lol even with simple calculation thats rubbish
250k / 30 days (means he works without any weekend off) = 8333
do u know consultation charges max is 235 for first visit and 105 for subsequent per visit?
which means he is seeing minimum 35 new patients per day every single day for 30 days a month
impossible

Hi Sean

I get the feeling you are unsatisfied by someone earning 200K / month.. especially doctors. 

But you are applying the moral argument of a high fixed salary  in a  self employed , pay for service rendered work model.

For example... In fixed salary situation.. like Directors or employees, you can questions their value. Why pay 100K for a foreign CEO , when a local one can do the same job for 70K ? (the local may do an even better job than the foreigner). Therefore you are right to question the salary in this situation.
For a doctor, its a pay per service model... the charges are the same across the board in Malaysia and go according to the type of consult or procedure done.

You're not going to ask you GP to remove your appendix are you? So you see a surgeon. The total fee for emergency appendicectomy is say 3000rm,.. that for all surgeons.. regardless of complexity of the case even.

You want the famous surgeon ?  go ahead, its your choice.. free to choose in private market.. everyone wants the famous guy. So famous surgeon is operating everyday at the SAME fee rate as less famous surgeon... but because more people want him, he has many cases and earns his 200K / month.

This is fair. Unless you want to say.. you can't operate more than certain amount of cases to limit the income. or Restrict the charges? Then the less busy surgeons who charge the same will drop off and competition drops further.. we are already one of the cheapest private markets in the world btw.

If he over charges for medications, the patients will buy in outside pharmacy. If a Dr recommend doing tests that the patient don't think is needed... The patients will go elsewhere for second opinion. like I said.. water will find its own level.
I know him personally. His only crime was to under declare tax. Not medical negligence or misconduct

All i can say is .. his patients LOVE him.. they bring their whole family to see him.. His own patients are very reluctant to see other doctors when he is not around..   

His income was over 500K / month at its peak. But he has since slowed down. He does scans and heart tests in his own clinic which is why he earns more, he does it than cheaper than the main hospitals charges

Did he over investigate? .. probably, but his patients love him for not missing anything or picking up things that other doctors dismissed as not important..

High income doctors are  all over la... like someone said.. the best will always rise..

Gleneagles famous Urologist. Earns 400K /month in his early 40s. People choose to go to him because they hear about what he can do and he explains well etc etc.. he has a VIP clientele because of his discretion and expertise in sex related disorders.

What I am trying to say is,.. the market is very complicated. you can't just say there someone earning XXX amount and its immoral and bad.. its actually their earned income by volume and service rendered.. also,  like everyone else has mentioned, there is 60%  of doctors in private (excluding GP) who don't pass 50-60K / month .

I admire your altruistic view of doctors and the world.

There's too much to debate here, so I'm going to pick and choose things that stand out as need a response.

The US physician average is an AVERAGE. That means there many above that. Thats also including GPs by the way. Their average is likely the average of our top 10%

Tier 1 hospitals like Gleneagles, PCMC, SJMC have a policy that they will not send patients away just because they are high risk or ill unless the patient or family requests it. They have a broad range of expertise and therefore can handle nearly all cases. Only the smaller ones will becuse they lack the experts in certain fields. Gleneagles currently even has an Infectious Diseases specialist covering from Sg buloh to help deal with things like this nCoV 2019 risk management.

You seem to think the reason successful private doctors earn alot by overcharging. Like I said , the truth is that they charge according to the set fee schedule. All of them charge the same amount. The only way to make more is to see more and offer more services. If you just want to sit in your clinic and see 10 patients a day, don't do on-call for emergencies and not take the risk of surgery or sick inpatients.. then you're not going to even pass 20K.

But lets say..  you are a good procedure based doctor like a gastroenterologist who sees 15 patients (this is not even that many) a day in clinic, accepts emergency cases and referrals no matter how ill .. usually have between 6-8 inpatients ... Do 2 or 3 colonoscopies a day maybe including removing a tumour/polyp. or stopping a bleeder.. Thats about 10K just there. And thats not even an overly busy day for most doctors that start at 7am -6pm. Sure its not going to like that everyday for everyone.. but I think on average, thats not unusual for a big hospital.

Part of the pay disparity if also driven by our own society.. we have a very Kiasu society.. we want the best only, must ask 5 relatives and friends on who they think is the best... and I'm going to stick my neck out on this... but chinese patients are the worst for this.. picking and choosing.. want only the "best doctor", chinese doctor, cannot too old , cannot too young, don't want empty waiting room .. coz think he must not be good. They are willing to wait HOURS to see the person they think is good. This is the main cause of skewing effect seen in private, all the patients skew to the bigger centres.

doctors are not angels.. not by a mile. But I still believe most mean well and will genuine do what they can. The richer ones are more likely to waive their fees when patients cannot pay

If you really want to go into a national health route, with standardised doctor salary and all, then be prepared not to have any choice in your treatment. It will be dictated by cost based guidelines and what the government budgets says you can do. You will not be able to choose your doctor for his level of seniority or expertise. And you cannot easily get a second opinion in public service. If you want to maintain a scenario where you have an option to get your treatment faster or get the best treatment on offer, then you need private hospitals to fill the gap... And as long as there are private hospitals, this attitude of people to want the "best expert" for their money will continue, and in turn this will make the top 10% of doctors 200K/month earners..

as someone said, this is the same in all professions..

p/s: before anyone starts accusing me of race gaming.. I am qualified to make the statements above as I am Chinese. I have worked in both the public and private sectors , in university and MOH hospitals. I have also spent 10 years in the NHS.. so I know what I am talking about here.

I can verify that this is correct. I am an Interventional Cardiology Registrar (ST7) in the UK, soon to be Consultant in 10 months' time (then balik Malaysia yahoo!) and it is a long training process. Gruelling, competitive, but I thrive on that so it was okay for me. Medicine / surgery is not for everyone. Don't think about the money only as someone wise told me once "no matter how rich you are, you can only eat 3 plates of koay teow a day".

I have been contacted by private hospitals back home offering good pay - 20K basic then after 6 months of settling in and building your practice, they claim they can pay 70K/month. If you bring in more work, the top guys in their hospital are earning 150K.

If that's all they are offering. I can tell you now you're being short changed.

You're misunderstanding what he is saying. They are not paying him a guaranteed 75-150k... That's what they expect him to EARN HIMSELF in the future. (Although it's tough). There's no fixed salary la.

He's saying they are offering him 20k salary to start off. Is called guarantee minimum income. And it comes with conditions. And is usually for a few months only to help you start off. That's where he's being short changed. 20k is considered a very low guarantee

I can assure you, their income is not fix, my father earn 70k to 120k per month.. depends on the number of operation he did..

Some folks earn wayyyyyyyy moreeee mang

But the best la

Hi guys,

I am researching the possibilities of returning home from US as an interventional cardiologist in 2023. I know it is still early at this point but due to my visa restriction I have to make up my mind by early 2022, otherwise I will have to start looking for a J1 visa waiver job in the US early next year.

I have a couple questions here, and I appreciate any input from you guys.

1) Do I need to serve the government upon returning home? Or can I go to private directly? I was born and raised in Malaysia, went to India for medical school, followed by internal medicine residency and cardiology fellowship in the US. I have recently matched to an interventional cardiology position from 2022-2023. I used to hear that one needs to have "10 years experience" overseas before returning home to avoid compulsory government service. Does this still hold true?

2) How easy, or tough it is for one to join private practice in Malaysia. Do Malaysians (especially my colleagues and patients) appreciate a US-trained physician? I have not worked in Malaysia before and I am sure there will be a huge difference in the medical system back home. My concern would be how easy it is for me to develop my practice from scratch (learning the system at the same time).

3) Would you recommend me joining teaching hospitals for a couple years to learn the system before venturing into the private world? Like joining IJN or some of the university hospitals for instance.
Thank you very much in advance! If there is anyone who went through the similar path that you know of, kindly let me know. Appreciate your help.

Thank you. Yes, I have been following Pagalavan's blog but I dont remember seeing any posts about returning to Malaysia (I could have missed those). The blog is mostly about the issues of malaysian medical education. He did talk a little bit about practicing in foreign countries etc.

The physician salary in US is good, taxes are high too. At the same time, patients are more demanding. It is very common for patients to call/message the office with questions and doctors are expected to reply within 24 hours. One of my attendings in private is getting up to 30 medical questions/emails/messages on a daily basis. If we talk about money alone, I don't think there is too much of a difference between interventional cardiologists in US as compared with the private cardiologists in Malaysia. For eg, interventionists here make about USD 400-700k/year in private; those in academic center make about 300-400k. (Forget about the outliers like Samin Sharma who makes 5 mil/year). With such income you are at the highest bracket for federal tax ie. 37%. On top of that, we pay state tax (more than 10% in California), social security, medicare etc. So I am talking about half a paycheck just for taxes, excluding retirement plan and disability/malpractice insurance etc.

From what I heard (correct me if I am wrong), private cardiologists in Malaysia make about RM100k/month which is about RM1.2 mil/year on average. The good earners are making RM 300k/month upwards. Bear in mind our highest tax bracket is less than 30%, with no state tax.

This is just about the money, which I think is important but not everything. Maybe I have been away from home for too long, or maybe the travel ban due to COVID stirred up my emotion. Now at this stage, for me, family is above all else.

Nice one, I am in the same boat, but in the UK. Family is most important - a fact that not many appreciate, until you have been away for a very long time.

I am in the midst of planning my return home in the next year or so, currently about to start a post CCT complex PCI fellowship in Bristol. My view/understanding is that it is very unusual to come home straight to private practice (although possible) if you have never worked in Malaysia before. The reason for this is there are some nuances about practising here that might not be apparent to us and a period of adjustment will do us good and the patients justice as well.

For that reason, a Uni environment is the best middle ground (they have private wings now so you can split your working time between Uni and private and the earning potential is decent) and it gives you the chance to earn as well as teach/do research/find your feet when you come home having previously worked in a completely different working environment. At least that's what I am planning to do. You can then understand the lie of the land and decide what you want to do long-term once you have settled down.

It just so happens that I am in KL this month on leave and have arranged visits to UMMC and UITM to see how things are. Happy to be PM'd.

Never thought I would meet a fellow interventional cardiologist on Lowyat!

Can somebody post an actual salary slip for verification purposes?

I prefer Malaysian pay gap on instagram. Thats more legit

45k is sort of the median, while the superstars pull in at least 200k a mth

Many years back, did a POC project for one of the chain specialists hospital in msia...

Averagely the doctor earns 100k to 200k per month. A few earns 500k to 800k. Just one very super specialized and famous doctor earning 1 million every month

Another example is the general surgeon that removed my appendix, back in 2009 he charged me 5k for surgery in private hospital.

Heard he does 2-3 surgeries a day, u do the math.

and yes i completely forgot about one specialist who is resident in a few private hospitals in Klang Valley. I used to audit his sdn bhd which he channels his income to. gross around 1.5 mil (2012) revenue p.a. But sadly i forgot what field he is in.

IMHO no specialist would do this. Alot of the guys I know don't do their taxes honestly and keep cash to be unreported