MAB Report
(4 May 1998 to 18 November 1998)
Contents
- On-Call Room in OT
- Penalty Charge for Delayed Commencement of Surgery
- Consent Form for Operations
- CME Contributions
- Private Health Care Facilities Act
- Medical Staff Education Fund
- Patients Seen in Emergency Room But Not
Admitted
- Professional Charges for Taking of Consent
for Imaging Procedures
- Recredentialling
- Booking of Patients for Surgery
- Monday Lunch for Doctors
- Legionella
- New Hospital Information System (HIS)
- Change in Affiliation Status
- Phantom Admissions
- Price Increase
On-Call Room in OT
4 May 1998
Dr. Jacon Thomas announced that an on-call room in the OT, separate from the one
used by the OT staff, had been identified for use by doctors. This room will be
locked in the daytime and will be open from 18:00 h onwards for use by the
medical staff at night.
This idea had been brought up by one of the surgeons. Question is, how many
times has that surgeon availed himself of the facility since its introduction?
In fact, did any of you even know of its existence?
Penalty Charge for Delayed Commencement of
Surgery
15 April 1998
Unfortunately, the OT subcommittee has deferred indefinitely, the implementation
of the scheme to impose a charge for surgeons who delay the commencement of
surgery without any good reasons.
Consent Form for Operations
15 April 1998
A new consent form was discussed in the OT subcommittee but some reservations
were expressed concerning the wording and so its implementation was delayed
until Dr. Jacob Thomas had clarified with Shearne Delamore the legal
implications.
9 September 1998
Meanwhile, Dr. Jacob Thomas comfirmed that there was no limitation on the
duration of validity of a consent form. He, in fact, revealed that the lawyers
had told him that a verbal consent was equally valid but that doctors must
document this in their notes.
CME Contributions
15 April 1998
The MAB confirmed that all courtesy staff had to pay the full RM300 annual
contribution to the CME fund. There would not be any waivers or reductions
entertained, regardless of the quantum of activity of the courtesy staff in the
Hospital.
Private Health Care Facilities Act
6 May 1998
This act has been passed by Parliament recently. Some of its more controversial
clauses include,
- The Minister of Health would have the authority to determine the quantum
of social obligations to be contributed by the various healthcare
facilities.
- The setting up of healthcare facilities, other than clinics, would require
licencing which would be dependent on the zoning of the area as determined
by the Ministry of Health.
- While clinics would have to meet certain minimum standards, they would not
be subject to zoning and registration would, for all intents and purposes,
be automatic.
- The Minstry of Health had the authority to introduce a compulsory Schedule
of Fees for both healthcare facilities fees and professional fees. They are
presently reviewing this and may introduce this at any time.
Medical Staff Education Fund
9 July 1998
For the information of members, the Administration revealed that as of 1 July
1998, the balance of the Medical Staff Education Fund stood at RM 137 071.30.
Any ideas of how we could utilise part of this fund?
Patients Seen in Emergency Room But Not
Admitted
9 September 1998
The Medical Officers complained of a case where the consultants had all been
less than helpful involving a case where the patient had to transferred out of
the hospital because the ICU and CCU were full. In fact, the MO's expressed the
view that the registrar at the Kuala Lumpur Hospital had been more helpful than
any of our consultants.
The MAB decided that all consultants should respond positively when contacted
for assistance. If they felt that they need not come in to see the patient, they
should,
- Ask the Medical Officer directly whether he felt that the consultant
should come in to see the patient, and
- At the very least, give his professional advise on how the patient should
be managed before and during the transfer.
Professional Charges for Taking of Consent
for Imaging Procedures
9 September 1998
The MAB felt that as was the case in all other specialties, there should not be
an additional charge for the taking of consent as this had already been
incorporated into the charge for the procedure. This was evident from the
practise of, for example, the anaesthetists doing epidurals or physicians doing
gastroscopies. However, they were free to charge for the setting up of an IV
line if one had been required.
Recredentialling
9 September 1998
The OT Subcommittee issued a reminder to all doctors to practise within the
boundaries of the procedures that they had been credentialled for. If they felt
that they wanted to expand their clinical horizons, they should apply to the
Credentialling Committee for approval first.
Booking of Patients for Surgery
9 September 1998
The OT Subcommittee reminded doctors that all patients should be examined by the
operator and that consent should be personally taken by the operator prior to
booking the case for surgery as had been stipulated in the OT Handbook.
Monday Lunch for Doctors
9 September 1998
In line with the austerity drive, the MAB agreed that the Monday lunch would be
scrapped. In its place, vendors would be encouraged to hold their videos and
talks on Mondays. Dr. Loh has also suggested that non-medically related lunches
be also held.
Legionella
21 October 1998
Dr. Jacob Thomas told the MAB that the South Tower Cooling Towers had now been
cleared of all Legionella after retreatment.
New Hospital Information System (HIS)
21 October 1998
Ms Elaine Cheong agreed to reinstate the inclusion of the corporate discount
schemes on the registration sheet for the information of all consultants.
However, this could not be done in the case of patients who did not have
the proper documents, like their guarantee letters, at the time of admission.
Further, the system was designed such that if a doctor had charged more than the
amount allowed under the relevant billing discount scheme, the discount would
only appear when the patient was discharged.
She also agreed to ensure that Day Care patients would not be billed as
inpatients.
Change in Affiliation Status
18 November 1998
Dr. Lim B P had applied to change his affiliation status from courtesy to
active. Based on the relevant SOP, it was decided that he was elgible to
participate in the on-call duty roster.
However, to provide clearer guidelines on future cases, the MAB decided on
the following:-
- Entry of new doctors into SJMC should always be based on the merits of an
individual doctor and not on his partnership or affiliation with past,
current, or future consultants in SJMC;
- Any requests by doctors for a change in affiliation status from courtesy
to active will not be automatic and wil need to be reviewed by the C & Q
Committee;
- Any change in Category status of active staff, for example from Category C
to Category B, will need to be reviewed by the C&Q Committee, in
particular with regard to eligibility for calls.
Phantom Admissions
18 November 1998
Because of the apprehension of the term phantom admissions as expressed
by several insurance companies, the hospital has decided to reclassify such
admissions as ambulatory admissions. There is no actual change in
procedures nor in charges. Only the name has changed. Doctors must request for
this classification at the time of admission.
Price Increase
18 November 1998
The hospital has budgeted an overall price increase of 7 % which includes an
increase for doctor's charges as well. This was necessitated by an inflation
rate of 15 % and cost increases of up to 129 %.
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