IN the late 1990s, Malaysia embarked on the promotion of medical tourism, especially in Indonesia. The Penang government had invited private hospitals in the state to take part in the well-organised Healthcare Service Exhibition in Medan, Sumatra.
Private hospitals also extended their campaign to other parts of Indonesia. These efforts have paid off.
In the meantime, the Malaysia Healthcare Travel Council was formed to coordinate and expand medical tourism. Between 2011 and 2018, the number of medical tourist arrivals had increased from 643,000 to 1.2 million.
The revenue also increased from US$127 million in 2011, to over US$362 million in 2018, according to the Medical Tourism Magazine.
During this flourishing period, many new private hospitals emerged to provide world-class healthcare services at affordable prices. Many existing private hospitals started to expand. Some have completed their expansion, while others are ongoing.
Before the pandemic, on average, medical tourism contributed between 40 per cent and 50 per cent of the business in private healthcare facilities. The local
insurance industry contributed about 30 to 40 per cent, which included personal and corporate health insurance.
During this period, many specialists left public hospitals for greener pastures in the private sector. This created a vacuum in public healthcare services, which allowed younger specialists to fill the gap.
However, due to the nation's financial constraints, there has been limited opportunity to train more specialists.
In August last year, it was reported that Malaysia was facing a shortage of specialists, with only four specialists to 10,000 citizens up to June 2020.
But the supply chain continued to produce around 5,000 to 6,000 new graduate doctors annually.
The waiting time to get a posting is between six and 13 months, and it may get even longer because of the pandemic.
This and the recent "Hartal Doktor Kontrak" demonstration by government doctors may significantly affect the decision of those who wish to take up medical studies. It will eventually lead to a drop in student intake at all private medical institutions nationwide.
The pandemic posed financial challenges to individuals and corporations. The United Nations reported that Malaysia's foreign direct investment (FDI) dropped by 68 per cent in 2020.
However, in such times, new opportunities also arose to benefit countries that are resilient. Much FDI has shifted to our neighbours, especially to Indonesia.
The shifting of FDI has affected job opportunities and corporate healthcare insurance contributions to the private healthcare industry.
Recently, the president of Indonesia announced the setting up of an international hospital in Bali in collaboration with Mayo Clinic in the United States to reduce the flow of money out of the country due to medical tourism. This will affect the industry in Malaysia, which has yet to recover from the pandemic.
It will have a domino effect of reducing job opportunities and the migration of doctors, especially of specialists from public to private hospitals. This will also affect the intake of new candidates for specialist training.
The challenges faced by contract doctors may get worse and the intake for houseman training will be further delayed, resulting in jobless graduates having to take up other jobs to survive.
Registration for medical studies in private institutions will be very challenging and this will affect business sustainability. How can private medical teaching institutions deal with these changes?
Private medical teaching institutions with financial resources can build teaching hospitals to cater for not only undergraduates, but also postgraduate training, which is in demand.
Alternatively, these institutions will have to create competitive advantage through the development of advanced clinical-skills labs for both undergraduate and postgraduate training, using a hybrid mode in collaboration with public and private hospitals.
Institutes with nursing schools can create post-basic courses for specialised nursing. Venturing into other healthcare-related courses, such as healthcare management and short certification courses, will create new sources of revenue.
And most importantly, it is important to create a resilient workforce of dedicated and talented people to achieve sustainability.
This is because human resource is the most important asset for an organisation to achieve its goals and cushion the domino effect.
The writer is the director of the Clinical Skills Centre, AIMST University