'Stars' of private sector earning HK$1m a month, while many GPs are left to struggle

The booming private health-care sector has produced a batch of superstar doctors who make more than HK$1 million a month, raising fears of a widening wealth gap between "rich" and "poor" doctors.

Several medical leaders say that while some specialists are making a fortune, general practitioners are experiencing a range of market pressures.

Choi Kin, a former president of the Hong Kong Medical Association, said the increase in health maintenance organisations that controlled fees, rocketing rents and recognition of sick leave issued by practitioners of Chinese medicine were changing the face of medical practice.

Dr Choi said a group of former university professors and public hospital consultants had brought new and expensive skills to the market.

"They are the top earners, who acquire the skills that fewer than 10 doctors have in the city, so they can set a very high market price. Some young doctors, however, cannot break even in their business. The increasing polarity is not a healthy development for the profession."

He said there were too many general practitioners and that most private hospitals had barred them from conducting certain procedures in operating theatres.

"This has narrowed their scope of practice. General practitioners are being marginalised to provide petty treatments."

Dr Choi said the government should promote primary care and provide an environment for general practitioners to treat not only common colds, but also chronic illnesses.

The big earners share similar backgrounds: they are former professors or consultants at teaching hospitals, run clinics in Central and have exclusive skills. The University of Hong Kong and Queen Mary Hospital are the major breeding grounds of these superstars.

Some charge between HK$1,000 and HK$1,500 for a consultation, not including medicine and tests.

One top earner said his private practice was doing much better than he had expected when he quit the public sector several years ago.

"After Sars, the economy picked up, more people were willing to pay for private doctors. Poor work conditions at public hospitals have pushed many senior doctors to the private sector."

Visiting doctors - private practitioners who bring patients to hospitals - once occupied the top rung of the profession. But in the past few years, private hospitals have been expanding their in-house teams to compete with the visiting doctors.

Some private hospitals have offered to double the pay of public physicians to be their in-house doctors.

"In the past, these in-house consultants were making close to HK$1 million, but in the last one or two years they have been making more than that because the patient loads keep going up," one private hospital source said.

Meanwhile, a surgeon in Central said he knew some colleagues who could not even make HK$1 million a year.

"These doctors are struggling. The surgical fee varies 10 times across the spectrum for the same kind of operation. The situation is like barristers - while the minority on the top are making a fortune, the junior barristers are struggling to survive."

Dr Choi said some primary care doctors were eager to "upgrade" to enhance their competitiveness.

One option is to take courses in treating mood disorders, which can lead to a 20 per cent increase in income. Some learn cosmetic medicine like laser treatment for skin or Botox therapy.