Featured Doctor

NOOR, Harzana

Malaysia - Family Doctor

Dr Noor Harzana from Malaysia is the WONCA World Rising Star Award winner 2021.

This award is based on WONCA’s 5-star Doctors award and its purpose is to recognize a young doctor who has demonstrated a drive for excellence in Health Care.

Many congratulations to Dr Noor Harzana! Discover more about her work and experience below.

What are you currently working on? 

I received my MD from University Science Malaysia in 2004 and Master in Family Medicine from University Malaya in 2015. I was gazetted as Family Medicine Specialist (FMS) in 2016 and fully certified as FMS in 2017. I have been working at a public health clinic (Pandamaran Health Clinic) since then. My clinic is a great place to work. All the staffs are dedicated and receptive to ideas. Our communities and neighbouring hospitals are friendly and reliable. My clinic delivers primary care services, including maternal and child health care, communicable and non-communicable diseases, adult, adolescence, elderly care, methadone maintenance therapy and other special programs.

My clinic caters a population of 190 000 and about 8% were in the elderly group. The daily clinic attendees were about 800-1000 patients, served by 120 staffs, which include 3 Family Medicine Specialists, 25 medical officers and the rest are the paramedics and allied personnel. I conduct an average of 15 to 30 consultations per day. I had great interest in elderly care and is currently pursuing subspeciality training in Primary Care Geriatrics since 2020. Prior to my sub-specialisation training, I worked most days at the resident clinic but once a month travelled to a satellite clinic; which is an island located 30 km away from the main clinic to provide services there. However, during the sub-specialisation training, I had two days per week geriatric attachment at Kuala Lumpur Hospital and University Malaya Medical Centre.

Tell us about your experience as a family doctor? 

I am glad that I chose Family Medicine as a platform to serve the community. In this field, I become a personal doctor for many people and their families, coming with undifferentiated problems, people of all ages and varied health conditions. I am also able to connect my staff with community resources. Together with my team, we provided a point of contact for patients and their families through the Family Doctor Concept (FDC) with the theme of ‘One Family, One Family Doctor’. We assigned doctors and paramedics into groups to take care of health concerns and needs of families in the community. Through this concept, we see all family members in one sitting. In strengthening the program, we introduced measures to improve data capturing of family populations, NCDs and elderly registry. We are fortunate because the clinic uses an electronic system in capturing data through the Tele Primary Care System (TPC). We are now moving to a new system TPC-OHCIS (Tele primary Care-Oral Health Clinical Information System), where richer data can be captured.

I supervised several clinical projects such as the Q-SIS project to improve Tuberculosis Direct Observation Therapy (TB DOT), Pain as 5th Vital Sign in collaboration with a private general practitioner, Quit Smoking Program, RESPIRE project to improve asthma care, Patient Navigation Program for fast tract detection and management of breast cancer, Wound Care with Modern Dressing,  Diabetic Mentor-Mentee Program to improve diabetic control through community participation, and Infectious disease projects such as Hepatitis C Screening and Direct Acting Antivirals (DAAs) treatment, and management of Sexually Transmitted Disease, especially among transgenders.

I am part of the District Primary Care and Emergency network to improve the referral pathway between Primary Care and Emergency Department of Tengku Ampuan Rahimah Hospital. 

During the COVID-19 pandemic, I participated in setting up the clinic’s new norms, vaccination program, especially for the elderly, managing outbreaks in nursing homes together with geriatricians and public health specialists. I handled positive COVID-19 patients at Covid Assessment Centre, stabilising them before transfer to the hospital, as well as managing the post-COVID-19 patients.

I  lead several clinic community projects such as ‘Town Orchard’ for methadone clients and ‘Kasih Project’ for PLHIVs in collaboration with several agencies and Non-Government Organisations (NGO) for rehabilitation as well as to reduce stigma among staffs and communities and “Therapeutic Garden’ for cognitive stimulus of the elderly.

I am also involved in multiple Quality Assurance Programmes, developing guidelines and protocols, research and teaching.

In 2017, I was awarded The Merit of Excellence in Service by the Ministry of Health Malaysia.

What other relevant activities have you participated in? 

I participated in many collaborative efforts with the hospitals, private general practitioners (GP), local government and private agencies, universities, NGOs and the community during my course of service.

I am a life member of the Malaysia Family Medicine Specialist’s Association. I was elected Assistant Honorary Secretary for session 2018-2020. 

I have been involved in many Investigator-Initiated Research (IIR) or Industry Sponsored Research (ISR). One of the research projects, titled “Assessing the Implementation of Decentralized HCV Testing at Primary Health Care Facilities In Malaysia” funded by The Foundation for Innovative New Diagnostics (FIND) and the Drugs for Neglected Diseases initiative (DNDi) in 2018. We screened 748 participants over eight months, referred 52 positive HCV antibodies to the referral hospital and handled 45 non-cirrhotic patients with DAAs. The study has been completed, and the clinic has become one of the Hepatitis C treatment sites.

My latest involvement in research is being the Principal Investigator for “Global Multicentre, Randomized, Double-Blind, Placebo-Controlled, Phase III Clinical Trial to Evaluate the Efficacy, Safety and Immunogenicity of Recombinant Covid -19 Vaccine (Vero cells) Inactivated (Coronavac) for the prevention of COVID-19 in Children Aged 6 Months to 17 Years. PRO-nCOV-3002. 

I had been involved in several Quality Projects at the clinic, district and state levels. To mention a few, at clinic level LEAN projects to reduce waiting time and congestion during peak hours, improving pathways for laboratory procedures and acute asthmatic care. At the district level, District Specific Approach (DSA) projects are titled: Improving BP control among Essential HPT Patients in Klang TPC Clinic and Improving the Appropriate Use of Clopidogrel in Klang Primary Care setting. At the state level, “The Stigma & Discrimination Project involving Healthcare workers and People Living with HIV (PLHIV)” in 2020. 

I am one of the development group members for Malaysian CPG in breast cancer management 3rd edition. I was involved in developing a Guideline for Clinical Frailty Score (CFS) in elderly 2021. I was also part of the national team to review Family Doctor Concept Implementation in the clinics. I am currently a reviewer for the Malaysian Family Physician Journal. 

I had presented several papers locally and internationally, including in WONCA conferences in Thailand (2017) and South Korea (2018). I participated in an Educational Program for Elderly Care in Japan (2018) and Addiction Conference in London (2020).

What are your professional and personal interests? 

Geriatrics is my special area of interest, and I am currently doing subspecialisation training in Primary Care Geriatrics under the Ministry of Health. Recently, I completed Post Graduate Diploma in Primary care for The Elderly (PGDPE) under Sunway University. 

I took a lot of drive, motivation and guidance from my mentor Dr Ruziaton Hasim, a former consultant at FMS and head of the clinic when I first started as FMS. She also has a great interest in geriatrics and a vast influence on me. Another two great influencers are Dr Ungku Ahmad Ameen, a geriatrician, and Dr Bahanordin Jaafar, a Rehabilitation Specialist at the Tengku Ampuan Rahimah Hospital. We have collaborated on expanding elderly care in the clinic in an integrated manner since 2016. We started with setting up of Clinic’s Senior Citizen Club. The program has improved networking and reduced silos of geriatric care among professionals at health clinics, hospital and community levels. It has provided links to several government agencies, local authorities, universities, Health clinic advisory panels, NGOs and the community. 

What is it like to be a family doctor in your country?

DR NOOR HARZANA BINTI HARRUN
Family Medicine Specialist (MD, MFamMed)
Pandamaran Health Clinic
Klang, Selangor