KUALA LUMPUR, Oct 6 — The Association of Private Hospitals Malaysia (APHM) has told a third-party administrative (TPA) that clinicians hold the ultimate authority to decide which anaesthesia to use during surgeries.
The association representing private hospitals in the country pointed out that certain patient conditions or circumstances may require general anaesthesia (GA), even though some procedures can usually be performed under local anaesthesia (LA). Hence, requiring justification for GA could disrupt treatment and care.
“The physician is required to advise the insurer that the patient needs the procedure under general anaesthesia; this communication is for administrative purposes only and should not be interpreted as insurer authorisation or used to limit the clinician’s independent medical judgment,” APHM president Dr Kuljit Singh told CodeBlue in a statement yesterday.
CodeBlue reported last Thursday an October 1 memo by MediExpress (Malaysia) Sdn Bhd to panel hospitals to prioritise LA as the first-line anaesthesia modality over GA for daycare procedures and surgeries, telling health care providers to provide a “detailed justification” of the need for general anaesthesia.
APHM said treating physicians at a private hospital usually take into account the patient’s overall condition, existing comorbidities, and the specific risks associated with the procedure in prescribing the appropriate choice of anaesthesia.
“The clinical judgment of treating physicians is important as inappropriate anaesthesia prescriptions can result in serious morbidity or even mortality,” said Dr Kuljit.
“Payers can always request clinical justification for the use of GA or LA, but must not override the clinical judgment of the treating physician as patient safety must always remain the highest priority.”
Dr Kuljit also cited the Federal Court’s landmark ruling in 2024 that held private hospitals liable for medical negligence, beyond individual doctors, as the apex court rejected the defence of doctors acting as “independent contractors”.
The Federal Court’s verdict essentially puts hospitals in the same boat as doctors in terms of medical liability.
Half a dozen medical groups, including the anaesthesiologist fraternity, have condemned MediExpress’ LA-first policy as a threat to patient safety.
