Anaesthesiologists warn against interference in patient care

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Anaesthesiologists warn against interference in patient care


Two bodies describe the recent TPA directive as a profit-driven intrusion into medical decision-making

The anaesthesiologists’ groups said medical treatment must be guided by professional judgment, patient needs, and evidence-based practice. (Bernama pic)

PETALING JAYA: The Malaysian Society of Anaesthesiologists, and the College of Anaesthesiologists, Academy of Medicine of Malaysia, have voiced concern over a recent circular by a third-party administrator recommending that surgeons prioritise local anaesthesia over general anaesthesia for surgical procedures.

They described the directive as a profit-driven intrusion into medical decision-making, saying it represented “an unethical attempt to dictate patient care”.

“Medical treatment must be guided by professional judgment, patient needs, and evidence-based practice, not financial imperatives imposed by insurers or TPAs,” they said in a joint statement.


The two anaesthesiologists’ groups said anaesthesia was a complex specialty requiring careful, individualised decisions as every patient presents unique challenges.

While local anaesthesia was appropriate for many procedures, it could not be applied as a blanket rule, they said.


“Generalising its use without proper medical assessment risks compromising patient safety, surgical outcomes, and ethical standards of care,” they said.

The groups also cautioned that undermining surgeons’ clinical judgment could erode professional autonomy and place undue pressure on doctors to prioritise cost over care, potentially endangering patient safety and leading to unnecessary litigation.

They said decisions on whether surgeries should be performed as daycare or in-patient procedures, and on which anaesthetic method to use, should remain with the treating surgeon and anaesthesiologist in consultation with patients.

They noted instances where insurers had declined approvals despite proper justification, forcing patients to make out-of-pocket payments before seeking claims. Such denials imposed unnecessary administrative hurdles.


They also said patients had the right to decide, together with their doctors, on the type of procedure and anaesthesia relevant to their condition. Factors such as the nature of surgery, comorbidities, and risk of complications must guide these decisions.

The groups urged insurers, TPAs, and managed care organisations to respect medical autonomy and work collaboratively with healthcare professionals to improve outcomes rather than impose prescriptive directives.

“Every patient deserves safe, evidence-based, and individualised anaesthetic care. Our commitment to patient safety is at the core of our opposition to any directive that threatens clinical autonomy,” they said.

The Private Medical Practitioners’ Association of Selangor and Kuala Lumpur and the Malaysian Medical Association have also criticised the directive.