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Sakmongkol ak 47

Monday 9 November 2009

Inside IJN: Views from the other side

When I wrote a series of articles on IJN recently, they elicited a spirited response from Dr Azlan Hussein, a cardiologist at IJN. I reproduced his comments because I thought he deserved a hearing and his voice can be regarded as representing the voice of IJN.

The danger of writing from an insider point of view is that it can also draw up retorts from persons within the same organization who may not share the views of Dr Azlan. I will be publishing a number of views representing the other side in IJN. In this first part, I am reproducing the views given by a commentator calling himself Cynic. They are as follows:-

Cynic said...

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 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 packages 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 often 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 doctors 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 elsewhere.

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

08 November 2009 11:00

Cynic said...


"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

08 November 2009 11:05

Cynic said...

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.


08 November 2009 11:07


Cynic,  9 November 2009 at 14:13  


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

It should be:

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

Anonymous,  9 November 2009 at 20:20  

Dato Sak

The answer is simple. Just look at the Board of Directors of IJN. Who is the Chairman and what is his/her background. What is his track record.
It answer them all.

When Khalid Sahan was there, no mentioned of privatisation, Dato. Because he is against any privatisation of public health.


Anonymous,  9 November 2009 at 21:35  

Anon 20:20

There's no privatisation in the very first WAU what-so-ever.

This is just the case of a wet dream of prominent doctor in IJN fabrication a story convincing enough for a blogger to wag his tail off!


Anonymous,  9 November 2009 at 23:25  

Good Luck Dato'. May God bless you and the exposure is much appreciated.
We have been drifting and so much out of track in nation building, Hard to trust anybody now even the PM.
Negara ku yang tercinta!!!

Anonymous,  10 November 2009 at 13:21  

MB of Selangor Khalid to quit PR-PKR to be BN friendly MB of Selangor in 10 days time.

Guys guys is this not obivious to you all. He has been sued by the bank for millions and can not pay so offer comes in. Jump and remain as MB. He is going to quit and that is why he chased Badrul out. Plus himself he need another 4 more no 3 more as Hassan ali will jump ship to UMNO too. 1 from PKR , one more from PAS and one from DAP will quit in the coming week to be BN friendly. About Khalid’s court case this will be postpone to a future date maye to year 2109 Dec.

I am serous because MACC is doing a bad job for BN and now rely on Banks and courts

Fi-sha 10 November 2009 at 22:31  



I must share here on Ms. Elinor Ostrom - the first ever lady - winning Nobel Prize in Economics 'for her analysis of economic governance,which demonstrated how common property could be successfully managed by groups using it'.

Snippets from

"Based on her work, Ms. Ostrom proposed several rules for managing common-pool resources, which the Nobel committee highlights. Among them are that rules should clearly define who gets what, good conflict resolution methods should be in place, people's duty to maintain the resource should be proportional to their benefits, monitoring and punishing is done by the users or someone accountable to the users, and users are allowed to participate in setting and modifying the rules. Notice the absence of top-down government solutions"

So, don't tell me we have not been warned about the prospect of failing big time. Unfortunately, the ones that suffer the most, if it happens, are common people.

Anonymous,  11 November 2009 at 00:28  


I think this Azlan fella must be biting his tongue.

After the tons of money he'd piled over the years in IJN, he doesn't even know who is the shareholders of IJN. He thinks MoH is one of them!

And also, IJN was formed in 1992. Therefore, it has been around for 17 years. Not 12 la brother!!

The more he open his mouth, the 'funnier' he becomes..


Agaknya dia tengah pening kot pasal JCI..hehe..agaknya la...

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