MyMedR

Leprosy for general practitioners

Rajagopalan K, Lim QJ

Family Practitioner, 1982;5:47-63.

Matched MeSH terms: Physicians, Family

Fulltext Founding of the College of General Practitioners Malaysia

Param Palam S

Family Practitioner, 1973;1(1):9-12.

Matched MeSH terms: Physicians, Family

Outpatient surgical procedures in ophthalmology for the general practitioner

Pall S

Family Physician, 1989;1:15-17.

Matched MeSH terms: Physicians, Family

Fulltext Knowledge, attitude, and practice regarding atrial fibrillation among primary care physicians: the potential role of postgraduate training

Ooi PC, Ramayah G, Omar SR, Rajadorai V, Nadarajah T, Ting CH, et al.

Malays Fam Physician, 2021 Mar 25;16(1):39-49.

PMID: 33948141 DOI: 10.51866/oa0002

Introduction: Atrial fibrillation (AF) is known to lead to stroke and thromboembolism, causing a five-fold increase in the risk of stroke and almost doubling the mortality rate. Optimal anticoagulant therapy is effective in reducing AF-related death. However, prescription of anticoagulants in AF in East Asian countries has been low, ranging from 0.5% to 28%. This study aimed to determine whether vocational training in family medicine improves primary care physicians' knowledge, attitude, and practice in the management of AF.

Method: This investigation was a cross-sectional study carried out during centralized workshops for two groups of trainees using a validated questionnaire: (i) junior trainees were newly enrolled postgraduate trainees in the Graduate Certificate in Family Medicine (GCFM) program, and (ii) senior trainees were postgraduate trainees in Advance Training in Family Medicine (ATFM) programs of the Academy of Family Physicians of Malaysia (AFPM).

Results: A total of 223 trainees (127 junior and 96 senior) participated in this study. Only 55.2% of the trainees passed the knowledge test; senior trainees were more likely to pass the knowledge test compared to junior trainees (69.8% vs. 44.1%, p < 0.001). Female trainees were significantly more likely to pass the knowledge test than male trainees. While the attitude of senior and junior trainees was similar, more of the latter group worked in public clinic that provide better support where there is better support for outpatient anticoagulation treatment (e.g., same-day INR test, direct access echocardiogram, and warfarin in in-house pharmacy).

Conclusion: Vocational training in family medicine appears to improve primary care physicians' knowledge regarding the management of AF. Better knowledge will help vocationally trained primary care physicians to provide anticoagulation treatment for AF within primary care clinics. More optimal AF management within primary care can take place if the identified barriers are addressed and a shared care plan can be implemented.

Matched MeSH terms: Physicians, Family

Fulltext Fish oil to prevent heart disease: the evidence and the controversy

Ong HT

Malays Fam Physician, 2006;1(2):65-66.

PMID: 27570590 MyJurnal

Evidence thus far still supports the contention that fish derived omega-3 fatty acids, EPA and DHA, are good for heart patients. But this controversy tells us something about the medical research, and the acquisition and application of medical knowledge. Being scientists, doctors try to perform studies as rigorously as possible with randomised, placebo-controlled trials and using tests of statistical significance. But since the studies are on humans, with all their individual differing habits and inconsistencies, different results are produced by different researchers. And so while medicine is a science, in that the trials are scientifically conducted, the interpretation of the results, and in particular its application for the individual patient, is very much an art. A good doctor, like the good artist, must spend much time, energy and effort sieving through the good from the not so good data before coming out with the correct picture. Only by keeping an unbiased, inquisitive mind can the evidence be reviewed to solve the problem at hand. Almost always, the balance of data will favour a particular stand. In this day when newspapers are full of medical articles, a family physician has to be educated, interested and inquisitive to be a source of accurate and relevant information for the patients.

Matched MeSH terms: Physicians, Family

Otitis media - how the family physician should manage

Ong CC

Family Physician, 2001;11:27-29.

Otitis media is a common disease presenting to family practitioners all over the world. There have been many changes in the way these patients were managed over the years. This article attempts to provide an overview to family physicians regarding the latest approach in managing this common condition. Keywords: Otitis, otitis media, otoscopy, eardrops.

Matched MeSH terms: Physicians, Family

Fulltext Spotted bone disease (osteopoikilosis)

Omar M, Abdul Rahman AA, Mohd Hussein AM, Mustafa N

Family Physician, 2005;13(3):15-15.

MyJurnal

Osteopoikilosis is a rare bone dysplasia which is inherited as an autosomal dominant trait with a prevalence of less than 0.1 per million.1 It is characterised by dense ovoid or circular spots in cancellous bone which may appear at birth or during skeletal growth. It is usually found in the metaphyseal and epiphyseal regions of long bones, the carpals and tarsals, the end of large turbular bones and around the acetabula. It is clinically asymptomatic and occasionally associated with hereditary multiple exostosis and dermatofibrosis lenticularis disseminata. It is not associated with spontaneous fractures and treatment is unnecessary. However a case of osteosarcoma developing in a man with osteopoikilosis has been reported. The first case of osteopoikilosis was reported in Malaysia four years ago in a 25 years old lady who is also of Indian descent. It would be interesting to know if these two patients are related. Since the bone lesions could easily be mistaken for metastatic disease, it is important that family physicians be aware of the benign nature of this condition.

Matched MeSH terms: Physicians, Family

Fulltext Over-prescription of antibiotics: both doctors and patients need education

Norsa'adah B

Med J Malaysia, 2007 Jun;62(2):181.

PMID: 18705463

Principally, there are two problems in prescribing . They are prescribing decision and prescribing writing process, which contribute to 39% and 61% of prescription problems respectively. The first type of problem has more serious consequences and may even cause mortality. In that study, the issue is the appropriateness of prescribing antibiotics for upper respiratory tract infections (URTI). Over-prescribing of antibiotics in primary health care, especially for respiratory tract diseases is a problem worldwide . There are concerns about the rising prevalence of antibiotic resistant bacteria, cost and the potentially harmful consequences of unnecessary prescription such as drug interaction and allergy.

Matched MeSH terms: Physicians, Family/education*

Fulltext The role of general practitioners in the management of erectile dysfunction-a qualitative study

Ng CJ, Low WY, Tan NC, Choo WY

Int J Impot Res, 2004 Feb;16(1):60-3.

PMID: 14963472 DOI: 10.1038/sj.ijir.3901141

The objective of this study was to explore the roles and perceptions of general practitioners (GPs) in the management of erectile dysfunction (ED). This qualitative study used focus group discussions and in-depth interviews. This study was conducted based on 28 GPs from an urban area in Malaysia who had managed patients with ED and prescribed anti-ED drugs. Main outcome measures included the roles of GPs in managing patients with ED (active or passive), perceptions regarding ED and the treatment, and factors influencing their decision to prescribe. Majority of the GPs assumed a passive role when managing patients with ED. This was partly due to their perception of the disease being nonserious. Some also perceived ED as mainly psychological in nature. The anti-ED drugs were often viewed as a lifestyle drug with potentially serious side effects. The fear of being perceived by patients as 'pushing' for the drug and being blamed if the patients were to develop serious side effects also hampered the management of this disease. GPs who participated in this study remained passive in identifying and treating patients with ED and this was attributed to their perception of the disease, drug treatment and patient's background.

Matched MeSH terms: Physicians, Family/psychology*

Fulltext What do primary care doctors do when they fall sick? A qualitative study exploring their help-seeking behavior

Ng CJ, Haidi NS

Asia Pac Fam Med, 2005;4(3).

Aim: To explore the help-seeking behavior of primary care doctors during illness. Methods: This qualitative study used focus group discussions to explore participants' help-seeking behavior during illness. It involved 22 primary care doctors (5 lecturers, 12 postgraduate trainees, 5 medical officers) working in a hospital-based primary care clinic. Result: Most primary care doctors in this study managed their illnesses without seeking help. Although most preferred to seek professional help for chronic illnesses and antenatal care, they tend to delay the consultations and were less likely to comply with treatment and follow-up. Explanations for their behavior include their ability to assess and treat themselves, difficulty to find suitable doctors, work commitment, easy access to drugs, and reluctance to assume a sick role. Conclusions: This study found that the help-seeking behavior of primary care doctors was similar to those in other studies. Due to their professional ability, heavy workload and expectations from peer and patients, primary care doctors were more likely to delay in seeking treatment especially for chronic and serious diseases. This highlights the need to enhance support services for doctors during illness. Key words: doctors, help-seeking behavior, illness

Matched MeSH terms: Physicians, Family

Barriers to implementing a national health screening program for men in Malaysia: An online survey of healthcare providers

Ng CJ, Teo CH, Ang KM, Kok YL, Ashraf K, Leong HL, et al.

Malays Fam Physician, 2020;15(1):6-14.

PMID: 32284799

Introduction: This study aimed to determine the views and practices of healthcare providers and barriers they encountered when implementing the national health screening program for men in a public primary care setting in Malaysia.

Methods: An online survey was conducted among healthcare providers across public health clinics in Malaysia. All family medicine specialists, medical officers, nurses and assistant medical officers involved in the screening program for adult men were invited to answer a 51-item questionnaire via email or WhatsApp. The questionnaire comprised five sections: participants' socio-demographic information, current screening practices, barriers and facilitators to using the screening tool, and views on the content and format of the screening tool.

Results: A total of 231 healthcare providers from 129 health clinics participated in this survey. Among them, 37.44% perceived the implementation of the screening program as a "top-down decision." Although 37.44% found the screening tool for adult men "useful," some felt that it was "time consuming" to fill out (38.2%) and "lengthy" (28.3%). In addition, 'adult men refuse to answer' (24.1%) was cited as the most common patient-related barrier.

Conclusions: This study provided useful insights into the challenges encountered by the public healthcare providers when implementing a national screening program for men. The screening tool for adult men should be revised to make it more user-friendly. Further studies should explore the reasons why men were reluctant to participate in health screenings, thus enhancing the implementation of screening programs in primary care.

Matched MeSH terms: Physicians, Family

Fulltext Family physicians with special interest in dermatology

Muthupalaniappen L

Malays Fam Physician, 2008;3(1):64-5.

PMID: 25606117

Matched MeSH terms: Physicians, Family

Managing Women with Sexual Dysfunction: Difficulties Experienced by Malaysian Family Physicians

Muhamad R, Horey D, Liamputtong P, Low WY

Arch Sex Behav, 2019 04;48(3):949-960.

PMID: 30238183 DOI: 10.1007/s10508-018-1236-1

Recognizing barriers to managing sexual issues makes it more likely that effective ways to overcome them will be found. In Malaysia, where discussion of sexual issues is taboo, sociocultural factors may influence how physicians manage patients with these types of problems. This article focuses on the challenges encountered by 21 Malay family physicians when women experiencing sexual problems and female sexual dysfunction (FSD) attended their clinics, an uncommon occurrence in Malaysia, despite their high prevalence. This qualitative study employed a phenomenological framework and conducted face-to-face in-depth interviews. Three main barriers to managing women with sexual problems were identified that can hinder assessment and treatment: insufficient knowledge and training; unfavorable clinic environments; and personal embarrassment. Some barriers were associated with physician characteristics but many were systemic. These were further evaluated using social cognitive theory. Professional attitudes appear important as those physicians with an interest in managing women's health seemed to make greater effort to explore issues further and work to gain trust. Physicians who appeared indifferent to the impact of FSD showed greater reluctance to find solutions. Systemic issues included unfavorable clinical settings, lack of training, and lack of local evidence. Any strategy to address FSD needs to be underpinned by appropriate policies and resources.

Matched MeSH terms: Physicians, Family/psychology*

Fulltext Peritonsillar swelling is not always quinsy

Mohamad I, Yaroko A

Malays Fam Physician, 2013;8(2):53-5.

PMID: 25606284 MyJurnal

Quinsy is a common encounter in family physician practice. It is defined as a collection of purulent material in the peritonsillar space, giving appearance of unilateral palatal bulge. Presenting symptoms include trismus, muffled voice, odynophagia, and ipsilateral otalgia. When the diagnostic needle aspiration reveals no pus, the diagnosis is changed into peritonsillar cellulitis or also known as perintonsillitis. Peritonsillitis is sufficiently treated with antibiotics unlike a quinsy which warrants surgical incision and drainage.

Matched MeSH terms: Physicians, Family

Editorial. HIV counselling and the general practitioner

Md Shajahan MY

Family Physician, 1993;5:3-4.

Matched MeSH terms: Physicians, Family

General practice research and the family physician

Md Shajahan MY

Family Physician, 1994;6:3-3.

Matched MeSH terms: Physicians, Family

Chronic disease and the family physician

Md Shajahan MY

Family Physician, 1994;6:1-1.

Matched MeSH terms: Physicians, Family

The clinical problems of the general practitioner and multiple concurrent pathologies

McKay AB

Family Practitioner, 1977;2(8):101-105.

Matched MeSH terms: Physicians, Family

Fulltext Risk factors for diabetic retinopathy in diabetic screened using fundus photography at a primary health care setting in East Malaysia

Mallika PS, Lee PY, Cheah WL, Wong JS, Syed Alwi SAR, Nor Hayati H, et al.

Malays Fam Physician, 2011;6(2):60-65.

MyJurnal

Introduction: This study reports on the prevalence of diabetic retinopathy (DR) and risk factors among diabetic patients, who underwent fundus photography screening in a primary care setting of Borneo Islands, East Malaysia. We aimed to explore the preliminary data to help in the planning of more effective preventive strategies of DR at the primary health care setting.
Materials and Methods: A cross-sectional study on 738 known diabetic patients aged 19-82 years was conducted in 2004. Eye examination consists of visual acuity testing followed by fundus photography for DR assessment. The fundus pictures were reviewed by a family physician and an ophthalmologist. Fundus photographs were graded as having no DR, NPDR, PDR and maculopathy. The data of other parameters was retrieved from patient’s record. Bi-variate and multivariate analysis was used to elucidate the factors associated with DR.
Results: Any DR was detected in 23.7% (95% CI=21 to 27%) of the patients and 3.2% had proliferative DR. The risk factors associated with any DR was duration of DM (OR =2.5, CI=1.6 to 3.9 for duration of five to 10 years when compared to <5 years) and lower BMI (OR=1.8, CI=1.1 to 3.0). Moderate visual loss was associated with DR (OR=2.1, CI=1.2 to 3.7).
Conclusions: This study confirms associations of DR with diabetic duration, body mass index and visual loss. Our data provide preliminary findings to help to improve the screening and preventive strategies of DR at the primary health care setting.
Keywords: Diabetic retinopathy, epidemiology, screening, primary health care, Malaysia
Study site: Klinik Kesihatan Jalan Masjid, Kuching, Sarawak, Malaysia

Matched MeSH terms: Physicians, Family

Fulltext Management of erectile dysfunction: barriers faced by general practitioners

Low WY, Ng CJ, Tan NC, Choo WY, Tan HM

Asian J Androl, 2004 Jun;6(2):99-104.

PMID: 15154082

Aim: To explore the barriers faced by general practitioners (GPs) in the management of patients with erectile dysfunction (ED).
Methods: This was a qualitative analysis of focus group discussions and in-depth interviews involving 28 Malaysian GPs.
Results: GPs' perception of ED being not a serious condition was a major determinant of their prescribing practice. Doctor's age (younger), gender (female), short consultation time and lack of experience were cited as barriers. The GPs' prescribing habits were heavily influenced by the feedback from the first few patients under treatment, the uncertainty of etiology of ED without proper assessment and the profit margin with bulk purchase. Other barriers include Patients' coexisting medical conditions, older age, lower socio-economic status, unrealistic expectations and inappropriate use of the anti-impotent drugs. Cardiovascular side effects and cost were two most important drug barriers.
Conclusion: The factors influencing the management of ED among the general practitioners were multiple and complex. An adequate understanding of how these factors (doctors, patients and drugs) interact can assist in the formulation and implementation of strategies that encourage GPs to identify and manage ED patients.

Matched MeSH terms: Physicians, Family*

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