Merpati: Building a united voice for GPs

How it started

MHSB and the MAG were established to bring general practitioners (GPs) together under a unified platform. “[At its infancy], we began as a small WhatsApp group in Petaling Jaya during the 2020 pandemic and has now grown into a national coalition and a business entity,” said Siva. The founders—Siva, Dr Benjamin Sinappan, and Dr Mahendraganesha—saw the need for constant communication, peer support, and stronger negotiating power for GPs.

Somewhere along the way, they decided they could do much more for the GP scene and decided to expand the group. Today, MAG and MHSB represent more than 1,300 members across Malaysia, with a focus on both clinical excellence and business sustainability. The ultimate mission is clear: unite GPs, strengthen their voice, and improve their business standing.

MAG and MHSB: How they differ

MAG is a coalition of doctors, primarily GPs. It focuses on clinical collaboration, peer-to-peer sharing, continuous medical education (CME), and standardising consultation and procedural fees. Meanwhile, MHSB is the business arm. It negotiates costs for drugs, medical devices, and insurance, and creates ventures that improve the financial sustainability of clinics. Together, MAG and MHSB create a balance between professional development and business survival.  

Membership of MHSB is simple i.e., one has to be a member of MAG and a clinic owner. Clinic owners may include non-doctor. An MOU is then signed, which formalises participation, allowing MHSB to represent members in business dealings. The MOU and subsequent non-disclosure agreements protect the confidentiality of members and ensure collective strength. There are no registration fees to join MAG and buying shares in MHSB is optional.

The seven pillars of MAG and MHSB

Siva said the Merpati group operates on several guiding pillars. These are, in no particular order:

1.        Intention: pool expertise and knowledge for the benefit of GPs.

2.        Sincerity: act altruistically without expectation of personal gain.

3.        Discussion: respect differing views to identify problems and solutions.

4.        Planning: design viable solutions that serve stakeholders.

5.        Execution: act on plans promptly and effectively.

6.        Support: provide help to members impartially.

7.        Reflection: ensure accountability and responsibility at every level.

These pillars form the foundation of the coalition’s culture and has so far served them well. Sensitive matters related to race, religion and royalty are strictly barred from discussion to maintain the professionalism and conducive environment for general practice to thrive.

Key initiatives
In the short time since its inception, MAG has launched a few notable initiatives. One of them is addressing challenges with third party administrators or TPAs. TPAs have long been a source of tension for GPs. This is due to some TPAs paying very low consultation fees, as little as RM20, leaving doctors frustrated. Others impose restrictions on dispensing and treatment, limiting professional judgement. The end result is GPs losing income when pharmacies take over long-term medication supply, and the patient suffers due to loss of follow-up and tracking.

To address these issues, MAG facilitated the creation of Persatuan Pentadbir Tuntutan Kesihatan (PPTK), an association aiming to unite TPAs under a self-regulated framework. The aim is to ensure fair practices, prevent monopolies, and safeguard GP representation. MHSB itself has begun the process of registering as a TPA to strengthen bargaining power. This step opens the possibility for GPs to negotiate directly with corporates, bypassing unfair intermediaries.

Each initiative reduces costs, creates new revenue opportunities, or protects clinics from financial risk.

Product development

Not happy to rest on its laurels, MHSB has launched its own product line, eleRise, developed exclusively for GPs. These products are only available through GP clinics. These products are aimed at ensuring GPs are able to maintain a steady, long-term relationship with their patients without losing them to other health entities. 

The list of products already in the market or in the pipeline include supplements for eyes, nerves and joints, gut health products, and tiger milk mushroom formulations. This move allows GPs to offer niche products directly to patients, countering the trend of pharmacies undercutting prices.

Academic Arm: DR4EVA

Beyond business, MAG has an academic branch. Called DR4EVA, it serves as a platform for knowledge-sharing. Key features of the group include weekly case discussions and clinical presentations. The education group has a membership of over 1,000 doctors, including senior specialists. The main aim of the group is to provide support for young doctors who recently left government service and need guidance in their day-to-day practice.

Very recently, MHSB has also been approved as a continuing professional development (CPD) provider, with the first official CME with CPD points being scheduled for mid-October. The inaugural CPD course will focus on joint injection techniques.

What is on the horizon?
Looking ahead, MAG and MHSB plan to expand their impact by registering as a TPA and obtaining pharmaceutical and Good Distribution Practice for Medical Devices (GDPMD) licences. They are currently exploring the possibility of directly importing drugs and medical devices to reduce costs.

MAG is also looking to build a digital marketplace for products and services from its members. Beyond products, Siva said they are looking to strengthen their hospital referral pathways, starting with partnerships like Thomson Hospital, and expand into corporate wellness programmes.

While not currently involved in any corporate social responsibility ventures, Siva said it is likely MAG will be looking to develop a CSR arm to contribute to community healthcare.

Currently, the unofficial target of 1,000 GP members has already been exceeded, but Siva hopes more members will join MAG and MHSB as further growth will enhance their bargaining power and influence.