The risk posed by unregistered doctors

The serious backlog at the Malaysian Medical Council in issuing annual practising certificates is not just an administrative challenge, it is a threat to the entire Malaysian medical system.

The collapse of the Malaysian Medical Council (MMC) system to issue the annual practising certificates (APC) to tens of thousands of medical practitioners is a failure of management and governance.

Worse still the response of the MMC encouraging doctors to continue to practise without proper credentials is potentially unlawful according to legal experts.

The MMC has faced criticisms for many years, most recently the “parallel pathway” imbroglio and the registration of specialists.

The long vacancy period between the departure of the previous CEO, Dr Khairi Yakub and the appointment of his replacement Dr Zakiah Mohd Said three weeks ago, suggests succession planning is also a concern.

Strong criticism has come from the Malaysian Medical Association (MMA), which represents all registered medical practitioners in Malaysia, and the MMC, which oversees public sector doctors. This signals a fragmented profession, placing all stakeholders at risk.

The most important risk is faced by Malaysian patients in public and private hospitals and clinics, especially private commercial polikliniks and high-street outfits offering cosmetic and elective treatments to passing trade.

In the worst-case scenario where 75,000 to 80,000 doctors have no APC and each treats 10 patients per day, 5.6 million Malaysians will be treated by unregistered doctors within a week.

With approximately 6% of medical treatments in Malaysia resulting in serious patient harm, this means that in one week 336,000 people could be harmed by unregistered doctors with no obvious protection from the MMC, the government or the law.

Media reports suggest that doctors are being pressured or even required to treat patients without their APC, especially in private hospitals. If they do, they face legal risks of professional misconduct, civil litigation or even criminal charges. If they refuse they face commercial and financial penalties which threatens their business viability as private medical providers.

From an ethical perspective they must balance the medical needs of the patient against their own personal risk without any guarantee that they will be protected if they put vulnerable patients first.

There is also an extreme risk to the medical tourism industry which generated around RM3 billion from 1.3 million foreign patients last year according to Malaysian Industrial Development Finance Bhd (MIDF). Only weeks ago, the Malaysian Healthcare Travel Council (MHTC) launched its Flagship Medical Tourism Hospital (FMTH) Programme and the Malaysia Year of Medical Tourism (MYMT) 2026.

Now every day around 3,500 foreign patients are at risk of being treated by unregistered doctors with uncertain legal protection until the APC backlog is cleared. This is devastating for the international reputation of the Malaysian medical tourism industry.

The private hospitals and clinics where many medical practitioners operate as independent service providers or medical entrepreneurs are also exposed to higher risks that push up out-of-pocket expenses for patients, and hike in insurance premium, pricing private medicine out of the market.

The Federal Court has ruled that private hospitals cannot escape liability from medical claims against doctors. Separately Federal Court Judge Vazeer Alam Mydin Meera has warned that negligence compensation costs will continue to rise considerably.

The medical market depends on the rule of law, with enforceable rights for patients if they are harmed or ill-treated. In the current circumstances where tens of thousands of doctors are not registered to practice the rule of law has broken.

Questions must be asked of the president and the CEO of the MMC, members of the MMC governing council and the health minister Dzulkefly Ahmad. Trust and confidence in the system can only be restored through transparency and holding those responsible to account. - FMT

The views expressed are those of the writer and do not necessarily reflect those of  MMKtT.