Factors that affect how patients decide on a doctor


There are some factors beyond a doctor’s control that may affect whether patients choose to see them or not. — AMITA SEVELLARAJA

When I first decided to move into private practice, I applied to a well-known private hospital in Johor Bahru.

My application was turned down as I was considered “not marketable”.

This decision had nothing to do with my skills or willingness to work hard; it was based on my physical characteristics, namely, being a male, Indian obstetrician and gynaecologist.

I would have had to do more to attract patients away from my female Chinese or Malay colleagues, who would have been the first choice for a woman requiring the services of an obstetrician and gynaecologist.

In this article, I will examine such similar factors that may play a role in attracting patients to your practice.

Race

We live in a multiracial country with 65% of the population being Malays, 25% Chinese and 8% Indians.

When I entered private practice in 1994, there were very few private hospitals.

Patients going to such hospitals had limited choices and I had patients of all races consulting me.

However, with more and more private hospitals being established, patients have more and more choices.

I also believe that the political environment and the education system have made the new generation of Malaysians more polarised.

One of my friends, who works in a group practice with doctors of all races, shared his observation that most patients choose to see doctors of their own race.

For a patient to cross racial boundaries, they would have either received a strong recommendation for a particular doctor or were brought up in a broad-minded environment.

Generally speaking, there are sufficient numbers of Malay and Chinese patients seeking consultations to provide enough business for Malay and Chinese private doctors.

However, as the Indian population in this country is small and only a small percentage of them can afford private healthcare, for an Indian doctor to depend solely on Indian patients for his private practice to survive is suicidal.

In order to compete to gain patients of other races, Indian doctors have to innovate.

Some, like me, learn a Chinese language.

Others may market themselves as “cheaper” than their colleagues by reducing their fees.

Others acquire special skills to stand out in their field.

Religion

Malaysia is also a multireligious country. But does religion matter in the choice of doctors in private practice?

As all Malays are Muslims, it is a moot point as to whether a Malay patient chooses a Malay doctor because of race or religion.

As for the non-Muslim public, religion is probably not an important consideration in their choice of a doctor, e.g. an Indian doctor may be a Hindu, Christian, Sikh or Muslim.

However, that is not to say that religion does not play a role for certain people.

I have a friend who is a staunch Christian and most of his church members see him.

Only when there is a strong recommendation to see a non-Christian doctor, will a member of that Christian group do so.

Language

I think language is a very important factor in determining a patient’s choice of doctors.

This is especially so among Chinese and Indian patients.

A Tamil-speaking patient who is not very fluent in Bahasa Malaysia or English will seek a Tamil-speaking doctor.

Similarly, Chinese patients are more comfortable seeing Chinese doctors because of their common language.

I myself have benefited from the ability to speak some Mandarin as my Chinese patients are able to communicate with me in that language.

As most doctors in Malaysia speak reasonably good Bahasa Malaysia, Malay patients do not have this problem.

Indeed, Indonesian patients are very happy to seek medical services in Malaysia as they can communicate in their own language due to the similarities between Bahasa Malaysia and Bahasa Indonesia.

Patients who are more comfortable speaking in their mother tongue might seek out doctors who are fluent in the same language or dialect. — FilepicPatients who are more comfortable speaking in their mother tongue might seek out doctors who are fluent in the same language or dialect. — Filepic

Looks

When I first entered private practice in Melaka, I remember a very senior gynaecologist telling me, “You are handsome and young, how can I compete with you?”

This struck me as strange as I was a brand new doctor and he was the most senior gynaecologist in town.

I have always wondered whether looks play an important part in a patient’s choice of a doctor.

It has been shown clearly in numerous studies that good-looking people get better jobs and higher salaries, compared to their not-so-good-looking counterparts.

However, does this apply to doctors as well?

I presume that if you are an obese, unattractive doctor doing aesthetic medicine, it might not work.

But then again, I know of a rather big-sized local plastic surgeon who is doing very well.

Again, if you are an obese doctor treating obese diabetics, this might not work either.

Patients have to look up to their doctors to follow their advice, and so the doctor should have the right look to complement their practice.

Age

It is said that you need to be old enough to have the experience and young enough to be energetic for patients to choose you as their doctor.

What then is this magical age?

Some say it is between 45 and 55 years of age.

Less than 45, you are considered too young and inexperienced; more than 55, you are too old and not energetic enough.

Of course, this may be too much of a generalisation.

Some patients want to be treated by the oldest and most highly-experienced doctor, while others prefer younger doctors who might be more energetic and up-to-date in their knowledge of the field.

When I was a young specialist, I wanted to look older so that my patients would trust me.

Now that I am older, I want to look young so that the same patient will still trust me.

Life is a cycle!

Gender

There is not a single speciality in medicine where gender is as important as in obstetrics and gynaecology.

Most women prefer their obstetrician and gynaecologist to be another woman.

(My advice to all male doctors is, never do gynaecology. If you do, marry a female gynaecologist so that she can “feed” you patients.)

As the world becomes more and more conservative, the number of male gynaecologists is dwindling.

Why do males want to do gynaecology in the first place?

I personally chose it because it is a happy speciality.

It is the one speciality where the final outcome is mostly a happy one: the patient going home with a baby.

What about other specialities?

Female breast surgeons do better than male ones for obvious reasons.

Most urologists are male.

A long time ago, one of my female gynaecologist colleagues told me that “the public do not trust young women gynaecologists to operate on them”.

I wonder whether that is still true in the 21st century?

Personality

A colleague of mine told me that she liked a certain male gynaecologist because he is quiet, professional and does not talk much.

Another colleague chose a female gynaecologist because she is friendly and talks a lot.

I guess it is impossible to please everyone.

It is difficult to change one’s personality to suit different patients. You will be found out to be a fake.

On the other hand, you can choose a speciality based on your personality.

Someone once said: “You don’t choose your profession, the profession chooses you.”

There may be some truth in this.

I find most neurosurgeons to be risk-takers as that profession has a high death rate and your personality must be able to take those risks.

Physicians usually have a more sedate personality than surgeons who are more adventurous.

Yet, most of us doctors also learn to adapt our personalities to the speciality we choose.

Conclusion

Factors that are beyond our control affect how we succeed in private practice.

These are inherent factors that cannot be changed; we have to live with them.

However, when choosing a speciality, you can consider whether the factors you possess will benefit or be detrimental to the field of your choice.

For example, in certain specialities such as pathology and radiology, your gender, personality, religion, etc, is not very important.

The only important factor is your skills.

In other specialities, even if you are very skilful at your work, other factors may play a major role in attracting patients to your practice.

You need to think carefully about these issues when you choose a speciality to pursue.

Dr S. Selva is a consultant obstetrician and gynaecologist, and fertility specialist, in private practice in Melaka. This is the ninth article in a weekly series about surviving private practice in Malaysia. For more information, email starhealth@thestar.com.my. The information provided is for educational purposes only and should not be considered as medical advice. The Star does not give any warranty on accuracy, completeness, functionality, usefulness or other assurances as to the content appearing in this column. The Star disclaims all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

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