Malaysian Medics International expresses concern about implementation of ‘Zero HO Protocol’

KUCHING (Jan 21): The Malaysian Medics International (MMI) is deeply concerned about the implementation of a ‘Zero HO (house officers) Protocol’ highlighted by CodeBlue recently.

MMI executive co-chair Kavilan Murthi said the protocol within the medicine department of the Universiti Malaya Medical Centre (UMMC) aimed to address the critical shortage of HO in different medical units as the services provided by HO were prioritised based on departmental workload.

He noted that the protocol was, among others, to encourage medical officers (MO) to perform procedures like IV cannula insertion and blood tests themselves to emphasise clinical judgement and discourage unnecessary test requests.

“Another key point of the protocol being the emphasis on mindfulness during patient admission as patient management is the responsibility of the admitting doctor,” he said in a statement today.

Kavilan pointed out that HO and MO are the grassroots of the healthcare system to achieve peak efficiency.

He said increased workload on the existing staff was leading to burnout, adversely affecting their overall well-being.

“Service reductions or cuts to cope with the strain could potentially compromise access to crucial medical services for patients, raising serious concerns about healthcare delivery and patient safety,” he cautioned.

He thus urged the Ministry of Health (MoH) and Ministry of Higher Education (MoHE) to adopt a targeted approach to involve expediting the intake of medical graduates into the housemanship system for a quicker transition from graduation to practical training.

He believed that this would overcome the “brain dead” issue which had been a concerning trend in the healthcare system.

He observed that Singapore offers a shorter time between graduation and work compared to waiting around six months in Malaysia.

With a shorter gap, Kavilan said more medical graduates are able to work sooner to reduce the shortage of HO.

“Task delegation, focusing on critical departments, is crucial for effective management without compromising quality. Public hospitals should identify critical departments that are particularly affected by the shortage and maldistribution of HO, as it would allow task prioritisation based on urgency and importance.

“Task delegation should focus on ensuring that essential responsibilities are managed effectively without shortage drawbacks. This emphasises the need for immediate attention and comprehensive strategies from healthcare authorities to rectify this concerning trend and fortify the resilience of the healthcare system,” he added

He also called for efficient collaboration between MoH and MoHE to bridge gaps and ensure better healthcare outcomes.

He asserted that clear communication with specific objectives and anticipated outcomes are necessary to foster a more cohesive and effective healthcare system.

He said the two ministries should collaborate on implementing interdisciplinary training programmes for medical students, tailored to their academic schedules to provide essential skills learning for them.

Towards this end, he believed that the workload among healthcare workers can be reduced by providing opportunities for medical students to sharpen their skills under supervision.

“Moreover, assessing the skills and competencies of available healthcare professionals ensures that responsibilities are delegated to individuals with appropriate expertise.

“This diversified approach ensures a more efficient distribution of tasks, compensating for the diminished workforce and minimising the impact on patient care. Early intervention at the foundation level can mitigate the issue of doctor shortage,” he said.

Kavilan appealed to both MoH and MoHE to promptly consider and address these issues.

“While this protocol might be perceived as a temporary drastic measure taken to cope with the decrease in HO or MO, it could impact the present and future of Malaysia’s healthcare sector,” he added.