Clarify GPs’ Role In Home Monitoring Covid-19 Patients: MMA

The Malaysian Medical Association asks the Ministry of Health for minimum RM35 daily remuneration for private general practitioners (GPs) to issue home surveillance orders and to monitor Category 1 and 2 Covid-19 patients at home.

KUALA LUMPUR, March 4 — Private general practitioners (GPs) have asked the government to clearly explain their proposed role in ordering home surveillance and monitoring asymptomatic and mild Covid-19 patients.

The Malaysian Medical Association (MMA) said it and other doctors’ groups welcomed the Ministry of Health’s (MOH) proposal to get GPs to participate in home monitoring, issuing quarantine and home surveillance orders (HSO), assigning pink wristbands, and issuing release letters for category 1 and 2 coronavirus patients.

MMA, on behalf of GPs, however, asked for a well defined job description to avoid miscommunication and misunderstanding.

“Time and duration of consultation, legal encumbrances on teleconsultation, indemnity coverage, and face-to-face consultation prior to a teleconsultation must be addressed too,” MMA said in their February 8 letter to Dr Norhayati Rusli, director of disease control at MOH’s disease control division, as sighted by CodeBlue.

The doctors’ group also asked for private clinics to be linked to a dedicated district health office (PKD) for administrative issues and a family medicine specialist for clinical consultation.

“It is also prudent to identify the referral hospital for the area of jurisdiction for each GP, with direct contact made available together with the infectious disease (ID) physician,” the letter stated.

MMA also proposed to MOH for a remuneration of minimum RM35 per day to cover GPs’ consultation and daily follow-ups with Covid-19 patients according to the home surveillance checklist.

“As the patients and their caregiver who may be among their family members will be anxious, we anticipate a typical 10 to 15 minutes consultation which will also cover our advisory role,” MMA said.

Besides that, the GPs also highlighted that they could assist MOH to screen close contacts of positive cases at a negotiated price.

“As the cost of practice and the cost of RT-PCR lab vary based on the lab, region, and the volume done, it is prudent that the respective PKDs to negotiate with the participating clinics in that area. We can assist you in negotiating the price if you deem necessary.”

MMA stressed that conducting a screening doesn’t just involve the cost of the test kit, but also personal protective equipment (PPE) for the doctors and their team, sanitisation, and proper waste disposal, as well as high level laboratory costs that vary from RM120 to RM230 for RT-PCR test itself.

The GPs suggested for a pilot run to be first conducted among 925 private clinics that have self-declared to conduct Covid-19 testing, which can then be reviewed on a weekly basis in order to fine-tune the process for seamless and good delivery of care to patients.

MMA said during a recent Covid-19 webinar on February 6 among GPs and MOH, out of the 1,100 participants, 795 participants were keen to participate, among which 574 of them have self-declared.

MOH’s family health development department responded to MMA on February 16, asking GPs who are interested in issuing HSO and do home monitoring of Covid-19 patients to provide their details to them.

Suzana Kipli, health nurse supervisor from the clinical support sector at MOH’s family health development department, added that for the moment, MOH is currently referring to a list of private medical practitioners who screen and diagnose people for Covid-19.

“For your information, currently there is no compensation given by MOH to private clinics who opt to provide this service,” Suzana said in an email to GPs, as sighted by CodeBlue.

Later, MOH’s infectious disease head Dr Norhayati, in a letter to MMA secretary-general Dr R. Arasu on February 24, said that since there is an urgent need for private GPs to issue HSO and undertake home monitoring of Covid-19 cases, MOH will recruit such health care providers according to its existing name list.

“Meanwhile, negotiations with MMA will continue to discuss what is an appropriate fee for outsourcing the monitoring of Covid-19 cases at home,” Dr Norhayati said in her letter, as sighted by CodeBlue.

“At the same time, MOH has also conducted some stakeholder engagements with a few other medical associations. Some associations, clinic groups, and individuals have expressed interest in assisting MOH.”

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