PRIMARY CARE PHYSICIANS AS EFFECTIVE GATE KEEPER

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Keynote Address by Dato Dr Hasan bin Abdul Rahman, Director of Health,Ministry of Health Malaysia.
At The 15th Family Medicine Conference 2011, Royale Bintang, Seremban, Negeri Sembilan.

The primary care services play an integral role as most of attendances to health services in Malaysia for both government and private health facilities were as outpatient attendances. The health system in Malaysia is facing several challenges such as increasing cost, high patient’s expectation, changing disease burden, accessibility in certain locality, limited resources, etc. In healthcare systems where primary care have an integral role, impressive health gains is achievable with relatively lower healthcare expenditure. With the introduction of a wide array of healthcare technologies and therapies, coupled with the increasing patient expectation, the hospitals and, increasingly, the primary care clinics, will continue to strain the healthcare budgets. It is now ever more important to strengthen the gatekeeping role of primary care physicians to ensure equitable and good quality healthcare for all Malaysians. The main aim for gatekeeping was mainly to reduce the cost of healthcare without affecting the quality. However, issues pertaining providing quality of care and ensuring patients’ satisfaction were doubtful. There are some drawbacks of gatekeeping such as it limit patient’s freedom, reduce patient’s satisfaction and may not be preferred by some specialists in hospital. In Malaysia, even though there is no strict role for gatekeeping yet, the gatekeeping role of primary care physician is still not optimal. Primary care physician face various challenges such as change in disease pattern, increasing disease burden, lifestyle related conditions, human resource, infrastructure, equipment & drugs. Role as effective gatekeeper can still be performed by prioritization, producing local guideline for primary care physician, multitasking, good & effective monitoring and upgrading knowledge & skill in order to provide holistic & comprehensive service to patient & community.

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