MMA President-Elect Manifesto 2007

Dear Colleagues & Friends,

First of all I would like to once again apologize to everyone for this year’s election stalemate, which has resulted in much confusion and uncommon absence of an MMA President-Elect for some months.

I believe this has never been so critical a moment, for each and every MMA member to come forward and exert his/her sovereign right to choose a President-Elect. It is a good time to reflect on and demand that this elected official would be that especial leader who can represent our medical professional interests in the best possible manner and authority, in the challenging years ahead.

For the past 6 months since this uncertainty arose, I certainly have had sufficient time to sit back, reflect and arguably debate within myself and my conscience, what is it that MMA needs in a new leader, for this coming era. It has been a seriously humbling experience, one that has made me question the very basic tenets of my intention to run, to lead, and yet to meet the utterly disparate expectations of so myriad a population of very highly-demanding co-professionals—all doctors no less, yet all leaders in our own unique ways. It is clear that I cannot therefore appease and please everyone.

Yet I pledge that whatever the support, I hope to be able to contribute meaningfully and with dignity, and with full commitment to our common cause. We must raise the profile and authority of engagement with all our interconnected players—the government (our policy makers and shapers), the Ministry of Health, and most importantly the public—our patients.

What do I envision would be my role as President of the MMA? I have thought long and hard on this, but one thing I think the president should not be, would be to be embroiled in the nitty-gritty minutiae of day-to-day running of the MMA and its secretariat. Of course, all these daily mundane issues are important and are ultimately under the final responsibility of the President and the Council. But these should be systematically and rigorously upheld by our executive secretary and our Hon. Gen. Secretary (our de facto CEO). Should the President then be a seat warmer just for the sheer lofty position of its power and prestige? Of course not!

I think the MMA President should be above the fray of micromanagement. So, what can I hope to offer?

My thoughts of what my presidency could be are as follows:

I am reminded of what Martin Luther King Jr. said, that “a genuine leader is not a searcher for consensus, but a molder for consensus.” I feel strongly that over the past few years, we have let our search for consensus dictate and displace our good sense, on what is good for our profession and our MMA. We have become bogged down by important yet time- and energy-consuming issues which could have been better tackled by smaller committees or respected specially-appointed councils. We can and must tap the great potential of our experienced past presidents and leaders to help us move forwards on contentious issues which can stonewall and seriously cripple our aspirations and function.

We must direct more attention and more timely deliberations on more pressing policy or regulatory issues, so that we can stay abreast of such challenges. Some of these are critically important and have yet to be fully resolved but which had already threatened to rock the very foundation of our association, e.g. the Private Health Care Facilities and Services Act and its contentious regulations; the as yet unannounced but secretive national health financing scheme and possible major revamp of our national health care systems and policy; third-party control for medical screening of public vehicular drivers; too many medical colleges and graduates; medico-legal implications of the recent reversal of the Bolam principle, etc.

I hope to mold a more robust consensus with all our council members (and all our members at large out there), so that our true focus would be on issues which affect our profession and our livelihood, directly or indirectly. It is but true that some have felt that MMA’s voice had weakened in the recent past. It appears that our once preeminent influence has continued to erode in today’s healthcare scenario, even though as doctors we are undeniably its main protagonist and most important player.

We have to regain our position of strength so that when we speak, we are listened to, not because we are loud and vociferous, but because we are respected, knowledgeable, sensible and most importantly because we are patient-centred. Our medically-vested interests inherent as they are of our association should not be that moral hazard or venal yoke for which to bargain with the authorities on policy or regulatory affairs. After all, our patients are our raison d’etre for existence. However, we must show that sensible regulations are not cast in immovable stones, which hamper rather than enhance our medical practice, even as we aspire to provide better and safer healthcare for our patients.

What I will try to do, if elected, would be to ensure that we present a robust yet fully-engaged leadership. As President I pledge to remain fully apprised of all matters medical and health care-related as these impinge upon our profession and the health of the public at large. I will be a fearless taskmaster, with my accustomed bluntness especially pertaining to principled aspirations and medical ethics. There can be no compromise with ethical professionalism, and MMA must lead the way in upholding this moral constant, and consistently remind our members that ethical behaviour is a professional trait which cannot be bartered away for transient pecuniary interests.

I think the MMA must also champion the wider population out there and not get too engrossed with our own parochial bread-and-butter stuff. The MMA can and must ensure that with the pressures to modernize and privatize, health care services for the less well-of, the needy and the working class, are not marginalized. Conversely, we must also temper the relentless demands to continually upgrade our private health care services to stratospheric levels of exuberance or extravagance (6-star facilities and ambience)—this will surely escalate the already rising cost of health care beyond what we as a nation can afford. Besides the cost, health care is seldom improved anyway except for the privilege, the trimmings and the luxury.

We must strive to improve the conditions for our public sector colleagues so that their services can be better respected, honored, and appreciated. We must try and find mechanisms to make public service for medical professionals painless, less demoralized and worthwhile, after all more than 60% of our population depend on them, on their often thankless drudgery. Yet we must acknowledge that private practice for the family physician or general practitioner is not as rosy as once perceived to be—many of our colleagues are languishing as permanent or shifting locums eking out a meagre living. GPs are struggling with community pharmacies for a larger piece of the competitive pie, with many losing out because our patients are still unready to pay the GP his/her just dues of consultation fees; and many simply cannot see beyond the wrongfulness or folly of buying medications without prescription or proper follow-up.

I am cognizant of the pressures of modern day living and rising expectations by almost everyone in society. Much is expected of the medical profession. I will try and engage in directing positively in our contemporary storms of uncertainty, the rising glitziness, our consumer-orientated market-driven society, heightened patient and public expectations, soaring health care costs, and tugging competing forces on reining in cost and expenses with healthcare payers—third party, employer, insurers and/or health maintenance organizations.

We must also address the issue of the burgeoning number of medical schools, both public and private. It has been projected that in ten years, at the rate of producing some 1,500 new local medical graduates per year and another potential 1000 returnees from foreign colleges, we will be facing an unprecedented glut of some 45,000 registered doctors! We have to engage the authorities to seek a common solution to minimize its potentially devastating impact. There are of course, many more issues to consider, and new ones and new crises can arise from time to time.

In short, we have a lot to do. As president, I hope to lead and help resolve some of these pressing issues, so that the MMA can play a more prominent and meaningful role in nation building.

Esteemed colleagues, if you share in my aspirations and my candidature, I urge you to exercise your vote with due care and diligence. Your vote can and will make an important difference. On my part I will pledge to do my best and not let you down. Much is at stake and more needs to be done, and we can do this together.

Professional Associations at a Glance

Malaysian Medical Association (MMA)

• Editor-in-Chief, Berita MMA (MMA News) (1996-2007)
• Editorial Board Member, MMA News, 1991-96
• Member for MMA National Health Policy Committee (2001-08)
• MMA National Council Member, 2004-2006
• MMA Wilayah branch, Vice-Chairman, 2004-2006
• Member for Funding Committee for MMA Foundation (2000-04)
• Committee Member, Cardiopulmonary Resuscitation Council, MMA, 1995-99
• Committee Member, Computer Technical Committee, MMA, 1996-2000
• Committee Member, Anti-Substance Abuse Committee, MMA, 1995-96
• Member, Ethical Board, MMA, 1995-96
• Member, Action on Smoking and Health, ASH MMA 1986-1991
• Secretary, ASH MMA, 1990-91, Member, since 1986.

Asian Pacific Society of Cardiology

• Current Vice-President, (2005-07)

ASEAN Federation of Cardiology:

• ASEAN College of Cardiology, Trustee (2007-2010)
• Past President ASEAN Federation of Cardiology (2004-07)

• President 2002-04

• Vice-President 2000-02
• Overall Organising Chair for ASEAN Congress of Cardiology, Kuala Lumpur, 2002

National Heart Association of Malaysia (NHAM):

• Heart House Building Fund Committee Chairman (2002-08)
• Council Member (2000-08)
• President (1998-2000),
• NHAM Credentialing Committee Member (2000-08)
• NHAM Chair for Professional Services & Fees Committee (2000-04)

• Chairman, Writing Committee on Clinical Practice Guidelines on UA/NSTEMI, Malaysia (2002)

• Chairman, Writing Committee on Clinical Practice Guidelines on Primary Prevention of Cardiovascular Disease, 2007-2008

Ministry of Health Malaysia

• Elected Member (2^nd term), Malaysian Medical Council (2004-10)
• Member, National Credentials Committee for Certification of Cardiology Subspecialty (2003-2005)
• Panel Member for Cardiovascular Research, Clinical Research Centre;
• Task Force member for National 9^th Malaysia Plan Policy for Cardiovascular Health and Research;
• Member, (Expert Panels in Anti-hypertensives, Anti-Lipaemics, Cardiac Therapeutics, Pharmaco-economics), National Medicines Use Survey (NMUS), Ministry of Health, Malaysia (2005-07)

Association of Specialists in Private Medical Practice, KL & Selangor

• Hon. Secretary (2001-04)

Private Medical Practitioners Association of Selangor & KL

• President (2005-2006)

Federation of Private Medical Practitioners Associations of Malaysia

• Council member (2005-2006)

Miscellaneous Societies

• Founding Council Member, Malaysian Erectile Dysfunction Advisory Council & Training (MEDACT);
• Panel Member of Asian VIEW Committee;
• Asia Pacific AII Board Member
• Cardiometabolic Risk Advisory Board member
• Atherothrombosis Board member; PROVE-IT Board member

• Member, Disciplinary Committee Panel, Advocates & Solicitors Disciplinary Board KL-Selangor, Malaysian Bar Council, 2005-07

• Chairman, Medical Ethics & Research Committee, Pantai Medical Centre, Bangsar, KL, 2004-2007

Medical Education & Professional Memberships

MBBS (University of Malaya), 1979

MRCP (UK), 1984

Fellow of the

Royal College of Physicians (London)

Academy of Medicine of Malaysia

National Heart Association of Malaysia

ASEAN College of Cardiology

American College of Chest Physicians

American College of Cardiology

"Each time a person stands up for an ideal, or acts to improve the lot of others, or strikes out against injustice, he sends forth a tiny ripple of hope, and crossing each other from a million different centers of energy and daring, these ripples build a current that can sweep down the mightiest walls of oppression and resistance."—Robert F. Kennedy