dear renus,
i dont know how it is in msia. whether you have a govt aided health plan for all citizens. or people have to take care of it on their own or through health schemes at work or thru insurance.
in canada, the doctor is essentially an employee of the govt. which pays him a set fee for each type of examination. the client pays nothing. out of this money, the doctor has to pay his expenses - which is usually a rental fee in a hospital or consulting building or in small towns, an office space.
in addition he has to pay a secretary, a nurse, electronic filing and such. but the beauty is that it is a single billing system for the doctor. he charges the govt on a single sheet per patient per visit and get reimbursed. there is ofcourse audit, and even my family doctor, a well established university prof also, for whom we got papers from the govt asking for verification
specialists are available only through referrals. in the rural areas, it is a captive market for both doctors and specialists. but in toronto, where choice is aplenty, it is chummy clannish friendship which makes the specialist his/her money. here the jews are at an advantage as they have a large set of specialists and get referred by their doctor colleagues. chinese/indians are just breaking into this.
the specialists appointments and surgeries are done per need. for example, someone we know, had been diagnosed with gall bladder infection, and also suspected through biopsy of being cancerous. surgery within 10 days. others non life threatening can take months. but all is free and the poorest and the richest get the same quality care.
doctors also own buildings and labs here. but it is illegal to even suggest they go to a particular lab. if word gets around (because some indian doctors tried the same tricks they do in india) they get delicensed