessity to reassess them. Time wasted for
redundant assessments will compromise patient care when staff shortage is acute.
The Health Ministry seems to handle the training of specialists in a haphazard way as can be
seen from the examples mentioned. There is lack of a clear flowchart of activities for the
aspiring doctors. Rules are being changed frequently, some of which are just plain impractical.
Procedures can be added and considered retrospectively. Many doctors in senior positions
do not seem to undertake their responsibilities ethically and seriously enough in managing the
training of those under their charge.
There is a perception that while the government is trying to increase the number of specialists
for the good of the public, there seems to be hidden hands trying to frustrate this initiative,
perhaps due to the narrow-minded mentality of the past that hopes to elevate their professional
positions by restricting new entries into their trade.
FOURTH QUESTION IS
 pros & cons of public and private hospital
specialist doctor

Pros and Cons of Private Hospitals

Many people prefer going to private hospitals for emergencies and various treatments. Some
advantages include:

 Thanks to their smaller size, they are more equipped to offer personalized care.
 Instead of being responsible for dozens of patients, nurses usually only have a few to
care for at a time.
 They tend to stay on the cutting edge of technology more easily than public hospitals,
and they often have upscale amenities that make them feel more like nice hotels than
hospitals.
 Wait times tend to be short, and doctor-to-patient ratios are usually excellent.

There are significant drawbacks to private hospitals, too. For example:

 They often only accept limited forms of insurance.

 They have the right to refuse to treat anyone who they don't think can pay.
 They also tend to be more expensive in general.
 Finally, they usually have very limited numbers of beds.

Pros and Cons of Big, Public Hospitals

When most people need a hospital, they generally wind up at a big, public one. Some
benefits to a public hospital include:

 Public hospitals can't turn anyone away, so you're sure to receive treatment when
you visit one.
 Because they are publicly funded and not for profit, they are usually a lot more
affordable than private hospitals.
 Due to their size, they also usually have a lot more beds than private hospitals.

As for the drawbacks of public hospitals, there are some to consider.

 Their sheer size is a big one.

 Although they have way more employees than private hospitals, patient-to-doctor
ratios don't tend to be very good.
 You are almost certain to wait when visiting the ER. Depending on the time of day
and the nature of your emergency, you could wait for hours before being seen.
 There isn't e much in the way of personalized care because nurses are often
overloaded with patients. After all, public hospitals can't refuse anyone.