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Fulltext Assessing predictors of intention to prescribe sick leave among primary care physicians using the theory of planned behaviour

Swarna Nantha Y, Wee LH, Chan CM

BMC Fam Pract, 2018 01 16;19(1):18.
PMID: 29338699 DOI: 10.1186/s12875-017-0690-5

BACKGROUND: Providing sickness certification is a decision that primary care physicians make on a daily basis. The majority of sickness certification studies in the literature involve a general assessment of physician or patient behaviour without the use of a robust psychological framework to guide research accuracy. To address this deficiency, this study utilized the Theory of Planned Behaviour (TPB) to specifically gauge the intention and other salient predictors related to sickness certification prescribing behaviour amongst primary care physicians.
METHODS: A cross-sectional study was conducted among N = 271 primary care physicians from 86 primary care practices throughout two states in Malaysia. Questionnaires used were specifically developed based on the TPB, consisting of both direct and indirect measures related to the provision of sickness leave. Questionnaire validity was established through factor analysis and the determination of internal consistency between theoretically related constructs. The temporal stability of the indirect measures was determined via the test-retest correlation analysis. Structural equation modelling was conducted to determine the strength of predictors related to intentions.
RESULTS: The mean scores for intention to provide patients with sickness was low. The Cronbach α value for the direct measures was good: overall physician intent to provide sick leave (0.77), physician attitude towards prescribing sick leave for patients (0.77) and physician attitude in trusting the intention of patients seeking sick leave (0.83). The temporal stability of the indirect measures of the questionnaire was satisfactory with significant correlation between constructs separated by an interval of two weeks (p

Matched MeSH terms: Physicians, Primary Care*
Fulltext Habits and attitudes of Malaysian military doctors towards smoking

Supramaniam V

Med J Malaysia, 1980 Mar;34(3):205-10.
PMID: 7412660

A postal questionnaire survey was carried out among military doctors during June to August 1979 on habits and attitudes to smoking. An 87% response rate was obtained. Smoking prevalence was found to be 50%. 45% of medical officers are heavy smokers. Age at starting influence the amount smoked. Service life had no influence on smoking habits. Attitudes to smoking vary between the different categories of doctors. The habits and attitudes indicate a mental revolution on the part of doctors is required prior to any anti-smoking programme as they have to be sufficiently motivated to lead the fight.

Matched MeSH terms: Physicians
Fulltext Medical manpower in Sarawak--the doctors

Supramaniam V

Med J Malaysia, 1983 Dec;38(4):299-303.
PMID: 6599986

200 doctors are gazetted as practising in Sarawak in 1982. 88% are males and only 12% are females. Of the 200, 65.5% are Chinese and the natives of Sarawak and Indians form 15.5% each. Nearly 30% are graduates from local universities, 44% from universities in Commonwealth countries and a few from universities in other countries. The majority of the doctors are under 40 years of age. 55 % are in government service, while 45% are in the private sector. All private practices are solo practices except three-one each in Kuching, Sibu and Miri which are based on partnership. The number of doctors with specialist qualifications is not known as it is not essential for these qualifications to be entered in the Register. The doctor-to-population ratio in Sarawak has improved from 1:14000 in 1964 to 1:6856 in 1982. To reach the Ministry of Health's target of 1:2500 by 1990, a yearly recruitment of 58 doctors would be needed from 1983 to 1990. This would be feasible if either an admission quota to the local medical faculties for Sarawakians is implemented or more doctors are posted to serve in Sarawak.

Matched MeSH terms: Physicians/supply & distribution*
Nuclear medicine in Malaysia - Strengths and challenges for physicians after more than half a century of experience

Suppiah S

Med J Malaysia, 2021 07;76(4):451-453.
PMID: 34305103

Nuclear medicine (NM) has been established in Malaysia for almost 60 years. It is a specialty that utilizes radiopharmaceuticals for theranostics, by the assessment of bodily functions to diagnose certain diseases and conditions particularly in oncology, cardiology, and neurology as well as to provide therapeutic solutions in certain instances. The strengths of NM include the establishment of various nuclear medicine centres throughout the country, including in Sabah and Sarawak, particularly for general nuclear medicine, and the mushrooming of positron emission tomography computed tomography (PET/CT) centres along the states in the west coast of Malaysia, the institution of a formal national nuclear medicine physician training programme, and collaboration with international bodies to develop theranostic services. The challenges for NM ahead are namely regulatory and financial constraints for utilizing newer radiopharmaceuticals available in the international market, expansion of accredited training programmes to produce skilled healthcare workforce, optimization of resources at hand and multidisciplinary collaborations to reduce premature mortality of patients caused by noncommunicable diseases, particularly cancer.

Matched MeSH terms: Physicians*
Role of the general practitioner in the management of psychiatric disorders

Subramaniam M

Family Practitioner, 1988;11:13-16.

Matched MeSH terms: Physicians, Family; Physicians, Primary Care
Exploring measurement tools to optimise hospital physician distribution

Suan NAM, Soelar SA, Rani RA, Anuar NA, Aziz KAA, Chan HK, et al.

Med J Malaysia, 2024 Mar;79(2):222-233.
PMID: 38553930

INTRODUCTION: Equitable healthcare delivery is essential and requires resources to be distributed, which include assets and healthcare workers. To date, there is no gold standard for measuring the correct number of physicians to meet healthcare needs. This rapid review aims to explore measurement tools employed to optimise the distribution of hospital physicians, with a focus on ensuring fair resource allocation for equitable healthcare delivery.
MATERIALS AND METHODS: A literature search was performed across PubMed, EMBASE, Emerald Insight and grey literature sources. The key terms used in the search include 'distribution', 'method', and 'physician', focusing on research articles published in English from 2002 to 2022 that described methods or tools to measure hospital-based physicians' distribution. Relevant articles were selected through a two-level screening process and critically appraised. The primary outcome is the measurement tools used to assess the distribution of hospital-based physicians. Study characteristics, tool advantages and limitations were also extracted. The extracted data were synthesised narratively.
RESULTS: Out of 7,199 identified articles, 13 met the inclusion criteria. Among the selected articles, 12 were from Asia and one from Africa. The review identified eight measurement tools: Gini coefficients and Lorenz curve, Robin Hood index, Theil index, concentration index, Workload Indicator of Staffing Need method, spatial autocorrelation analysis, mixed integer linear programming model and cohortcomponent model. These tools rely on fundamental data concerning population and physician numbers to generate outputs. Additionally, five studies employed a combination of these tools to gain a comprehensive understanding of physician distribution dynamics.
CONCLUSION: Measurement tools can be used to assess physician distribution according to population needs. Nevertheless, each tool has its own merits and limitations, underscoring the importance of employing a combination of tools. The choice of measuring tool should be tailored to the specific context and research objectives.

Matched MeSH terms: Physicians*
An exploratory analysis of general practitioner prescribing patterns in Malaysia using a health insurance claims database

Su WS, Thum CM, Loo JSE

Int J Pharm Pract, 2022 Jan 07;30(1):59-66.
PMID: 34962576 DOI: 10.1093/ijpp/riab075

OBJECTIVES: To determine the prescribing patterns and identify potentially inappropriate prescribing practices among general practitioners in the private primary care sector by analysing a large electronic health insurance claims database.
METHODS: Medical claims records from February 2019 to February 2020 were extracted from a health insurance claims database. Data cleaning and data analysis were performed using Python 3.7 with the Pandas, NumPy and Matplotlib libraries. The top five most common diagnoses were identified, and for each diagnosis, the most common medication classes and medications prescribed were quantified. Potentially inappropriate prescribing practices were identified by comparing the medications prescribed with relevant clinical guidelines.
KEY FINDINGS: The five most common diagnoses were upper respiratory tract infection (41.5%), diarrhoea (7.7%), musculoskeletal pain (7.6%), headache (6.7%) and gastritis (4.0%). Medications prescribed by general practitioners were largely as expected for symptomatic management of the respective conditions. One area of potentially inappropriate prescribing identified was inappropriate antibiotic choice. Same-class polypharmacy that may lead to an increased risk of adverse events were also identified, primarily involving multiple paracetamol-containing products, non-steroidal anti-inflammatory drugs (NSAIDs), and antihistamines. Other areas of non-adherence to guidelines identified included the potential overuse of oral corticosteroids and oral salbutamol, and inappropriate gastroprotection for patients receiving NSAIDs.
CONCLUSIONS: While prescribing practices are generally appropriate within the private primary care sector, there remain several areas where some potentially inappropriate prescribing occurs. The areas identified should be the focus in continuing efforts to improve prescribing practices to obtain the optimal clinical outcomes while reducing unnecessary risks and healthcare costs.

Matched MeSH terms: Practice Patterns, Physicians'
Fulltext The measurement of mental fatigue following an overnight on-call duty among doctors using electroencephalogram

Su AT, Xavier G, Kuan JW

PLoS One, 2023;18(7):e0287999.
PMID: 37406016 DOI: 10.1371/journal.pone.0287999

This study aimed to measure the spectral power differences in the brain rhythms among a group of hospital doctors before and after an overnight on-call duty. Thirty-two healthy doctors who performed regular on-call duty in a tertiary hospital in Sarawak, Malaysia were voluntarily recruited into this study. All participants were interviewed to collect relevant background information, followed by a self-administered questionnaire using Chalder Fatigue Scale and electroencephalogram test before and after an overnight on-call duty. The average overnight sleep duration during the on-call period was 2.2 hours (p<0.001, significantly shorter than usual sleep duration) among the participants. The mean (SD) Chalder Fatigue Scale score of the participants were 10.8 (5.3) before on-call and 18.4 (6.6) after on-call (p-value < 0.001). The theta rhythm showed significant increase in spectral power globally after an overnight on-call duty, especially when measured at eye closure. In contrast, the alpha and beta rhythms showed reduction in spectral power, significantly at temporal region, at eye closure, following an overnight on-call duty. These effects are more statistically significant when we derived the respective relative theta, alpha, and beta values. The finding of this study could be useful for development of electroencephalogram screening tool to detect mental fatigue.

Matched MeSH terms: Physicians*
Education of the general practitioner

Sreenivasan BR

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

Matched MeSH terms: Physicians; Physicians, Family
Fulltext Pathways to mental healthcare in high-income and low-income countries

Sorketti EA, Zuraida NZ, Habil MH

Int Psychiatry, 2013 May;10(2):45-47.
PMID: 31507730

Understanding the way in which people seek care for mental disorders is important for planning services, training and referral mechanisms. Pathways to care fall broadly into three categories: via primary care physicians; via native healers; and via patient choice (patients can have direct access to mental health professionals). The pattern and nature of access to service in low-income countries are different from those in high-income countries. In many societies, deep-seated cultural beliefs on the part of patients and families about the causes of mental disorders are a major barrier to the receipt of modern psychiatric care.

Matched MeSH terms: Physicians, Primary Care
Curricula Mapping of Physician Associate/Physician Assistant-Comparable Professions Worldwide Using the Learning Opportunities, Objectives, and Outcomes Platform

Smalley S, Bruza-Augatis M, Colletti T, Heistermann P, Mahmud A, Song D, et al.

J Physician Assist Educ, 2024 Mar 01;35(1):108-115.
PMID: 38251929 DOI: 10.1097/JPA.0000000000000571

Given the international growth of physician associate/physician assistant (PA) and PA-comparable professions, it is crucial to understand the educational curricula of PA/PA-comparable professions worldwide. This article provides an overview of the process and development of the PA/PA-comparable curricula mapping design applying an international framework. It uses an innovative web-based tool, the Learning Opportunities, Objectives, and Outcomes Platform (LOOOP), to map and evaluate course content, teaching strategies, assessment formats, and learning outcomes. It highlights the project's rationale, challenges, and future implications.

Matched MeSH terms: Physicians*
Are our new medical graduates ready to prescribe?

Sim SM, Choo WY, Ng CJ

Med Educ, 2009 May;43(5):492.
PMID: 19422512 DOI: 10.1111/j.1365-2923.2009.03352.x
Matched MeSH terms: Practice Patterns, Physicians'/standards*
Management problems of insomnia in primary care

Sidek Nontak MA, Hamzah N, Salleh MO

Family Physician, 1993;5:28-34.

There is increasing evidence that insomnia is a common complaint. Furthermore, physicians tend to institute treatment without adequate assessment of the patients with insomnia. For the purpose of management, cases are presented on the basis of classification. A survey of doctor's knowledge and practice in the primary care department is discussed. Management principles and problems are outlined.

Matched MeSH terms: Physicians, Primary Care
Fulltext A case of congenital anomaly of the utinary tract and neurogenic bladder

Sia, S.F., Dublin, N.

JUMMEC, 2006;9(2):22-23.
MyJurnal

Anomalies of the genitourinary tract occur in approximately 10% of the population and account for about one third of all congenital malformations in children (1). Congenital malformations involving the genitourinary system are major therapeutic challenges faced by the practising urologist.

Matched MeSH terms: Physicians
Fulltext Malaysian family physicians: are they satisfied with their job?

Sharifah Nurul Aida Syed Ghazaili, Norwati Daud

Malaysian Journal of Public Health Medicine, 2016;16(2):24-29.
MyJurnal

Job satisfaction is defined as pleasurable or positive emotional state which results from the appraisal of one’s job or job experience. It is often determined by how well outcome meet or exceed expectations. There are many factors which are related to job satisfaction among family physicians. Data on satisfaction among family physicians varies from country to country. This study aimed to determine the level of job satisfaction among family physicians in Malaysia and its associated factors. A cross sectional study was performed among 117 family physicians in Malaysia between July 2012 and December 2012. A questionnaire consists of socio-demographic characteristic, professional and health clinic characteristics and Warr-Cook-Wall job satisfaction scale was used. The results showed that 85% of Malaysian family physicians are satisfied with their job. They are mostly satisfied with hours of work, colleagues and fellow workers, and freedom to choose own method of working. They are least satisfied with physical working condition, rate of pay and recognition. Female gender and less number of health clinics in-charged were associated with increased in overall job satisfaction. Most of the family physicians in Malaysia are satisfied with their job. However there are certain areas that should be looked into which are physical working condition, rate of pay and recognition. Malaysian family physicians should receive equal career opportunity, promotion and salary scale like other specialties

Matched MeSH terms: Physicians, Family*
Fulltext Treatment satisfaction and its influencing factors among fixed orthodontic patients in UiTM

Shamsul,Fadzil,S,S,, Ahmad,Khalil,A,I,, Noviaranny,I,Y,, Abdullah,Al-Jaf,N,M,, Kazi,J,A,

Compendium of Oral Science, 2020;7(1):21-29.
MyJurnal

Abstract
Objectives: The aims of this study were to evaluate patient’s satisfaction regarding the orthodontic treatment
provided by the Faculty of Dentistry Universiti Teknologi MARA (UiTM) and to determine the factors that
affected their satisfaction level.
Methods: : A cross-sectional study was conducted among the patients treated with full fixed appliances in the
faculty’s orthodontic clinic using a validated questionnaire.
Results: : The final sample consisted of 105 subjects (response rate 76%) which comprises of 26 males and 79
females were chose with 97% of the respondents are Malay. Most subjects had orthodontic treatment duration
of more than 1.5 years (100%) and were still wearing fixed appliances (89%). Items included in the
questionnaire: reasons for seeking orthodontic treatment, questions relevant to satisfaction with orthodontic
treatment, doctor-patient relationship and pain experience during orthodontic treatment. Concerning the doctor
patient relationship, 91% of the respondents were contented with their orthodontist. Respondents answered
‘Yes’ to the treatment plan explained prior to the procedure (91.4%), questions answered promptly (94.3%),
gentleness of the orthodontist (91.4%) and dental assistant (88.6%), orthodontist honesty about treatment
duration (90.5%) and cost (97.1%), and recommendation to others (90.5%).
Conclusion: Generally, patients who had received orthodontic treatment from the orthodontic clinic in Faculty
of Dentistry UiTM were satisfied with the overall treatment outcomes. However, there were still some aspects of
the service that can be improved in the future in order to provide a better healthcare services specifically in
orthodontic treatment.

Matched MeSH terms: Physicians
Fulltext A young man with chronic dry cough

Shalihin SE, Osman IF, Harun Z, Mukhali HB, Gnathimin B

Malays Fam Physician, 2020;15(1):68-70.
PMID: 32284811 MyJurnal

In primary care, chest X-rays are commonly performed to assess patients presenting with a prolonged
cough. However, the extent to which the flms are accurately interpreted depends on the skill of the
doctors. Doctors with insufcient experience may miss an exact diagnosis when evaluating a flm,
especially in patients with nonspecifc symptoms, such as in the case discussed in this paper.
( Copied from article ).

Matched MeSH terms: Physicians
Fulltext Utilization and Impact of Electronic and Print Media on the Patients' Health Status: Physicians' Perspectives

Shakeel S, Nesar S, Rahim N, Iffat W, Ahmed HF, Rizvi M, et al.

J Pharm Bioallied Sci, 2017 Oct-Dec;9(4):266-271.
PMID: 29456378 DOI: 10.4103/jpbs.JPBS_327_16

Aims: Despite an increased popularity of print and electronic media applications, there is a paucity of data reflecting doctors' opinions regarding efficient utilization of these resources for the betterment of public health. Hence, this study aimed to investigate the perception of physicians toward the effect of electronic and print media on the health status of patients.
Setting and Design: The current research is a cross-sectional study conducted from January 2015 to July 2015. The study population comprised physicians rendering their services in different hospitals of Karachi, Pakistan, selected by the nonprobability convenience sampling technique. In this study, 500 questionnaires were distributed through email or direct correspondence.
Methods and Materials: Physicians' perception toward the impact of electronic and print media on the health status of patients was assessed with a 20-item questionnaire. Different demographic characteristics, such as age, gender, institution, position, and experience of respondents, were recorded. Quantitative data were analyzed with the use of Statistical Package for Social Sciences, version 20.0 (SPSS, Chicago, IL). The association of the demographic characteristics of the responses of physicians was determined by one-way ANOVA using 0.05 level of significance.
Results: In this study, 254 physicians provided consent to show their responses for research purposes. A response rate of 50.8% was obtained. Nearly one-third of the respondents negated that patients get health benefit using electronic and print media. The majority did not consider electronic and print media as lifestyle-modifying factors. Physicians thought that patients particularly do not rely on mass media for acquiring health information and consider healthcare professionals as unswerving information resource.
Conclusions: Mass media can be productive resources to augment awareness among patients, although physicians seem unconvinced about the extended usage of print/electronic media.

Matched MeSH terms: Physicians
Profile of doctors who participate in continuing medical education in Malaysia

Shahabudin SH, Edariah AB

Med Educ, 1991 Sep;25(5):430-7.
PMID: 1758320 DOI: 10.1111/j.1365-2923.1991.tb00091.x

A random survey of 400 doctors was carried out over a period of 3 months to determine the factors that would facilitate or inhibit the participation of doctors in continuing medical education (CME) in Malaysia. Regular participation in CME was defined as participation in any activity (self-directed reading or attending organized activities) at least once a month during the past year. It was found that 78% of doctors regularly participated in CME. Working in a hospital environment and being members of the Malaysian Medical Association and at least one specialty organization appeared to be important facilitatory factors in CME participation. These doctors also read the local medical journals regularly and subscribed to other journals. In addition, they were more likely to possess postgraduate qualifications and would have teaching, research, diagnostic or clinical responsibilities as major components of their work. They were more likely to practise in the big cities and would tend to be active in at least one voluntary or social organization. If they were in the Government sector, they were more likely to work in the Universities or in the Hospital Division of the Ministry of Health. The 22% who were less likely to participate in CME were general practitioners in the private sector. They worked long hours with day, evening and/or night shifts every day. If the doctors were in the Government sector, they were more likely to be in the Health Division, working in administration and public health, or they were in the armed forces and other organizations such as local councils. They worked in the smaller towns or in the districts.(ABSTRACT TRUNCATED AT 250 WORDS)

Matched MeSH terms: Practice Patterns, Physicians'; Physicians/psychology*; Physicians/statistics & numerical data
Validation of the Physician-Pharmacist Collaborative Index for physicians in Malaysia

Sellappans R, Ng CJ, Lai PS

Int J Clin Pharm, 2015 Dec;37(6):1242-9.
PMID: 26408408 DOI: 10.1007/s11096-015-0200-6

BACKGROUND: Establishing a collaborative working relationship between doctors and pharmacists is essential for the effective provision of pharmaceutical care. The Physician-Pharmacist Collaborative Index (PPCI) was developed to assess the professional exchanges between doctors and pharmacists. Two versions of the PPCI was developed: one for physicians and one for pharmacists. However, these instruments have not been validated in Malaysia.
OBJECTIVE: To determine the validity and reliability of the PPCI for physicians in Malaysia.
SETTING: An urban tertiary hospital in Malaysia.
METHODS: This prospective study was conducted from June to August 2014. Doctors were grouped as either a "collaborator" or a "non-collaborator". Collaborators were doctors who regularly worked with one particular clinical pharmacist in their ward, while non-collaborators were doctors who interacted with any random pharmacist who answered the general pharmacy telephone line whenever they required assistance on medication-related enquiries, as they did not have a clinical pharmacist in their ward. Collaborators were firstly identified by the clinical pharmacist he/she worked with, then invited to participate in this study through email, as it was difficult to locate and approach them personally. Non-collaborators were sampled conveniently by approaching them in person as these doctors could be easily sampled from any wards without a clinical pharmacist. The PPCI for physicians was administered at baseline and 2 weeks later.
MAIN OUTCOME MEASURE: Validity (face validity, factor analysis and discriminative validity) and reliability (internal consistency and test-retest) of the PPCI for physicians.
RESULTS: A total of 116 doctors (18 collaborators and 98 non-collaborators) were recruited. Confirmatory factor analysis confirmed that the PPCI for physicians was a 3-factor model. The correlation of the mean domain scores ranged from 0.711 to 0.787. "Collaborators" had significantly higher scores compared to "non-collaborators" (81.4 ± 10.1 vs. 69.3 ± 12.1, p < 0.001). The Cronbach alpha for the overall PPCI for physicians was 0.949, while the Cronbach alpha values for the individual domains ranged from 0.877 to 0.926. Kappa values at test-retest ranged from 0.553 to 0.752.
CONCLUSION: The PPCI for physicians was a valid and reliable measure in determining doctors' views about collaborative working relationship with pharmacists, in Malaysia.

Matched MeSH terms: Physicians*

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