Commenting on:
https://www.facebook.com/100002048184721/posts/2392264154185167?s=1759664068&sfns=mo
The Problem
This is an excellent analysis of the situation the profession currently faces. While not totally preventable, it was definitely foreseeable.
Option 4 is not an option. Dental surgeons chose to undergo a long and rigorous course of study and training to practise dental surgery; not to become product salesmen, or whatever. Same goes for option 3. No doubt there is a pressing need for professionally-or vocationally-trained dental technologists, one needs to undergo a dental technology course such such the degree offered by the Manchester Metropolitan University, not a dental surgery degree. Some estimate there is a need for 7 dental technologists for every dental surgeon.
Background and Context
Initially, the 3-year compulsory government service was a form of national service for nation-building, an attempt at capacity building. In the years after merdeka, not onlly dental surgeons, but also other professionals such as medical doctors, pharmacists, architects and engineers were required to undergo compulsory government service.
Public Policy & Healthcare as Social Safety Net
As the years went by, the situation of the country has changed. While the national population has grown, healthcare infrastructure has not kept up with increass demand due to population growth. Earlier this month, I commented on an article that complained that our hospitals are in critical condition because there are too many patients. I would argue the issue is not too many patients but the pace of healthcare infrastructure development did not commensurate with population growth. Free public healthcare is a social safery net we must upkeep. Instead of investing in military hardware and iconic mega towers, we must address real needs, not in ego building to glorify one’s self or family.
Even to enter the compulsory government service program, there was at one stage a waiting list of three years, now I believe it is down to seven months, thanks to pressure brought on the government by members of the MDA and MDC, to name just two.
The Reality
Starting a new dental clinic and surgery on your own for a new dental surgeon is not easy. Quite apart from the issue of funding, it must be borne in mind that a private practice is a business operation. Dental surgeons are trained as clinicians, not in the skills of running and marketing a on-going business, let alone initiating a start-up (quite different business management and marketing skills need to be applied).
An Initiative
In this regard, I must commend the initiative of IDAM, the Islamic Dental Association of Malaysia, in successfully organising annual Dental Entrepreneurship conferences for the past three or four years. We must build on this, definitely. I have suggested to your president the production of a series handbooks or manuals and we will proceed to discussions as soon as I am discharged (I’m admitted until Sept 8 ). I am bored stiff, so I welcome visitors if you wish to come here to discuss.
Self-Determination
As to the issue of limited skills practised at a Klinik Pergigian, I was made to understand that dental surgeons were given the opportunity to undergo rotations or internships with various specialists at the district and general hospital level. Perhaps this need to be better organised. There needs to be structure and transparency, perhaps Pegawai Pergigian need to take the initiative and request for it.
I cannot over-emphasise that the onus is on the dental surgeon himself or herself to learn. On average is takes a minimum of 8 years after obtaining a basic dental degree to have the necessary work experience and postgraduate training to reach the professional pinnacle - the fellowship of the Royal College of Surgeons.
While this may not be the ultimate goal of every dental surgeon, even undergoing a masters in clinical dentistry in a dental speciality takes four years of postgraduate study.
Alternative Paths - There are Many Ways to Skin a Cat
There are clinically-rigorous certificate-level courses a young dental surgeon can undertake in dental implants, orthodontics and even oral surgery.
Dental Hospitals
Perhaps, it is time for the dental profession to pressure the government to open not just a dental hospital but a string of them, one in each state. They would serve as postgraduate teaching hospitals for postgraduate clinical dental courses at both masters, PhD and postdoctoral levels. Its been to be remembered that clinical courses been to be hospital- not campus-based, unlike purely academic courses. Masters students are already APCs holders so an earn-as-you-learn business model may be viable and applicable. The alternative - to give up two years of your professional earning life to pursue a full-time course has too high an opportunity cost.
In the Meantime What Can We Do?
From the business side, senior dental surgeons, particularly specialists, can provide mentorship programs with the eventual goal of opening additional clinics under a franchise program with the mentor. Dental Surgeons leaving government service after the three-year compulsory government service would be the target market. With a GDP as a PIC, these clinics will also provide referrals for patients who need speacialist treatmenr by their mentors. This is truly a win-win scenario.
A group practice model with perhaps dental surgical assistants, dental therapists, dental hygienists and even dental technologies working together perhaps under a cooperative model is something that needs to be explored and requires further study.
Now is the time to think out of the box and explore new business models and paradigms because we already know the same old same old ideas no longer work as they have broken down.
Disclosure
I am not a dental surgeon. I am trained in international business and management and provide a different perspective, a helicopter view from a management eye lens. I have a minority interest in a dental clinic. My daughter, ex-wife and many of my friends are all dental surgeons, some specialists. I am the founder of the Green Party of Malaysia, our principles go beyond socialist and deep ecology ideology but a more holistic approach to managing our biotic-associations with not just other species with which we share this planet but with all planetary resources. I am guided not just by Islamic principles of stewardship but also Buckmister Fuller’s Critical Path, an approach for a sustainable future for the planet. At the end of the day, sustainability is all about the survival of the human species. The planet does not need Homo sapiens, in fact, I dare say the planet would be better off without this destructive species. But Homo sapiens needs this planet to be in a clean, pure and healthy state if it wishes to survive as a species. Spaceship Earth is our only home, our whole evolutionary biological development was geared to living on this planet, not on Mars.
Copyright 2003-2019 Azlan Adnan. This blog post is sponsored by The Green Party of Malaysia
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