PETALING JAYA: Malaysia is “sorely short” of rheumatologists, or specialist doctors who treat arthritis, gout and autoimmune diseases like lupus.
Currently, the country has 132 rheumatologists in the public and private sectors.
“To meet the ideal ratio, we would need about 684 rheumatologists.
“But we currently have only 62 under the Health Ministry, which is sorely short,” the ministry said, adding that there were another 12 rheumatologists in facilities under the Education Ministry and an estimated 58 in the private sector.
In an ideal situation, there should be two rheumatologists for every 100,000 population.
But in Malaysia, the current ratio is 0.38 rheumatologists per 100,000 population, said the ministry.
Nevertheless, about eight to 10 new rheumatologists are expected to qualify each year.
The ministry said there was a need to strengthen gout management in primary care.
“This is because rheumatology units are prioritising the management of various autoimmune rheumatic conditions, which have been on the rise in recent years,” it said.
Consultant rheumatologist Dr Pradeep Dass said the distribution of specialists was also a major challenge, as rheumatology services were still concentrated in urban areas.
“At the same time, some patients often require multidisciplinary co-management involving other specialists such as nephrologists, neurologists and respiratory physicians,” he said.
In many public hospitals, rheumatologists were also required to perform general internal medicine and physician duties, on top of offering rheumatology services.
“As a result, many rheumatologists in public service are stretched quite thin,” Dr Pradeep said.
Nevertheless, he lauded efforts in Malaysia to strengthen gout management nationally, such as the periodic review and updating of clinical practice guidelines.
“While rheumatologists continue to manage more complex gout cases, the guidelines help equip primary care doctors to manage straightforward cases, while recognising patients who require specialist referral,” he said.
Federation of Private Medical Practitioners’ Associations Malaysia president Dr Shanmuganathan TV Ganeson said while there is a shortage of rheumatologists, most gout cases are effectively managed at the primary care level.
“What is more practical and impactful is to strengthen continuous professional development and continuing medical education for primary care doctors,” he said.
