Open Letter | Health Minister

OPEN LETTER TO THE MINISTER OF HEALTH

YB Dr Dzulkefly Ahmad

Minister of Health Malaysia

Ministry of Health

Block E1, E3 , E6 , E7 & E10, Parcel E

Federal Government Administration Centre

62590 PUTRAJAYA 

Malaysia

Phone No: 03-8883 2527

Email: drdzul@moh.gov.my 

Dental Surgeons (general dental practitioners) are exposed to a variety of dental specialities during their undergraduate training. As a matter of fact, dental students are taught to bend wires and apply simple orthodontic appliances. With new innovations, new dental materials and advances, many simple orthodontic procedures may be performed by general dental practitioners exposed to proper training. Similarly, with dental implants. While it would be professionally, ethically and legally wrong for General Dental Practitioners to claim to a Specialist when they are clearly not, there is nothing to stop them from treating simple cases within the limits of their training, competency and experience; and know when to refer cases to the various Specialists when patients require specialist treatment. This is such common sense that it hardly needs repeating.

As a healthcare consumer, I applaud the non-specialist professional dental organisations such as the Malaysian Orthodontics Practitioners Association,  the Malaysian Oral Implant Association (MOIA), the Islamic Dental Association of Malaysia (IDAM). While many of their members are Specialists in their own right, these professional organisations are open to General Dental Practitioners and even to dental students. It is a way for experienced and senior members of the dental profession to pass on their vast experience and knowledge to the next generation of dental surgeons. I see it as a form of national capacity building, in our nation-building efforts.

This is unlike a few of the specialist dental organisations whose members are exclusively from their speciality. They are not inclusive and appear to be protectionist cartels. If they continue with this aloof stance, it is little wonder why general dental practitioners are wont to refer complicated cases to them.

The dental profession in Malaysia is undergoing dynamic structural change. With the issuance of licences for the establishment of ten private dental schools in Malaysia about ten years ago, a few cohorts have graduated, finished their housemanship (read compulsory national service) and are entering private practice in increasingly larger numbers every year. Their syllabus is by nature, having kept up with recent developments and research, different from that of dental graduates of 15 or even 10 years ago. Even as undergraduates, they have been exposed to the latest techniques and procedures unheard of a decade earlier. This puts pressure on General Dental Practitioners to upgrade their professional development over and above their compulsory annual CPD points requirements. At the same time, they are faced with a dilemma - the financial opportunity cost of giving up three years of income to pursue a professional course of specialist studies leading to becoming a Specialist is high. At the same time, they face competition from the annual cohort of newly-minted General Dental Practitioners who have completed their housemanship and received their APC (Annual Practising Certificate). This young generation is not contented with merely doing scaling, polishing and extractions as their undergraduate studies have trained them to do far more than that. Furthermore, their two years of compulsory government service as housemen have given them the requisite practical experience to complement their undergraduate academic studies. They are ready to contribute to the nation’s dental health. We should do everything within our power to assist, not impede, their professional growth and contribution to the healthcare level of our society.

On the subject of housemanship, it deeply saddens me to hear of cases where fresh graduates (medical as well as dental, mind you) have to wait for up to two years to get a housemanship posting. Apparently, the Ministry of Health has the posts and vacancies but the Ministry of Finance has not approved the necessary budget to pay them. This is an allocation of financial resources issue and needs to be tackled at the highest political level to see any improvement in the current deplorable situation. Malaysian graduates (private students, not government scholars) of foreign universities appear to get the least priority, since they are so many local private dental and medical schools. I have personally met Malaysian medical and dental graduates from foreign universities working as sales promoters for health supplements manning booths in supermarkets and malls. While I applaud their personal initiative, I really, really lament this tragic waste of trained human resource. Their parents had not only actually saved our government money by funding their children overseas but by studying overseas, they had made available more places in local medical and dental schools for other students. Such a missed opportunity in terms of national capacity building and nation building!

I urge, in the strongest possible terms, for the Ministry of Health to get the necessary budget from the Treasury to right this tragic and deplorable waste of a missed opportunity, for the sake of our beloved country and the healthcare of its people. Human capital is our biggest resource; it is a criminal waste to squander it.

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