Out-dated advertising rules affect Malaysia

Domestic medical tourism is held back by advertising rules, so Malaysians are ignorant about treatment they can get locally. Strict rules on what doctors and hospitals can advertise locally.

Substantial numbers of Malaysians go overseas for medical treatment and cosmetic surgery, South Korea is very popular for the latter, while for medical treatment some go to Singapore or Thailand. A key reason is that the advertising rules, controlled by the professional medical association, not an advertising regulator, mean that Malaysians may be ignorant about what treatment they can get locally.

One area that may be tackled is the strict rules on what doctors and hospitals can advertise locally. Adverts are restricted and under the Medicines (Advertisement and Sale) Act 1956 that includes any notice, circular, report, commentary, pamphlet, label, wrapper, or other document and announcement. So even a doctor giving a lecture is not allowed to publicise his place of practice. Before and after pictures of patients are not allowed. Hospitals in Singapore and Thailand can publish patient testimonials that are easily accessible online, but Malaysian ones cannot. This means that Malaysians have access to information about treatments abroad but may know less about what is available in Malaysia.

MHTC is reviewing and revising the code of practice but local medical professional bodies are still very much against any doctor using publicity, in any media, to promote his practice and skills, as they argue that it allows that doctor to gain undue advantage over colleagues and market competition.

So MHTC is fighting an out of date concept that does not allow patients to know which hospitals offer specialist facilities for a particular problem. And as the travel industry shows, customer reviews and testimonials play an increasing part in where people decide to go.

So in many ways, while attracting overseas patients, the medical establishment in Malaysia is driving locals overseas- as overseas hospitals can offer the essential information any patient needs. With the increased use of social media, online activity and mobile technology, it is as though the medical establishment is pretending that none of this exists.

The Malaysian Medical Council takes punitive action against doctors and individual clinics regularly but there are so many loopholes that the larger hospital groups have the capacity to find ways round, and the MMC is reluctant to take action against hospital groups-particularly overseas owned ones- that can bring expensive lawyers and experts into play, as well as substantial political clout.

MMC tries to argue that there is a distinction between a small clinic and individual doctor that is advertising individual expertise and a hospital that is advertising its business. That larger hospitals and clinics can use advertising billboards and advertisements in cinemas, while individual doctors get penalised for even distributing flyers to announce the opening of the clinic in the neighbourhood- just adds fuel to the flames that there is no law for the big groups but a tough one for individual doctors and small clinics.

There is a general consensus that advertising needs some regulation, but an increasing number feel that a professional body is not the right regulator as this leads to imbalance between individuals and hospital groups.

The increasing desperation of the MMC in defending outdated practice is shown as president Dr Ashok Zachariah Philip argues, “There is no need for public advertisements. Patients see family doctors or go to clinics when they are unwell. If their regular doctor sees a need for further investigation or treatment, the patient will be referred to where the doctor knows they can be properly managed. Allowing advertising may lead to patients believing that they need the latest, most expensive technology when something far more readily available and at a lower cost will suffice. It could also lead to patients seeking treatments they may not need. When someone advertises, he’s trying to sell something. We should not sell healthcare. The public’s lack of medical knowledge makes it easy for advertisements to worry them. Doctors are constrained in their actions by ethical codes but in private hospitals, the management may be under pressure to bring in the profits. So I don’t think advertising should be further liberalised.”

MMC logic means it is fine for the MHTC and doctors and government to sell healthcare to foreigners, but not to “ignorant” Malaysians. The outcome is that Malaysians go overseas, as they do not know what their own country can offer, even if it may be cheaper and better.