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Sakmongkol ak 47

ariff.sabri@gmail.com

Saturday, 7 November 2009

IJN- The Real Way Forward.




Let me give a graphic description.

We want IJN to become a 38 storey building but the doctors are advising the PM, to accept a foundational structure that is fit only for a 3-storey building. The weight of the centre of excellence idea will collapse on such a foundation.

Only by this 4th series on IJN do I get it. It's actually a turf war between contending parties in IJN. Those who thought they could savor victory when the Sime Darby overtures were repulsed suddenly found they have to contend with another fight within their own backyard. This time, a more insidious and ominous one. One, which could spell the end of IJN as a center of excellence institution. Doctors, despite their Hippocratic Oath don't really care about IJN being a centre of excellence.

TDM may want it to be but a group of doctors can persuade him. If the hospital is theirs, they will be more prudent with how they spend money. That, if they choose to be prudent. If they choose to be extravagant, they may want to use the money that's 'theirs' now to splash themselves with the accoutrements of wealth and power. Hell, they see Nor Yaakob's son driving a Ferrari Modena, Dr Robaayah may decide to have one too. Possible, if they apply the money that's in IJN according to their ownership status.

It's all hogwash really- people are only interested in feathering their nests and making hay while the sun shines. Doctors are not above wanting to make money out of IJN and if they have to do it by going back to a pre 2005 business entity, they will do so. This is what they represent to the meeting chaired by our economics trained PM.

There are 2 contending parties. A group of senior doctors who thought that IJN is effectively their creation and the business managers who thought IJN can turn into a possible duplicate of Mayo or Cleveland or John Hopkins by creating a group of profit centers. This group of 33 doctors is really doing whatever possible to keep wealth within the family and therefore proposes as a 'way forward', the creation of a private limited company like organization. It's back to a command centre style of managing the health care business more suitable for a general practitioners practice.

So they are 2 answers really; Doctors want IJN to be a private business entity so that profits can be privatized and cornered by 33 or so members of the doctor's cartel. If, in future business is not doing well, uncle G headed by 1 Malaysia PM can help out.

What do we want IJN to become? All of us, from the kampong people hoping they can still get subsidized fee for some debilitating illnesses to those who can afford the full fees, want IJN to remain as a centre of excellence for the right reasons. The right reasons being IJN houses the best doctors and medical specialists, provide top of the line support services, an educational and training institution etc.

Now, some one commented on my article the following:-

The doctors led by the eminent lady doctor made a presentation to the Economic Council on the 27th Nov presenting the single structure as the "way-forward". The PM, chairman of that meeting, bought the idea sold by eminent lady doctor hook, line and sinker. Therefore, the PM, has indeed agreed in that 27th Nov meeting, on the single structure, thus reverting to the pre-2005 structure. Now, surely the PM must be aware of the short and long term effect of such a reversal.

This is puzzling. The doctor must have superb persuasive powers. It's also puzzling because the PM was trained in Industrial Economics at Robin Hood's county university (Nottingham) and knows a fair bit about organizational compatibility. Plus, he is an avid reader of high end management books. He should know this:-

Many of us want to know why was Sime Darby's offer turned down before, but the proposal by a group of IJN doctors presently, becomes acceptable. Where is the logic for turning it down? Sime Darby has deeper pockets than the class of doctors now wanting to take over and certainly has the organizational capability to bring IJN to greater heights and yet, the proposal by these doctors is regarded economically better? This is very strange. IJN has better chances of retaining the 2005 structural proposals than having it vested in the hands of the doctor's cartel.

The acceptance of a proposed organizational structure to a pre-2005 reorganization flies against the cold logic of business facts. Who is a better suitor? The clinicians or the business organization?

How will the doctors finance the acquisition of IJN? Why do we need to sell IJN to the doctors yet found it justifiable to reject the offer from Sime which could have landed the government with a large amount of money? God knows, that every government department has no money to spare.

The whole idea of taking over IJN seems to be peddled by a group of specialist doctors eying the profit making IJN. IJN is really controlled by about 33 specialist forming themselves as the doctor's cartel devising plans to lay siege on the money making machine that's IJN. Yes folks, IJN is making lots of money. Its operating profit in 2007 was 15 million on revenue of about 270 million. Not much, but it's not a losing concern and it was making operating profits. It's unlike other GLC behemoths such as MAS whose strategy of making money was to carry out corporate slash and burn strategies not dissimilar to native Sarawakian agriculture we learnt in our geography lessons.

This whole idea of returning to a pre 2005 organizational structure (which was put up so that IJN can emulate Mayo and Cleveland in substance) smells like a shark smelling blood scene. It looks like it's a concerted attempt by a group of senior doctors laying claim on the spoils of war. In my previous articles, I have stated that this shadowy group consists of about 13 eminent doctors. I was wrong there. The cartel-like group consists of some 33 top physicians at IJN.

IJN actually has 89 Specialists or Clinicians out of which 33 belonged to what is loosely referred to as the 'cartel' in IJN. The remaining are Clinicians who drew up salaries of around 8k a month (about the same as in other govt. hospitals). To add glamour, they are often referred to as 'Junior Specialists' but really, what they are; is that they serve as workhorses for the specialists.

Doctors pay and remunerations make up 40% of the operating costs at IJN. This cost component is likely to increase if the 33 doctors have their way. Who wouldn't, given the frame of mind of the doctors insisting on taking back IJN to a pre 2005 management structure? Doctors pay and remunerations are likely to remain a cost centre. You can't be seen to make profit on doctors pay can you?

That leaves other avenues to be shaped into profit centres. For instance hospital support activities which account for about 16% of operating costs. IJN can turn this component into a revenue and profit making centre by forming joint ventures with others excelling in this area. It can then offer this expertise to other customers even outside Malaysia. By expanding support service businesses, IJN can reduce this cost component and turn it into a profit centre.

Similarly, IJN makes profits in pharmaceuticals. Indeed, pharmaceuticals in IJN's cash cow and the doctors have a cut in the profits there too. See? Doctors want and know how to make money. IJN Pharmacy SB can be a vehicle which IJN can use to increase the income by producing and re-selling under license the commonly used medicine by heart patients.

These two examples show that the avenues for making money are not directly related to clinicians activities per se but those indirectly related. Now, if these indirectly related or even non-related businesses are the ones making money and can make more, it reinforces our argument in order for IJN to become a centre of excellence, it must have a management structure that's amenable for turning it so. And that is not the structured proposed by the 33 doctors.



Our PM should' be aware of these scenarios as he gets reports after reports that are submitted on IJN.

24 comments:

Anonymous,  7 November 2009 at 10:40  

Sang Mongkol,

1) The doctors have no say at all in the building. We are only asked on what equipment we need to to function, period.The design, funding and project management are entirely managed by IJN Cooperate, not IJN Clinical.
(It is delayed by more than two years, btw)

2) Our shareholders include MOH and MOF. They define our salary structure( fixed amount, btw) and we have no say AT ALL how we much pay we get.

3) Dr.Robaayah is more than half a century old and she can’t drive a manual car. Therefore, she does not know how to enjoy a Ferrari let alone wanting one. Hell, someone has to drive her around most of the time!!!

4) If doctors in IJN are all interested in feathering their nest,then IJN is the least place they want to be. Private practice is where you want to be. You can make more in a week working in private than a month working in IJN MINUS ALL THE HEADACHES ! .

5) The need to revert to a clinician led organization is to comply with the Private Healthcare Facility and Services Act 1998,which became fully enforced in 2006. The act stated that the person in charge of a PHFS entity( of which IJN belongs to) have to be a medical doctor of certain PHFS defined standing.

6) PM Najib,who you allude to as being a reader of high end management, may have read “ Management Lessons from Mayo Clinic “ by Leornard Berry and Kent T. Seltzman which showed the culture of excellent hospitals and the need to put the interest of the patients above all else, even business matters and the need to have a patient’s advocate in the form of a medically qualified CEO. More so that the doctors in IJN WILL NOT HAVE BUSINESS INTERESTS/SHARES WHATSOEVER.


7) There is no cartel existing in IJN. IJN has been profitable ever since its inception 12 years ago and if indeed there is a cartel with such a motive, the cartel would have made its move a long time ago. Therefore, a better question a blogger worth his salt would ask is :

- Why is there such a hullabaloo about taking IJN private, privatizingsome services of IJN now?
- Why now ? Why not 5 or 6 years ago?
- The doctors have remain more or less the same in IJN. Why only now that the doctors think of taking IJN private?
- If the doctors have not changed in IJN, WHAT HAVE CHANGED IN IJN FOR THE LAST 3 – 4 YEARS?

Ask yourself the right questions, then you will get the right answers.

8) To claim that doctors have a cut in pharmaceuticals/ IJN profits are
BLATANT LIES and have malicious intent.
Please be mindful if you accusing us without proof. I am sure you are well versed with what Allah has in store for those who indulge in unsubstansiated accusations or FITNAH





9) IJN Pharmacy SB is a rent seeking behaviour some mediocre businessmen disguised as CEOs are trying to concoct to build their retirement chest or buy their Benzes or luxury 4WDs.

Majority of IJN patients are govt patients and by adding an extra layer of transactions(i.e reselling), the drug costing will increase and the cost obviously will be passed to the government.

Why is there a need to create Pharmacy SB to make drugs for IJN when

- the drugs used for cardiac purposes are not more than 15 types, therefore there is no economies of scale for production.

- There are already government companies producing drug under licence in Malaysia?


- The additional cost will be borne by MOH(as payee) who are then forced to refer their patients elsewhere as the cost of referring to IJN has increased tremendously? This will create a negative feeback loop as the volume of “ kampung folks” receiving first class treatment in IJN will decrease!!!

Thanks Sangmongkol.

I will be more than happy to assist you so in whatever way possible to ensure a fair and balanced reporting from your perspectives.

May Allah protect us from ourselves.

Azlan Hussin.

sakmongkol AK47 7 November 2009 at 10:54  

azlan hussin,
thanks for the explanation. i hope that's not a typo error you are making, otherwise i shall conclude you are spelling it to be spiteful.
i am assuming you are a doctor from the way you explain things. as to the Dr Robaayah driving a Ferrari, i hope you are aware that's a figure of speech.
about the book that you mentioned- yes i have a copy.

donplaypuks® 7 November 2009 at 13:45  

Show me! Showmedamoney! Show me!

In the end it's always about money. The Hippocratic oath very often comes second. And if you split up purely surgical and treatment services from pharmacy, consultation and hospital room charges, there's a way to double your profits in 1 clean stroke. You can also bet that car parking charges will double!

Then you can go place that order for that Ferrari, Porsche or Aston Martin Lagonda'!!

So, if you go to 1 of these private medical centres, you pay 30%-50% more for panadol, cardiprin (asprin) and lipitor that you would if you hopped over to Watson or Guardian Pharmacy!!

As I said before, the Taxpayer subsidises the education and training of doctors here to the tune of several million ringgit per doctor. A really good cardiac surgeon will take anywhere from 3-5 years or more to hone his skills and mature.

So, these doctors enter Govt service with their eyes wide open and cannot pretend that they are being short changed. It is also true that they can leave and join the private sector anytime they desire, once they have served their scholarship and other bond obligations. Therefore, it is not unreasonable of the PEOPLE to expect uncomplaining loyalty from the IJN docs.

What worrie me is that if they privatise IJN and it fails financially for whatever reason, they will definitely pass the buck back to the Taxpayer. That's been the case with many of the Govt's grandiose privatistion schemes, and in several cases, the same buck's been passsed back and forth more than once!!

If IJN needs a finance and biz savvy GM answerable to a CEO with a medical qualification, that's easily done. It's not rocket science! But don't confuse that with making instant millionaires of doctors and screwing the public and taxpayer in 1 go!

dpp
We are all of 1 race, the Human Race

fadli,  7 November 2009 at 14:00  

"Please be mindful if you accusing us without proof. I am sure you are well versed with what Allah has in store for those who indulge in unsubstansiated accusations or FITNAH"


i love this part...

artikel syok sendiri ka datok

burstaxon,  7 November 2009 at 14:18  

Azlan is a Cardiologist in IJN. If i were him, I'd call you worse than Sangmongkol too.

Anonymous,  7 November 2009 at 17:53  

Dear Sakmongkol,

My apology on the typo. My bad.
Being on call continuously for the last one week disconnects my brains from my limbs sometimes.

I am an electrophysiologist in IJN.

Thanks for pointing out the Robaayah on a Ferrari as a figure of speech. After reading your four monographs, I seem to lose my ability to detect sarcasm even at its visible best.

Salam.

Azlan Hussin.

sakmongkol AK47 7 November 2009 at 20:40  

burstaxon,
you mean yr line of defence against someone who doesnt share yr views is to call them names?
at least Dr Azlan maintains some decorum and for that, i was willing to publish his rebuttal.

editorsemasa.net 7 November 2009 at 21:45  

Everybody seems to be looking for easy money nowadays... Amanah is now meaningless to most of us. We just want hartanah. Afterall, we are going to be buried into one one day.

burstaxon,  7 November 2009 at 22:38  

Salam Datuk Sak,

Calling names is far better than accusing someone of trying to rip off innocent rakyat.

Somehow your not so innocent defence of 'sharing your view' ring hollow.

If i read correctly, you were accusing some fine doctors in IJN of outright greed.

If that is exactly what you meant then I damn well don't share your view, but I have yet to call you names.

umar,  7 November 2009 at 23:07  

Dear,
You are so much against the doctors taking over IJN. On the other hand you're approving Sime Darby or any other giant corporate entity taking IJN private. Looks like you have vested interest in this pending deal.
Why not any interesed parties set up from scratch any "Centre of Excellence " be it of cancer , kidney ..etc. Why must they target anything built with public funds be it PROTON,MAS, TELEKOM. PLUS.etc ?

Afterall the current shareholders ; MOF has said in IJN is not for sale. If something is not broken , why fix it ?
Do you have a personal vendeta against that lady doctor ?

Money is the root of all evil, my dear. Doctors today are more materialist than humanist. Capitalism knows no mercy. Doctors together with insurance giants are riding this wave in medical industry. They are making money even while asleep.They are flying high at the same time dreaming even higher. I hope this noble profession comes down to earth with their feet firmly on the ground.
Nobody should exploit healthcare and siphon the money at the expense of poor patients.

Sherlock Holmes,  8 November 2009 at 03:10  

Clue is here

- Why is there such a hullabaloo about taking IJN private, privatizingsome services of IJN now?
- Why now ? Why not 5 or 6 years ago?
- The doctors have remain more or less the same in IJN. Why only now that the doctors think of taking IJN private?
- If the doctors have not changed in IJN, WHAT HAVE CHANGED IN IJN FOR THE LAST 3 – 4 YEARS?


My guess: Current management issue
My second guess: Hidden agenda to exploit current management issue.

Am I asking the right questions?

Burstaxon and Fadli are morons - thats not a guess. thats a fact

Izham 8 November 2009 at 10:20  

Dear All:

My take on the proposal by the doctors arise from some internal issues that has been simmering for quite some time that has not been fully addressed by all stakeholders, be it mgmt, MOF and MOH.

The proposal by the doctors merit a consideration but should not be accepted by the highest authority without due cross-reference being done.

We need to be clear that IJN is created to serve the Rakyat, if there is a good case for it to be re-organized, why not. But one to do a thorough evaluation of the proposal.

IJN is only one of the many institures under MOH. So, should we re-organize it, we need to think about the rest as well.

In the evaluation of the proposals, hopefully the authority assess the ability of the doctors to manage the business entity. Pardon me, but not all professionals are capable of wearing the different hat..what more managing a business entity..

Cynic,  8 November 2009 at 11:00  

There are several points stated by Dr Azlan which adds curiosity in me.

"1) The doctors have no say at all in the building. We are only asked on what equipment we need to to function, period.The design, funding and project management are entirely managed by IJN Cooperate, not IJN Clinical. (It is delayed by more than two years, btw)"

Why should the doctors be involved? It is like the management have to answer to management.

He should have blamed those doctors who are part of management for not doing their job.

"2) Our shareholders include MOH and MOF. They define our salary structure( fixed amount, btw) and we have no say AT ALL how we much pay we get."

No say? Is he lying? All salary package undergo thru a negotiation.

I read in one blog commentary that doctos complained when their bonus is pegged to 3.8 against nurses' 4.2 months. Then the extra few hundred thousand was demanded to be shared among top 13 consultants.

Government decide?

"3) Dr.Robaayah is more than half a century old and she can’t drive a manual car. Therefore, she does not know how to enjoy a Ferrari let alone wanting one. Hell, someone has to drive her around most of the time!!!"

How about if the doctors reveal what cars they are driving?

"4) If doctors in IJN are all interested in feathering their nest,then IJN is the least place they want to be. Private practice is where you want to be. You can make more in a week working in private than a month working in IJN MINUS ALL THE HEADACHES !."

That is only part of the pictures. Why is it that there are few doctors leaving IJN for private practise?

My physician described that although IJN doctors are earning less than their counterpart in private hospitals, there are lots perks.

They get to go on conferences all over the world at the expense of IJN. Thats why there doctors who are oftenly away abroad.

Private doctors have to get own patients but IJN doctors have it on a platter from Government throughput.

Private doctors personally attend and be responsible to their patients. IJN doctos can pass it to others to cover for them.

IJN is the only place for them to get the chance to finetune their skills and knowledge in complicated procedure and cases.

To prevent the doctors and top consultant from leaving, a salary and perk structure was put together to prevent them from leaving.

Come on Dr Azlan, please be honest.

"5) The need to revert to a clinician led organization is to comply with the Private Healthcare Facility and Services Act 1998,which became fully enforced in 2006. The act stated that the person in charge of a PHFS entity (of which IJN belongs to) have to be a medical doctor of certain PHFS defined standing."

Is that not is the reason for the holding company. So if the need a rise that the right person leading the organisation is a non doctor, he or she may be able to do so.

"6) PM Najib,who you allude to as being a reader of high end management, may have read “ Management Lessons from Mayo Clinic “ by Leornard Berry and Kent T. Seltzman which showed the culture of excellent hospitals and the need to put the interest of the patients above all else, even business matters and the need to have a patient’s advocate in the form of a medically qualified CEO. More so that the doctors in IJN WILL NOT HAVE BUSINESS INTERESTS/SHARES WHATSOEVER."

Sakmongkol also have the book and he must have read it first. It means the doctors only read what they want.

Azlan is caught in a myopic view to think business is a sin. As though the doctors are not business minded and moon lighting else where.

The right person to lead an organisation is according to requirement of time and post. Doctors can't be leading it at the phase of reorganisation where it requires reorganisation, fund raising, and some shuffling of asset. They are useful for stable times where it is about improving work process, upgrading organisational capability, etc.

to continue

Cynic,  8 November 2009 at 11:05  

Continue

"7) There is no cartel existing in IJN. IJN has been profitable ever since its inception 12 years ago and if indeed there is a cartel with such a motive, the cartel would have made its move a long time ago."

Why would a cartel not exist when they just did a mutiny against management, board decisions, and shareholders as what is happening now? Defending a cartel?

If there is no cartel, why same faces? Why too few promotions to be consultants?

"Therefore, a better question a blogger worth his salt would ask is :

- Why is there such a hullabaloo about taking IJN private, privatizingsome services of IJN now?"

Reading bigdog blog, it shows doctors creating it.

"- Why now ? Why not 5 or 6 years ago?"

Maybe it is right timing? Or maybe someone influential is now on their side.

"- The doctors have remain more or less the same in IJN. Why only now that the doctors think of taking IJN private?"

Why is it that the doctors remain the same people? The money and perks good? Kerja relax? Why?

Please don't say they are dedicted to helping people. Some perhaps, but not all.

"- If the doctors have not changed in IJN, WHAT HAVE CHANGED IN IJN FOR THE LAST 3 – 4 YEARS?"

This question is a spin to direct attack on management. Actually the management is the same people in the last 4 years.

The PM changed in case you did read newspaper, doctor.

"Ask yourself the right questions, then you will get the right answers."

What can I say? You should ask the rightly worded question.

To continue 2

Cynic,  8 November 2009 at 11:07  

Continue 2

"8) To claim that doctors have a cut in pharmaceuticals/ IJN profits are BLATANT LIES and have malicious intent.

Please be mindful if you accusing us without proof. I am sure you are well versed with what Allah has in store for those who indulge in unsubstansiated accusations or FITNAH"

What made you think Sakmongkol cook it up from thin air?

Tell us do you get a cut in the patients you handle and cut (operate I mean)? Those are basically walk-in and referral from Government.

"9) IJN Pharmacy SB is a rent seeking behaviour some mediocre businessmen disguised as CEOs are trying to concoct to build their retirement chest or buy their Benzes or luxury 4WDs.

Majority of IJN patients are govt patients and by adding an extra layer of transactions(i.e reselling), the drug costing will increase and the cost obviously will be passed to the government.

Why is there a need to create Pharmacy SB to make drugs for IJN when

- the drugs used for cardiac purposes are not more than 15 types, therefore there is no economies of scale for production.

- There are already government companies producing drug under licence in Malaysia?

- The additional cost will be borne by MOH(as payee) who are then forced to refer their patients elsewhere as the cost of referring to IJN has increased tremendously? This will create a negative feeback loop as the volume of “ kampung folks” receiving first class treatment in IJN will decrease!!!"

If you are serious about cutting cost, the major cost at IJN are the doctors salary. Would they want to just live on salary alone? Off course not?

They made IJN so must have a piece of the action. This is despite the patients are given by Government and not from the doctors marketing effort.

The negative or naive sceptical way of looking at pharmacy is the manner he questioned the decision?

A negative reply would be why do they want it as a department in IJN Sdn Bhd or IJN hospital? To show the prima donna doctors made more profit? That is thus a way of gauging the cost part of pharmacy operation.

A positive way of looking at it is by isolating pharmacy, way s and mean can be thought through to bring cost down by either increasing ... or reducing ... or both ... I can't give away trade secret.



Have the doctor pondered on the bigger issue of making the quality heartcare accessible to the whole population of Malaysia beyond Kuala Lumpur or former Government servants?

Have the doctor pondered on the issue of making IJN able to maintain the price structure with increasing cost and patients outside Government service? This is issue of sustanability.

The way I see the doctors are being myopic and self serving.

A clear case of the doctors wanting to keep IJN for their own ego and indulgence to be at the top of organisation.

He should know that Mayo separate out the role of adminstration/management from the doctors. IJN will not.

In 3-5 years, Najib will be remembered for doing this flip flop that lead to deterioration of IJN and end up being sold to corporate vultures. This is possibly what is being planned by some doctors.

End

Anonymous,  8 November 2009 at 17:01  

Why does everyone seem to want to take over things from the government and therefore the public?

If these people were really clever and capable they would start their own enterprises....

Seems to me that this is yet another get rich quick scheme, not matter how it is disguised, by greedy people, doctors or not!

What have Malaysians come too!

jay

Anonymous,  8 November 2009 at 20:43  

Sak, sadly to say, in the docs presentation on the 27th Oct, there's NO mention wat-so-ever about turning IJN into CENTRE OF EXCELLENCE.

I wonder why? Maybe the good doctor Azlan care to explain. After all he's spokeman for the lot. (Look back at his comments from the SD failed take-over days)

Do check also on the role of Dr Ismail Merican, the sitting DG of MoH, in this soap-opera. He sits on the Board of IJN SB & is fully aware of the present business model of IJN. It's no secret that there's no love lost between IJN & him!

Oherwise how do one explain the 10% reduction on the patients number this year alone. He's pushing patients to Serdang Hospital instead of IJN. Mind you, IJN have been receiving "nyawa-nyawa ikan" patients from Serdang Hospital!

What you have probing of late is bigger that you think. Do probe further. PM Najib must be made aware of this scheming & put a stop to this nonsense.

RAKYAT Didahulukan bukan DOKTOR Diutamakan

Putrajaya

Anonymous,  9 November 2009 at 10:06  

Dato'

The doctor's presentation to the EC comprise a 7-slide presentation.

There's no financial numbers to back-up their proposal for a single structure organisation.

No pro's and con's between the present and their proposed structure.

No nothing..except air-liur & gusi!!

And yet, in a matter of couple of hours, the EC decides that the single structure organisation is the BEST option for IJN.

Who's d sucker now??

Dr DoLittle

Anonymous,  9 November 2009 at 10:45  

1) The doctors have no say at all in the building. We are only asked on what equipment we need to to function, period.The design, funding and project management are entirely managed by IJN Cooperate, not IJN Clinical.
(It is delayed by more than two years, btw)


Ye ke..?? The matter for the expansion project was mooted way back in 2003 by the then CEO. In case you forget, she's among your peer i.e. a Doctor too.

You guys tortured her emotionally, remember?

When the project finally kick-off the ground, the doctors were involved all the way. The doctors participated via the user-interaction. Not only on what equipment you need to function, but also the processes as well. Even up to the four-wall drawings.

To say that the doctors have no say is not true isn't it?


2) Our shareholders include MOH and MOF. They define our salary structure( fixed amount, btw) and we have no say AT ALL how we much pay we get.

The shareholder of IJN is MOF (99%) and The Federal Land Commissioner (1%). MoH only involves itself in policy matters. The salary structure is defined by a two-way negotiation!

To say that the doctors have no say AT ALL on how much the doctors gets every month, it's very MISLEADING. Are you trying to say that you guys are being paid peanuts??

Take a look at the LG (doctor's parking bays) and it's like Naza's showroom.

You are portraying as if you are the VICTIM here.


4) If doctors in IJN are all interested in feathering their nest,then IJN is the least place they want to be. Private practice is where you want to be. You can make more in a week working in private than a month working in IJN MINUS ALL THE HEADACHES !

You sure or not? Are you implying that if you are in private practice you will make RM70,000 a week?? Woww!! if that's the case you are definately in a wrong place. Furthermore, your headache will be gone too!

But, who pays for the doctors overseas trip, business class and all the trimmings? The courses you attend? The speaking engagements? I bet it's definitely not from the doctor's own pocket right?

While the doctors in the private practice have to rely on the available bodies to maintain their lifestyle, the doctors in IJN have abundant of bodies.

Therefore, in comparison, while the doctors in the private practice is experiencing a low-season in terms of pay, the doctors in IJN is still able to maintain, as the patients numbers remains constant.

burstaxon,  9 November 2009 at 23:27  

Salam Datuk sak,
My only issue with IJN is IJN itself.

How is it possible for the Govt to discriminate doctors from other field of clinical medicine?

How is that doctors from Institut Urologi, Pediatrik etc are considered inferior to 'heart doctors'.

How is that academic specialists in all teaching hospitals are denied salary increment?

Anonymous,  10 November 2009 at 00:33  

Common lah...it is a blinking monopoly with capital sunk in by tax payers....any fool can make money....you have to be an absolute nut case if you didnt.

And in today's high tech world what the heck is IJN expanding in the middle of traffic jammed Tun Razak road....

The government created this monster...and like all dinosaurs it will be extinct one day...just like Proton and MAS...

Building and opening its new wing was an absolute disaster...like all of Mahathir's projects...it is doomed....doomed because like everywhere else in the world...small efficient heart units will have to go to the people ....and when that happens, which by the way is happening...it will be too late for the government to bail this one out....

dr,  10 November 2009 at 01:39  

degree in medicine: RM300,000-500,000.
duration: 5-6years

monthly salary in COMPULSORY government service: rm4000-7000.
duration: 5years

off topic, but
i really think the doctors being blamed solely for the hoo-haa would be such a disgrace. it is as if we doctors live to serve the government (i did not mention the rakyat).

its true, we're here to serve the people but should we say no when an opportunity to expand financially comes knocking on our doors, after all that we've gone thru in our initial days as house and medical officers? wouldn't it be considered as hving a fair share of the pie?

for the amount of hours working as a doctor in the government sector, the salary is pathetic even for a barista at starbucks.

why hasn't anyone complained about it? why is it when 33 dictators and a listed company compete to get their hands on a hospital everyone's making a big fuss out of it?

why blame the doctors when the government has the final say upon it? politicians do get a cut from the deals going thru don't they? well, this could simply be FITNAH but working 100+ hrs a week earning peanuts makes me wonder 'where did all the money go?'

(doctors in australia earn the same amount, working 40hrs a week)

p/s: im not from IJN. just my two cents as a doctor. sorry for being off topic; just needed to vent.

i love my country. i despise its government.

Anonymous,  11 November 2009 at 10:53  

Assalamualaikum saudara2 ku...

Aku nak cakap Melayu la.. takut nanti dikritik salah eja ke pulak... biar la Allah nilai apa aku tulis... tapi ingat! yang fasih mat saleh tu lah yang gadai tanah melayu dulu dan sekarang niii... contoh singapura, batu putih, hak kerayatan dan sebagainya...
Kepada sesapa yang sokong penswastaan IJN ni nak kasi ingat sikit.. aku nak kata bahawa lebih dari 70 peratus dari projek swasta ni gagal menjaga hak dan kebajikan rakyat (contoh jalan raya tol,TNB, Bekalan air dan yang sewaktu dengannya)..
Bahagian untung dapat kat depa.. tang kebajikan rakyat dan kerugian.. kerajaan kena tanggung (duit rakyat la tuu)... A'pa Niii!!..
Pasai IJN niii... khususnya doktot2 pakar yang menyokongnya... kita orang tahu berapa pendapatan purata kau orang bulan2... lebih dari gaji menteri punyee...
kalau campur semua elaun, bones dan lain2 faedah dan kerja-kerja luar kau orang dapat sekitar 30K sebulan kan-kan-kan!... pada masa sama rakyat hidup dengan pendapan sekitar 3K sebulan, tak cukup ke? kita orang tahu kalau kau orang pi swasta boleh dapat sampai 70K sebulan..
kalau kau orang nak tu.. Pi la swasta berhenti laa.. dari IJN.. kita tahu macam mana cara kerja kat swasta tuu... Jangan kerana kau orang rakyar yang susah..
Kami rakyat nak dirawat oleh doktor2 yang berkerja kerana Allah lebih utama dari pertimbangan lain..
TAPI INGAT! DALAM KUBUR NANTI PANJANG SOALNYA.. kalau pasai sepasang tali pon dah tak tertanggung nak jawab.. ni kan pulak pasai... Kau Pikr Lah Sendiri!
Istigfar banyak2 la..
terima kasih
Salam

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