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The Federation of Private Medical Practitioners Associations of Malaysia (FPMPAM) has received several reports alleging that some private hospitals, MCOs and third party payers may have policies or directives that contravene the Code of Professional Conduct (Code) of the Malaysian Medical Council (MMC). 

As in a recent case, a doctor was sacked by the Management of a private hospital when he reported the wrongdoings of the hospital to the MMC. The said doctor then sued the hospital for wrongful termination. The court subsequently found the hospital had acted wrongfully in the said case.

The Private Health Care Facilities and Services Act (PHFSA) require all private healthcare facilities board of management to comply with the requirements of the MMC’s Code. The provisions in the PHFSA include, among others:

1. Section 44 (g) which states “The Director General may issue the show cause notice in section 43 if he is satisfied that it is expedient so to do on the ground that the holder of the approval or the licensee or the holder of the certificate of registration, as the case may be, has established or maintained policies or issued directives that result in healthcare professionals contravening the code of professional conduct of the medical, dental or nursing or other healthcare profession issued by the Malaysian Medical Council…”
2. Section 78 (a) states “The licensee of a private healthcare facility or service shall ensure that the medical and dental management of patients vests in a registered medical practitioner and a registered dental practitioner respectively”
3. Section 83 (1) states “The licensee of a private healthcare facility or service or the holder of a certificate of registration shall not enter into a contract or make any arrangement with any managed care organization that results in -

(a) a change in the powers of the registered medical practitioner or dental practitioner over the medical or dental management of patients as vested in paragraph 78(a)…
(d) the contravention of the code of ethics of any professional regulatory body of the medical, dental, nursing or midwifery profession …”

Similarly, all doctors practising in private hospitals and other private healthcare facilities are required to comply with the MMC’s Code, its guideline Duties of a Doctor, comprising Good Medical Practice and Confidentiality, and the MMC’s other guidelines.

Section 2.2.2 of the MMC’s Code states “A practitioner may not improperly disclose information which he obtained in confidence from or about a patient.”

Section 3.2 of Good Medical Practice states “In the final analysis, good medical practice dictates that the doctor must exert all in his powers to preserve patient confidentiality. The information that the doctor has come to possess is, in the first place, through the patient's voluntary revelations and consent to submit to physical examination and diagnostic investigative procedures. It is the patient's belief that such information will be kept private and used solely for his benefit.”

The duty of confidence is enunciated in detail in the MMC’s document Confidentiality. The doctor still has an obligation to keep personal information confidential after a patient dies.

The FPMPAM calls on all parties to always ensure that patients’ rights and interests are paramount and desist from policies and/or directives that contravene the MMC’s Code.

The FPMPAM will support all necessary action by doctors who refuse to enter into such contracts that may result in them breaching the law. This will include seeking legal recourse to support doctors who have been victimised because they have refused such contracts.

We urge that all such contracts be forwarded to the Medical Practice Division, Ministry of Health for vetting and for record as required by PHFSA.

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For further information or media enquiries, please contact:
Dr. SC Ng
Medical Affairs Committee
FPMPAM