With the government now only employing new doctors on a contract basis (absorption to permanent is very slow), a lot of doctors opted to work in the private sector. unfortunately, the Malaysian healthcare system does not allow specialist training in the private sector for nearly all field. As such, most doctor can only work in two fields : family medicine (general practitioner) or the emergency department.

Consequently, a lot of general practice clinics are opened everywhere. Competition become so tough, especially in cities like Selangor or Kuala Lumpur. More clinics are closing every year due to low income. Wages are going negative. To stay relevant most clinics attempted to provide service plus. Unfortunately, at times this come at the price of ethics.