The main purpose of this book is to introduce Primary Care and Primary Care Physicians to the general public; the historical background of this specialty, the different roles and functions of primary care physicians and public health specialists in the Malaysia healthcare delivery system. This book briefly touches on the Non-Communicable Diseases (NCDs), the health and economic impact of these chronic diseases in the heavily subsidized health sector such in Malaysia. And the new national strategy played by the Primary Care Physicians as the frontline in battling NCDs in the communities, families, and individuals

Syed Alwi, Alhabshee

Unimas Institutional Repository

 Front coverPRIMARY CARE PHYSICIANTHE PATH I CHOSESYED ALWI ALHABSHEE© UNIMAS Publisher, 2021All rights reserved. No part of this publication may be reproduced, stored in retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the publisher.Published in Malaysia byUNIMAS Publisher,Universiti Malaysia Sarawak,94300 Kota Samarahan,Sarawak, Malaysia.Printed in Malaysia byLot 2050, Jalan SwastaPending Industrial Estate93450 Kuching, Sarawak,MalaysiaPerpustakaan Negara Malaysia                        Cataloguing-in-Publication Data Syed Alwi Syed Abdul Rahman AlHabshee, 1963- Primary Care Physician :  The Path I Chose / Syed Alwi Syed Abdul Rahman AlHabshee.ISBN 978-967-2298-54-0  1. Primary care (Medicine).2. Chronic diseases.3. Health services administration.4. Government publications --Malaysia.I. Title.616vList of Figures vii List of Tables viiiPreface ixAcknowledgement xiChapter 1 How i became a primary care physician: from house officer to family medicine specialist1Introduction 1From medical officer to general practitioner in private practice3Joining Universiti Malaysia Sarawak students health centre4Lecturer in the faculty of medicine and health sciences4Chapter 2 The primary care 7What is primary care? 7Primary care practice 8Primary care physician 9Contentsviii List of Tables3.1 Number of doctors in public and private health facilities in 2018233.2 Primary care healthcare facilities in 2018 (government and private)233.3 Outpatient attendances in public, private health facilities and maternal child health centre in 2018243.4 Programme offered at health centre 244.1 Prevalence of selected ncds risk factor in malaysia for adults’ age 18 years and above, 2006 to 2019.314.2 Total number of klinik kesihatan with family medicine specialist  314.3 Total number of primary care physicians (fms/fracgp/mrcgp) graduated from 2015 324.4 Projected family medicine specialist (fms) to population ratio needed by Malaysia 33ixPrefaceThe main purpose of this book is to introduce Primary Care and Primary Care Physicians to the general public; the historical background of this specialty, the different roles and functions of primary care physicians and public health specialists in the Malaysia healthcare delivery system. This book briefly touches on the Non-Communicable Diseases (NCDs), the health and economic impact of these chronic diseases in the heavily subsidized health sector such in Malaysia. And the new national strategy played by the Primary Care Physicians as the frontline in battling NCDs in the communities, families, and individuals.xiAcknowledgementI wish to express my appreciation to Universiti Malaysia Sarawak for giving me the opportunity and continued support for my career in a field that I love. My appreciation also goes to the Faculty of Medicine and Health Sciences, UNIMAS for all the support they have given me. My heartfelt thanks go to my colleagues from the Department of Family Medicine, UNIMAS, especially for a great team work that all have shown. Special thanks to Professor Dr. Syed Hassan bin Syed Ahmad AlMashoor for my official debut in the academic life and for all the continuous support throughout my career in the faculty.To my wife Dr Siti Rubiah binti Zainudin and my children Syed Hafiz, Sharifah Nafisa and Sharifah Sakinah, my deepest gratitude for all the encouragement, support and patience you have shown throughout my career.  1Chapter 1How I Became a Primary Care Physician: From House Officer to Family Medicine SpecialistIntroductionMy career as a medical doctor began 30 years ago as a House Officer at Seremban General Hospital. A few years later, after upgrading and rebranding, it was later changed to Seremban Hospital by the Ministry of Health. I did not know how I ended up being a medical doctor. If I had a choice, I would have chosen another career, perhaps engineering or something more technical. The journey began with my good examination performance in my 1st and 2nd semester during my Asasi Sains. Hence, I was streamed into Biological Science instead of Physical Science. My late mother was overwhelmed with the news as she had always wanted me to be a doctor. As the youngest member in the family, she managed to talk me into accepting it. (Figure 1.1)Housemanship was only for a year in those days. The attachment usually lasted around three to four months on a few major clinical disciplines or specialties such as Internal Medicine, Surgery, Obstetrics & Gynaecology 2Primary Care PhysicianThe Path I Choseat Seremban Hospital. I became familiarised and started to understand the health care delivery system in Malaysia during my housemanship days. As a tertiary care or referral centre, Seremban Hospital was very busy. Most of the patients admitted were in acute or critical stages, hence given curative care. After stabilisation, they would be discharged. The patients would usually have a few follow-up sessions with the specialists or medical officers before they were discharged from departmental care. There were no long-term or continuity of care at the hospital level except for certain cases. The health services given at the tertiary hospitals were very fragmented where patients were not treated as a whole individual but rather as a disease or condition. The doctor-patient communication was very poor. Most of the time the family members were left in the dark and not knowing what happened to their loved ones. Then, I realised that hospital-based was not how I wanted to spend my medical career. Upon completion of my housemanship, I was posted to Kajang Hospital, a Secondary Care Facility. I was with Kajang Hospital for 2-3 years before transferred to Pusat Kesihatan Besar Seri Kembangan, a primary care centre as a Health and Medical Officer. As a Health and Medical Office who was in charge of the centre it became clearer to me that MOH has an established and good health care delivery system. The primary care delivery system was well coordinated, easily accessible, integrated, and gave continuity of health care for individuals, families, and the community level.     Seri Kembangan is a township, and the primary care centre was very busy with 400-500 patient visits per day, I enjoyed working at the centre. Throughout the years at the centre, I had made up my mind that if I was ever going to do my postgraduate study, I would be going to do Primary Care or Family Medicine as my specialty.  35ReferencesAdeyi O, Smith O, Robles S: Public policy and the challenge of chronic non communicable diseases. World Bank, Washington DC; 2007. http://siteresources.worldbank.org/ INTPH/ Resources/ PublicPolicyandNCDsWorldBank2007 FullReport.pdf Ageing Population Will Create Opportunities for Drugmakers.https://www.fitchsolutions.com/corporates/healthcarepharma/malaysias-ageing-population-will-create-opportunities-drugmakers-15-01-2020British Medical Association (BMA). Safe Working in General Practice. BMA, London, 2016. file:///C:/Users/user/Downloads/20160684-GP-safe%20working-and-localityhubs%20.pdf Brown AD, Upshur R, Sullivan TJ. Public Health and Primary Care: Competition or Collaboration. Healthcare Papers. 2013; 13(3): 4-8. DOI:10.12927/hcpap.2014.23690Cheong AT, Tong SF, Sazlina SG, Azah AS, Salmiah MS: Blood pressure control among hypertensive patients with and without diabetes mellitus in six public primary care clinics in Malaysia. Asia Pac J Public Health. 2013; Epub ahead of print. DOI:10.1177/1010539513480232 Demographic Statistics First Quarter 2020. Malaysia Departmen of Statistics.Malaysia.https://www.dosm.gov.my/v1/index.php?r=column/cthemeByCat&cat=430&bul_id=aFYzVjJ3anNyQytHZGxzcUZxTG9Ydz09&menu_id=L0pheU43NWJwRWVSZklWdzQ4TlhUUT09Department of Health, United Kingdom. Transforming Primary Care: safe, proactive, personalised care for those who need it most. National Health Service (NHS) England. Crown Copyright 2014. https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment data /file/304139/Transforming_primary_care.pdf Back Cover

Primary Care Physician The Path I Chose

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