MyMedR

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

Family physicians and medical writing

Yong Rafidah AR

Family Physician, 2003;12:1-1.

Matched MeSH terms: Physicians, Family

Fulltext Family Practice: Is It For Me?

Teng CL

ISBN: 978-983-3909-42-1

Citation: Teng CL. Family Practice: Is It For Me? In: Ong HT (editor). The Life of a Doctor. Petaling Jaya: Unipress Medical & Healthcare; 2008, p115-119

Matched MeSH terms: Physicians, Family

Family Physicians' satisfaction with factors affecting the dynamism of the urban family physician program in the Fars and Mazandaran provinces of Iran

Kabir MJ, Hassanzadeh-Rostami Z, Ashrafian Amiri H, Nasrollapour Shirvani SD, Keshavarzi A, Hosseini S

Malays Fam Physician, 2019;14(3):28-36.

PMID: 32175038

Background and objective: A successful family physician program needs ongoing and full cooperation between people and the organizations in charge. Ensuring the satisfaction of family physicians through improvement of the underlying factors could motivate them to provide high-quality services. This study aimed to determine the family physicians' satisfaction level with the factors affecting the dynamism of the urban family physicians program in the Fars and Mazandaran provinces of Iran.

Method: This cross-sectional study was carried out in urban areas in the Fars and Mazandaran provinces in 2016. The sample consisted of 143 and 96 family physicians, respectively, in Fars and Mazandaran provinces and was selected using the stratified random sampling method. Data were collected using a questionnaire and included both sociodemographic variables and factors assessing the family physicians' satisfaction levels. Each factor was scored based on a Likert scale from 0 to 5 points, and any satisfaction level higher than 3 out of 5 was equated with being satisfied.

Results: The overall satisfaction levels among family physicians in Fars and Mazandaran provinces were 2.77±0.53 and 3.37±0.56, respectively, revealing a statistically significant difference between provinces (p<0.001). Moreover, the mean satisfaction scores for the performances of healthcare centers, insurance companies, specialists, healthcare workers, and the population covered were 2.78±0.1, 2.54±0.9, 2.52±0.8, 4.24±0.07, and 2.96±0.8, respectively. The family physicians' levels of satisfaction were significantly correlated with population size (p=0.02, r= -0.106), and willingness to stay in an urban family physician program (p<0.001, r= +0.398).

Conclusion: This study revealed that family physicians exhibited a low level of satisfaction with the urban family physician program. Given the direct association between family physicians' satisfaction levels and retention in the program, it is expected that family physicians will no longer stay in the program, and it is likely to have subsequent executive problems.

Matched MeSH terms: Physicians, Family

Fulltext Family Medicine, Healthcare & Society: Essays By Dr M K Rajakumar, Second Edition

ISBN: 978-967-0538-17-4

Citation: Teng CL, Khoo EM, Ng CJ (editors). Family Medicine, Healthcare & Society: Essays By Dr M K Rajakumar, Second Edition. Kuala Lumpur: Academy of Family Physicians of Malaysia, 2019

First edition: 2008

Contents of second edition:
Preface to the Second Edition iii
Acknowledgements iv
Contents vi
Foreword by Dr Harbaskh Singh vii
Foreword by Professor Chris van Weel (in the First Edition) viii
Foreword by Datuk Dr D M Thuraiappah (in the First Edition) ix
Section 1: Primary Health Care and Family Medicine 1
1 Put not New Wine into Old Bottles 3
2 The Importance of Primary Care 6
3 Primary Health for all the People 11
4 The Evolution of General Practice 16
5 Future of Family Medicine in Developing Countries 23
6 Family Practice: Uniting Across Frontiers 27
Section 2: Training for Family Medicine 31
7 Specialisation in Primary Healthcare training for the new General Practice in Malaysia [summary] 32
8 A Proposal for the Training of Physicians in Primary Care for the Rural Areas of Malaysia 34
9 The Family Physician in Asia: Looking to the 21st Century 40
10 Training Family Doctors in a Developing Country 46
Section 3: Family Medicine journals 51
11 Family Physician [inaugural issue of Family Physician] 52
12 Our journal [inaugural issue of Malaysian Family Physician] 56
Section 4: Healthcare Improvement 58
13 The Future of the Health Services in Malaysia. [summary] 59
14 Quality in Family Practice 68 15 Foreword, In: Chee HL, Barraclough S (ed). Health Care in Malaysia 75 Section 5: Ethics and Professionalism 81
16 Ethical Consequences of Technological Change 83
17 Dr Sun Yat Sen Oration. Between Faith and Reason 91
18 Ethics, Professionalism and the “Trade” 99
19 Rural Health and Global Equity: Am I My Brother’s Keeper? 103
20 Achieving Equity Through a Primary Care-Led Health System 108 Section 6: Civil Society 112
21 Looking Back, Looking Forward 113
Appendix 1: Dr M K Rajakumar: A brief curriculum vitae 120
Appendix 2: Books and articles about Dr M K Rajakumar 124
Appendix 3: Reflections and comments 125

Matched MeSH terms: Physicians, Family

Fulltext Factors influencing the role of primary care providers as gatekeepers in the Malaysian public healthcare system

Ang KT, Ho BK, Mimi O, Salmah N, Salmiah MS, Noridah MS

Malays Fam Physician, 2014;9(3):2-11.

PMID: 26425299 MyJurnal

Primary care providers play an important gatekeeping role in ensuring appropriate referrals to secondary care facilities. This cross-sectional study aimed to determine the level, pattern and rate of referrals from health clinics to hospitals in the public sector, and whether the placement of resident family medicine specialist (FMS) had made a significant difference. The study was carried out between March and April in 2012, involving 28 public primary care clinics. It showed that the average referral rate was 1.56% for clinics with resident FMS and 1.94% for those without resident FMS, but it was not statistically significant. Majority of referred cases were considered appropriate (96.1%). Results of the multivariate analysis showed that no prior consultation with senior healthcare provider and illnesses that were not severe and complex were independently associated with inappropriate referrals. Severity, complexity or uncertain diagnosis of patients' illness or injury significantly contributed to unavoidable referrals. Adequate facilities or having more experienced doctors could have avoided 14.5% of the referrals. The low referral rate and very high level of appropriate referrals could indicate that primary care providers in the public sector played an effective role as gatekeepers in the Malaysian public healthcare system.

Matched MeSH terms: Physicians, Family

Experience with a general practitioner hospital

Robinson PH

Family Practitioner, 1977;2:28-30.

Matched MeSH terms: Physicians, Family

Ethnicity, health and medical care: towards a critical realist analysis of general practice in the Korean community in Sydney

Han GS, Davies C

Ethn Health, 2006 Nov;11(4):409-30.

PMID: 17060035 DOI: 10.1080/13557850600824054

This paper investigates the use and provision of biomedicine among Korean-Australian men on the basis of interview data from all of the eight Korean-speaking doctors practising in the Korean community in Sydney in 1995. From the viewpoint of these general practitioners, an analysis is made of the processes Korean men go through in adjusting to a new country, being involved in constant hard manual work and long working hours, and explores how they make use of all available resources to stay healthy. The Korean men have fully utilized the 'freely' available medical services under government-subsidized Medicare, bearing in mind that health is a capacity to work under the current environment, although illegal migrants restrained themselves from using it until they obtained legal status. Korean-speaking medical practitioners have been able to provide their fellow Koreans with 'culturally appropriate' health care, with the key factor being the absence of a language barrier. The level of patient satisfaction is high, possibly due to the excellent understanding the doctors have of the social aspects of illnesses, although the doctors do not go beyond curative medicine in their practice. However, the increasing number of Korean-speaking doctors in the small Korean community means that there is competition for patients. Consequently, the medical care is highly entrepreneurial. Referral by Korean doctors to practitioners of Korean herbal medicine is also a notable feature of the health care sector of the Korean community, especially as this offers Korean patients 'satisfactory' health relief for problems that are not easily relieved by doctors in the biomedical system.

Matched MeSH terms: Physicians, Family/psychology*

Education of the general practitioner

Sreenivasan BR

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

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

Editorial. General practitioners' role in V. D. treatment and health education

Lau J

Family Practitioner, 1975;2(3):5-9.

Matched MeSH terms: Physicians, Family

Fulltext Economic evaluation of type 2 diabetes management at the Malaysian Ministry of Health primary care clinics, in Machang, Kelantan

Rohana, D., Wan Norlida, W.l., Nor Azwany, Y., Mazlan, A., Zawiyah, D., Che Karrialudin, C.A., et al.

Malaysian Journal of Public Health Medicine, 2007;7(1):5-13.

MyJurnal

Public health care programme evaluation includes determining the programme effectiveness (outcome assessment), efficiency (economic evaluation), accessibility (reachability of services) and equity (equal provision for equal needs). The purpose of this study was to make comparison on cost·( efficiency and costeffectiveness in managing type 2 diabetes between the Ministry of Health (MOH) health clinics with family medicine specialist (FMS) and health clinics without FMS. A costeffectiveness analysis was conducted alongside across-sectional study at two government health clinics in Machang, Kelantan, one with FMS and the other without FMS. A total of 300 patients, of which 155 from the health clinic without FMS and 145 from the other group were evaluated for sociodemographic and clinical characteristics from August 2005 to May 2006. HbA1c
analysis was measured for each patient during the study period. Macrocosting and microcosting were used to determine costs. The provider cost for diabetic management ranged from RM270.56 to RM4533.04 per diabetic patient per year, withla mean cost of RM1127.91(t906.08) per diabetic patient per year in health clinic with FMS. In health clinic without FMS, the provider cost ranged from RM225.93 to RM4650.13, with a mean cost of RM802.15 (:626.26). Proportion ofgood HbA1c was 17.2% for health clinic with FMS and 10.3% for the health clinic without FMS. The annual mean provider cost per proportion of good HbA1c control (< 7%) (Costefkctiveness ratio/ CER) was RM6557.65.for health clinic with FMS and RM7787.88 for health clinic without FMS. This provider cost-epfectiveness ratio was not different statistically between the health clinic with FMS and health clinic without FMS (p=0.063). The cost of building, equipments, overheads, staff and consumables were higher for FMS group. Sensitivity analysis was performed for three discount rates (0, 5 and 7%). Relative cost-effectiveness of diabetes management in health clinic with FMS and health clinic without FMS was unchanged in all sensitivity scenarios. Even though, there was no significantly difference in provider CER in type 2 diabetes management at Malaysian MOH health clinics, but the provider CER in health clinic with FMS was lower compared to health clinic without FMS. Therefore, we can conclude that the presence of FMS in the health clinic will effectively improved the management of type 2 diabetes.

Matched MeSH terms: Physicians, Family

Fulltext Doctors treating family members: A qualitative study among primary care practitioners in a teaching hospital in Malaysia

Hanafi NS, Ng CJ

Asia Pac Fam Med, 2006;5(2).

Aim: To explore primary care practitioners' experiences and feelings about treating their own family members. Methods: A qualitative study was carried out using focus group discussions. Five sessions were held among 22 primary care practitioners (five academic staff members and 17 medical officers). Results: Most participants treated their family members, especially their immediate families. They considered factors such as duration and severity of illness before seeking consultation with other doctors. Some participants felt satisfied knowing that they were able to treat their own families. However, most felt burdened and uncomfortable in doing so, mainly due to the fear of error in diagnosis and management. They were concerned that strong emotions may make them lose objectivity. Many were aware that negative outcomes resulting from their treatment may affect future relationships. Conclusions: While some doctors were comfortable about treating their own families, some faced significant conflict in doing so. Their decisions depended on the interplay of factors including the doctor, the family member and the relationship they share. A doctor needs to consider the potential conflict that may arise when carrying out one's professional role and at the same time being a concerned family member. Key words: doctors, family, Malaysia, primary care, self-treat.

Matched MeSH terms: Physicians, Family

Critical appraisal skills and the family physician

Krishnan R

Family Physician, 1997;10:1-1.

Matched MeSH terms: Physicians, Family

Fulltext Continuity of care of diabetic patients in a family practice clinic: How important is it?

Hanafi NS, Teng CL, Yasin S

Asia Pac Fam Med, 2003;2(1):10-15.

Aim: To assess the importance of continuity of care among diabetic patients attending a primary care clinic and to correlate degree of continuity of care with diabetic control. Methods: A cross sectional survey was carried out among diabetic patients (n = 166) attending follow-up consultations in a family practice clinic of a teaching hospital. Face-to-face interviews were carried out on patients' perception of continuity of care and various aspects related to diabetes. Diabetic control was assessed by glycosylated hemoglobin. Retrospective chart audits of each patient over the previous 28 months were done to assess the degree of continuity of care, measured with the Usual Provider Continuity Index (UPCI). Results: The UPCI ranged from 0.18 to 1.00 with a mean value of 0.60. The average number of visits per patient over the 28-month period was 11.7 visits. The majority of patients saw five different doctors for all their visits. There were no statistically significant associations between the degree of provider continuity with diabetic control (r = 0.054) and diabetic self-care behavior (r = 0.065). The majority of patients (89%) felt that it was important to have a regular doctor. The main reason given was that a regular doctor would know the patient's problems. Conclusions: Continuity of care was highly valued by diabetic patients attending a hospital-based family practice clinic. Even though the degree of continuity was not associated with the degree of diabetic control, patients felt that it was important to have doctors who are aware of their problems.

Matched MeSH terms: Physicians, Family

Congratulatory message from the Singapore College

Wong HS

Family Practitioner, 1973;1(1):6.

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

Cervical cancer prevention

Khoo EM

Family Physician, 1996;8:8-10.