Star: PUTRAJAYA: The Health Ministry is mulling over a proposal to allow repeat patients of government hospitals to seek follow-up treatment at government or private clinics near their homes at minimal cost.
Newly-appointed Health Minister Datuk Liow Tiong Lai and ministry officials came up with the proposal recently to lighten the burden of the people.
“We are thinking of ways to help these patients seek treatment at nearby clinics, including private ones, and having a certain understanding on how they could work closely with government hospitals,” he said.
He said the medical records could be sent to a clinic near the patient’s home through a specific channel of communication or the Internet, accessible only to those involved.
Liow said officials would have to come up with innovative ways and study the matter extensively, including the cost to be borne by the Government, before implementation.
“However, our main target is to provide better services.
“Currently, repeat patients have to travel to specific hospitals for follow-ups or treatment.
“The proposal is also part of the ministry’s effort to reduce the waiting period at government clinics as they are facing a shortage of doctors and other medical staff,” he said.
Liow said he was concerned that the current ratio of doctors to patients at government hospitals was just one doctor to 1,121 people, while in developed countries it was 1: 600.
“Only 60% of the posts are filled and this problem has been dragging on for quite some time.
“The Cabinet has addressed this problem many times by giving incentives to doctors, but it appears that the move was not enough to retain them,” he added.
Liow said government hospitals would not be able to compete with the private sector in terms of providing better income and incentives.
Therefore, he added, the only solution was for the two sectors to work together to overcome the many problems.
Malaysian Medical News: keeping you up to date with news sourced from various online sites, put in one place for your convenience, with a searchable archive
Monday, March 31, 2008
Sunday, March 30, 2008
Pay attention to ADD
Star: KUALA LUMPUR: Teachers need to learn how to spot Attention Deficit Disorders (ADD) among pupils and get quick help. Otherwise, the children will be doomed to learning difficulties throughout their school years.
About one in five children are afflicted with ADD and, if left unattended, lose motivation, become noisy, naughty and lazy.
These were the findings of a nine-month pilot study on Year One and Two pupils in five Klang Valley primary schools jointly carried out by University Malaya Medical Centre's (UMMC) Child Psychiatry Unit head Dr Aili Hanim Hashim and senior lecturer Dr Subash Kumar Pillai.
Dr Subash said that a few teachers and counsellors, trained to identify ADD pupils in Year One and Two, spotted 50 of them and sent them to the Child Psychiatry Unit.
“They were treated by psychiatrists to cope with learning difficulties and being unable to follow the teacher,” he said.
Some pupils were asked to bring along their parents as they were depressed or suffered emotional problems because the parents constantly quarrelled or were divorced, he said.
“After treatment, the pupils returned to classes and about half of them showed improvement,” he said at a UMMC Seminar on Mental Health Problems Among Children in Schools aimed at raising awareness about the need to promote and protect children's mental health.
“Good mental health is essential for a child's learning, social development and self-esteem.
“It is shown that mental health developed in early childhood becomes the basis of one's mental health throughout adult life,” Dr Subash said.
About one in five children are afflicted with ADD and, if left unattended, lose motivation, become noisy, naughty and lazy.
These were the findings of a nine-month pilot study on Year One and Two pupils in five Klang Valley primary schools jointly carried out by University Malaya Medical Centre's (UMMC) Child Psychiatry Unit head Dr Aili Hanim Hashim and senior lecturer Dr Subash Kumar Pillai.
Dr Subash said that a few teachers and counsellors, trained to identify ADD pupils in Year One and Two, spotted 50 of them and sent them to the Child Psychiatry Unit.
“They were treated by psychiatrists to cope with learning difficulties and being unable to follow the teacher,” he said.
Some pupils were asked to bring along their parents as they were depressed or suffered emotional problems because the parents constantly quarrelled or were divorced, he said.
“After treatment, the pupils returned to classes and about half of them showed improvement,” he said at a UMMC Seminar on Mental Health Problems Among Children in Schools aimed at raising awareness about the need to promote and protect children's mental health.
“Good mental health is essential for a child's learning, social development and self-esteem.
“It is shown that mental health developed in early childhood becomes the basis of one's mental health throughout adult life,” Dr Subash said.
Newcastle medical campus for Iskandar
NST: KUALA LUMPUR: Newcastle University will open a medical education branch campus in the Iskandar Development Region (Iskandar), a move which is expected to halve the cost of producing a UK-educated doctor.
South Johor Investment Corporation Bhd senior vice-president (education development) Khairil Anwar Ahmad said construction of the branch campus was expected to start later this year.
The university would have an intake of about 150 students per year, he said.
"We are setting up the campus based on the demands of the university and expect to complete it by 2011.
"It will be one of four international universities that will be opened in Iskandar," he said.
Khairil said arrangements were now being made to allow students to do their practical work at hospitals in the area.
"The students may also be able to do this at healthcare facilities in Iskandar later," he said.
Khairil said Newcastle University was the first foreign university partner in Iskandar.
"The arrangement is that we provide the facility, then lease it to the university," he said.
Malaysia has suffered from a shortage of doctors and a low doctor-to-patient ratio for some time.
In 2002, the country began a programme to bring in foreign doctors to alleviate a shortage of medical practitioners. However, since then the Health Ministry has stopped taking foreign doctors in, with some who were already here being sent back due to poor performance.
Currently, it costs RM1 million to train a doctor in England.
Newcastle University international medical education project manager David Forman said the degrees would be exactly the same as the ones that were offered in the UK.
"It's not just a franchise or training programme. The programme will be the same. There will be no dilution of standards."
South Johor Investment Corporation Bhd senior vice-president (education development) Khairil Anwar Ahmad said construction of the branch campus was expected to start later this year.
The university would have an intake of about 150 students per year, he said.
"We are setting up the campus based on the demands of the university and expect to complete it by 2011.
"It will be one of four international universities that will be opened in Iskandar," he said.
Khairil said arrangements were now being made to allow students to do their practical work at hospitals in the area.
"The students may also be able to do this at healthcare facilities in Iskandar later," he said.
Khairil said Newcastle University was the first foreign university partner in Iskandar.
"The arrangement is that we provide the facility, then lease it to the university," he said.
Malaysia has suffered from a shortage of doctors and a low doctor-to-patient ratio for some time.
In 2002, the country began a programme to bring in foreign doctors to alleviate a shortage of medical practitioners. However, since then the Health Ministry has stopped taking foreign doctors in, with some who were already here being sent back due to poor performance.
Currently, it costs RM1 million to train a doctor in England.
Newcastle University international medical education project manager David Forman said the degrees would be exactly the same as the ones that were offered in the UK.
"It's not just a franchise or training programme. The programme will be the same. There will be no dilution of standards."
E-Kesihatan will not be dumped
NST: KUALA LUMPUR: The e-kesihatan system will not be scrapped but will be further studied by the government.
Transport Minister Datuk Ong Tee Keat said the government was aware of public complaints against the system.
"This is among some of the initiatives that are being looked at again," he said after officiating the sixth Universiti Tunku Abdul Rahman convocation at Wisma MCA yesterday.
The transport ministry has been attempting to implement the e-kesihatan system since 2005.
The system was supposed to allow the annual health checks of commercial vehicle drivers in the country to be electronically submitted to the Road Transport Department (RTD).
However, it received widespread criticism from doctors, taxi and bus operators who claimed that the scheme was a money-making operation.
A former RTD director was alleged to be a director of the company responsible for implementing the system.
However, this was refuted by the RTD.
Transport Minister Datuk Ong Tee Keat said the government was aware of public complaints against the system.
"This is among some of the initiatives that are being looked at again," he said after officiating the sixth Universiti Tunku Abdul Rahman convocation at Wisma MCA yesterday.
The transport ministry has been attempting to implement the e-kesihatan system since 2005.
The system was supposed to allow the annual health checks of commercial vehicle drivers in the country to be electronically submitted to the Road Transport Department (RTD).
However, it received widespread criticism from doctors, taxi and bus operators who claimed that the scheme was a money-making operation.
A former RTD director was alleged to be a director of the company responsible for implementing the system.
However, this was refuted by the RTD.
Act meant to weed out unqualified practitioners
NST: KUALA LUMPUR: "Doctors, just write to me at tionglai@gmail.com."
This was Health Minister Datuk Liow Tiong Lai's response to complaints about the Private Healthcare Facilities and Services Act 1998.
Doctors had complained that the act was being unfairly enforced.
Liow said he was certain the act was not meant to penalise doctors in the private sector, but to help ensure good healthcare services.
"We really have to do something about the irresponsible ones. But this act is not meant to give people problems."
The act compels private practitioners to register with the ministry or face a fine of RM300,000. He said the act was meant to weed out bogus doctors and unqualified practitioners.
Doctors have been writing to the press recently to express their dismay over the Dr Basmullah Yusom case.
Dr Basmullah was jailed when he could not pay a fine of RM120,000 for failing to register his practice with the Health Ministry in January.
Liow, who took office last week, gave his private email address as he has yet to be assigned an official one.
This was Health Minister Datuk Liow Tiong Lai's response to complaints about the Private Healthcare Facilities and Services Act 1998.
Doctors had complained that the act was being unfairly enforced.
Liow said he was certain the act was not meant to penalise doctors in the private sector, but to help ensure good healthcare services.
"We really have to do something about the irresponsible ones. But this act is not meant to give people problems."
The act compels private practitioners to register with the ministry or face a fine of RM300,000. He said the act was meant to weed out bogus doctors and unqualified practitioners.
Doctors have been writing to the press recently to express their dismay over the Dr Basmullah Yusom case.
Dr Basmullah was jailed when he could not pay a fine of RM120,000 for failing to register his practice with the Health Ministry in January.
Liow, who took office last week, gave his private email address as he has yet to be assigned an official one.
Govt hospitals to send weekly reports
NST: KUALA LUMPUR: Government hospitals will be required to send a weekly report to the Health Ministry on patient care services.
They will have to pay special attention to the outpatient department and the intensive care unit.
Health Minister Datuk Liow Tiong Lai said the ministry was especially concerned with the time taken for patients to see doctors as well as the number of doctors available to see patients.
Liow said the waiting time for outpatients at hospitals should be cut from the current average of 45 minutes to 30 minutes.
"I met some patients (at KLH) who have been waiting for two hours to see the doctor," he said.
He said this during his first official tour of the Kuala Lumpur Hospital.
Liow was briefed by hospital director Datuk Dr Zaininah Mohd Zain on the running of the hospital.
Liow was accompanied by Deputy Minister Datuk Dr Abdul Latiff Ahmad and Health Director-General Tan Sri Dr Ismail Merican.
They will have to pay special attention to the outpatient department and the intensive care unit.
Health Minister Datuk Liow Tiong Lai said the ministry was especially concerned with the time taken for patients to see doctors as well as the number of doctors available to see patients.
Liow said the waiting time for outpatients at hospitals should be cut from the current average of 45 minutes to 30 minutes.
"I met some patients (at KLH) who have been waiting for two hours to see the doctor," he said.
He said this during his first official tour of the Kuala Lumpur Hospital.
Liow was briefed by hospital director Datuk Dr Zaininah Mohd Zain on the running of the hospital.
Liow was accompanied by Deputy Minister Datuk Dr Abdul Latiff Ahmad and Health Director-General Tan Sri Dr Ismail Merican.
No decision to stop doctors from dispensing medicine
NST: KUALA LUMPUR: The Health Ministry has not decided to disallow doctors from dispensing medicines.
Health Minister Datuk Liow Tiong Lai said yesterday he would like to meet the Malaysian Medical Council, doctors and pharmacists to discuss the matter.
Liow said he was aware of the Malaysian Pharmaceutical Society's proposal for pharmacists to dispense medication to patients.
"At the moment, we are still looking at the proposal.
We have not made any decision yet," he said after his first official visit to the Kuala Lumpur Hospital yesterday.
Liow was commenting on a New Straits Times report yesterday headlined "Doctors to be disallowed from dispensing medicines" that quoted health director-general Tan Sri Dr Ismail Merican as saying that the move was in the pipeline.
He had also said that a pilot project on the proposal would be launched soon.
He said the move could not be implemented earlier because of logistics problems, especially the shortage of pharmacies and pharmacists.
Liow said the most important thing was for the people to have a good healthcare system.
"That is the responsibility of the government. We do not want to burden the rakyat with extra costs," he said.
The Malaysian Medical Association is against the proposed move to disallow doctors from dispensing medicines.
President Datuk Dr Khoo Kah Lin said the public should decide if they wanted to get medication from either pharmacists or doctors.
He said a doctor's primary role was to diagnose and treat which included giving appropriate medication to patients.
"Therefore, doctors cannot give up their right to dispense medicine," he said.
Dr Khoo said doctors were already separating the consultation fee from the cost of medication, to avoid being accused of profit-making in dispensing medicines.
The MMA's recommended fee for consultation is RM30 for minor ailments. However, doctors generally provide consultation and medication for less than RM30.
Dr Khoo said pharmacists should not be allowed to prescribe medications without a doctor's prescription.
In another development, a senior medical consultant, who declined to be identified, said some pharmacists were already dispensing medicines and treating patients, especially after checking their glucose level and blood pressure.
"This is already affecting our business," he said
He said pharmacists should refer patients to doctors for diagnosis and treatment.
"Their work is only to dispense medicines prescribed by doctors. Pharmacists cannot become doctors. They cannot prescribe medicines based on basic tests," he said.
A doctor in Klang, who only identified himself as Dr Rahim, asked if pharmacies would be open around the clock to cover prescriptions issued by doctors at 24-hour clinics.
"So who is going to dispense medicines in this context, the doctor or the pharmacies?" he asked.
The Malaysian Dietary Supplement Association, however, said the proposed move to disallow doctors from dispensing medicines was long overdue.
Its president, Jagdev Singh, said pharmacists were best suited to dispense medicines because they were more knowledgeable about "drug to drug interaction, drug to health interaction and adverse reactions".
Health Minister Datuk Liow Tiong Lai said yesterday he would like to meet the Malaysian Medical Council, doctors and pharmacists to discuss the matter.
Liow said he was aware of the Malaysian Pharmaceutical Society's proposal for pharmacists to dispense medication to patients.
"At the moment, we are still looking at the proposal.
We have not made any decision yet," he said after his first official visit to the Kuala Lumpur Hospital yesterday.
Liow was commenting on a New Straits Times report yesterday headlined "Doctors to be disallowed from dispensing medicines" that quoted health director-general Tan Sri Dr Ismail Merican as saying that the move was in the pipeline.
He had also said that a pilot project on the proposal would be launched soon.
He said the move could not be implemented earlier because of logistics problems, especially the shortage of pharmacies and pharmacists.
Liow said the most important thing was for the people to have a good healthcare system.
"That is the responsibility of the government. We do not want to burden the rakyat with extra costs," he said.
The Malaysian Medical Association is against the proposed move to disallow doctors from dispensing medicines.
President Datuk Dr Khoo Kah Lin said the public should decide if they wanted to get medication from either pharmacists or doctors.
He said a doctor's primary role was to diagnose and treat which included giving appropriate medication to patients.
"Therefore, doctors cannot give up their right to dispense medicine," he said.
Dr Khoo said doctors were already separating the consultation fee from the cost of medication, to avoid being accused of profit-making in dispensing medicines.
The MMA's recommended fee for consultation is RM30 for minor ailments. However, doctors generally provide consultation and medication for less than RM30.
Dr Khoo said pharmacists should not be allowed to prescribe medications without a doctor's prescription.
In another development, a senior medical consultant, who declined to be identified, said some pharmacists were already dispensing medicines and treating patients, especially after checking their glucose level and blood pressure.
"This is already affecting our business," he said
He said pharmacists should refer patients to doctors for diagnosis and treatment.
"Their work is only to dispense medicines prescribed by doctors. Pharmacists cannot become doctors. They cannot prescribe medicines based on basic tests," he said.
A doctor in Klang, who only identified himself as Dr Rahim, asked if pharmacies would be open around the clock to cover prescriptions issued by doctors at 24-hour clinics.
"So who is going to dispense medicines in this context, the doctor or the pharmacies?" he asked.
The Malaysian Dietary Supplement Association, however, said the proposed move to disallow doctors from dispensing medicines was long overdue.
Its president, Jagdev Singh, said pharmacists were best suited to dispense medicines because they were more knowledgeable about "drug to drug interaction, drug to health interaction and adverse reactions".
MMA opposes move to make pharmacist sole dispensing agents
NST: The Malaysian Medical Association (MMA) will oppose a move by the Health Ministry to make pharmacists the sole dispensing agents in the country.
Its president, Datuk Dr Khoo Kah Lin, said based on the ministry’s statistics in 2006, the pharmacist-population ratio in the public sector is 1:29,966, the private sector 1:7,828 and the total ratio is 1:6,207.
He said MMA felt that the public should be left to decide from where they wanted to obtain medication, either from a doctor or pharmacist.
“In helping them to make such a choice, the public need to have all the facts regarding the present position, their advantages and disadvantages and the costs to them as individuals and a community, if the system is to be changed,” he said in a statement here today.
Yesterday, Director-General of Health Tan Sri Dr Ismail Merican said soon, doctors would only be allowed to issue Rx-prescribe medications but patients needed to obtain their medication from pharmacies.
Currently, doctors especially at private clinics diagnose diseases, prescribe medicines and dispense them to patients.
Dr Khoo said some local manufacturers did not use the same base substance as the original patented drug.
“Thus, although the amount of active substance is the same, the potency and duration of action may differ...so may the shelf life of the drug.
“This is the main reason most doctors still prefer to use patented medicine, not because we want to gain profit or get incentives,” he said.
Dr Khoo said if the proposal shot off prematurely, patients would face the inconvenience of having to travel to another location to buy the medicine prescribed by the doctor.
He said if there was to be change, it should be made gradually beginning with the larger towns, and pilot studies should be considered so that problems that arise could be ironed out.
“In the meantime, both professions (doctor and pharmacist), together with the ministry could look at this problem objectively and solve it amicably, keeping in mind the interest of patients,” he said.
Its president, Datuk Dr Khoo Kah Lin, said based on the ministry’s statistics in 2006, the pharmacist-population ratio in the public sector is 1:29,966, the private sector 1:7,828 and the total ratio is 1:6,207.
He said MMA felt that the public should be left to decide from where they wanted to obtain medication, either from a doctor or pharmacist.
“In helping them to make such a choice, the public need to have all the facts regarding the present position, their advantages and disadvantages and the costs to them as individuals and a community, if the system is to be changed,” he said in a statement here today.
Yesterday, Director-General of Health Tan Sri Dr Ismail Merican said soon, doctors would only be allowed to issue Rx-prescribe medications but patients needed to obtain their medication from pharmacies.
Currently, doctors especially at private clinics diagnose diseases, prescribe medicines and dispense them to patients.
Dr Khoo said some local manufacturers did not use the same base substance as the original patented drug.
“Thus, although the amount of active substance is the same, the potency and duration of action may differ...so may the shelf life of the drug.
“This is the main reason most doctors still prefer to use patented medicine, not because we want to gain profit or get incentives,” he said.
Dr Khoo said if the proposal shot off prematurely, patients would face the inconvenience of having to travel to another location to buy the medicine prescribed by the doctor.
He said if there was to be change, it should be made gradually beginning with the larger towns, and pilot studies should be considered so that problems that arise could be ironed out.
“In the meantime, both professions (doctor and pharmacist), together with the ministry could look at this problem objectively and solve it amicably, keeping in mind the interest of patients,” he said.
Saturday, March 29, 2008
No decision on docs dispensing medicine
Star: KUALA LUMPUR: The Health Ministry has denied a report which said doctors would be prevented from dispensing medicine.
Health Minister Datuk Liow Tiong Lai said the article, which was published on the front page of a local English daily on Saturday, was not true.
"We have not made any decision at all. We are conducting a study, but it is only at a preliminary stage," he said.
The report said a pilot project on the separation of functions between doctors' clinics and pharmacies would be launched by the Health Ministry.
It also said that the pilot project would be launched at selected major towns, with the ministry closely monitoring the strengths and weaknesses of the system before implementing it nationwide.
Liow said while the Ministry was considering the request by pharmacists, the study had yet to be completed and a pilot project might not even be launched if the findings were not encouraging.
"If we find that people will be affected (negatively), we might not even carry out the pilot project," he said.
He added that he wanted to meet up with doctors and pharmacists to understand more about the issue.
"But most importantly, at the end of the day, the people must enjoy good medical services," he said.
Liow was speaking to reporters after visiting the Kuala Lumpur General Hospital on Saturday.
Health Minister Datuk Liow Tiong Lai said the article, which was published on the front page of a local English daily on Saturday, was not true.
"We have not made any decision at all. We are conducting a study, but it is only at a preliminary stage," he said.
The report said a pilot project on the separation of functions between doctors' clinics and pharmacies would be launched by the Health Ministry.
It also said that the pilot project would be launched at selected major towns, with the ministry closely monitoring the strengths and weaknesses of the system before implementing it nationwide.
Liow said while the Ministry was considering the request by pharmacists, the study had yet to be completed and a pilot project might not even be launched if the findings were not encouraging.
"If we find that people will be affected (negatively), we might not even carry out the pilot project," he said.
He added that he wanted to meet up with doctors and pharmacists to understand more about the issue.
"But most importantly, at the end of the day, the people must enjoy good medical services," he said.
Liow was speaking to reporters after visiting the Kuala Lumpur General Hospital on Saturday.
TB a problem once again
NST: SERI ISKANDAR: Tuberculosis (TB), a killer disease in the country in the 1950s and 1960s, is once again posing a threat.
There has been an increase in the number of TB cases in the last 10 years.
Malaysian Association of Prevention of Tuberculosis president Datuk Seri Yeop Junior Yeop Adlan said this was despite the government's success in implementing the national TB control programme which brought the number of cases down to below 100 for every 100,000 people.
"However, in the last 10 years, the number of cases has been increasing, with 59.8 cases recorded for every 100,000 people in 1994 and 62.6 cases in 2006," he said at the opening of the state-level World TB Day here yesterday.
Also present were Perak deputy health director (public health) Datin Dr Ranjit Kaur and Perak Tengah district health department medical officer Dr S. Elangovan.
The theme of this year's event, "I am stopping TB", is in line with the World Health Organisation's vision of eliminating TB by the year 2050.
Yeop Junior, who is also MAPTB Perak branch chairman, said that an average of 16,000 cases had been recorded yearly.
Among the factors believed to have contributed to the increase are medical staff who fail to diagnose TB in patients seeking treatment for continuous cough, a symptom of the disease.
They have since been instructed to conduct a thorough examination if a patient complains of a week-long cough.
There has been an increase in the number of TB cases in the last 10 years.
Malaysian Association of Prevention of Tuberculosis president Datuk Seri Yeop Junior Yeop Adlan said this was despite the government's success in implementing the national TB control programme which brought the number of cases down to below 100 for every 100,000 people.
"However, in the last 10 years, the number of cases has been increasing, with 59.8 cases recorded for every 100,000 people in 1994 and 62.6 cases in 2006," he said at the opening of the state-level World TB Day here yesterday.
Also present were Perak deputy health director (public health) Datin Dr Ranjit Kaur and Perak Tengah district health department medical officer Dr S. Elangovan.
The theme of this year's event, "I am stopping TB", is in line with the World Health Organisation's vision of eliminating TB by the year 2050.
Yeop Junior, who is also MAPTB Perak branch chairman, said that an average of 16,000 cases had been recorded yearly.
Among the factors believed to have contributed to the increase are medical staff who fail to diagnose TB in patients seeking treatment for continuous cough, a symptom of the disease.
They have since been instructed to conduct a thorough examination if a patient complains of a week-long cough.
Move will not necessarily cost patients more
NST: KUALA LUMPUR: Contrary to public perception, separating the doctor's function as a healer and as a provider of medicine will not necessarily cost patients more.
Malaysian Pharmaceutical Society president John Chang Chiew Pheng said this was because consumers would have the choice of drugs.
"Many doctors usually dispense the more branded and expensive medicines simply because they get incentives and bonuses from the drug companies.
"When the consumers get their medication and make up their minds whether to get branded or generic drugs, they end up saving money.
"The Poisons Act 1952 allows for doctors to dispense drugs because there were hardly any pharmacists when the law was passed," he said.
There are now roughly 5,000 pharmacists and 13 pharmacy schools in the country that produce an average of 600 graduates every year.
Chang also said that with serious risks to health due to improper medication, it made better sense for patients to get their drugs from a pharmacist who would have spent four years acquiring the knowledge than from a doctor who had none.
"Doctors are only familiar with medicines that they often prescribe, not knowing adverse reactions and drug interactions. However, pharmacists are constantly in touch with the drugs industry," he said.
With the separation of functions between clinics and pharmacies, Malaysia will join the ranks of other developed countries around the world which separate the role of doctors and pharmacists.
In the last 30 years, Asian countries like Japan, South Korea, Taiwan, the Philippines and Indonesia have implemented the separation with varying degrees of success.
When South Korean health officials enforced the separation in 2000, tens of thousands of doctors took to the streets and forced clinics around the country to close for three days.
The various countries also experienced teething problems such as administrational confusion when charging corporate patients seeking treatment in panel clinics or claiming health insurance.
Separation laws in several countries also had loopholes, abused by pharmacists who were in cahoots with doctors for patient referrals in exchange for kickbacks.
All this, Chang admitted, could very well also happen in Malaysia if the separation was not closely enforced and scrutinised.
Malaysian Pharmaceutical Society president John Chang Chiew Pheng said this was because consumers would have the choice of drugs.
"Many doctors usually dispense the more branded and expensive medicines simply because they get incentives and bonuses from the drug companies.
"When the consumers get their medication and make up their minds whether to get branded or generic drugs, they end up saving money.
"The Poisons Act 1952 allows for doctors to dispense drugs because there were hardly any pharmacists when the law was passed," he said.
There are now roughly 5,000 pharmacists and 13 pharmacy schools in the country that produce an average of 600 graduates every year.
Chang also said that with serious risks to health due to improper medication, it made better sense for patients to get their drugs from a pharmacist who would have spent four years acquiring the knowledge than from a doctor who had none.
"Doctors are only familiar with medicines that they often prescribe, not knowing adverse reactions and drug interactions. However, pharmacists are constantly in touch with the drugs industry," he said.
With the separation of functions between clinics and pharmacies, Malaysia will join the ranks of other developed countries around the world which separate the role of doctors and pharmacists.
In the last 30 years, Asian countries like Japan, South Korea, Taiwan, the Philippines and Indonesia have implemented the separation with varying degrees of success.
When South Korean health officials enforced the separation in 2000, tens of thousands of doctors took to the streets and forced clinics around the country to close for three days.
The various countries also experienced teething problems such as administrational confusion when charging corporate patients seeking treatment in panel clinics or claiming health insurance.
Separation laws in several countries also had loopholes, abused by pharmacists who were in cahoots with doctors for patient referrals in exchange for kickbacks.
All this, Chang admitted, could very well also happen in Malaysia if the separation was not closely enforced and scrutinised.
Doctors to be disallowed from dispensing medicines
NST: KUALA LUMPUR: Soon, doctors will not be allowed to dispense medicines. Doctors will only be allowed to prescribe medications but patients will have to get the medicines from pharmacies.
Currently, doctors diagnose the disease, prescribe the medicines and their own clinics dispense them.
For almost 20 years, pharmacists have been fighting for the "return" of their right to dispense medications but had been unsuccessful for various reasons.
A pilot project on the separation of functions between doctors' clinics and pharmacies will be launched by the Ministry of Health.
It is scheduled to be launched at selected major towns with the ministry closely monitoring the strength and weaknesses of the system before implementing it nationwide.
Director-General of Health Tan Sri Dr Ismail Merican said the ministry was not able to implement this system earlier due to logistics problems, especially the shortage of pharmacists and pharmacies in the country.
"We also have to take into consideration the welfare of patients. If we have the separation, then patients must have easy accessibility to pharmacies to get their prescribed medications," he told the New Straits Times.
He said the ministry had conducted a detailed study, "Pharmacy and clinic Mapping" on various issues ranging from welfare of patients, facilities available and capability of pharmacies to meet the demand.
"We found that the logistics problem is still an issue and needs to be resolved as we do not want patients to be running around looking for pharmacies with the doctors' prescriptions," said Dr Ismail.
Furthermore, he said, the pharmacies should be able to provide quality care.
He said the ministry had been doing the study with various stakeholders, focusing on the spread of community pharmacies or pharmacy outlets in major towns, rural and remote areas.
Some 5,000 registered pharmacists are actively practising in some 1,600 pharmacies nationwide.
In 2004, there were only 3,927 registered pharmacists with about 1,540 retail pharmacies or one for every 16,445 persons.
Dr Ismail said the pilot project would be implemented in major towns based on the study where there were pharmacies near clinics.
"If the pilot project is successful, we will have to look into the existing laws to allow for the separation," he added.
India, South Korea and Taiwan have implemented the separation. Malaysian Pharmaceutical Society president John Chang Chiew Pheng said the ministry's move to conduct a pilot project was definitely a positive development which would enhance the level of healthcare delivery.
The separation, he added, would benefit patients as doctors could now focus on their clinical, diagnosing, counselling and prescription, while pharmacists could focus on educating patients on how best to optimise the usage of medicines prescribed.
Furthermore, Chang said, pharmacists could help patients choose between generic and branded drugs based on their financial situation.
"With commitment and determination we can overcome teething problems and patients can understand their medicines," he added.
He said if the government went ahead with the separation, then more pharmacies could be set up near clinics for easy accessibility to patients.
Currently, doctors diagnose the disease, prescribe the medicines and their own clinics dispense them.
For almost 20 years, pharmacists have been fighting for the "return" of their right to dispense medications but had been unsuccessful for various reasons.
A pilot project on the separation of functions between doctors' clinics and pharmacies will be launched by the Ministry of Health.
It is scheduled to be launched at selected major towns with the ministry closely monitoring the strength and weaknesses of the system before implementing it nationwide.
Director-General of Health Tan Sri Dr Ismail Merican said the ministry was not able to implement this system earlier due to logistics problems, especially the shortage of pharmacists and pharmacies in the country.
"We also have to take into consideration the welfare of patients. If we have the separation, then patients must have easy accessibility to pharmacies to get their prescribed medications," he told the New Straits Times.
He said the ministry had conducted a detailed study, "Pharmacy and clinic Mapping" on various issues ranging from welfare of patients, facilities available and capability of pharmacies to meet the demand.
"We found that the logistics problem is still an issue and needs to be resolved as we do not want patients to be running around looking for pharmacies with the doctors' prescriptions," said Dr Ismail.
Furthermore, he said, the pharmacies should be able to provide quality care.
He said the ministry had been doing the study with various stakeholders, focusing on the spread of community pharmacies or pharmacy outlets in major towns, rural and remote areas.
Some 5,000 registered pharmacists are actively practising in some 1,600 pharmacies nationwide.
In 2004, there were only 3,927 registered pharmacists with about 1,540 retail pharmacies or one for every 16,445 persons.
Dr Ismail said the pilot project would be implemented in major towns based on the study where there were pharmacies near clinics.
"If the pilot project is successful, we will have to look into the existing laws to allow for the separation," he added.
India, South Korea and Taiwan have implemented the separation. Malaysian Pharmaceutical Society president John Chang Chiew Pheng said the ministry's move to conduct a pilot project was definitely a positive development which would enhance the level of healthcare delivery.
The separation, he added, would benefit patients as doctors could now focus on their clinical, diagnosing, counselling and prescription, while pharmacists could focus on educating patients on how best to optimise the usage of medicines prescribed.
Furthermore, Chang said, pharmacists could help patients choose between generic and branded drugs based on their financial situation.
"With commitment and determination we can overcome teething problems and patients can understand their medicines," he added.
He said if the government went ahead with the separation, then more pharmacies could be set up near clinics for easy accessibility to patients.
Friday, March 28, 2008
5.1 million to gain from Socso free check-up
NST: KUALA LUMPUR: The Social Security Organisation (Socso) will provide a one-time free medical check-up for contributors aged 35 and above.
Human Resources Minister Datuk Dr S. Subramaniam, who announced this yesterday, said Socso hoped to provide more benefits to its 5.1 million contributors.
He also called on employers to notify Socso of injuries sustained by their workers so that the processing of compensation could be speeded up.
"We have trained more than 900 government doctors to carry out examinations for workers seeking compensation for injuries.
"At the same time, our panel doctors will help speed up rehabilitation of patients so that they can return to work as soon as possible," he said after a three-hour briefing by Socso officials at its headquarters in Jalan Ampang here.
Present were Dr Subramaniam's deputy, Datuk Noraini Ahmad, and ministry secretary-general Datuk Thomas George.
The Malaysian Medical Association (MMA) and the Malaysian Trades Union Congress (MTUC) welcomed the free medical check-up.
MMA president Datuk Dr Khoo Kah Lin said medical check-ups should be conducted more frequently with age.
"Just like a car, the older it gets the more frequent servicing it needs.
"Older people may require not only more frequent medical check-ups but more stringent ones, too. This can be costly," he said.
Dr Khoo said medical check-ups should be conducted from young so that abnormalities could be detected early.
He added that as people today were more health conscious, Socso could undertake more programmes to educate workers on health risks and remedies.
MTUC secretary-general G. Rajasekeran said Socso's free check-up was a good start.He also hoped Socso would make the free check-ups available more frequently to workers exposed to health hazards, such as those working in mines, mills, quarries and factories dealing with chemicals, electronics and asbestos.
Human Resources Minister Datuk Dr S. Subramaniam, who announced this yesterday, said Socso hoped to provide more benefits to its 5.1 million contributors.
He also called on employers to notify Socso of injuries sustained by their workers so that the processing of compensation could be speeded up.
"We have trained more than 900 government doctors to carry out examinations for workers seeking compensation for injuries.
"At the same time, our panel doctors will help speed up rehabilitation of patients so that they can return to work as soon as possible," he said after a three-hour briefing by Socso officials at its headquarters in Jalan Ampang here.
Present were Dr Subramaniam's deputy, Datuk Noraini Ahmad, and ministry secretary-general Datuk Thomas George.
The Malaysian Medical Association (MMA) and the Malaysian Trades Union Congress (MTUC) welcomed the free medical check-up.
MMA president Datuk Dr Khoo Kah Lin said medical check-ups should be conducted more frequently with age.
"Just like a car, the older it gets the more frequent servicing it needs.
"Older people may require not only more frequent medical check-ups but more stringent ones, too. This can be costly," he said.
Dr Khoo said medical check-ups should be conducted from young so that abnormalities could be detected early.
He added that as people today were more health conscious, Socso could undertake more programmes to educate workers on health risks and remedies.
MTUC secretary-general G. Rajasekeran said Socso's free check-up was a good start.He also hoped Socso would make the free check-ups available more frequently to workers exposed to health hazards, such as those working in mines, mills, quarries and factories dealing with chemicals, electronics and asbestos.
No more fast food ads on kids’ TV shows
Star: PETALING JAYA: Children will now be fed a healthier diet of TV programmes.
Fast food advertisers have agreed not to place advertisements during children's programmes or sponsor such shows with immediate effect.
Association of Accredited Advertising Agents Malaysia (4As) president Datuk Vincent Lee said new guidelines would set the standards of what could be advertised.
“It will encourage companies to develop and advertise foods we wish our children to consume more of,” he said in a statement here yesterday.
“A pre-vetting system will be introduced to ensure that only advertisements which meet the new standards make it to the television screens and inappropriate advertisements weeded out.”
Lee said fast food advertisers also pledged not to encourage commercials showing excessive food consumption or provide inaccurate or misleading information on nutritional value in any product.
Such commercials would also not imply that a product could replace a complete or balanced diet, he said.
According to the statement, the guidelines had been accepted by the Health Ministry, which also mandated the nutritional labelling of fast food.
Malaysian Advertisers Association president Peter Das said the advertising industry wanted to work with the Government in promoting a healthy lifestyle and diet.
“There is a clear consumer demand for healthy options to which the industry is increasingly responding,” he said.
Fast food advertisers have agreed not to place advertisements during children's programmes or sponsor such shows with immediate effect.
Association of Accredited Advertising Agents Malaysia (4As) president Datuk Vincent Lee said new guidelines would set the standards of what could be advertised.
“It will encourage companies to develop and advertise foods we wish our children to consume more of,” he said in a statement here yesterday.
“A pre-vetting system will be introduced to ensure that only advertisements which meet the new standards make it to the television screens and inappropriate advertisements weeded out.”
Lee said fast food advertisers also pledged not to encourage commercials showing excessive food consumption or provide inaccurate or misleading information on nutritional value in any product.
Such commercials would also not imply that a product could replace a complete or balanced diet, he said.
According to the statement, the guidelines had been accepted by the Health Ministry, which also mandated the nutritional labelling of fast food.
Malaysian Advertisers Association president Peter Das said the advertising industry wanted to work with the Government in promoting a healthy lifestyle and diet.
“There is a clear consumer demand for healthy options to which the industry is increasingly responding,” he said.
Incentives for doctors working overtime
Star: PUTRAJAYA: The Cabinet has approved the Health Ministry’s proposal for incentive payments to be made to doctors and specialists working overtime and weekends.
Health Minister Datuk Liow Tiong Lai said this would allow more elective surgeries to be held on Saturdays and more patients to seek treatment at certain health clinics after office hours.
“We already have these after-office hours services at 33 of our hospitals. The ministry decided to expand this to 16 health clinics so that non-critical patients can seek treatment at these places instead of coming to the emergency units at public hospitals,” he told reporters after chairing the post-Cabinet meeting here yesterday.
“It will also allow elective surgery to be conducted in 19 hospitals on Saturdays. These are among our measures to reduce the waiting time for patients from 45 minutes currently to 30 minutes. It will cost the ministry a total of RM19.3mil in allocation.”
On Feb 6, Health director-general Tan Sri Dr Ismail Merican announced that doctors at selected clinics would be paid more than double or RM80 per hour in incentive payment for overtime while specialists would be paid RM200 per hour to work after office hours and on weekends.
Dr Ismail had said then that the proposal was pending approval from the Cabinet.
Liow said elective surgery on Saturdays were necessary because the number of operations had increased by 23% from 636,867 in 2002 to 782,514 in 2006.
Health Minister Datuk Liow Tiong Lai said this would allow more elective surgeries to be held on Saturdays and more patients to seek treatment at certain health clinics after office hours.
“We already have these after-office hours services at 33 of our hospitals. The ministry decided to expand this to 16 health clinics so that non-critical patients can seek treatment at these places instead of coming to the emergency units at public hospitals,” he told reporters after chairing the post-Cabinet meeting here yesterday.
“It will also allow elective surgery to be conducted in 19 hospitals on Saturdays. These are among our measures to reduce the waiting time for patients from 45 minutes currently to 30 minutes. It will cost the ministry a total of RM19.3mil in allocation.”
On Feb 6, Health director-general Tan Sri Dr Ismail Merican announced that doctors at selected clinics would be paid more than double or RM80 per hour in incentive payment for overtime while specialists would be paid RM200 per hour to work after office hours and on weekends.
Dr Ismail had said then that the proposal was pending approval from the Cabinet.
Liow said elective surgery on Saturdays were necessary because the number of operations had increased by 23% from 636,867 in 2002 to 782,514 in 2006.
Clinics to take load off emergency units
Star: PUTRAJAYA: Sixteen health clinics nationwide will start operating after office hours in a bid to lessen the number of patients at the emergency units in hospitals.
Health Minister Datuk Liow Tiong Lai said these clinics, which see a lot of patients, would offer services from 5pm to 9.30pm.
"We already have these after office hours services at 33 of our hospitals. The ministry decided to expand this to the health clinics so that non-critical patients can seek treatment at these places, instead of coming to the emergency units at public hospitals.
"These are among our measures to reduce the waiting time for patients from 45 minutes currently to 30 minutes, which is our target.
"The Cabinet has also approved the ministry's proposal for doctors and specialists working on weekends to be paid incentives, and for those working overtime to have their fees increased from RM30 per hour currently to RM80," he told reporters Wednesday after chairing the post-Cabinet meeting here.
On Feb 6, Health director-general Tan Sri Dr Ismail Merican had announced that doctors at selected clinics would be paid more than double or RM80 per hour in incentive payment while specialists would be paid RM200 per hour to work after office hours and on weekends.
This would allow them more time to serve the public and to conduct elective surgery from 8am to 1pm on Saturdays at 19 selected hospitals to reduce the backlog of cases.
Liow said elective surgery on Saturdays were necessary because the number of operations had increased by 23% from 636,867 in 2002 to 782,514 in 2006.
"This increase has forced our anaesthesiologists and surgeons to give priority to emergency cases. This has caused our non-critical patients to wait between one to six months for their surgery," he said, adding that this could lead to their conditions becoming more chronic and affecting their quality of life.
He said the ministry also planned to include more hospitals and clinics offering such services if this project proved to be successful.
"It will cost the ministry a total of RM19.3mil," he said.
Health Minister Datuk Liow Tiong Lai said these clinics, which see a lot of patients, would offer services from 5pm to 9.30pm.
"We already have these after office hours services at 33 of our hospitals. The ministry decided to expand this to the health clinics so that non-critical patients can seek treatment at these places, instead of coming to the emergency units at public hospitals.
"These are among our measures to reduce the waiting time for patients from 45 minutes currently to 30 minutes, which is our target.
"The Cabinet has also approved the ministry's proposal for doctors and specialists working on weekends to be paid incentives, and for those working overtime to have their fees increased from RM30 per hour currently to RM80," he told reporters Wednesday after chairing the post-Cabinet meeting here.
On Feb 6, Health director-general Tan Sri Dr Ismail Merican had announced that doctors at selected clinics would be paid more than double or RM80 per hour in incentive payment while specialists would be paid RM200 per hour to work after office hours and on weekends.
This would allow them more time to serve the public and to conduct elective surgery from 8am to 1pm on Saturdays at 19 selected hospitals to reduce the backlog of cases.
Liow said elective surgery on Saturdays were necessary because the number of operations had increased by 23% from 636,867 in 2002 to 782,514 in 2006.
"This increase has forced our anaesthesiologists and surgeons to give priority to emergency cases. This has caused our non-critical patients to wait between one to six months for their surgery," he said, adding that this could lead to their conditions becoming more chronic and affecting their quality of life.
He said the ministry also planned to include more hospitals and clinics offering such services if this project proved to be successful.
"It will cost the ministry a total of RM19.3mil," he said.
Thursday, March 13, 2008
Kidney Patients On The Rise
KUALA LUMPUR, March 13 (Bernama) -- About 15,000 kidney patients underwent dialysis nationwide last year and the number is expected to increase to 20,000 by 2010, Kuala Lumpur Hospital (HKL) head of nephrology Dr Ghazali Ahmad said today.
"So far,57 per cent of the chronic kidney disease cases are caused by diabetes and if not treated early, the patients may have to undergo dialysis," he told reporters after the launch of the World Kidney Day by HKL director Datuk Dr Zaininah Mohd Zain here.
Most kidney failure cases area caused by diabetes, said Dr Ghazali.
He advised the public to maintain balanced and nutritious diet to prevent diabetes, gout, and high blood pressure which are associated with kidney problems.
In her speech, Dr Zaininah said steps should be taken not only to treat kidney patients, but also to slow down the process of kidney failure to delay dialysis and prevent disease that increase the risks of kidney problems.
The annual World Kidney Day organised by the HKL Nephrology Department in collaboration with its Catering and Dietetic Department is aimed at raising public awareness in the prevention, detection, and treatment of kidney disease.
"So far,57 per cent of the chronic kidney disease cases are caused by diabetes and if not treated early, the patients may have to undergo dialysis," he told reporters after the launch of the World Kidney Day by HKL director Datuk Dr Zaininah Mohd Zain here.
Most kidney failure cases area caused by diabetes, said Dr Ghazali.
He advised the public to maintain balanced and nutritious diet to prevent diabetes, gout, and high blood pressure which are associated with kidney problems.
In her speech, Dr Zaininah said steps should be taken not only to treat kidney patients, but also to slow down the process of kidney failure to delay dialysis and prevent disease that increase the risks of kidney problems.
The annual World Kidney Day organised by the HKL Nephrology Department in collaboration with its Catering and Dietetic Department is aimed at raising public awareness in the prevention, detection, and treatment of kidney disease.
Wednesday, March 05, 2008
Promotions for house officers in govt hospitals
Star: PUTRAJAYA: At least 2,000 graduate house officers in government hospitals will get an automatic promotion to grade UD44 upon completion of their two-year housemanship in 2010.
They will be getting at least RM6,000 including allowances every month which is almost double what the present graduate house officers are getting.
At present, graduate house officers come under UD41 with a monthly income of RM3,768.39 including allowances. Most of them are stuck under the grade for at least six to seven years or more.
"This is a hefty jump," Health Ministry director-general Tan Sri Dr Ismail Merican announced at a press conference here on Wednesday.
He said the promotion exercise was expected to cost RM1.7mil annually.
Dr Ismail said at least 7,000 house officers under UD41 and UD44, who were appointed before 2008, would also get their long overdue promotions, which would cost RM9.8mil.
He said those who had been stuck under the grade for many years would however be placed under the higher scale of UD44.
"Hopefully, this promotion opportunity will indirectly encourage many doctors to remain in the civil service," he said, adding that at least 70% of young doctors under UD41 resigned to join the private sector.
The Health Ministry extended the housemanship from one year to two years in January following several complaints including the unsatisfactory quality of service.
They will be getting at least RM6,000 including allowances every month which is almost double what the present graduate house officers are getting.
At present, graduate house officers come under UD41 with a monthly income of RM3,768.39 including allowances. Most of them are stuck under the grade for at least six to seven years or more.
"This is a hefty jump," Health Ministry director-general Tan Sri Dr Ismail Merican announced at a press conference here on Wednesday.
He said the promotion exercise was expected to cost RM1.7mil annually.
Dr Ismail said at least 7,000 house officers under UD41 and UD44, who were appointed before 2008, would also get their long overdue promotions, which would cost RM9.8mil.
He said those who had been stuck under the grade for many years would however be placed under the higher scale of UD44.
"Hopefully, this promotion opportunity will indirectly encourage many doctors to remain in the civil service," he said, adding that at least 70% of young doctors under UD41 resigned to join the private sector.
The Health Ministry extended the housemanship from one year to two years in January following several complaints including the unsatisfactory quality of service.
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