Scarcity of manpower resulted in long waiting lists for surgery

18 November 2011

KUALA LUMPUR: The scarcity of manpower in the healthcare sector, especially where healthcare is publicly funded, has resulted in long waiting lists for surgery, said Raja Muda of Perak Raja Dr Nazrin Shah.

Not only was there a shortage of surgeons, there was also a worrying mal-distribution of resources, he said in his address at the 14th Annual Meeting of The Malaysian Association of Thoracic and Cardiovascular Surgery (MATCVS) here today.

"The reluctance of doctors to operate in the less lucrative public sector or more remote locations, despite increased perks, have left thousands of patients without the means to obtain the treatment they need, needless to say surgeons are extremely overworked," he said.

Raja Nazrin said furthermore, surgeons were reported to experience a decrease in their autonomy because of greater external influences on their decisions, and as society became more discerning and educated, there was a far more equal relationship between patients and surgeons.

"Paternalism is becoming less and less of a norm and surgeons are often pressured by the high expectations of patients and their relatives that may even exceed a surgeon's ability.

"Sometimes, surgeons feel pressed by patients and their relatives to perform highly complex and high-risk procedures with unpredictable outcomes. On the other hand, the fear of being sued can lead surgeons to be on the defensive," he said.

He said he felt very heartened to note that hospitals such as the National Heart Institute (IJN), Universiti Malaya Medical Centre and Universiti Kebangsaan Malaysia Medical Centre had been playing a much needed role in making cardiothoracic surgery more accesible to the general public, while at the same time, enhancing human capital in the field.

Meanwhile, Raja Nazrin said research indicated that chronic illness such as cardio-pulmonary diseases were largely a consequence of lifestyle with behavioural risk factors such as unhealthy diets, physical inactivity, tobacco use and harmful use of alcohol which were responsible for about 80 per cent of coronary heart disease and chronic obstructive pulmonary disease in the country.

Raja Nazrin said in Malaysia, the forces of urbanisation was turning people increasingly towards sedentary lifestyles and towards conveniently-available, unhealty, processed and high fat foods.

"The Third National Health and Morbidity Survey conducted in 2006 revealed that the national obesity rate has rapidly increased over the decade from 4.4 percent in 1996 to 12.7 percent in 2002 and to 14.2 percent in 2006.

"Despite government efforts to curb smoking, the national prevalence of smokers remained virtually unaffected at 21.5 percent of the population and among the male population, the smoking rate was at a startling 46.4 percent," he said.

He said these trends indicated that there would be no shortage in the demand for healthcare with the number of cardio-thoracic surgeries performed having increased exponentially over the past four decades.

"Bypass surgery and catheterization have become routine procedures. Now surgeons are operating on patients that none would have dared to operate in the past and all these are made possible because of modern scientific discoveries and the continuous ugrading of knowledge, hardware and techniques," he said.

About the meeting, Raja Nazrin said with this year's theme "Back to Basics and Beyond" a proactive mutual commitment by the surgical fraternity, academic and research institutions was vital in renewing a focus on the powerful fundamentals that are unique to surgeons.

"Surgeons are able to test their hypotheses and see rapid, graphic results of their actions on their patients. This I imagine can be extremely rewarding and should not be lost sight of," he added. - Bernama

© 2012 Malaysian Association for Thoracic & Cardiovascular Surgery