More Specialists needed to care for the Terminally Ill

Kuala Lumpur, March 31–Some 32,000 Malaysians are estimated to need palliative care and end-of-life care every year and the numbers are growing, especially with more Malaysians afflicted with cancer and heart and kidney failures.

The incidence of new cases of cancer in Malaysia has increased to 37,400 in 2012 from 32,000 in 2008 and this could swell to 56,932 by 2025 if no action is taken.

At the same time Malaysia is short on specialists and other support staff who could provide palliative care.

Palliative care focuses on providing patients with relief from the symptoms and stress of a life-threatening illness with the goal of improving quality of life for both the patient and the family.

Dr Richard Lim Boon Leong, the national advisor on palliative medicine for the Ministry of Health and Head of the Palliative Care Unit at Hospital Selayang, has estimated that the country needed at least 60 specialists in palliative care.

This is based on the ratio of one specialist per 500,000 population, and hence an estimated number of 60 for Malaysia’s population of 30 million. This however is a very conservative ratio and the ideal norm should be about 1:200,000 population.

“Currently the number of specialists to population in Malaysia is only 1: 1.7 million, which translates to only seven specialists with 10 still undergoing training.

“These figures reflect the urgent need for more medical practitioners in Malaysia to become specialists in palliative care because there is a great demand for it. It is not a totally new field in Malaysia, but the interest among the healthcare professionals is still very small compared to other countries.” said Dr Lim.

To alleviate the problem, the College of Physicians from the Academy of Medicine of Malaysia will organise a two-day conference (April 11 and 12) here on the end-of life care.

Entitled “Fulfilling the Duties of a Physician to Relieve and Comfort”, it aims to create greater awareness and interest among medical practitioners to become specialists in palliative care.

The conference will also bring together the best caregivers, clinicians, researchers and educators in the field along to meet their medical colleagues and share new ideas and insights to improve care for patients and their families.

Dr Lim said palliative care services in Malaysia must be able to cater to the diverse needs of patients, their care givers and families.

“It must be available to patients in their preferred setting and must be accessible to vulnerable groups including people living in rural and remote areas,” he added.

The scope of palliative care in Malaysia is constantly growing. Previously,palliative care was only provided to patients with late stage cancer. However, today, palliative care is being provided to patients with non-cancerous life limiting conditions such as heart disease, kidney failure, neurodegenerative conditions and also to paediatric patients with life limiting conditions.

Dr Lim said palliative care was not often the first choice for medical practitioners because of a lack of awareness.

“Doctors often choose other areas of specialisation but overlook palliative care because it is not as exciting as other areas of specialisation,” he said, adding that the College of Physicians from the Academy of Medicine would like to encourage more specialisation in this field.

The health ministry has set up dedicated palliative care units in government hospitals since the mid-1990s and in 2005, the field of Palliative Medicine was recognised as a medical sub-specialty by the ministry. To date there are 29 palliative care units in government hospitals but only three have specialist palliative care.

For more information on the conference Organised by College of Physicians from Academy of Medicine Malaysia, contact the CPAMM Secretariat at 0340234700/ 40254700/ 4025 3700 or e-mail them at secretariat@acadmed.my.

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