- 1 year ago
- #considerthis
As part of the recent special announcement by Prime Minister Anwar Ibrahim in July,
more than 4,000 positions for government doctors, including contract medical officers, will be made available this year. However, the Malaysian Medical Association, which is the main representative body for all registered medical practitioners in Malaysia, has urged the government to instead abolish the contract employment system for doctors. On this episode of #ConsiderThis Melisa Idris speaks with Datuk Dr Kalwinder Singh Khaira, President of the Malaysian Medical Association, (MMA).
more than 4,000 positions for government doctors, including contract medical officers, will be made available this year. However, the Malaysian Medical Association, which is the main representative body for all registered medical practitioners in Malaysia, has urged the government to instead abolish the contract employment system for doctors. On this episode of #ConsiderThis Melisa Idris speaks with Datuk Dr Kalwinder Singh Khaira, President of the Malaysian Medical Association, (MMA).
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00:00Music
00:00Hello and good evening. I'm Melissa Idris. Welcome to Consider This.
00:14This is the show where we want you to consider and then reconsider what you know of the news of the day.
00:19Now as part of that special announcement that Prime Minister Anwar Ibrahim did in July,
00:25he announced that more than 4,000 positions for government doctors will be made available this year.
00:32And this includes contract medical offices.
00:35However, the Malaysian Medical Association, which is the main representative body for all registered medical practitioners in Malaysia,
00:43has urged the government to instead abolish the contract employment system for doctors.
00:49Now today on the show, we'll find out why.
00:51Dr. Dr. Kawinda Sinkera, who is president of the Malaysian Medical Association MMA, joins us on the show.
00:59Thank you so much for being on the show with me.
01:01Dr. Dr. Kawinda, talk to me a little bit about the contract system for doctors.
01:05Let's start at why we have this system.
01:08Why is it that there is no automatic permanent post when doctors join the public healthcare system?
01:17How did we get to work the circumstances that led to this system being introduced in the first place?
01:22First and foremost, thank you, Melissa, for having me on the show.
01:25And it is the second time I'm coming up.
01:26Well, first time in person.
01:28First time in person.
01:28I'm glad that you're here in person.
01:30Thank you so much.
01:30And thank you for allowing us to highlight the issues.
01:34So as you know, prior to 2016, like every other civil servant, doctors used to join on the permanent positions.
01:42But of course, with a period which is called as, you know, like for probation.
01:47Probation.
01:48Probation.
01:48If you're okay, you're confirmed.
01:50But in 2016, what happened, the number of doctors which were graduating and coming out,
01:56as a consequence of the increased number of medical colleges which were set up earlier to that, came into being.
02:05So at one time, from around 3,000 doctors a year, it went up to 6,000 doctors at that year.
02:14So now, for them to enter housemanship, the post, in a way, it was limited.
02:20So what they did was, and the waiting period was long.
02:23So the thinking at that time was, never mind, it's easier to take them onto contracts so that they can start the training earlier.
02:31And what was told at that time was that, after a short while, they will be absorbed into permanent stuff.
02:39But however, what started as a short-term solution has lingered on until now.
02:48It's going to be almost 10 years.
02:50It's 10 years.
02:51So that is what we're saying.
02:51It's 10 years.
02:53And because of that, from that 6,000 now, it has dropped down to back to 3,000 and even less.
03:00And because of the problems associated during this period, the number of people taking up the profession has dropped.
03:09You know, if you look at the places in the medical colleges in the country, a lot of the seats are not filled up.
03:16Many of the young students are not taking up medication because they hear all the negativity because of the contract.
03:21At the moment, the contract system is, they give you three years, another two years, another two years,
03:27and if you're specializing, another four years.
03:29But thankfully, over the last few years, most have been getting their permanent positions within four or five years of service.
03:38And then, you know, but having said that, that process, to some, has not been transparent and is not following court.
03:47So, you know, there was no criteria set up who will get the permanent first, who will get permanent later.
03:52So, a lot of discontentment and many resigned.
03:55Many resigned, many left the service.
03:57So, our numbers became less.
04:00And then, you know, and the ones coming in became less.
04:03And then, what we see is, from an abundance of doctors, it became a shortage.
04:09And the shortage also, in a way, is because of the maldistribution in different places, you know, different areas.
04:15But in terms of numbers, you know, it became an issue.
04:19And we know that the number of facilities, health facilities, is getting more and more.
04:23And instead of numbers growing.
04:25So, that is where the issue ended up until now and still on contract.
04:31And from contract, being offered permanent post, you know, over the years.
04:36But we are thankful that, you know, as you mentioned, after the, you know, regarding the announcement by the Prime Minister.
04:46Actually, we did bring this issue up with the Prime Minister when we had a meeting.
04:50So, actually, I brought this issue up twice, once when there was a meeting on the nursing side.
04:55And the other one, when there was the stakeholder meeting on the budget issue, I think, two weeks ago.
05:02That the government is now moving the transition from contract to permanent earlier.
05:09They are providing more posts, which we are very thankful for.
05:14But I think the time has come to go back to the prior to the 2016.
05:18Because at the end of the day, we have to make the profession a preferred profession for the young, for our students.
05:27And also, more importantly, parents.
05:29Because it's only when they know that if my child graduates and he has a secured job, you know, he's got a job security, there's career progression.
05:38And I think they will come back.
05:40Okay. Well, talk to me a little bit about that.
05:42First of all, a couple of things that I want to tackle here from what you've just said.
05:45Let's start with the Prime Minister's announcement of 4,352 new doctor positions.
05:52We've talked a lot, especially on this show, about the critical shortage of doctors in the public healthcare system.
06:014,300 positions, will that make a dent at all?
06:06Is that a significant number to address the chronic shortage of doctors?
06:11Okay. This will help to convert those who are already on contract now to get permanent posts.
06:20Okay.
06:20So that will help out.
06:21You know, contract posts can be created by the government anytime.
06:24If the permanent post is the one that's important.
06:27Understood.
06:27So this creation of new posts helps.
06:30So which means the number of contract doctors will get less and less.
06:33And I think the government is creating new permanent posts every year.
06:36Okay.
06:37We're thankful for that.
06:37So numbers will drop and drop and drop.
06:40But I think if we can do that, then we just have to give that extra push.
06:44Create those extra posts.
06:46And, you know, because an equilibrium is almost there now.
06:48It will be in the near future between numbers coming in, number of posts,
06:52that we should be able to offer permanent posts right from the start.
06:56So you, MMA, while happy that there are new permanent positions being opened up,
07:04you're actually saying, well, let's just go all the way.
07:07Let's just abolish this system altogether.
07:09Yes.
07:10Help me understand the difference between a doctor under contract,
07:16the circumstances of a doctor under contract,
07:17and the circumstances of a doctor under a permanent position.
07:20How has the contract employment scheme affected doctors on the ground, right?
07:25In terms of morale, in terms of career progression,
07:29in terms of even, I wonder, does it affect patient care even?
07:33Okay.
07:34Let's talk about a contract doctor.
07:35Because now the first contract is given for three years.
07:38Housemanship is for two years, and most finished even in two years.
07:43It was a permanent post.
07:44After two years, they'll be moving on to their next scale.
07:47But here, they will only be moving to the next scale
07:50after they've finished their first contract of three years
07:53and they're offered the next contract of two years.
07:55So it affects salary.
07:57It affects salary.
07:59It affects your salary also.
08:00It affects your promotion.
08:02And the thing is, along the way,
08:04when you are converted from contract to permanent,
08:07your years of service as a contract is not taken into consideration.
08:11You go back to a start.
08:14You mean the three plus two years are not taken into consideration?
08:17It depends on the contract.
08:18Yeah.
08:18And this is what we're having problem,
08:20especially in terms of when they're given new placement,
08:24this we have called the government to help these doctors.
08:26If you are a contract doctor given a permanent now,
08:29if you're transferred to Sabah in Sarawak,
08:32there is no payment for you to bring your belongings,
08:40your car.
08:40It's not paid for.
08:41Of course, if you are transferred from KL to KL to Ipoh and all that,
08:45that's okay.
08:46But when you're moving from KL to, let's say, you know,
08:49I mean, you go to Sandakan to Kapit to Belaga,
08:51you're on your own.
08:53There's no payment for that because you are starting job for the
08:55permanent job for the first time.
08:57Because your contract is not taken into consideration
08:59once your contract is over.
09:00So like any other civil servant,
09:02when you report for a permanent post,
09:05you know, at that place, that's your own thing.
09:08So your years of service is not taken into consideration.
09:13That's not fair.
09:13So we said, help these people.
09:15I mean, you know, it's not cheap for a family to go from KL to Sarawak
09:19or to Sabah to bring a...
09:21It takes $10,000.
09:22If you're deployed somewhere rural, it's harder.
09:24And so that is one of the reasons why many of them appeal
09:26and they don't want to go because it incurs cost.
09:29Of course, you know.
09:31So again, in terms of training, now it's better.
09:34Previously, you did not know whether you'll get permanent or not
09:37because there's a cohort.
09:37Because when you change to permanent, right,
09:40they'll open up a certain number of posts.
09:42You go for interviews.
09:43Okay.
09:44Which you know, the criteria was not very clear.
09:46And then some will get this year
09:47and the rest will apply again next year.
09:50So actually, initially we used to score.
09:51MMA used to say that, make it transparent.
09:54Isn't it not according to seniority,
09:56meaning how long you've had the contract position
09:58and then therefore you are transitioning into permanent?
10:01That is what we have called for.
10:02But unfortunately, we don't really know the criteria.
10:05MMA has asked that this criteria be very clear.
10:09But then again, there are certain other criterias.
10:11But I think the way they're doing it now,
10:13I think they're following cohorts,
10:14which is the correct thing to do.
10:16So, you know, we have pushed that
10:18it'll be done by cohorts and seniority.
10:21But again, it is not a perfect system.
10:23So hence our call, make it permanent.
10:25Like every other civil servant.
10:28Are you saying that other positions in the civil service
10:33don't follow the contract employment system?
10:37Most of them are still on permanent post.
10:40Teachers, police, army, even nurses.
10:43I've been shown now, they've started to get permanent post.
10:45So why is the doctors different?
10:48The approach for doctors is slightly different.
10:50So, you know, when doctors always bring up issues,
10:53one of the questions they always ask is,
10:56why do doctors think they're different?
10:58But then again, things like this are there.
11:00So, I mean, you know, so we applaud the Prime Minister's,
11:04you know, understanding of the issue
11:06and in his intention to hasten the process.
11:09But we are calling that, you know, a little bit of push.
11:13Actually, we even ask for this year's budget,
11:16just create the extra post, you know.
11:18So hopefully, you know, even if not done this year,
11:21over the next two, three years, at least it can be done.
11:23Well, you highlighted, so one more thing I wanted to talk about.
11:26So you highlighted how it's affected enrolment in medical schools,
11:30the perception of the medical profession
11:33being less preferred nowadays.
11:35You also talked a little bit about the impact of kind of personal,
11:40funding a permanent position being deployed elsewhere.
11:45Talk to me about specialisation,
11:47because that also affects, right,
11:48how we are supporting our doctors.
11:51Are there obstacles in their pathway to specialisation
11:54under this contract system?
11:55Okay, now, since the last few years,
11:58contract doctors can apply for specialisation posts.
12:01So this is where they created the 3 plus 2 plus 2,
12:05and that 4 years is at the end,
12:06if you are in a specialisation programme,
12:09they can offer you the contract.
12:10But of course, I think most people now get the permanent post,
12:14you know, before that.
12:16But the specialisation programme is,
12:18you know, what we have been calling for,
12:20is we have a big shortage of specialists.
12:22Specialists, yes.
12:23So I think they were saying that
12:24we have around 7,000 plus specialists in the government service
12:27and maybe a shortage of 10,000, 11,000.
12:30So we need to increase the number of specialists.
12:33And one thing we are thankful to the YBMK,
12:35our health minister,
12:36is that the Medical Amendment Act last year passed
12:39and which, in a way,
12:40makes the health ministry as a training institution.
12:44And this is what we are calling that, you know.
12:46And hence, it is an opportunity to increase the numbers
12:49that can be trained in the government service.
12:51Okay.
12:52So, of course, the main pathways are, of course,
12:55through the master's programme in the universities
12:57and the other one is through the parallel pathway.
13:00So we are saying that open up the system.
13:03But of course, at the moment,
13:04we have a system which is called the HLP,
13:06Hadiya Latihan Vashkota,
13:06which means everyone who wants to enter the training programme
13:09has to apply for a scholarship,
13:10of which there's a finite number
13:12because of the costs involved.
13:13But we are saying that have an option,
13:16you know, without this HLP
13:18so that more people can join in.
13:20And we need to speed up the number of specialists that we need
13:23because the whole country needs specialist care.
13:26And I'm a strong believer that every citizen of this country
13:30deserves the same level of care,
13:32be they, you know, in Sarawak, Sabah
13:34or the other parts of West Malaysia.
13:35Is it realistic, Dr. Karinda,
13:39to expect the system of contract employment for doctors
13:46to be abolished altogether?
13:47Is that a feasible proposal from MMA?
13:51With the new intake of around 3,000 doctors a year now,
13:56you know, as I said, in 2016, 18, 17, 18,
14:00from 5,000, 6,000 a year,
14:01it has dropped down to around 3,000 new doctors a year.
14:04I think it is feasible.
14:06I think you just have to...
14:07If you keep creating more permanent posts
14:11over the next few years,
14:13and I think you will reach an equilibrium
14:14that the empty posts every year
14:17versus the new ones coming in is just balanced up.
14:20Because remember, some of the posts will be cleared up
14:22for those who resign for other reasons,
14:25those who retire.
14:26So if you have an equilibrium,
14:28I think it is possible.
14:29It is possible.
14:30It is possible.
14:31But I don't expect it to be done this year,
14:33to be honest.
14:33You would give it a runway of time?
14:36I think we will need to give a runway.
14:38But I think we have to start somewhere.
14:39We have to start...
14:40I do wonder whether we are being fair
14:42to the Ministry of Health.
14:43Because I think what most people don't realise
14:46is the Ministry of Health actually lacks
14:48the necessary authority to do this.
14:52Because recruitment, remuneration,
14:54and promotions all fall under the purview of JPA,
14:57the Public Service Department.
14:59Are you lobbying the right people for this?
15:03So hence, as I said,
15:05when we had the opportunity to meet the Prime Minister,
15:07that's what we do.
15:08So I think we are trying to help the Ministry of Health.
15:11So I know that the Minister of Health
15:13has made an announcement recently
15:15that they will try to, you know,
15:17also push for this system to be abolished.
15:19And I think we think...
15:20So I do think, you know,
15:21I agree with you that the Health Minister
15:22is doing his best.
15:24The Health Ministry is doing their best
15:27to facilitate this.
15:28But of course, finances are not under them.
15:31You know, but I think hence...
15:32It's tough for them.
15:33So hence, I think we have to...
15:35Like for MMA, we are on the ground.
15:36So we are trying to bring up the issues,
15:38not only to the Health Ministry,
15:39but we have gone one step higher
15:41to the Prime Minister
15:43so that, you know,
15:43so that this can be done.
15:46So that they understand that
15:47there are effects of this,
15:49as you said, on the morale.
15:51And of course, patient care.
15:52How does it affect patient care?
15:54Why should citizens or people
15:57care about resolving the contract doctor issue?
16:01Okay, let me put it this way.
16:03It's a vicious cycle.
16:04When you have got X number of doctors serving,
16:07right,
16:07and there's some who are leaving
16:09for whatever reasons,
16:11you know, as I said,
16:11you know,
16:12career progression,
16:14job security,
16:15and the number coming in is less,
16:17those who are remaining
16:19have to bear the burden
16:21of the service.
16:23And they do on calls.
16:24You know, they are on call.
16:26Doctors in hospitals
16:27work seven days a week,
16:2924 hours a day.
16:31So they take shifts,
16:32they take turns,
16:33especially the junior doctors.
16:34So when you have to bear
16:36the burden of that,
16:37you know,
16:37you have to work extra hours,
16:39you know,
16:39and the calls are very long.
16:41You know,
16:42and then,
16:42in a way,
16:43it is to be expected
16:44that patient care can be affected.
16:46You know,
16:47doctors are only human.
16:49Yeah.
16:49I would want,
16:50as a patient,
16:51my doctor to be well-rested
16:53and happy
16:54and healthy.
16:56Everybody wants it.
16:57But I want my doctor
16:58to be happy first
16:59before he turns to me.
17:00I agree.
17:01I mean,
17:01but that is the issue here
17:03because doctors are supposed
17:05to be benevolent people,
17:06self-sacrificing,
17:08that they work the extra mile.
17:09So, you know,
17:10so they have to,
17:11they put their patients first.
17:13You know,
17:14they put their patients first
17:15and, you know,
17:17and when they speak up a bit,
17:19of course,
17:19you know,
17:20it doesn't rhyme with doctors
17:21and, you know,
17:22asking for all these things.
17:23It doesn't go together.
17:25Doctors are supposed to,
17:25you know,
17:25the perception is that.
17:26Self-sacrificing.
17:27Self-sacrificing.
17:28You know,
17:28and there is something
17:29sometimes we feel is not right.
17:31Which is,
17:31I have to say,
17:32which is why your role
17:33is important and difficult.
17:35Yeah, it is.
17:37For MMA to be the professional body
17:39to speak up on behalf of
17:40Yes.
17:42healthcare professionals.
17:43You've also,
17:44MMA has pointed out
17:45that on-call allowance
17:47is also another issue
17:48that you're raising.
17:49Not just,
17:50so all of this affecting
17:52doctors' morale
17:53and well-being, right?
17:54Right.
17:55So we are saying
17:56that doctors work,
17:57you know,
17:58the on-call hours,
17:59weekend,
18:00and it is important
18:01to emphasize
18:02that this is not by choice.
18:05A doctor cannot say,
18:06you know,
18:07oh, we don't want to be
18:07on-call on the weekend.
18:08We don't want to see patients
18:09on Saturdays, Sundays.
18:10You can't do that.
18:11You have to work.
18:12It's part and parcel
18:13of your job scope
18:14and your responsibility
18:16to your patients.
18:17So at the moment,
18:19you know,
18:19if I may just give a figure,
18:20for active call,
18:21which means you have to stay in,
18:22you know,
18:23and work on weekends
18:25from 8 o'clock
18:25to 8 o'clock
18:26the next day
18:27and on weekdays
18:28from 5 o'clock
18:28to 8 o'clock
18:30the next day
18:30and you carry on working
18:32as a normal doctor
18:34the next day.
18:35So you are just paid,
18:36for the medical offices,
18:37you are paid
18:37$200 on a weekday
18:40and $220 on a weekend,
18:43which comes to $9.16.
18:45You know,
18:45it's a very well-known word,
18:47$9.16,
18:47you know,
18:48approximately $9.16 an hour.
18:50So we are saying
18:52that increase it.
18:53We are not even asking
18:54to compare with your
18:55neighbouring countries
18:55or even other countries
18:57because we can't.
18:59So we said,
18:59make it something
19:00which is,
19:01you know,
19:02which values
19:03the service of the doctors.
19:05So hopefully,
19:07we are very hopeful.
19:09I mean,
19:09you know,
19:09so I know that
19:10it was announced
19:11the budget last year
19:12but it's still waiting
19:14to be implemented
19:15because there were some
19:15issues on its implementation.
19:17we are pushing that
19:19at least this year
19:21it must be done.
19:22And then,
19:22one of MMA's calls
19:23is that it has to be
19:24across the board.
19:25It has to be
19:26every doctor
19:27who is on call,
19:28wherever he is,
19:30should get
19:30that same quantum
19:32of on-call allowance
19:33and not based on,
19:34you know,
19:35based on which department,
19:37which area.
19:37So every doctor
19:38who is on call
19:39should be eligible
19:41to claim
19:41the certain quantum.
19:42So,
19:44you know,
19:44the government
19:45has set up a task force
19:46and hopefully,
19:46the task force
19:47will give its,
19:48you know,
19:49answer.
19:50Okay.
19:51I sit in the task force too
19:52and I've also pushed
19:53that,
19:54you know,
19:54you must increase
19:55on call.
19:56So,
19:56you know,
19:56but,
19:57and I understand
19:58that it will be presented
19:59to the cabinet
20:00and hopefully,
20:01we will get this settled
20:02as soon as possible
20:03and the quantum
20:04will be at least,
20:06at least,
20:06a significant increase.
20:08Can I just ask you,
20:09I mean,
20:09there's been a lot of issues raised
20:14in terms of the challenges
20:17that the healthcare workforce is facing.
20:22From your perspective,
20:24what are your biggest concerns
20:26if we don't move fast enough?
20:29I'm so happy
20:29that the government
20:30is aware of this
20:31and is thinking about it,
20:32has set up multiple task force
20:33and has issued
20:34multiple roadmaps for it.
20:36but the concern is
20:39whether it will progress fast enough,
20:42whether there will be momentum
20:44on this
20:44because it's very easy
20:46for other things
20:46to take precedence over it,
20:48for other things
20:49to be prioritized.
20:49What are your concerns
20:51if we don't get momentum
20:54going on this?
20:55Hence,
20:55our call for the abolishment
20:57of the contract doctors.
20:58You know,
20:59because time is of the essence.
21:00We are losing doctors.
21:02Our junior doctors
21:03are not starting
21:04the housemanship here.
21:05They are leaving to Singapore,
21:07Ireland,
21:08UK,
21:09Australia.
21:10We are losing a lot of doctors there.
21:11This is at the starting point.
21:13Wow.
21:13Even before anything?
21:14Before entering the housemanship,
21:16a lot of our graduates leave.
21:18Secondly,
21:19we have those already in service
21:20and because of the permanent post issues
21:22and all that,
21:23career progression,
21:24job,
21:24they leave.
21:25So we have to do both
21:27at the same time.
21:28You know,
21:29as I said,
21:29training pathways
21:30and for the new in-checks,
21:32we have to make sure
21:33that when they enter,
21:34they know they have
21:35job security,
21:36they have career progression,
21:37everything.
21:38So hence,
21:39the urgency of getting it done
21:40and I think if we do that,
21:42it will take time.
21:43You know,
21:43it's 10 years,
21:44you know,
21:4410 years,
21:45you can't change whatever
21:46transpired in 10 years.
21:4810 years,
21:49it was meant to be
21:50a temporary solution.
21:52It was a band-aid solution
21:53which has lasted a decade.
21:54It has lasted too long.
21:55So whatever we do now,
21:57even,
21:57you know,
21:57we say,
21:58whatever we do now,
21:59the effect will be seen
22:00a few years down the road.
22:01Right.
22:01But if we don't do anything now,
22:04it will get worse and worse.
22:05So that is something
22:06we have to do.
22:08Hopefully,
22:09our intake in the medical schools
22:10will go up.
22:11The number of people
22:12joining housemanship
22:13in Malaysia will increase.
22:14The number of people
22:15who stay in service
22:17increase.
22:17And of course,
22:18our specialists,
22:19you know,
22:19there's another group
22:20who always leave,
22:21our senior specialists,
22:22because of career progression,
22:24that is always a tough one.
22:25But, you know,
22:26we always forget
22:27that this group
22:27of senior specialists
22:28have alternatives.
22:30They can always go to private
22:31and earn so much more.
22:32And so we are fighting
22:33for their challenge.
22:34So we need to keep them
22:35because they are the ones
22:36who train the junior ones.
22:37Can I ask you,
22:38so one of the roadmaps
22:39in terms of addressing
22:40the healthcare workforce,
22:43because I think
22:44the government
22:45has acknowledged
22:45the fact that
22:46there is a disconnect
22:47between workforce production
22:48and workforce absorption,
22:50how much the system
22:51can absorb.
22:51they've proposed
22:54a Human Resource
22:56for Health Governing Board,
22:58a HRH Governing Board
22:59that will overlook
23:00education training,
23:02deployment,
23:03retention.
23:04Is that something
23:05that you think
23:06will be useful
23:07to have one body
23:08to overlook everything?
23:10Because as mentioned earlier,
23:11all of this
23:12is fragmented, right?
23:14You've got
23:15Ministry of Health,
23:16you've got JPA,
23:17all of that,
23:17you've got MOHE,
23:20Ministry of Higher Education
23:21as well as part of the mix.
23:23Earlier on,
23:24there used to be a call
23:25for a health commission,
23:27healthcare commission.
23:28But to me,
23:29whatever body is formed
23:30must have the authority
23:32and the power
23:33to get things done.
23:35As you rightly mentioned,
23:37the finance
23:38is a different thing,
23:40creation of posts,
23:41you know,
23:41it's not easy.
23:42So if you have a body
23:44which can do all this,
23:45I think it's doable.
23:46But then again,
23:47it must come
23:48with the authority
23:49and the power
23:50to get things done
23:51and maybe a direct linkage
23:52with the finance ministry
23:54to get the necessary post
23:57and financing.
23:58So there is,
23:59you know,
24:00so I think
24:00if everything can be done
24:01in, you know,
24:03totality,
24:04I think
24:04then there is
24:05definitely can be done.
24:07So it's a good idea
24:08but it has to be executed well.
24:10Executed well
24:10and with the correct
24:12authority
24:12and power,
24:14you know,
24:15and, you know,
24:15of course,
24:16engaging with everybody.
24:17That's important.
24:19Dr. Kavinder,
24:19thank you so much
24:20for being on the show
24:21highlighting some of the
24:22real challenges
24:24that our doctors
24:24are facing today.
24:25Thank you for your time.
24:26Thank you very much, Melissa.
24:28That's all the time
24:28we have for you
24:29on this episode
24:29of Consider This.
24:30I'm Melissa Idris
24:31signing off for the evening.
24:33Thank you so much for watching.
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