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PERKEMBANGAN AMALAN PERUBATAN DAN CABARAN OLEH DR MOHD KHAIRI BIN YAKUB PENGARAH AMALAN PERUBATAN KKM Di Seminar Penolong Pegawai Perubatan JKN Pahang, Temerloh, 4 Mei 2007 Amalan Perubatan Tata amalan Perlakuan etika oleh professional kesihatan

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PERKEMBANGAN AMALAN PERUBATAN DAN CABARAN

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Perkembangan amalan perubatan dan cabaran l.jpg

PERKEMBANGAN AMALAN PERUBATAN DAN CABARAN

OLEH DR MOHD KHAIRI BIN YAKUB

PENGARAH AMALAN PERUBATAN KKM

Di Seminar Penolong Pegawai Perubatan JKN Pahang, Temerloh, 4 Mei 2007


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Amalan Perubatan

  • Tata amalan

  • Perlakuan etika oleh professional kesihatan

  • Dalam memberi perkhidmatan jagaan kesihatan


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Tata amalan

  • Yang ditentukan oleh badan pengawal professional berkaitan

    • Lembaga Pembantu Perubatan Malaysia

    • Lembaga Pembantu Hospital Estate Malaysia

    • Majlis Perubatan Malaysia

    • Lembaga Jururawat Malaysia

    • Lembaga Perbindanan Malaysia

    • Majlis Optik Malaysia

    • Lembaga Ahli Farmasi Malaysia

    • Majlis Pergigian Malaysia


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Tata amalan

  • Contoh – kod tatacara, garispanduan, arahan dan keputusan mesyuarat badan professional

  • Ditentukan oleh perundangan

    • Kelayakan dan pendaftaran

    • Hak dan istimewa

    • Tanggung jawab dan kesalahan

    • Hukuman dan penalti


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Perlakuan etika oleh professional kesihatan

  • Kod etika

  • Amalan etika

  • Standard melebihi kehendak undang-undang

  • Bertujuan “self governance” dan menjaga reputasi profesyen


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Perkhidmatan jagaan kesihatan

  • Berkaitan dengan penjagaan pesakit atau pelanggan yang mengharapkan perkhidmatan professional kesihatan

  • Mengharapkan suatu standard penjagaan yang setaraf dengan profesyen kesihatan

  • Jika terjadi kecederaan akibat dari perkhidmatan yang kurang dari standard ini maka terjadilah kecuaian

  • Orang yang tercedera akibat kecuaian layak mendapat pampasan dalam bentuk wang ringgit


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Fakta semasa

  • Kesihatan dilihat suatu perkhidmatan awam

  • Kesihatan boleh didagangkan

  • Ujud industri kesihatan- produk dan perkhidmatan

  • Contoh- hospital swasta 233 buah, pusat h/dialysis 110 buah, 8000 klinik swasta

  • IMP3 – sektor perkhidmatan menyumbang kepada 57% GNP dalam 2020


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Liberalisasi kesihatan negara

  • Perkhidmatan specialties perubatan -13 jenis

  • Pelaburan asing di benarkan 40% untuk hospital 70 katil

  • ASEAN- pelaburan asing 49%, 51%

  • MRA jururawat dan doktor

  • FTA Malaysia- US, Jepun, Australia, NZ


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Perkembangan - konsep

  • Perkhidmatan kesihatan TIDAK boleh dilihat secara sempit iaitu KKM, Kerajaan, atau Swasta. HARUS di lihat dalam konteks negara.

  • Tuntutan hak individu

    • dalam ketidakpuasan hati:

      • Grievance mechanism dalam Akta Kemudahan dan perkhidmatan Jagaan Kesihatan Swasta

      • Complaints mechanism di KKM


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Perkembangan – hak individu

  • Hak individu – contoh consent;

    • Tugas menerangkan fakta berkaitan dengan prosedur, kebaikan, risiko dan alternatif

    • Informasi yang dapat difahami oleh dengan difahami pesakit atau ahli keluarga

    • Mendokumentasi tugas memberi informasi tersebut dan persetujuan pesakit

    • Persetujuan adalah atas kehendak bebas(freewill) pesakit dan tiada unsur paksaan atau ditakut-takutkan.


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Perkembangan – hak individu

  • Hak individu-

    • Hak diberitahu akan perkhidmatan diberikan

    • Hak mengetahui harga perkhidmatan

    • Hak menuntut gantirugi

    • Hak mendapat laporan perubatan / rekod perubatan

    • Hak mendapat rujukan pakar jika diperlukan

    • Hak dijaga kehormatan dirinya


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Perkembangan – penguatkuasaan undang-undang

  • Undang-undang professional

  • Private Healthcare Facility and Services Act 1998 and Regulations 2006

  • Penal Code

  • Tindakan Civil


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Private Healthcare Facility and Services Act 1998 and Regulations 2006

  • Priorities

    • Unregistered clinics

    • Unregistered healthcare professionals

    • Unsafe facilities/ services

  • Unregistered clinics – blatant flouters, deemed unsafe facilities/services rendered

    • RM300,000 or 6 yrs imprisonment or both


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Private Healthcare Facility and Services Act 1998 and Regulations 2006

  • Unregistered healthcare professionals

    • MA running clinics

    • Nurses conducting abortions

    • Foreigners bogus doctors

    • Employed by businessman

    • Employed by doctors

    • In registered clinics or unregistered clinics

  • PIC – RM100,000 or 2 years imprisonment


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Private Healthcare Facility and Services Act 1998 and Regulations 2006

  • Unsafe facilities/ services

    • Temperature control on vaccines

    • Expired medicines

    • Recycled medical devices such as syringes, tubes, etc

    • Contaminated premises

    • Tooth extraction or clinics run by the roadside

    • Poorly maintained medical equipments

    • Unsafe practices e.g. non-sterile procedures


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CHALLENGES

  • Expectation of high professional standards

    • Current medical knowledge

    • Communication skills

    • High ethical standards and compassionate to patients

    • Skillful to patient’s needs and act professionally

  • Know patients’ rights and respect these rights


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CHALLENGES

  • Meet the changing health sector

    • Of liberalisation of the profession

    • Of multi-skill professionals

    • Of continuously gaining respect from the public

    • Of making your profession relevant to present times

    • Of other significant “factors” in health care services e.g. advertisements, MCO, new technologies, life-styles, demography, cost in health care etc.


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Challenges

  • Future medical laws-

    • Pathology Laboratory Act

    • Human Cloning Act

    • Artificial Reproductive Technique Act

    • Allied Health Professional Act

    • Amendments to all the professional Acts


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Suggestions

  • Read (self improvement), read (base knowledge), read (other related fields and interest)

  • Develop communication skills

  • Explore in new areas in medicine or health related areas

  • Be a good team player and a leader

  • Be proud of your organization and profession and live up to its name

  • Reflect on your contribution to the society, family and self


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THANK YOU

[email protected]


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