Dr. HM Goh started his career as a medical doctor. Then he transitioned to an informatics expert. Later he moved to health care management and now he is a health care investor working with a private equity. In part 1 he described how he transitioned from a medical doctor to his current job as a health care investor. In this part he will be giving advise to young doctors who want to pursue an alternative path to health care management. He will also talk about the future of private practice in Malaysia.

In this podcast I will be interviewing Dr. HM Goh. Dr. HM Goh started his career as a medical doctor. Then he transitioned to an informatics expert. Later he moved to health care management and now he is a health care investor working with a private equity. This podcast is divided into 2 parts. In this part 1 he will describe how he transitioned from a medical doctor to his current job as a health care investor. In Part 2 of this interview Dr HM Goh will be giving advise to young doctors who want to pursue an alternative path of health care management. He will also be giving his view on the future of private practice in Malaysia.

There is an unseen bond between pharmaceutical companies and doctors. Pharmaceutical companies need the doctors to promote their products and doctors need the financial assistance and marketing capabilities of pharmaceutical companies. The Malaysian Medical Council has a specific guideline entitled “Relationship between doctors and the Pharmaceutical industry” (MMC guideline 007/2006), which aims to ensure, that doctors be as ethical as possible when dealing with pharmaceutical companies. In this podcast, I will describe my experience with the pharmaceutical companies and I will give some advice to young specialist moving to private practice.

There are many situations in which you will need assistance from your colleagues or a specialist from another specialty. When and how to get assistance can be tricky. There will be situations where a colleague will ask you for assistance. You will have to decide whether you want to provide that assistance and the consequences that follow. I will discuss my experience in this area.

You are a government doctor and you want to move to the private sector. In the government service you get a fixed salary. You do not charge for your work that you do. In the private sector, you earn a living by charging a fee for your service. One decision you will have to make is when are you going to waive your fees or give a discount. Are you going to charge your colleagues, other doctors and the staff at your hospital? This issue is rarely discussed among doctors in Malaysia. In this podcast I will explain my experience having worked in a private hospital for more than 25 years. This I hope, will give you some insight on the decisions you will need to make when you move to the private practice.

As a practicing private practitioner, I will divide specialists in private practice into 2 categories and I will call them frontline specialists and supportive specialists. Let me explain further.

A frontline specialist is a specialist who has direct contact with patients. These are the specialists whom patients look for to seek treatment. Examples of these specialities are: Medicine and its subspecialities (general medicine, cardiologist, endocrinologists, rheumatologists etc), Paediatrics, Surgery and its subspecialties, Orthopaedic surgery, Obstetrics and Gynaecology. ENT specialists, Ophthalmologists etc.

Supportive specialists are those who support the frontline specialists. Patients don't seek them out. Examples of these specialities are Anaesthesiologists, Pathologist and Radiologist.

In this podcast I will discuss the advantages and disadvantages of these two different categories.

When I first decided to move to private practice, I applied to a well-known private hospital in Johor Bahru. My application was turned down, as I was considered “not marketable”. This had nothing to do with my skills or ability to work very hard. The decision was just based on my physical characteristics, namely being a male, Indian gynaecologist. I had to do more to attract the patients away from my female Chinese or Malay colleagues who will be the first choice for a woman requiring the service of an obstetrician and gynaecologist.  In this podcast I will examine all these physical factors namely race, religion, language, looks, age, gender and personality that may play a role in attracting patients to your practice.

So you have decided to move to Private Practice. How are you going to persuade the public to consult you in preference to your colleagues? At medical school, you were never taught about the economics of medicine or marketing for patients. In fact talking about money in the medical field is abhorred. Having concentrated on working hard to become a specialist, you have never thought of how to survive in private practice. You are unaware of how you are going to market yourself when you move to private practice. When working in the public service, you work in a cocoon where there is always an overflow of patients. In private practice, you will have to compete for your patients. This is a topic often discussed by doctors but rarely penned down. Having worked in the private sector for 25 years, I will try to outline my thoughts on this topic.

One clause in that contract that has always bothered me is that I am not allowed to practice anywhere else unless I get prior approval from the management. I have always wondered about the unfairness of this clause. We are not allowed to practice elsewhere but the management can bring in anyone into the hospital without even informing us! Bringing in another specialist in my field would definitely eat into my patient load and thus lessen my earnings but I am not allowed to go out to practice elsewhere to supplement my income? This, I have always felt was unfair. In this podcast I will discuss this issue.

I left government service for Mahkota Medical Centre, Melaka in 1994 at the age of 34.

I was a young specialist at that time. Most of the pioneer doctors were off about the same age. Being in a brand new hospital, we worked very hard to build it. As time passes, more doctors joined the hospital. In 2019 we celebrated our 25th anniversary. I am now considered a senior Consultant Obstetrician and Gynaecologist (although I still feel very young) in this hospital. Like most private hospitals in Malaysia, all specialists work as solo practitioners because most of the time we work alone with little involvement of our colleagues.

In order to survive in this kind of environment, I had to learn how to interact with all the resident specialists as well as the management of the hospital. Over the years I have gained much experience on how to build relationship with the various stakeholders of this hospital. Some of my experiences were good while others were not so pleasant. Somehow, even though these experiences are talked about casually among doctors, I think no one has actually written them down. So I decided to write down what I feel is important for a young specialist to know before joining a private hospital.