1. Family Doctor Concept in Klinik Kesihatan Putrajaya Presint 18
Baizury Bashah
Baizury Bashah

2. Content Introduction Principles of Family Doctor Concept, FDC
Family Doctor Service, Putrajaya Precinct 18 Health Clinic model
Challenges

3. Content Introduction Principles of Family Doctor Concept, FDC
Family Doctor Service, Putrajaya Precinct 18 model
Challenges

4. Introduction FDC meant for primary care Starts in public sector
Private sector to follow
Introduced by MOH late 2014
To ensure continuity of care for clients & family
To reduce doctor shopping

5. Introduction Presently > 40 health clinics practicing FDC
Local adaptation
Misnomer - client & population taken care of by a primary health care team, not just a doctor

6. Objective of FDC
Render continuous, comprehensive treatment to individuals & their families
Identify health risk factor, early diagnosis & treatment in order to prevent / reduce morbidity & mortality
Appropriate follow up & timely referrals

7. Content Introduction Principles of Family Doctor Concept, FDC
Family Doctor Service, Putrajaya Precinct 18 model
Challenges

8. Principles of FDC Primary Health Care Team, PHCT
Continuous, integrated, client centered care
Population health

9. 1. Primary Health Care Team
Basic PHCT consists of health care workers from various categories
(Family Medicine Specialist), Medical & Health Officers, Assistant Medical Officers, Nurses, Health Attendants
2 or more PHCTs share the service of other profesionals (comprehensive PHCT)
pharmacist, dietician, nutritionist, DE, medical social worker, physiotherapist, occupational therapist, medical laboratory technologist, radiographer, driver

10. 1. Primary Health Care Team
Enable multi disciplinary treatment approach towards a client with complex problems (bio-psycho-social)
Client centredness
management according to clients' needs
clients' autonomy

11. 2. Continuous, integrated, client centered care
The same PHCT will look after a client
on every visit to ensure continuity of care
regardless of any medical problem / presenting complaint, e.g
acute medical problen like upper respiratory tract infection
from pre pregnancy to ante natal, post natal, family planning
health education, screening, early diagnosis & treatment, follow up of chronic disease

12. 2. Continuous, integrated, client centered care
Case manager (doctor / PT / MSW) to ensure plans are carrried out
Client centered
management according to clients' needs
clients' autonomy, informed decisions

13. Ensure healthy population
3.Population health
Ensure healthy population
Population & family registry
Coverage / Operational area
Health Promotion (1⁰ prevention)
Health talks
Health camps
KOSPEN & KOSPEN Plus
Public health activities - search & destroy aedes breeding places
Screening, early diagnosis (2 ⁰ prevention)
Rehabilitation & palliative (3 ⁰ prevention)

14. Content Introduction Principles of Family Doctor Concept, FDC
Family Doctor Service, Putrajaya Precinct 18 model
Challenges

15. POPULATION Putrajaya SELANGOR Kuala Lumpur Population = 88300*
Population daytime = + 41,700
Area = 46 km2
(1920/km²)
*2015 – unjuran berdasarkan data Banci Penduduk & Perumahan Malaysia 2010

16. HEALTH FACILITIES Screening Centre for ladies
Screening centre for Govt Officers > 40 yrs old
National Cancer Institute
14 Private GPs
2 Private Dental Surgeries

17. Putrajaya Presint 18 Health Centre (Type 2)

18. Types of Clinic – Patients attendance /day
Resident FMS
Wellness
Illness
Emergency
Clinical support
Information support
Mobile Teams
P18HC
Visiting FMS
>1000
Comprehensiveness
<800
<500
<300
<150
<50
Type 1
Type 2
Type 3
Type 4
Type 5
Type 6
Advanced
Intermediate
Universal
Type of Health Clinic/Level of service
BPKK

19. Clinic opened on 2 March 2015

20. Tele Primary Care

21. Initial Services on 2 March 2015 :
maternal & child
walk-in, out patient
infectious diseases
pharmacy
medical laboratory
diagnostic imaging
1 April Follow up of chronic diseases, medical check up, clinical support services (dietician / PT / OT / MSW)
February 2016 – School health service

22. Clinical support services
PHCT PP18 Health Clinic  
Anggerik
Rafflesia  
PPK
AMO
Nurse
AMO SN
PPK Dr
Clinical support services Dr
PHCT Anggerik
PHCT Rafflesia
Sharing basis:
Pharmacist
Dietician
Nutritionist
Medical social worker PT OT
MLT
Radiographer
Driver

23. Continuous & integrated care
Each doctor have to be able to manage :
all kind of medical problems
through out the life course (womb to tomb)
common procedures like basic obstetric ultrasonography, IUCD insertion
HIV pre & post test counseling

24. Continuous & integrated care
Except
infectious diseases - different wing & registration counter
school health service - MOs do some of adolescent health activities
occupational health service
quit smoking service

25. Population health
To facilitate family & population registry, each PHCT looks after a demarcated, operational area
Clients not from the 2 zones will be registered to either Anggerik or Rafflesia, alternately
Community services like domiciliary (home) care, rehabilitation at community based rehab centres are shared between the 2 PHCT

27. Population according to operational area
ZONE
PRECINCT
POPULATION / PRECINCT
TOTAL POPULATION
Rafflesia 5
3691
10474 16
4231 17
2552
Anggerik
(Orchid) 15
1978
10454 18
8352 19
124
Total population
20,928

28. Clients according to home address June 2017 (19 working days)
State
Number of clients
Percentage %
Putrajaya
10457
75.1
Selangor
3028
21.7
Kuala Lumpur
217
1.6
N Sembilan
142
1.0
Others 86
0.6
TOTAL
13930
100.00

29. Content Introduction Principles of Family Doctor Concept, FDC
Family Doctor Service, Putrajaya Precinct 18 model
Challenges

30. Challenges
Doctors need to be competent in managing all type of illness
continuous training, C&P, audit
encourage MMed / Graduate Certificate FM / MAFP-FRACGP
Multidisciplinary team meeting
to get a full quorum, especially 1-man-show professionals (dietician / MSW)

31. Challenges Family & population registry
No specific family registry in TPC, need other software
Outreach activities to capture individuals & families in the community, work with
Clinic advisory panel
KOSPEN volunteers
Data from school health service

32. Q&A Comments

33. drbaizury@moh.gov.my baizuryfms@yahoo.com
Thank you