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BulletinMalays ian Medical Counci l

KDN:UKP 100-3/3 Jld.2-(29)

01-2008

by the public to move rapidly to regulate itself when issues that worry the public emerge i.e. matters that may suggest that the profession is deviating from the high standards it has set for itself.

An article in one of our newspapers announced that an organisation is shifting its biotechnology manufacturing plant from Slovakia to Malaysia. The cost incurred would be RM280 million over 3 years. The article continued to state that 100 cases involving stem cells have been treated in Malaysia at a cost of RM 26,000 each onwards. It was claimed that the therapy could cure diabetes, hormone deficiency disorders, early menopause, male and female infertility, immune deficiency disorders such as AIDS, cancer and autoimmune diseases, aging diseases including menopause, impotence and depression, cirrhosis of the liver and chronic hepatitis as well as regeneration of damaged cells and tissues.

This company would be sourcing the stem cells from rabbit fetuses which would be inbred with claimed minimal exposure to vectors of infectious disease. Recently, there were even more outrageous claims of cure using stem cell therapy. What should be the response of our profession to such news items? Both the Ministry of Health (MOH) and the MMC will not endorse the practice of non-evidence based therapies practiced outside the context of clinical trials.

There are in existence well defined research guidelines that govern the conduct of clinical trials. The MOH has made it mandatory for all its clinicians intending to conduct research to have approved GCP training so that they fully understand the importance of discipline and accountability when conducting clinical trials and that the safety of human subjects and data integrity are paramount. Human subjects must know their rights and be fully informed of all issues pertaining to research and all the relevant information about the product or procedure in question. Consent forms used in research make this clear to the research participants. When innovative or emerging therapies are translated into clinical practice,

PRESIDENT’S FOREWORD:

T he Malaysian Medical Council (MMC) has issued a set of nine guidelines on various professional areas of concern. The profession must be seen

TCONTENTS

President’s Foreword

Editorial Reflection

Mediation

Secretary’s Report

Highlights of meeting with HonourableMinister of Health

Stop Press !

Editorial Board

Editor:Dr. Milton Lum Siew Wah

Associate Editors:Dr. David Quek Kwang LengProf. Dr. Yunus Gul Alif Gul

Prof. Dr. Zaleha Abdullah Mahdy

Secretary of MMC:Dr. Wan Mazlan Mohamed Woojdy

Secretariat:Dr. Karen Sharmini a/p Sandanasamy

(Assistant Secretary)

Mr. Perumal a/l Chinaya,(Legal Officer)

Contact Adresses

Putrajaya DivisionMalaysian Medical Council

Aras 2, Blok E1, Kompleks EPusat Pentadbiran Kerajaan Persekutuan

62518 Putrajaya

Telephone numbers:- Secretary – 03-88831400 Full Registration – 03-88831403/09/17 Annual Practising Certificate (APC) – 03-88831411/13 Letter of Good Standing (LOGS) – 03-88831407 Provisional Registration – 03-88831408 Temporary Practising Certificate (TPC) – 03-88831402 Administration – 03-88831401 Recognition of Degrees – 03-88831401

Fax: - 03-88831406Email:[email protected]

Web page: www.mmc.gov.my

Kuala Lumpur DivisionTingkat 3, Blok D

Jalan Cenderasari, 50580 Kuala LumpurTelephone:- 03-26947920

Fax:- 03-26938569Email: [email protected]

Web page: www.mmc.gov.my

Safeguarding patients, guiding doctors

Bulletin MMC new.indd 1 7/16/08 3:14:37 PM

2 Malaysian Medical Council


such advice on risks and benefits may not be given to patients.

It is generally unacceptable for new remedies or techniques to be applied without ethical overview or independent assessment. In 2001, the report of the public inquiry into children’s heart surgery at the Bristol Royal Infirmary 1984-1995 (the Bristol Report) stated that in any case of a new, untried invasive clinical procedure, permission should be sought from the local research ethics committee thereby indicating that innovative treatments should be treated as a form of research, especially when they involve an unknown or increased risk for the patient. Patients must be informed of why the proposed treatment differs from the usual measures and have an opportunity to consider the risks involved. Patients are also entitled to know the experience of the physician or surgeon involved in any procedure.

Patients involved in innovative therapies need to know: Why the therapy is proposed in their case The evidence to support its use and the areas of uncertainty surrounding it Whether it has had any form of ethical review The clinician’s experience in using the drug or doing the procedure The alternatives, if any How it differs from standard treatment The likely risks and benefits for themselves The measures for safety monitoring and support if things go wrong The likely future use of the therapy, if successful

Public confidence in the profession can be eroded if innovative therapy is perceived to be carried out in a clandestine manner.

Malaysia has attracted a lot of investors and businessmen to enhance or purportedly to jumpstart our biotechnology industry. While I have no problems with that, I want to caution our Malaysian counterparts to be critical of all proposals put forward, lest they be taken for a ride. I always tell the relevant authorities or agencies that the best way to deal with the situation is to refer such proposals to the MOH as we are the largest healthcare provider and the main regulatory authority dealing with matters pertaining to health and healthcare. We know how to differentiate between glass and diamond and between a gem and a fraud. Even some of our own doctors are indulging in the practice of so-called new and innovative therapies that are not backed by sound scientific evidence.

Doctors should not be too anxious to recommend new & innovative therapies until such evidence appears in peer-reviewed scientific journals. Otherwise research protocols and guidelines should apply. Doctors should be cautious and make a considered professional decision and not a commercial one about using innovative and experimental therapies.

The majority of our doctors abide by the Code of Professional Conduct. Some gets too adventurous and

indulge in professional misconduct. If they are found guilty, we have to discipline them to serve as a deterrent to others. At the same time, we take cognisance of the fact that the public is now very knowledgeable and demanding and expects a lot from the profession. We have to be aware of these fact at all times in our dealings with the public. A seemingly friendly patient whom we have known over the years may turn out to be our greatest critique who may report you to the MMC, simply because you have not accorded him or her enough time.

The members of the self governing profession have a pride in their profession that acts in the public interest, in that standards are set high and lapses in the conduct or performance are not taken lightly. Public members of regulatory authorities in other countries are known to comment that medical members are harsher in their judgment of physicians than they are. The doctor answers to a higher standard than that of the market place namely the authoritative judgment of fellow physicians.

Modern medicine is extremely complex. A non-medical person would have greater difficulty in developing the appropriate expertise and knowledge to operate efficiently and effectively.

Rapid changes in practice brought on by advances in medical science may render the knowledge and skills we acquire and practise as a young medical doctor, obsolete and irrelevant. Throughout the developed world, countries have moved or are moving towards instituting some form of recertification. Nevertheless, public demands for assured competence are both present and growing, virtually guaranteeing a future for the processes of relicensure and recertification. The MMC will introduce measures for recertification of doctors and specialists in the near future and this will include CPD (Continuing Professional Development) activities. It is better for us to be the ones introducing this rather than be compelled to do so by the public in keeping with practices around the world.

Conflict is inherent in a profession in which individuals are expected to be altruistic while as human beings, still pursue their own interests. As long as the profession remains in high esteem, outside observers presume that altruism would prevail and that the patient’s needs would be paramount. Negative events have overtaken those relatively simple days and the situation medicine now faces are different. Trust must be continuously earned from a skeptical public who are very aware of the opportunities for its abuse in a highly competitive market orientated health care system that encourages and rewards entrepreneurial behaviour. Doctors are exposed to a plethora of potential and real conflicts. Not all these conflicts originate from outside the profession. Self referral to doctor-owned laboratories, surgery centres or pharmacies and getting non-medical personnel to screen patients in a centre and sending those found positive, whatever that means, to selected specialists and centres, can cause a conflict of interest and thus far the profession’s attempts to regulate conflicts have met with only limited success.


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The very high profile problem of unethical or incompetent doctors can tarnish the reputation of the entire medical profession. This small number of doctors will need to be dealt with. While the methods must be consistent with the principles of due process and natural justice, the main objective must be to protect the public. Although there certainly have been attempts to improve disciplinary procedures, both the Institutes of Medicine Reports from the United States have not satiated the public concern as to whether the profession is meeting its obligation to adhere to the highest standards.

The concept of self-regulation is strongest in the medical profession. Self-regulation implies a voluntary and internal regulatory mechanism within the profession, irrespective of whether such controls are demanded by law or others outside the profession. Self-regulatory mechanisms must have sufficient transparency before they can gain credibility in the public eye.

Health care is and should remain a public responsibility. We, as doctors, should continue to develop standards and guidelines for the profession and for society.

We must value the autonomy of our profession in controlling major aspects of our work as we do not wish to be dictated by a third party. But to play this game, we must be fair and not steer away from our professional responsibilities for monetary gains. We also must be obsessed with enhancing our competence to ensure

excellence in medical practice and professional activities.

Hard work and long hours as well as life long education are still characteristics of the profession although perhaps not as highly valued as previously.

Whatever the circumstances and whichever role we may play in our dealings with ourselves, our families, our friends, colleagues , the community and society at large, we must not allow ethics to take a back seat, especially as we are doctors. Those in the profession must use their scientific reasoning, which is inherent in their training as a doctor to distinguish between the truth and sales gimmicks of the industry.

I believe the profession will prevail because the majority of us are trained to behave ethically. It is the grounding in ethics that will carry us forward past the cross-roads on to the road ahead where we look forward to seeing well trained doctors behaving professionally and ethically while the medical profession is still held in high esteem by the public. We owe this to ourselves, our profession, our patients and the society at large.

Thank you.

TAN SRI DATUK DR. MOHD ISMAIL MERICAN,President

Madam A, a single mother, brought her only child and daughter, B, aged six years, to a private hospital, after B sustained a fall at the playground. There was a deep laceration on B’s chin, measuring about five centimeters long. Dr C, who was the Medical Officer at the Accident and Emergency Department, carried out toilet and suture on B. The nurses held B while Dr C sprayed ethyl chloride on the laceration and then completed the procedure in less than ten minutes. Madam A and B then went home.

Madam A consulted a general surgeon, Dr D, a week later, about B’s management. Dr D opined that a peadiatrician should have been called and the wound would have healed better had the toilet and suture been done under general anaesthesia.

Madam A lodged complaints with the hospital’s management and the Malaysian Medical Council (MMC), alleging mismanagement and that Dr C carried out the procedure without anaesthesia and without Madam A’s consent. Madam A also claimed that Dr C ignored her protests.

During the inquiry by the Preliminary Investigation Committee (PIC), Madam A reiterated her complaints. However, she did not bring any witnesses or medical reports. Dr C’s documentation was poor. No consent form was signed. The PIC recommended an inquiry by the MMC. The charge against Dr C was:

“That you had disregarded and neglected your professional duties to the patient, abused your professional privileges and skills and conducted yourself in a manner derogatory to the reputation of the medical profession by having failed to provide and/or neglected to provide a sufficient and/or appropriate standard of medical care in the management of the patient and violated the Code of Professional Conduct as adopted by the Malaysian Medical Council in that you had proceeded to place three stitches on the chin of the patient without using either local or general anaesthetic despite the protestations of the mother of the said child patient/ without obtaining valid consent prior for the procedure.”

COMMUNICATION & DOCUMENTATION

Dr Milton Lum FRCOG


� Malaysian Medical Council


The MMC concluded that no case had been made out against Dr C and directed that the charge be dismissed. The MMC’s Standing Orders for the Conduct of Disciplinary Inquiries requires that the burden of proof lies with the complainant. In other words, “He who alleges must prove.”

Madam A did not substantiate her allegations with supportive evidence e.g. statutory declaration, medical report from Dr D, testimonies from witnesses. Dr C claimed he had obtained verbal consent from Madam A, who sat at the side of the treatment couch. It was a matter of Madam A’s word against Dr C’s word. The benefit of the doubt was given to Dr C. Lessons

The MMC found that there were two main problems in this case: • poor communication; and• poor documentation.

Dr C was fortunate that the complainant did not provide evidence to support her allegations. He was reminded to be more sensitive towards patients, particularly when providing care to children. In particular, parents need reassurance and an explanation of the procedure that is to be carried out.

Dr C had not documented in the patient’s medical records what he claimed he did. He was reminded that had the event occurred after the enforcement of the Private Health Care, Facilities and Services Regulations (PHFSR), he could have faced a criminal charge, in addition. The punishments, upon conviction, are a fine, imprisonment or both as there was non-compliance with the statutory requirements for written consent to be obtained prior to any procedure(1). Council was also of the view that ethyl chloride is not an appropriate anaesthetic in this case.

References

1. Private Health Care, Facilities and Services Regulations (Private Hospitals and Private Health Care Facilities) 2006 Sections 47-48

MEDIATIONDr Milton Lum

Adverse events occur in medical practice and will continue to occur notwithstanding whatever is done by health care organizations and/or doctors and other healthcare professionals. When things go wrong, some victims of medical accidents will complain to the Medical Council; others will resort to litigation. It has been reported in many studies that most victims of medical accidents want:1. An honest explanation for what went wrong;2. A genuine apology;3. Reassurance that the same event will not happen

again; and4. In some instances, compensation.

Many neutrals are of the view that the legal process cannot provide what victims want.

Litigation incurs expenditure and takes a long time to reach a conclusion. The process, which encourages secrecy and entrenched positions, does not result in an amicable, early or satisfactory resolution for many.

Mediation, a mode of alternative dispute resolution, is increasingly used in many jurisdictions as a way of dealing with patient complaints about medical care which has resulted in unsatisfactory outcomes.

Mediation is an alternative to litigation. The judge hears the position taken by each party in court and then hands

down a decision. On the other hand, a mediator listens to both parties’ case, finds common ground and identifies areas of dispute. He then works towards an agreed solution. The mediator does not give an opinion on the law or the merits of the case. There is no finding of fault or apportioning of blame.

Mediators help in the definition and analysis of the differences between the two parties and look at the underlying interests and needs of both parties.

Mediation differs from litigation in two other important aspects:• It is voluntary• It is without prejudice (i.e. it does not bind either

party, who are not held to what has been said or has occurred during the process).

Mediation can take place at any time. It can be at the outset of a complaint, or at a later stage, when litigation is underway, but is not meeting the needs of the parties and/or when negotiations to settle the case have broken down.

The advantages of mediation are discussed below:

1. Speed Litigation usually takes a long time to conclude. In

general, it takes at least five to ten years for the conclusion of a case in the Malaysian courts. In the


�Malaysian Medical Council


6. Cost The cost of litigation is increasing as evidenced by

the marked increase in the premiums of medical indemnity organizations in the past two decades. Legal costs, rather than compensation awarded to the injured patient, constitute an increasingly significant proportion of the expenditure incurred. Sometimes, the legal costs exceed the court award.

There are several factors for the lower costs of mediation. They include the more rapid conclusion, informality and the non-requirement for the exchange of all the evidence.

7. Equity and ethics The high cost of litigation has made it very difficult for

patients without means to commence proceedings. Furthermore, there are allegations of cases being taken on contingency basis, an unhealthy practice which is considered unethical by the legal fraternity.

The lower costs of mediation can make it possible

for more aggrieved patients to address their complaints.

8. Results It is reported that settlements result in as many as

80% of mediations. For example, court directed resolution (CDR) is offered to all who file law suits in Singapore. It is not mandatory as it takes place with the consent of both parties to the lawsuit. The implementation of CDR in its Subordinate Courts has contributed significantly to the early and amicable resolution of large number of lawsuits prior to trial, including medical negligence claims. In 2006, about 7,310 cases were resolved through CDR. The Straits Times in Singapore reported that only 11 medical negligence lawsuits were filed in 2005 in the Subordinate Courts. All the cases were settled out of court. It further reported that of the 79 medical negligence suits filed in the Subordinate Courts since 1998, only two went to trial.

The disadvantages of mediation are discussed below:

1. Sub-optimal outcome It is possible that, with mediation, the patient may be

disadvantaged by the settlement, either in monetary or accountability terms. There may be pressure to reach a conclusion on the mediation date, as everyone is expected to arrive at an agreement. There may be a feeling of failure for everyone involved if this does not occur.

2. No changes in medical practice It is believed by some that the increase in litigation has

lead to a corresponding increase in risk management in medical practice and greater awareness of patients’ communication needs. It is unclear if unreported mediated cases behind closed doors will create the same impetus for patient safety.

landmark case, Foo Fio Na vs Assunta Hospital and Dr Soo Fook Mun, the Federal Court gave its judgement in December 2006 when the incident occurred in July 1982, a period of more than 24 years.

In countries where Pre-Action Protocols are adhered to strictly, there is more rapid movement of the cases in the courts. However, time is still needed to get through investigation, proceedings, settlement or trial. Attempts at negotiation and, if this fails, the issuing of court proceedings and proceeding to trial all takes time. The whole process takes a few years to conclude. Where there are no Pre-Action Protocols, or if there are, no strict adherence to it, the whole process takes an even longer time.

Mediation can provide a speedier resolution to disputes. It permits both parties to have an earlier mutual evaluation of the case. Even if there is no settlement or resolution, mediation may be helpful, if the case goes to trial, because, the parties would have a more focused view of the issues between them.

A sine qua non for mediation, however, is the availability of all medical records and medical reports.

2. Confidentiality Mediation allows parties to state their grievances

and discuss areas of concern in private rather than in court, where it may be reported in the print and electronic media.

3. Less stress It is well documented that litigation is stressful to

both patients and doctors. Mediation can help avoid this with the early settlement of complaints. It may be healing for both parties. The claimant has his or her say in a setting where he or she is listened to. Many mediated cases have addressed the emotional aspects of the complaint rather than monetary compensation. There is greater likelihood of a continuation of the patient-doctor relationship unlike in litigation, where it is likely to be destroyed in most instances.

4. Control Mediation allows both parties to feel that they are in

control of the proceedings instead of lawyers and the courts. There is no feeling that a third party’s view is imposed on them. This leads to no one feeling that they have lost out. It may also be less confrontational. This is, however, dependent on the parties involved.

5. Flexibility There is greater flexibility in mediation because the

remedies are more varied. Settlements in litigation are monetary. However, mediation permits more customized settlements which are not just monetary e.g. explanation, apology, dissemination of lessons from the case to other doctors.


� Malaysian Medical Council


3. Lower damages It is likely that mediation will result in lower payouts

for damages in some cases because it is often the threat of the court action that provides the impetus for defendants into offering realistic damages.

4. Lack of control As in any informal process, there is less control of

processes which are not controlled by the claimant or the usual procedures of the litigation process or the court.

5. Cost If a case is mediated after initial investigations, then

the costs of mediation may exceed negotiation. A negotiated settlement often occurs at this stage and well before litigation.

6. Stress It can be stressful for some claimants to have to

meet doctors and the mediator(s) face to face. On the other hand, lawyers can obviate direct contact with the other side and also act as a buffer in some circumstances.

Conclusion

At a time when the litigation process takes so long and is inequitable in many respects, the advantages of mediation far outweigh its disadvantages. Mediation can provide benefits, both monetary and otherwise, for victims of medical accidents. However, because few cases in Malaysia have actually been through the mediation process, it is not yet possible to determine its usefulness as a means of resolving issues for victims of medical accidents. A better understanding of mediation will increase its uptake by claimants, doctors, medical defence organizations and health care facilities.

In summary, one need to bear in mind Richard Lamb’s caution “No nation in history has ever sued its way to greatness.”

Dr Milton Lum is a practising gynaecologist and an elected member of Council. The views expressed do not represent that of any organization he is associated with.

The Honourable Minister of Health chaired the meeting which was attended by the Honourable Deputy Minister of Health, the President of the Malaysian Medical Council and 13 Council members as well as several senior Ministry of Health officials.

The Minister in welcoming the delegation stressed that the Council played a pivotal role in the delivery of healthcare services to, not only the public sector but the whole country including the private sector. He expressed his wishes to see that the Council continuing to shoulder this onerous responsibility by galvanising the energy of all registered practitioners in the country to realise the mission and vision of the Ministry of Health to provide quality healthcare to all Malaysians.

He propounded that it is the core business of all healthcare providers to inculcate professionalism, teamwork and a caring attitude into all aspects of their daily dealings with members of the public. Insofar as the Ministry of Health

Highlights of Meeting Betweenthe Honourable Minister of Health

Y.B. Dato’ Liow Tiong Laiand Members of the Malaysian Medical Council

on 17th April 2008 at 9.00am at the Conference Room, Block E7, Putrajaya

is concerned, he gave his undertaking that unequivocal support will be provided to the Council in its endeavour to establish itself as the prime custodian of the healthcare services in the country.

The President in his response thanked the minister for initialling this important meeting with the Council and expressed the Council’s undivided support in all of MOH’s efforts in improving the healthcare delivery system of the country.

He went on to outline some of the achievements of the Council over the last few years namely:-

1. The amendments to the Medical Act 1971 which is ready to be presented to the MOH

2. The approval by the Cabinet for the independent statutory body for the Council and efforts are underway to realise this milestone in the near future.

3. The complete computerisation of the administration


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and function of the Council and very soon online registration and payment will be introduced.

4. The launching of a comprehensive webpage in August last year; and

5. The endorsement and launching of a further set of 9 ethical guidelines for the consumption of practitioners as well as the public during the webpage launching.

Following this a power point presentation of the function and the current affairs of the Council was presented by Dato’ Dr. Abdul Hamid Kadir, a member of the Council on the following headings:

a) Functions of MMCb) Amendments to the Medical Act 1971 and the

Medical Regulations 1974;c) Private Healthcare Facilities and Services Act 1998

and its Hospital as well as Clinic Regulations 2006;d) Continuous Professional Development (CPD);e) Independent statutory body status of the MMC;f) Traditional and Complementary Medicine g) Committees of the MMCh) MMC Publicationsi) MMC homepage

Finally a dialogue session was held between the Honourable Minister and Council members where the following issues were discussed:

i) Private Healthcare Facilities and Services Act 1999 and its Regulations

The minister, taking cognisance of the reservation expressed on various short comings in the said Regulations, proclaimed his sincere intention to give serious consideration to proposals to be forwarded at a meeting of all stakeholders which is to be organised by the Medical Practice Division, Ministry of Health soon to amend the Regulations to make it more user friendly.

ii) Amendments to the Medical Act 1971 and Medical Regulation 1974.

The Minister gave his undertaking to give priority for the submission of the amendments in Parliament this year.

iii) Independent statutory body status of the MMC

The Minister directed all parties involved to expedite the process so that the Council can function independent of MOH as well as sanctioned the allocation of the whole of Block B at MOH office complex in Jalan Cenderasari, Kuala Lumpur to the Council for its activities.

iv) Disposal of Complaints by the MMC

It was emphasised that issues related to negligence does not come under the jurisdiction of the Council and many complainants are disgruntled over the outcome. It was proposed to look into the possibility of setting up a mediation/arbitration team to overcome the deadlock being faced by the Council over issues that do not fall squarely under the Code of Professional Conduct. The Minister expressed his support for this proposal.

v) Traditional Complimentary Medicine (TCM)

The Minister agreed that a clear demarcation be indentified between the practice of a registered medical practitioner and TCM practitioner in the areas of treatment, usage of drugs and equipments, taking into consideration all the legislations involved.

vi) Advertisement by Registered Medical Practitioner

There was agreement that there must be more liberalisation of advertisement in consonance with the “health tourism” policy of the country.

vii) Practice of aesthetic medicine by Registered Medical Practitioners

Only Registered Medical Practitioner who possess the prerequisite training and qualification be allowed to be involved in aesthetic medicine to protect the general public and guidelines related to this issue be given ample publicity and be displayed in the webpage.

viii) Emergency Services to be provided by Registered Medical Practitioners

The Minister proposed that MOH establishes proper guideline for emergency services to be provided by a Registered Medical Practitioner or a facility depending on the type of practice conducted by him or services provided by the facility.

ix) Introduction of Provision of the Private Healthcare Facilities and Services Act 1998 Into Government Facilities

The Honourable Minister was in total concurrence with the views of the Council members that the provisions of the Private Healthcare Facilities and Services Act be extended to government facilities as well so that the healthcare needs of the general public who cannot afford private care be provided for in the same manner as those provided for in the private sector.


8 Malaysian Medical Council

STOP PRESS!!!

x) Credit transfer for Graduate from unrecognised universities to recognised universities

The Minister welcomed the noble intention of MMC to allow graduates from unrecognised universities to pursue their course in recognised universities on a credit transfer but at the same time stressed that there must be no compromise on the quality of the medical education to be provided.

Finally, on behalf of the Council, the President appreciated and thanked the Minister and all members for their

contributions and will ensure that all decisions made will be successfully realized.

Thank you.

Jointly prepared by:Dr. Wan Mazlan Mohamed Woojdy, Secretary for the Council.

and Mr. Perumal a/l Chinaya, Legal Officer for the Council.


RE:CESSATION OF REGISTRATION UNDER SECTION 24 OF THE

MEDICAL ACT 1971

The public is hereby informed that the Malaysian Medical Council had ordered the

registration of the name of Mr. Shuib bin Hussain, (NRIC 510610-02-5599/3585996,

Full Registration No. 23116 dated 30/10/1979) address at Poliklinik & Surgeri

Titiwangsa, Dr. Shuib dan Rakan-Rakan, 79-1A, Jalan Raja Abdullah, 50300 Kuala

Lumpur be ceased to be registered from 9 January 2007 till further notice.

However, information has been received by the Council that the said practitioner

is continuing to practice and is signing certificates or documents required by any

written law which is against the Medical Act 1971.

Please take note that the Council will not be responsible for any untoward incidences

that may arise out of the malpractice of this practitioner.

The public is hereby requested to provide the Council with any information regarding

the conduct of practice by Mr. Shuib bin Hussain for our further action.
