MyMedR

Fulltext Founding of the College of General Practitioners Malaysia

Param Palam S

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

Matched MeSH terms: Physicians, Family

Fulltext The family physician in Asia: looking to the 21st century

Rajakumar MK

Family Medicine Education in the Asia-Pacific Region. Core Curriculum for Residency/Vocational Training and Core Content for Specialty Qualifying Examination., 1993.

Citation: Rajakumar MK. The family physician in Asia: looking to the 21st century. Family Medicine Education in the Asia-Pacific Region. Core Curriculum for Residency/Vocational Training and Core Content for Specialty Qualifying Examination. The Philippine Academy of Family Medicine, 1993. [Originally published in the Filipino Family Physician in 1993]

Republished in:
1. Republished in: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare and Society: Essays by Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019: 40-45
2. An Uncommon Hero. p354-360

Matched MeSH terms: Physicians, Family

Fulltext Preventing diabetes: The task of the family doctor

Rajakumar MK

Asia Pac Fam Med, 2003;2(1):8-9.

Matched MeSH terms: Physicians, Family

Training of general practitioners in health and safety in the workplace

Rampal KG

Family Physician, 1991;3:17-18.

Matched MeSH terms: Physicians, Family

Experience with a general practitioner hospital

Robinson PH

Family Practitioner, 1977;2:28-30.

Matched MeSH terms: Physicians, Family

Fulltext Modifying antibiotic prescribing: the effectiveness of academic detailing plus information leaflet in a Malaysian primary care setting

Teng CL, Achike FI, Phua KL, Nurjahan MI, Mastura I, Asiah HN, et al.

Med J Malaysia, 2006 Aug;61(3):323-31.

PMID: 17240584

We assessed the effectiveness of an educational intervention in reducing antibiotic prescribing in public primary care clinics in Malaysia. Twenty-nine medical officers in nine clinics received an educational intervention consisting of academic detailing from the resident Family Medicine Specialist, as well as an information leaflet. The antibiotic prescribing rates were assessed for six months - three months before and three months after the intervention. A total of 28,562 prescriptions were analyzed. Among participating doctors, general antibiotic prescribing rates for pre- and post-intervention phases were 14.3% and 11.0% (post-intervention vs pre-intervention RR 0.77, 95% CI 0.72 to 0.83). The URTI-specific antibiotic prescribing rates for pre- and post-intervention phases were 27.7% and 16.6%, respectively (post-intervention vs pre-intervention RR 0.60, 95% CI 0.54 to 0.66). No significant change in antibiotic prescribing rates was observed among primary care practitioners who did not participate in the study. This low cost educational intervention using both active and passive strategies focusing on URTI produced a statistically significant (and clinically important) reduction in antibiotic prescribing.
Study site: Klinik Kesihatan, Negeri Sembilan, Malaysia

Matched MeSH terms: Physicians, Family/education*

Fulltext Reorientation of medical education for primary health care

Sahan AK

Med J Malaysia, 1987 Mar;42(1):1-8.

PMID: 3431498

There is universal concern on the current inequitable coverage and low quality of health care. The lead roles of medical practitioners in health care and how they are prepared for such roles are being re-examined in many countries. This paper attempts to rationalise the need to reorientate medical education towards primary health care, and to suggest possible emphasis and direction for change.

Matched MeSH terms: Physicians, Family/education*

Cardiac surgery and the general practitioner

Saw HS

Family Practitioner, 1983;6:43-49.

Matched MeSH terms: Physicians, Family

Fulltext A study of clinical questions in primary care

Fozi K, Teng CL, Krishnan R, Shajahan Y

Med J Malaysia, 2000 Dec;55(4):486-92.

PMID: 11221162

This is a prospective study of clinical questions generated in primary care consultations and a comparison of two approaches to answering those clinical questions. Twenty-one doctors in a university-based primary care clinic submitted 78 clinical questions arising from patient consultations during 24 clinic days (0.01 question per patient encounter). These doctors subsequently found answers to 40% of their questions but were satisfied with only 67% of these answers. The investigators were able to provide answers for 95% of the questions asked and the doctors rated these answers as satisfactory in 86% of instances. Answers obtained by investigators had significantly higher satisfaction score than those obtained by doctors' search (p = 0.002). The two main findings of this study are (1) almost all questions arising in clinic setting could be answered by intensive search; (2) answers found by intensive searches were judged to be more satisfactory than those found routinely by doctors. Provision of an information retrieval service in addition to training in the searching and appraisal of medical literature are possible solutions to the information needs of busy clinicians.

Study site: Primary Care Clinic,
University Hospital Kuala Lumpur i

Matched MeSH terms: Physicians, Family*

Fulltext Antenatal profile and obstetric outcome of adolescent pregnancy in a Malaysian semi-rural clinic

Kwa SK, Lu AIC, Zairul Azwan MA, Aman Fuad Y, Siti Aishah A

Family Physician, 2001;11(3):7-10.

Adolescent pregnancy is associated with long term medical and sociological problems. For intervention, it is important to have information on their profile and obstetric outcome. A study was conducted in 1999 on teenage mothers compared to mothers in the 20-34 year age group. Antenatal records of all these mothers registered in a Malaysian semi-rural Health Clinic in 1998 were reviewed and the relevant information was analysed using descriptive statistics and chi-square for comparison in SPSS 7.5. Only 402 (80.9%) of the 497 antenatal records could be included. There were 40 (9.95%) adolescent pregnancies and 362 (90.05%) pregnancies in mothers aged 20-34 years. Pregnant adolescents were more likely to be Malays (85% versus 66%), unmarried (65% versus 5.5%) and less educated (32.5% versus 12.1%). They have a significantly lower rate of contraceptive usage (2.5% versus 20.2%) and tend to come late for their first antenatal visit (55% versus 18.5%). Their pregnancy complications of anaemia and pregnancy induced hypertension were no worse. But they had a significantly higher preterm delivery rate (37.5% versus 21.8%) and their babies were more likely to have low birth weight (32.5% versus 9.9%). Based on this preliminary finding, further investigations should be carried out and polices should include programmes targeted for this group.

Matched MeSH terms: Physicians, Family

Education of the general practitioner

Sreenivasan BR

Family Practitioner, 1974;1(3):3-10.

Matched MeSH terms: Physicians, Family

Role of the general practitioner in the management of psychiatric disorders

Subramaniam M

Family Practitioner, 1988;11:13-16.

Matched MeSH terms: Physicians, Family

Address by DYMM Tuanku Syed Sirajuddin ibni Almarhum Tuanku Syed Putra Jamalullail, Raja of Perlis. Royal Patron of the Academy of Family Physicians of Malaysia. At the 27th Annual Dinner and Convocation Ceremony, 17th February 2001

Syed Sirajuddin SPJ

Family Physician, 2001;11:iii-iv.

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

The small-for-dates baby - the family practitioners' role

Tan FEH

Family Practitioner, 1975;2(1):32-34.

Matched MeSH terms: Physicians, Family

The family practitioner's role in sex education

Tan FEH

Family Practitioner, 1977;2(8):49-51.

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*

Sexual Health Problems: Attitudes and Practices of Malaysian General Practitioners

Low WY, Khoo EM, Tan HM

ISBN: 0-86471-096-8

Citation: Low WY, Khoo EM, Tan HM. Sexual Health Problems: Attitudes and Practices of Malaysian General Practitioners. Auckland: Adis International Ltd, 2002

Matched MeSH terms: Physicians, Family

Weighing the necessities and concerns of deprescribing among older ambulatory patients and primary care trainees: a qualitative study

Goh SSL, Lai PSM, Ramdzan SN, Tan KM

BMC Prim Care, 2023 Jun 30;24(1):136.

PMID: 37391698 DOI: 10.1186/s12875-023-02084-8

BACKGROUND: Deprescribing can be a challenging and complex process, particularly for early career doctors such as primary care trainees. To date, there is limited data from patients' and doctors' perspectives regarding the deprescribing of medications in older persons, particularly from developing countries. This study aimed to explore the necessities and concerns of deprescribing in older persons among older ambulatory patients and primary care trainees.

METHODS: A qualitative study was conducted among patients and primary care trainees (known henceforth as doctors). Patients aged ≥ 60 years, having ≥ 1 chronic disease and prescribed ≥ 5 medications and could communicate in either English or Malay were recruited. Doctors and patients were purposively sampled based on their stage of training as family medicine specialists and ethnicity, respectively. All interviews were audio-recorded and transcribed verbatim. A thematic approach was used to analyse data.

RESULTS: Twenty-four in-depth interviews (IDIs) with patients and four focus group discussions (FGDs) with 23 doctors were conducted. Four themes emerged: understanding the concept of deprescribing, the necessity to perform deprescribing, concerns regarding deprescribing and factors influencing deprescribing. Patients were receptive to the idea of deprescribing when the term was explained to them, whilst doctors had a good understanding of deprescribing. Both patients and doctors would deprescribe when the necessity outweighed their concerns. Factors that influenced deprescribing were doctor-patient rapport, health literacy among patients, external influences from carers and social media, and system challenges.

CONCLUSION: Deprescribing was deemed necessary by both patients and doctors when there was a reason to do so. However, both doctors and patients were afraid to deprescribe as they 'didn't want to rock the boat'. Early-career doctors were reluctant to deprescribe as they felt compelled to continue medications that were initiated by another specialist. Doctors requested more training on how to deprescribe medications.

Matched MeSH terms: Physicians, Family

Fulltext Primary care doctors' perceptions towards evidence-based medicine in Melaka State: a questionnaire study

Chan GC, Teng CL

Med J Malaysia, 2005 Jun;60(2):130-3.

PMID: 16114151

A cross sectional study using a self-administered questionnaire to determine the perceptions of primary care doctors towards evidence-based medicine (EBM) was conclucted in Melaka state. About 78% of the primary care doctors were aware of EBM and agreed it could improve patient care. Only 6.7% of them had ever conducted a Medline literature search. They had a low level of awareness of review publications and databases relevant to EBM; only about 33% of them were aware of the Cochrane Database of Systemic Reviews. Over half of the respondents had at least some understanding of the technical terms used in EBM. Ninety percent of the respondents had Internet access and the majority of them used it at home. The main barriers to practicing EBM were lack of personal time and lack of Internet access in the primary care clinics.

Matched MeSH terms: Physicians, Family/standards*

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