Private general practitioners (GPs) in Malaysia are grappling with mounting operational costs and regulatory pressures, prompting discussions about potential fee hikes for patients. As clinics navigate long-standing consultation rates and new compliance requirements, such as the recent medicine price display order, many are reevaluating their billing structures to remain sustainable. With the Health Ministry yet to announce an updated fee schedule, the financial strain on these essential healthcare providers—often seen as the backbone of affordable care in Malaysia—raises broader questions about accessibility and equity in the nation’s healthcare system.

Operational Realities Push Billing Adjustments

Across Malaysia, private GPs are feeling the pinch of rising costs for staffing, utilities, and medical supplies, compounded by new regulatory mandates. The Price Control and Anti-Profiteering (Price Marking for Drugs) order, which took effect on May 1, 2025, requires private healthcare providers to display medicine prices, adding compliance costs to already strained budgets. Dr Shanmuganathan Ganeson, president of the Federation of Private Medical Practitioners’ Associations Malaysia, highlighted the challenges clinics face in absorbing these expenses.

“These changes reflect operational realities—rising costs for staffing, utilities, compliance with regulations, and supplies—that have been absorbed by clinics for many years” said Dr Ganeson. He emphasized that any billing adjustments are not about introducing new charges but rather making existing costs more transparent to patients.

Some GPs, guided by their state associations, are reviewing how to structure their fees to address these pressures. While no uniform decision has been made, the possibility of fee hikes looms large, particularly if the long-awaited revision to consultation fees under Schedule 7, currently stagnant at RM35 (US$7) since 1992, does not provide relief. Dr Ganeson expressed hope for a fair update from the Health Ministry, suggesting that a reasonable adjustment could prevent the need for additional charges.

Voices from the Ground: GPs Weigh Options

The sentiment among practitioners varies, with some already implementing small increases while others remain cautious. In Penang, a GP speaking on condition of anonymity revealed ongoing discussions about introducing service or facility fees to cover operational costs. “There are talks among practitioners in the state about introducing new fees. I am also considering it. The government should really look at providing us with a comfortable rate for consultation fees” he said.

In Kuala Lumpur, another GP has started charging an additional RM10 (US$2) to offset expenses related to the price display mandate. “I have to factor in the cost of putting up screens for the price display. But if this is not addressed soon, I am sure more GPs will have to raise their fees” he noted. Surveys conducted by local media, including The Star, indicate that at least three GPs are considering fee adjustments, reflecting a broader trend among solo practitioners facing high overheads, especially in urban centers with steep rental costs.

Former president of the Medical Practitioners Coalition Association of Malaysia, Dr Raj Kumar Maharajah, acknowledged the growing frustration among GPs. “There have been some rumblings on the ground by GPs who feel the noose is getting tighter around their necks as costs of living have gone up” he said. He pointed out the historical role of GP practices in providing accessible, affordable care since pre-independence days, a unique feature of Malaysia’s healthcare landscape that he believes is unmatched globally.

Health Ministry Response and Industry Expectations

The Health Ministry is under pressure to address the stagnation of consultation fees, which doctors’ groups have long argued should be revised to a range of RM50-RM60 (US$10-US$12). Health Minister Datuk Seri Dr Dzulkefly Ahmad announced on May 4, 2025, that a resolution is imminent. “I have prepared the documents, so I expect to resolve this within one month at the latest” he stated. This timeline offers a glimmer of hope for practitioners awaiting clarity on Schedule 7 updates.

Meanwhile, other healthcare stakeholders, such as the Malaysian Pharmacists Society, have called for dispensing and professional fees for pharmacists, signaling a broader push for fee restructuring across the sector. In Penang, the Penang Medical Practitioners Society plans to meet within weeks to recommend a new service fee range for private GPs and solo specialist clinics, according to local reports.

The potential for fee increases comes at a time when Malaysia’s cost of living continues to rise, placing additional burdens on households already stretched thin. Private GPs have historically been a critical access point for affordable healthcare, especially for those who cannot afford private hospitals or face long waits in public facilities. A fee hike, even if modest, could disproportionately affect lower-income families, potentially driving them toward overburdened public clinics or delaying necessary medical care.

Economically, the sustainability of private GP practices is intertwined with Malaysia’s broader healthcare ecosystem. These small clinics employ thousands of staff and serve millions of patients annually, often in underserved urban and rural areas. If financial pressures force closures or deter new practitioners from entering the field, the ripple effects could strain public health resources and exacerbate existing disparities in care access.

On the other hand, failing to adjust fees may compromise the quality of care provided by GPs, as clinics struggle to maintain equipment, retain skilled staff, or comply with regulations. This delicate balance between affordability for patients and viability for practitioners underscores the urgency of the Health Ministry’s forthcoming decision. A fair revision to consultation fees could strike a middle ground, allowing clinics to cover costs without passing excessive charges onto patients.

Regulatory Context and Regional Comparisons

The Price Control and Anti-Profiteering order reflects Malaysia’s broader efforts to enhance transparency in healthcare pricing, a move aligned with global trends toward patient empowerment through cost visibility. However, the implementation has revealed gaps in support for small-scale providers like GPs, who lack the economies of scale enjoyed by larger hospitals or chains. In contrast, neighboring countries such as Singapore and Thailand have adopted tiered pricing models for private healthcare, often with government subsidies or incentives to offset compliance costs for smaller clinics.

In Singapore, for instance, polyclinics and private GPs operate under a framework where consultation fees are periodically reviewed in consultation with industry stakeholders, ensuring adjustments reflect economic conditions. Thailand, meanwhile, has introduced tax relief for small healthcare providers to mitigate the impact of regulatory changes. Malaysia could draw lessons from these approaches, potentially integrating subsidies or phased compliance timelines to ease the burden on GPs.

Patient Perspectives and Public Sentiment

Public reaction to potential fee hikes remains mixed, with limited formal surveys available as of May 2025. Anecdotal evidence suggests frustration among patients who already perceive healthcare costs as high, particularly in urban areas like Kuala Lumpur and Penang. On social media platforms like X, some users have expressed concern over affordability, with posts highlighting the cumulative impact of small fee increases across multiple clinic visits. Others, however, acknowledge the challenges faced by GPs, advocating for government intervention to balance costs rather than leaving practitioners to shoulder the burden alone.

The Malaysian government faces a complex challenge: ensuring that healthcare remains accessible while supporting the financial health of private practitioners who form a critical part of the system. Any decision on fee revisions will need to consider public sentiment alongside industry needs, potentially incorporating public consultations to build trust and transparency.

Looking Ahead: Sustainability vs. Accessibility

As Malaysia’s private GPs await clarity from the Health Ministry, the debate over consultation fees and billing adjustments highlights a fundamental tension in healthcare policy—balancing sustainability for providers with affordability for patients. The outcome of the Schedule 7 revision will likely set a precedent for how the nation addresses similar challenges in other healthcare sectors, from pharmacies to specialist clinics.

For now, practitioners and patients alike are left in limbo, with potential fee hikes casting a shadow over the future of affordable primary care. Whether the government can deliver a solution that satisfies both sides remains an open question, one that will shape the accessibility of healthcare for millions of Malaysians in the months to come.