My wife went to Jinjang Health Clinic to see a doctor. She complained of blood in her urine. Instead a MA saw her and prescribed medicine as well. It did not seem right. What do you think?
Among the responses are the following:
From palmdoc
Thanks for writing in LKS. I think there were some typos in your feedback and I made corrections as above based on what I thought you meant. If I am mistaken, please correct me.
I presume you are referring to the Government Jinjang Health Clinic as mentioned in Tan Seng Giaw’s blog
The Health Clinic in Jinjang North treats over 500 out-patients daily,covering a radius of over four kilometers with a population of about 300,000. It provides maternal and child care. It is on 999 calls. It treats over 30 drug addicts with methadone.
On 2.12.2007, Dr Tan accompanied some residents to revisit the new Jinjang Clinic that has 10 consulting rooms, six doctors, six medical assistants, no physiotherapist and no occupational therapist. The next day, Dr Tan raised the shortage of doctors and the inadequate facilities in Parliament during the debate on the Supply Bill at the committee stage with the allocation of RM 12.9 billion for the Health Ministry including RM 1.6 billion for public health.
Medical Assistants (MAs) were formerly known as Hospital Assistants (HAs) and they have and still are performing a vital role in the public health service in Malaysia where there is a perennial shortage of doctors. The role of HAs is pretty similar to the role of Physician Assistants in the US where trained PAs are allowed to “conduct physical exams, diagnose and treat illnesses, order and interpret tests, counsel on preventive health care, assist in surgery, and write prescriptions”. MAs are particularly important in the rural clinics where there may be no permanent doctor stationed. Some of these MAs who have worked for years are very experienced in what they do and indeed many a young doctor working in rural areas would have learnt alot from such senior experienced MAs. I recall as a young MO, I learnt the most efficient way to remove a fish hook embedded in one’s thumb from a senior MA working in casualty! Some MAs in Orthopedics would be able to reduce fractures far better than young orthopedic surgeons I tell you. It all boils down to experience.
So, the short answer to your question, LKS, is yes. In Malaysia, an MA can see patients, treat patients and prescribe medicine but only in government clinics. MAs under the PHFSA cannot do the same in private clinics which are expected to be manned by medical doctors at all times as stipulated in their opening hours (under threat of jail or a hefty fine). Double standards for the public sector vs the private sector you might ask? I think the public sector has no choice as there are still insufficient doctors and in any case, for simple or minor illnesses, care by an MA is appropriate.
The issue is many a time, whether an illness is “minor” or “major” hinges on the diagnosis. Whether a young inexperienced MA without an MBBS can diagnose the cause of blood in the urine (medically termed as hematuria) correctly is another matter. Hematuria is commonly due to disorders like urinary tract infection or stones in the urinary tract. It may also be symptomatic of more serious disorders like cancer of the urinary tract or kidneys, glomerulonephritis and in our part of the world sometimes tuberculosis of the urinary tract. So if in doubt, do consult a doctor.
For those interested to know about MAs, you may visit these links:
Malaysian Association of Medical Assistants
Lembaga Pembantu Perubatan Malaysia
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