KUALA LUMPUR, April 16 — One out of two private general practitioner (GP) clinics in Malaysia contemplated shuttering their practice if the Covid-19 crisis caused significant financial losses, a survey showed.
The survey among 806 private GPs and family physicians, which represents about 12 per cent of some 7,000 GPs nationwide, found that 78.8 per cent faced immediate and long-term financial constraints in running their practice.
The Primary Care Collaboration Survey on Covid-19, as sighted by CodeBlue, was conducted from April 11 to April 14 by the Academy of Family Physicians of Malaysia, the Malaysian Medical Association, the Medical Practitioners Coalition Association of Malaysia, the Malaysian Muslim Doctors Organisation (Perdim), and the Private Medical Practitioners Association of Selangor and KL.
Half of family doctors reported getting only a quarter of their usual patient load during the Covid-19 epidemic. Two out of 10 family physicians, or 21.7 per cent, reported not getting any patients at all on most days.
Some 16.7 per cent said the coronavirus outbreak has halved their patient load, while 11.8 per cent said the number of patients visiting them has declined to 75 per cent of their usual crowd. Only 1 per cent said their patient visits either stayed the same or grew during the Covid-19 epidemic.
Most GPs surveyed, at 90.2 per cent, said they have either reduced or considered cutting further their clinic operating hours.
More than a third of respondents, or 34.8 per cent, said they were planning to reduce their staff. Over a quarter of GPs surveyed, or 26.1 per cent, were negotiating salary reductions for their staff. Some 28.8 per cent said pay cuts were being negotiated with their doctor or locum, a temporary physician.
Malaysia imposed a nationwide partial lockdown from March 18 until April 28. Since April 1, the Movement Control Order (MCO) prohibits people from generally travelling beyond 10km from their homes, unless for health care purposes or to buy food and daily necessities if there are no nearer facilities.
On whether respondents considered closing their clinic during the MCO, 61 per cent said they did not.
The majority of respondents, or 67.6 per cent, complained about delays in payment from managed care organisations, which are bodies that manage companies’ health care plans for employees. Nearly a third, or 31.7 per cent, said they have applied for delayed payment to their vendors and suppliers.
About 80.1 per cent of family doctors surveyed have not implemented teleconsultations in their practice. A vast majority at 92.7 per cent suggested applying for tax rebates for this year.
Personal Protective Equipment (PPE) Coverage
Most GPs surveyed, or 94.2 per cent, did not screen for Covid-19 using swabs for lab PCR tests, while 96.8 per cent said they did not test for coronavirus using the rapid test kit for IGM/IGG antibodies.
On a question about whether family physicians were sufficiently equipped with PPE in their practice, 52.4 per cent said they had face masks and shields, 34.7 per cent only had face masks, 11.8 per cent had a full PPE set “sometimes”, while 6.6 per cent had complete protective gear daily. Only two per cent reported not having any PPE at all.
On whether clinic staff had enough PPE, 45.5 per cent of family doctors said their workers only had face masks, 44.2 per cent said their staff had face masks and shields, 8.6 per cent reported full PPE for their staff “sometimes”, and 6.2 per cent said their workers had full PPE every day. Just 2.1 per cent said their staff completely lacked protective gear.
Health director-general Dr Noor Hisham Abdullah said last Saturday that medical practitioners should wear face masks when treating patients not suspected of coronavirus infection, while health care workers seeing confirmed Covid-19 cases should don PPE.
Most GPs in the survey, or 84 per cent, reported physical, mental, social, and psychological impacts on them and their staff during the coronavirus epidemic.
Some 93.7 per cent of respondents felt that the government has not been supportive enough of private GPs and family physicians.
The survey of 806 respondents included solo practitioners (70.7 per cent), physicians in group practice (20 per cent), and freelance or locum doctors (11.2 per cent). The majority, 66.4 per cent, were male, while 33.6 per cent were female.