|
 Professional
Obligations
The
National Specialist Register (NSR) is up and running, although totally
voluntary at the moment. In other words, it is not mandated by law as
yet and there has been apparent resistance by some, questioning its
legitimacy. The NSR is currently managed by the Academy of Medicine.
There is great necessity for the public to know who they are seeking
professional medical consultation from. In addition, the NSR also serves
to ensure that all doctors who have specialised in particular fields of
medicine maintain professional competence. The latter seems redundant as
why wouldn’t any doctor want to ensure he/she was up to date, skilled
and deemed competent in the rapidly changing and progressing world of
medicine? Yet, complacency plagues some in the profession. Nothing like
a little jolt and prod to re-motivate and re-energise all in the noble
practice of medicine. After all, it is a professional obligation. We all
want to do what’s best for the patient! Is that not the core of
medicine? How to measure continued professional development, competence,
attitudes and ethics is another matter that at the moment is still
evolving.
Turf
Wars
That brings me to reflect on Turf Wars. It seems senseless that medical
professionals bicker over who is qualified or competent to deal with
certain areas of medicine. A good example is in the field of xrays,
subsequently referred to as diagnostic imaging and now, it is best
described as biomedical imaging and intervention. Why has this arisen?
The once very well defined boundaries of the different specialities have
been blurred by the convergence of technologies and medical progress.
It’s just like globalisation in the world. We should not be wasting our
time over who should do what, but to ensure that all who practise it
have been properly trained. We should look towards working smarter,
better and more efficiently to bring timely service/treatment to the
public. We should be joining forces and looking at ways to complement
each other’s specialities.
I am pleased the College of Radiology (CoR) and the National Heart
Association of Malaysia (NHAM) has embarked on the project for the Joint
Statement on Cardiac Computed Tomography (CT). The statement is nearing
its final stages and is targeted to be launched by the 3rd to 4th
quarter of the year. The joint committee co-chaired by cardiologist,
Adjunct Prof Dr KH Sim and radiologist, Assoc Prof Dr Yang Faridah have
had to grapple with some issues related to competency, training and of
course clinical indications for the procedures, in addition to safety
considerations. I am sure they have controversies to handle and
naturally will not be able to please everyone in the cardiology,
cardiothoracic and radiology fields. Yet, at the end of the day, it is
NOT WHO WINS but that a framework is drawn up for better and competent
service for patients for whom cardiac CT is justified.
There are of course, more areas in Radiology, Nuclear Medicine and
Clinical Oncology where the issue of other medical professionals
dispensing treatment or performing imaging procedures or image guided
intervention has become a “sore” point and in dispute. Yet, even amongst
our fraternity utilising ionising radiation, turfs exist!
Should the nuclear medicine physician be the only one who administers
radioactive “treatment” for cancer patients when indeed, traditionally
the oncologists are the specialists for non surgical treatment of
cancers and where does the radiologist come in since some of these
radioactive materials need to be introduced to the cancer specifically
under imaging guidance and through skilled interventional techniques?
What about cross training? How are these specialists categorised since
they obviously cannot profess to be in 2 specialties?
Malaysia does not have enough specialists especially in clinical
radiology and clinical oncology. Splitting hairs and having to super
subspecialise may not serve the country’s greatest need. The public
needs service at a general level more than at a subspecialised level.
However, this does not mean, Malaysia does not need people highly
specialised in specific fields of medicine. It does mean, we have to
serve the needs of the masses and that should dictate our priorities.
For that reason, generalist clinical radiologists are sorely needed to
provide the diagnostic imaging services. Yet, we cannot negate the fact
that to have higher levels of expertise, specialisation is also
essential. (Note, I ask more questions than I have answers to!)
We are not sitting on our laurels. We (the government, universities and
professional bodies) are trying to increase the number of specialists
trained, yet in the “race” to produce more specialists to meet the
country’s needs, can we compromise on the necessary duration and quality
of training just to churn out the numbers? We should not and in fact,
CANNOT compromise. People’s lives are at stake here!
Emerging Technologies
Positron Emission Tomography (PET) and PET/CT has been introduced in
Malaysia and radiologists and nuclear medicine physicians have had to
update themselves on this modality of imaging (PET). As it is a new
modality, training requirements, safety considerations, operational
issues have to be dealt with, guidelines drawn up on the justified
usage. This is also a very expensive modality, with great potential and
yet comes with limitations and a relatively significant radiation dose!
It is important the public and the referring clinicians know how to use
this wisely and the radiologists/nuclear medicine physicians interpret
the images accurately.
I have no doubt that our medical physicists world wide and biomedical
engineers and scientists will develop even more technologies that will
come into mainstream use in medicine. This begs another question:
exactly who is qualified to track treatment response at the molecular
level, after all, it utilises imaging modalities?
Scientific/Academic Programmes for Continuing Medical and Professional
Development
The CoR is committed to the provision of scientific programmes and
workshops to help all members of the related profession keep up to date,
maintain skills and competence as well as develop in other areas. As
such, we organise, support, and collaborate to bring these programmes
into fruition. The CoR is a joint organiser of the 8th
Asia Pacific
Congress of Cardiovascular and Interventional Radiology to be held
in June 2008 in Kuala Lumpur. Do check our
Events Calendar regularly for
updates.
The CoR is supportive of special interest groups (SIG) as a start to
nurture special interests in various fields in radiology, oncology,
nuclear medicine. This allows the generalists to have special interests
in up to 2 or 3 subspecialised areas. Since our numbers are small, it
would be more cost and human resource effective to start this way. We
already have a paediatric SIG, cardiac SIG and only recently at our AGM,
a member cited his interest to start the musculoskeletal SIG.
Tripartite Collaboration between Hong Kong College of Radiologists,
Singapore College of Radiologists and the Malaysian College of Radiology
This collaboration was initially mooted several years back and in the
recent 41st Singapore-Malaysia Congress of Medicine in July 2007, it was
agreed that we should look into a firmer commitment to collaborate on
areas of relevance to our sister colleges. All colleges represent
radiologists, clinical oncologists, nuclear medicine and medical
physicists.
CoR
Mammogram Programme 2007 & Breast Health Awareness Programmes
Thanks to the trust and generous donations from corporates, groups of
individuals and partners, the College of Radiology (CoR) is able to
carry on its
value
added subsidised mammogram programme (CMP for short) for the year
2007-2008. These new donors have answered the “prayers” of the breast
cancer support groups in Johor where such service was very much
appreciated.
The funds have come from the
Wear It Pink 2 Breast Cancer Education and Awareness Campaign 2006
organised by Pantai Medical, Bangsar and Asia Assistance (RM 100,000);
Estée Lauder Companies (ELC) Malaysia donated RM 60,000 towards the end
of 2006 from funds raised in their Pink October
Charity Hi Tea event while in 2007, in conjunction with their
20th Anniversary in Malaysia, the CoR’s CMP programme received
another RM 50,000.
Donations from Johnson & Johnson through the
Give2Asia Foundation
will complement the other aspects of the CoR’s breast health/awareness
programmes.
We will always be grateful for and thankful to the previous donors,
corporates as well as individuals who made it possible to kickstart our
nationwide campaign in 2001. In particular, Johnson & Johnson, Meditel
Electronics and the MMA Foundation Radiology Fund for having been our
partners from 2001 to 2006 for the various aspects of our breast
health/awareness programmes. Others include Tan Chong Motor, Shell, PS
Pipeline, Marti Butler and her group of expatriate ladies and many
others who helped to make the programmes such a success!
The CoR works with many partners as breast health should be approached
holistically. The CoR is also a member of the
Malaysian Breast Cancer Council.
Thank you - The industry for your support & all
Friends of CoR
I wish to express once again our appreciation and gratitude to the
industry for their support of our various activities, to our colleagues
and members as well as the public for their continued support and
contributions. Keep them coming!
Before you know it, another year comes to a close. I hope 2007 has been
productive, and there are still 5 more months to make 2007 count. Let me
now wish everyone a time of reflection, festivities and preparation as
we count down to the year end!
Dr Evelyn Ho
President 2006-2008
College of Radiology
Academy of Medicine of
Malaysia
Email:
president@radiologymalaysia.org
August 2007
Click here
to view previous messages
|
