LOCUM GUIDELINE

1. LOCUM FEE
 Day time (830am - 6pm) : RM 40/hour
 Night (6pm - 10pm) : RM 45/hour
 Overnight (10pm - 7am) : RM300

2. VCLINIC
 Proper documentation
 Detail history & physical examination
 Clear action plan
 Ask nurse on duty if anything not sure

3. DIAGNOSIS
 Acute
 Chronic
 Others- acute/ chronic (type your diagnosis)
 Select the best fit diagnosis
 Try to put in chronic diagnosis if total charge exceed RM50

4. MEDICINES
 Key in available meds in stock
 Adjust accordingly
 Refer appendix

5. INJECTIONS
 Remember to key in
 Avoid deltoid, preferably gluteal upper outer or lateral thigh, <5ml per injection
 Deltoid: for ATT injection only
 Needle: preferably green needle, min blue needle
 Technique: make sure sterilise the area & inject deep IM
 Informed / written consent from patient, explained in detail risks & complications involved
eg pain, hematoma, abscess etc.

6. LAB TEST
 State justification/ indication
 Itemize each test eg. FBC, RFT, LFT, FBS, FSL, Urinalysis, TFT etc
 Refer appendix for coding & price

7. SURGICAL PROC.
 Eg. Neb / ECG / Minor op / Dressing / Suction
 Charge accordingly
 Informed / written consent from patient, explained in detail risks & complications involved

8. PANEL EXCLUSIONS
 Illnesses not covered- ED/ STD/ HIV/ Self-inflicted injury/ psychiatric illness
 Cosmetic reason
 Pregnancy related eg UPT, Hyperemesis gravidarum
 Health screening / medical check up/ Family planning
 Blood test eg HIV, Hep B & C, Blood grouping
 Meds eg vitamin C, supplements, soap, anti obesity agents
 Procedures eg. Circumcision
 Immunization
 Refer appendix

9. MC
 State the date of MC & duration
 Be strict but reasonable and with proper counseling
 Signature & MMC number

10. REFERRAL LETTER

 Detailed notes
 Doctor referred/ specialty/ hospital
 If panel, according to entitlement/ company policy.
 Refer to GH only if diagnosis under exclusion.
 Signature

11. SPECIAL GROUP

 PAEDS: Strictly no sedative medicine below 2 year old
 OBSTETRIC: avoid procedures and medicine if possible
 ELDERLY/FRAIL: avoid injection
 VIP/***patient: avoid arguement/ conflict

12. CONDUCT
 Be punctual
 Examine every patient including measure BP for adult patients
 Be professional
 Dress up properly
 Always has a chaperon when examine female patient
 Spend more time with patient & give more TCA for review, eg BP monitoring etc.

13. DOCUMENTATIONS
 Injury cases- detailed mechanism of injury, time & place, injuries sustained
 Medicolegal cases- refer hospital for potential court case

13. LOCUM SLOTS

 Leave a notes stating available dates and time for locum and pass to nurse on duty
 Minimum 1 week notice before cancellation of slot
 Must get replacement locum if last minute cancel slot

LOCUM ACKNOWLEDGEMENT

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