Life in Private: Personal touch is important

This month we start a new column featuring everyday heroes such as yourself. MIMS Doctor speaks to GPs in various locations throughout Malaysia to learn about their life, their struggles and their hopes for the future. Dr Soo Tai Kang, who is also a treasurer of the Medical Practitioners Coalition Association of Malaysia (MPCAM) is the first person in our lineup.

Completing his studies in 2003, Soo quickly started his journey in healthcare by performing his housemanship in Selayang Hospital. There, he spent a total of 2 years before being seconded to Sabak Bernam for 1.5 years. Soo then returned to Hospital Selayang this time as a Medical Officer, where he spent a few more years learning the finer points of medicine.

Soo has been in private practice for the past 11 years, completing his tenure in the public service in 2008. Immediately after coming out on his own, Soo entered into a partnership with a colleague to start a clinic under a group practice. On hindsight, it wasn’t the best decision, said Soo. With partners in the picture, some members may be indifferent to another’s needs and at times there may be conflicts of interest. In Soo’s case, things came to a head and the partnership ended 2 years after it began.

When asked about the benefits of attaching to a chain clinic setting or an independent clinic, Soo said it would probably depend on the individual GP. When being part of a chain, the needs of an individual practitioner may be overlooked and there may be instances of conflict of interest ie, one partner wanting to head in one direction while the other wants something else.

The separation proved to be quite a costly lesson, as he only retrieved a fraction of his initial investment. But as things were falling apart on a personal level, he decided to cut his losses to start afresh on his own. It was then he started Soo Family Clinic, a general practice based in Klang Valley.

The early days
Soo said the early days proved to be stressful as many uncertainties were weighing down on him. “One of the things I worried most about was patient load ie, would I make enough to cover the overheads, ” said Soo. 

Another concern constantly on Soo’s mind was his ability to provide the best care to the patients who walk through his door.  As the clinic was just opened, it was basically a bare-boned facility. Even when it came to medicines, Soo had to ration the purchases. It was a steep learning curve as financial skills are not taught in medical school and yet it is one of the most important things to know once one goes into private practice. “So that’s one of the things I learnt—that financial skills are self-taught.”

He recalls having to order originator drugs and pricier items in small batches. “So what I did was, I ordered originator drugs in batches of three and ordered more when it was running out.” Even when managing his inventory, Soo had to be extra careful not to stock up on medicines that would rarely be prescribed so as not to impede his finances.

As a word of advice for young doctors looking to start out on their own, Soo said it is better to look for a mentor first. “Don’t come out on your own immediately. There is a large amount of initial monetary investment involved. Instead, the mentorship period will allow you to learn up skills such as inventory management and people skills. Some of the patients you encounter during the mentorship may turn out to be your patients in the future.”

When asked about the mentoring he described ie, would a doctor mentor a young doctor just to have him or her come out and be a competitor, Soo said there is no monopoly in the GP market. “We should be looking into what is known as shared service.” The idea is that doctors can work together, and patients can go to any clinic which best suits their needs.

Learning to survive
In an effort to improve his clinic and his professional skills, Soo ventured into aesthetic practice in 2008. He began to attend continuous professional development (CPD) courses. Soo advises new younger GPs to come up with a plan and diversify their services or skills in order to survive. These courses involved those organized by the American Academy of Aesthetic Medicine (AAAM) and our Singaporean counterparts. Soo pursued the qualifications until diploma level and began offering aesthetic procedures in line with qualifications gained from AAAM.

Services Soo offered included botox and filler injections; chemical peels and laser treatments. These were, of course, in addition to healthcare services as a family GP.

These services came to a halt some time in 2015/2016 when the Ministry of Health (MOH) put in place the requirement for the Letter of Credential and Privilege (LCP) to all GPs offering aesthetic procedures in their clinics. When asked about the decision to stop aesthetic services, Soo said GPs interested in obtaining the LCP would need to pay to undertake the examinations and interview with the governing board before they can qualify to provide aesthetic medicine.  He said it was an additional burden and there was no guarantee one would pass.

What it takes to succeed
When asked about the important traits to survive and succeed as a GP, Soo said one paramount aspect of being a GP is being trustworthy and ethical in every aspect of care and decision involving a patient. Such attributes naturally endear the GP to the patient. The result is a close rapport and strong patient-doctor relationship. He said: “I always treat them the best I can and if I can’t handle it, I will refer the patient to the best specialist I know.”

The confidence a patient has in him as a result of the close rapport translates into better cure rates and patient satisfaction, too, said Soo. Therefore, even when they must pay more ie, for better medications and minor procedures, the patient doesn’t feel they are being overcharged. Also, when a patient receives a complete consultation and doesn’t require further visits for a single bout of illness, the patient feels confident and satisfied with the service provided.
 
Of course, perseverance is a necessary attribute for any GP to succeed, said Soo. At times, it can be hard. With the worst of times behind him, Soo now looks forward to expanding his practice. He said: “I’m a little wiser now. I don’t want to rush into things and am in no hurry to expand. That said, expansion is definitely in the works.”

Stay ahead and continue to learn
Soo is a strong proponent of continuous learning, and by extension, the CPD. Soo’s association, the MPCAM, also organizes its own CPD conference for the benefit of its members.  He said: “It is important to always keep up to date with new findings and changes in treatment paradigm. Medicine is dynamic.”

Keeping abreast with updates in medicine helps us look at each patient individually, said Soo. That is the tenet of individualized medicine, which is being expounded by experts. Soo said mindfulness matters in treating patients. “You may have the same disease in different persons. The result is different treatments.”

GP concerns
When asked about his concerns with regard to GP and medical practice in the country, Soo said it can be distressing as “the government wants to regulate everything but does not want to provide assistance.” It’s a case of creating a problem and not providing the solution. 

Soo brings to light a recent scenario were one patient felt he was being charged excessively for his treatment. Instead of bringing up the matter at the clinic, he made a formal report to the consumer bureau. As a response to the report, the regulators sent his clinic a letter which was accusatory in nature. It was as though he was already guilty even though they didn’t hear the other side of the story. The system of reporting is easily open for abuse and very one-sided, said Soo.

He laments the lack of support from MOH, too. He said the MOH, instead of just regulating medical practice, should also look into the welfare of all doctors. This includes those in government and private practice. It should not be a case of us versus them, said Soo.

Another point brought up by Soo is the lack of unity among the various GP groups. Without a unified front, the representatives find it hard to fight or represent the members in meetings involving regulators and the ministry. He hopes for improvement in this aspect.

Family comes first
With all the hard work put into the foundation of his practice in the early years, Soo now has time to focus more on his family and himself. “I’d like to watch my children grow up and be a part of that journey,” he said. Nowadays, he spares time to send his children to and from school and follows them to sports activities.

For exercise, Soo’s go-to sport is badminton. “I play badminton twice a week,” he said. Soo picked up badminton in medical school in Crimea, Ukraine. He actively played as a university representative and also during his housemanship days.

His passion for the game has trickled down to his children, as Soo has now put his children into badminton training classes. The father’s passion for the Malaysia’s favourite sport seems to have infected his children, too, and they eagerly look forward to their training sessions.

Note: Views expressed by the interviewee in this article are not necessarily those of MIMS.