General practitioners (GPs) in the private health sector are in the midst of discussions with the Malaysian Health Ministry to plan a bundle system that will reduce medical costs and ensure fair, transparent, as well as more regulated fees for better patient care, according to Health deputy director-general Dr Jeyaindran Sinnadurai.

“The GPs would adopt a system that ensures fair, transparent and standardised charges with better care and taking into account patient safety,” he said.

“In this way, simple, moderate and complex cases, would have different rates, respectively.”

Bundling system to improve healthcare costs

Just last month, Jeyaindran announced that new guidelines pertaining to a bundle system for the “Top 10” causes for patients’ admissions to public hospitals would soon be implemented as a strategy to reduce healthcare costs.

According to the president of the Malaysian Medical Association (MMA), Dr John Chew, a proposal has already been extended to package consultation, diagnosis and treatments for common ailments in order to simplify procedures and manage costs.

“We are also working with Third Party Administrators and insurance companies to standardise fees and drug prices,” he added.

Recent bundling simulation exercises for over 130 common ailments in primary care clinics revealed an overall cost reduction for almost 80% of patient visits, according to Dr Raj Kumar Majaharajah, vice-president of the Medical Practitioners Coalition Association of Malaysia (MPCAM).

“If more diseases were managed at the primary care level, healthcare costs and insurance pre¬miums would be low because it would prevent unnecessary hospital visits,” he added.

MPCAM vice-president : Increase professional fees for GPs

In addition to the bundling system, discussions are ongoing between the MPCAM and the Ministry of Health (MOH) to increase the roles of GPs.

“We also talked about senior doctors practising from home instead of a registered clinic, rates for follow up visits, credentialling and privileging for certain procedures like circumcision,” said Raj, adding that the MPCAM also proposed for GPs to provide emergency home visits to the elderly.

According to Raj, independent GPs are struggling to stay afloat, and many have been forced to close their practices due to increasing overheads, consumables, medicine, medical devices, staff salaries as well as licensing fees.

“Medicine prices increase every six months but GP fees haven’t increased for decades because we empathise with patients,” he also said, stressing that the professional fees for GPs should be increased.

Chew also agreed to the review of GP fees, highlighting that the Consumer Price Index has increased by 40 points in the last 20 years. GPs also end up financing the rising medical liability insurance premiums as they are unable to pass the cost of GST to patients.

GP fees still based on regulations from 1997

In 2012, a 14.4% fee hike under an amendment to the 13th Schedule of the Private Healthcare Facilities and Services (Private Hospitals and Other Private Healthcare Facilities) Regulations 2006 was approved by the Cabinet. However, this was only applicable to specialists and not to GPs.

According to Raj, the allowed patient fees for GP are still based on the 1997 MMA Fee Schedule.

MPCAM has proposed to allow GPs to implement charges between RM30 and RM125 per patient visit, depending on the severity of the medical problem and time spent with patient.

“But even with higher GP fees, patients won’t have to pay more if we standardise medicine prices and implement bundling,” Raj assured.

“What they’re asking for isn’t exorbitant,” he added. “It’s in line with what other professionals are charging.” MIMS

Read more:
A look at healthcare systems across Asia
Malaysia to introduce "bundling system" in hospitals to keep healthcare costs down
The rising costs of traditional medicine in Malaysia
Improvements needed in the contrasting healthcare systems of Malaysia and Singapore
Malaysia’s MOH to cut costs by sourcing more generic drugs