Diploma In Management

January / 2023

BDKN 3103

Introductory Business Communication

NO. MATRIKULASI : 930227055219001

NO. KAD PENGENALAN : 930227055219
NO. TELEFON : 013-5231638
E-MEL : cheewhye_93@hotmail.com

PUSAT PEMBELAJARAN : Johor Bharu Learning Centre

 TABLE OF CONTENTS

1.0 INTRODUCTION 1-2

1.1 IMPORTANCE OF EFFECTIVE 3-6

COMMUNICATION

1.2 BARRIERS TO COMMUNICATION 6-8

1.3 STRATEGIES TO IMPROVE COMMUNICATION 8-10

1.4 CONCLUSION 10

1.5 REFERENCES 11-12

2.0 ONLINE CLASS PARTICIPATION 13-17

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1.0 Introduction

It is an established fact that the healthcare system in Malaysia, which is accessible to

nearly all of the population, is lauded internationally. Malaysian healthcare sector
operates on a two-tier systems namely government-based healthcare system and private
healthcare system (Malaysia Healthcare Travel Council, 2020). Besides, healthcare sector
in Malaysia also engages in various fields such as medical tourism, the manufacturing of
medical devices, pharmaceuticals and clinical research. One notable achievement is
Ministry of Health has established Malaysia Healthcare Travel Council (MHTC) to
promote the healthcare travel industry at home and abroad. Malaysia has some of the
lowest medical fees in the world with the government subsidising up to 98 % of
healthcare cost.

In 2020, Malaysia, like other countries worldwide, is hit with the unprecedented Covid-
19 pandemic. To tame the deadly virus, government allocated RM30.6 billion ringgit for
operating and developing expenditure of healthcare sector. The government has
increased up to 118 hospitals for Covid-19 screening and 40 hospitals for Covid-19
treatment as well as admission. In terms of diagnosing the diseases, not only Institute for
Medical Research (IMR) but also 44 laboratories natonwide are involved. In addition, the
government spend more than 503 million on immunisation programme to keep residents
at the bay of disease.Furthermore, contact tracing and telemedicine apps like Mysejahtera
and Mydoctor are also developed to trace Covid-19 patients and treat patients who are
afraid to visit healthcare establishments.

In 2021, the overall allocation to the Health Ministry moves from RM 30.6 billion to RM
31.9 billion, recording a 4.3 % increase year on year. With the main priority to tackle the
Covid-19 pandemic which has haunted the country for a year, RM 4.7 billion is set aside
for development expenditure while the balance RM 27.2 billion for operating costs
(Dawn & Dhesegaan, 2021). An additional RM1 billion is also allocated to purchase
reagents, test kits and consumables during the pandemic. Futhermore, more hospitals and
clinics are built in the district and a spike in the procurement of medical vehicles as well

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as devices are witnessed in the sector. In addition, the Ministry of Health also launches an
unprecedented one-off payment of RM 500 to 100,000 medical staffs and Perlindungan
Tenang Voucher programme to give a RM 50 voucher to B40 individuals buying life and
personal accident insurance.

In 2022, the 12th Malaysia Plan aiming to ease the strain on the public healthcare system
and tackle any future pandemic is rolled out. Therefore, the ministry of health receives
higher fiscal allocation which is RM 32.41 billion in the 2022 Budget (Cindy Yeap,
2021). This indicates a 1.5 % increase from RM 31.94 billion in the 2021 Budget. Of the
32.41 billion, RM 4.38 billion is set aside for building of new hospitals and clinics as
well as upgrading, renovating and repairing existing health facilities. Besides, a total of
RM 4 billion is disbursed to enhance the Covid-19 national immunisation programmes
and increase the capacity of healthcare facilities like the purchase of personal protective
equipments and medical test kits respectively. Moreover, MHTC also receives RM 20
million to assist in the recovery of the international health tourism industry.

1.1 Importance of Good and Effective Communication in the Healthcare Sector

Communication is a two way interaction process which involves a sender, a

communication channel and a receiver (Ratna, 2019). In healthcare sector,
communication takes place among healthcare professionals or between healthcare
providers and patients. Since the messages transmitted during the communication process
can be interpreted differently, it is important for the communication to be good and
effective in the healthcare sector.

First, good and effective communication can increase patient enablement which refers to
the extent to which a patient is capable of understanding and coping with his or her health
issues (SDSU Global Campus, 2019). This is closely associated with the patients’ health
outcomes such as self-management of chronic disease and quality of life. Low patient
enablement causes patients to lack basic knowledge of disease processes, health self-
management concepts and healthcare bureaucracy structure. For instance, a patient

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diagnosed with diabetes might misuse their medications unintentionally if they do not
understand the instructions given to them. Such scenario is most prominent among
elderly population. No doubt, low patient enablement,especially the instructions of
medication, is related to the information gained when consulting the doctor. McGuire et
al. (2016) found out that nine out of ten doctors are not interested in the information
needs of patients and their relatives.They neither encourage patients to ask questions nor
include patients in the decisions on the treatment plan, as well as avoid providing
feedback.

Moreover, patient satisfaction can be enhanced with good and effective communication
in place (SDSU Global Campus, 2019). Undeniably, patients’ perception of the quality of
the health care they receive are highly dependent on the quality of their interactions with
their health care providers. Empathy plays a major role in increasing patient satisfaction
during the interaction process. A survey conducted at China National Hospital reveals
that physicians and nurses who exhibit friendliness, honesty, empathy and respect for
patient preferences promote patient satisfaction (Mohammed et al., 2022).If the patients
are satisfied with their physicians’ behaviour, the patients will build good relationship
and trust with their health care providers apart from recommending them to their friends
and relatives. It is crucial for health care professionals to bulid trust with their patients as
the personal connection that a patient feels with his or her provider can indirectly
improve their health through active participation in their care, following treatment
recommendations and overall patient self-management. The health care personnels can
express their empathy in their interaction by adopting active listening. They should not
interrupt when their patients are telling them about their diseases and listen to their
problems with full attention and engagement.

Another importance of effective communication is that it improves internal teamwork

and collaboration (Sibiya, 2018). It is an established fact that healthcare is delivered by
teams of professionals who represents different disciplines and domains of training.
Although they are not trained on how to work together in teams, they are expected to do
so in an effective way. Therefore, communication among internal health care team

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members impacts the quality of working relationships, job satisfaction and patient safety.
Wittenberg (2016) finds out that lack of preparation to work as a team is a barrier for
nurses in communicating about goals of treatment with other healthcare providers.
Deficient communication between doctors and nurses can result in frustration and distrust
among health care providers which might lead to errors in treating a patient. It is because
the doctors’ main role is to obtain information about patients from sources like medical
history, physical examination and laboratory investigations whereas the nurses provide
the doctors information about the patients’ progress which is vital to conduct further
treatment. To establish good communication among healthcare workers, they should be
included in communication skills course programmes so that they know how to
communicate with one another under different communication flows like upward
communication. downward communication and horizontal communication.

In addition, effective communication in health care sector enhances the interaction

between healthcare providers and patients (Sibiya, 2018).Once a better patient-provider
interaction is developed, the doctors have the potential to regulate patients’ emotions and
identify the patients’ needs, perceptions and expectations easily. Furthermore, patients
reporting good interaction with their doctors are more willing to share pertinent
information for accurate diagnosis of their problems, follow advice and adhere to the
prescribed treatment. This not only benefits patients in terms of fast recovery from
diseases, but also increases doctors’ job satisfaction. Thus, when interacting with the
patients, the doctors should acknowledge the patients’ feelings for their behaviours or
illnesses, respect the patients’ cultures and beliefs, engage patients in their treatment
plans and give patients assurance that their medical problems will be addressed together.
As a result, the patients will perceive themselves as a full participant during discussions
relating to their health and comply with the treatment.

Finally, effective communication in healthcare sector reduces patients’ readmission rates.

Patients, lab technicians and healthcare practitioners need to engage in effective
communication to create a system that operates smoothly. Establishing effective
communication can prevent the occurrence of ineffective care transition which can lead

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to patient readmission. A care transition refers to the movement of patients between
healthcare practitioners, settings and the home. Factor contributing to ineffective care
transition is communication breakdown among healthcare staffs which might stem from
differing expectations among the parties involved in the transition, a lack of standardised
procedures and inadequate time provided for a successful hand-off. Likewise, patients
sometimes receive conflicting follow-up care information and confusing medication
regimens.This increases patients’ readmission rates which contributes to frustrating
patient experience.

1.2 Barriers To Communication In Healthcare Sector

One of the preventive factors to communicate effectively in healthcare sector is language

differences (Tideman & Tengelin, 2019). Malaysia is a country where 15 foreign
countries supply labour with the majority from Indonesia (39%), Nepal (24%),
Bangladesh (13%) and Myanmar (7%). This indicates that Malaysian healthcare workers
have to cope with patients from different social backgrounds during their daily routines.
Some of the migrant workers state that they are unable to communicate with local
healthcare providers as not all of them are conversant in the international language,
English. Therefore, the patients from foreign countries cannot explain clearly about the
symptoms of their illness to doctors and leads to misdiagnosis and medication errors. For
instance, an Indonesian who complains having a headache receives stomachache
medication from doctor. Besides, some migrant workers also fail to understand the
instructions given by doctors when it comes to taking medication .On the other hand,
language barriers restrict a doctor’s ability to explain accurately to their patients about
their diseases and their relevant treatment plans. As a result, doctors are unable to obtain
informed consent from their foreign patients before conducting a treatment, thus resulting
in the patients’ mistrust of healthcare professionals.

Besides, healthcare professionals also find cultural differences an obstacle to

communicate effectively (Tideman & Tengelin, 2019). Effective doctor-patient
communication is blocked by the patients’ culture as perceptions on health and death are
different between patients.The healthcare providers need to be sensitive when dealing

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with a patient from different cultures because they cannot possibly know the health
beliefs and practices of every culture.Likewise, the Japanese are more likely to visit the
health facilities which employ Japanese doctors as they prefer their complaints to be
heard by healthcare providers who speak native Japanese language and share same
culture values with them. Despite living in Malaysia, the Japanese tend to trust Japanese
people and are reluctant to assimilate with the local cultures.In addition, some cultures
also prohibits its people from having physical contact such as handshakes or hugging
with different genders. A survey conducted among 323 citizens reveals that 2.5% of them
avoid seeking healthcare in the clinics due to the absence of different gender
doctor.Healthcare providers therefore have to use their past experiences to understand
others’ cultural differences in verbal and non-verbal communication so that they can
develop trust with patients from different races and cultural backgrounds.

Perception plays a significant role in the healthcare sector when it comes to

communicating effectively (Sibiya, 2018). No doubt, not only patients but also healthcare
providers perceive others’ behaviours in different ways. An individual’s perception is
usually influenced by his or her past experiences, assumptions and expectations, cultures,
values and character traits. Some foreign patients are sensitive to how local medical
professionals address them and speak to them. For example, an Indonesian patient may
feel humiliated when a doctor addressses them as Idon. Thus, Malaysian healthcare
providers should be aware that certain words used regularly may be perceived by foreign
patients as derogatory. Moreover, a small percentage of local doctors are also reported to
be negligent towards migrant workers as they do not show concern and empathy when
interacting with their patients.The doctors might feel that the migrant workers as low
status and do not adopt active listening when the workers complain about their health.
Since preconceived attitudes affect the way medical personnels interact with patients,
such attitudes should be avoided as it decreases patients’ satisfaction which impacts
Malaysian health tourism industry significantly.

Moreover, conflict is also inevitable in causing the healthcare providers fail to

communicate effectively (Mohammed et al., 2022). Poor understanding about

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individual’s roles contributes to conflict as it leads to overlap of healthcare workers’ roles
and brings friction among them. Likewise, nurses nowadays need to conduct a lot of non-
nursing work such as checking medical bills apart from providing healthcare services.
This will increase the nurses’ workload and decrease their job satisfaction. There are also
some cases where a pathologist carries out the task of a medical laboratory scientist,
thereby robbing the respect of laboratory technician due to professional boundary
negligence. Another reason is the poor inter-professional communication among
healthcare workers which causes their goals to differ in patient management. For
instance, a doctor and a pharmacist might have different views on a patient’s drug
prescription. In short, conflict in a healthcare team negatively impacts the quality of
patient care because the healthcare workers cannot communicate effectively, hence not
including all team members’ perspectives on patients.

1.3 Strategies To Improve Effective Communication In Healthcare Sector

A notable approach to overcome language barrier in healthcare sector is to learn another

language (Tideman & Tengelin, 2019).It is an inevitable fact that healthcare workers
have to cope with patients from diverse population daily. Thus, they should grab the
chances to work abroad so that they stand an opportunity to learn a new language.
Additionally, healthcare professionals like doctors and nurses should also attend
additional language course when they are pursuing their tertiary education. For example,
foreign language courses are now available for Universiti Kebangsaan Malaysia (UKM)
healthcare undergraduates to attend amid their journey in completing their degrees
(Husna Hasri, 2022). For healthcare workers who are busy with their daily routines, they
can make use of Youtube to learn a few key words in different languages. Being
conversant in more than language not only develops mutual understanding between
patients and healthcare workers, but also shows the patients that the medical
professionals care and try their best to help them. It also increases patients satisfaction as
some foreign patients like Japanese feel more comfortable to communicate with their
doctors in their mother tongue. They prefer to visit medical establishments where
Japanese doctors and interpreters are available.

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Using non-verbal communication is another way to improve communication in the
healthcare sector (Ratna, 2019). Non-verbal communication cues like nodding, facial
expressions and thumbs up or down can be used to complement the use of technological
tools such as Google Translate when the healthcare workers and patients are not speaking
the same language.It is because Google Translate and other tools are useless if the
healthcare workers do not understand the language the patients speak. With the use of
non-verbal communication, the patients can express their questions, feelings and anxiety
to their healthcare providers.It enables the healthcare workers to assess the patients’
needs and understand their health problems in an emergency situation so that they can
conduct appropriate treatment in time.Besides, healthcare workers like nurses can use
body languages to enhance the key point in the information given to the patients like how
and when the medication should be taken.This not only makes patients not understanding
the languages feel acknowledged and develop relationship with medical workers, but also
safeguard their safety when taking their medicines.

To address cultural differences in the diverse patient population, healthcare personnels

should determine typical patient demographics in the organisation’s patient service area
and hire healthcare staffs that are representative of target demographics for the
organisation (Ratna, 2019).The healthcare workers can divide the geographical areas of
patients according to their ethnicities and cultures. For example, the Malaysian nurses can
provide medical services to patients living in the Malaysian area. With better
understanding of local knowledge about the area and patients, miscommunication due to
culture differences will not arise when nurses interact with the patients during their home
visits. Hence, healthcare professionals can tailor their healthcare delivery to the
individual needs of a multicultural population. Once the healthcare services become
patient-centred, the patients will feel more respected and have more meaningful
interactions with their physicians which can get patients in shared decision-making in
their healthcare. This definitely improves patients’ satisfaction, increases patients’
adherence to treatment plans and improves patients’ health.

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In addition, leaders of healthcare organisations should conduct weekly meetings to foster
communication and mitigate conflict in the healthcare teams (Mohammed et al., 2022). In
the meetings, all the healthcare practioners should be given detailed job descriptions and
clear job responsibilities by their department leaders to reduce role ambiguity.
Furthermore, the healthcare staffs should be allowed to negotiate about their roles and
voice out their concerns during the meetings. It is definitely a must for the healthcare
workers to practise active listening when the others are speaking so that they can
understand their messages. By having weekly meetings, the healthcare team can
experience patient cases together, therefore developing a mutual understanding on each
other’s roles and responsibilities as well as the stressors and pressures each group faces.
No doubt, the role of decision-making should not be neglected in the meetings. To
achieve equally important level of agreement, the managers should avoid any bias and
include all healthcare staffs in the decision-making process since decision adequacy
increases with participation of more group members. Decision consensus is important in
a healthcare team as it operates based on dyad leadership where two people from
different healthcare professionals work together to deliver healthcare services.

1.4 Conclusion

The healthcare sector in Malaysia is divided into two systems, namely government-based
healthcare systems and private healthcare system. Moreover, Malaysian healthcare sector
also involves in health tourism industry due to its lowest medical fees in the world.

Malaysia sees an increase in expenditure on healthcare from RM30.6 billion in 2020 to

RM 32.41 billion in 2022. In the Covid-19 era, most of the healthcare spending is
allocated for building healthcare facilities, procuring medical service equipment and
vehicles, emoluments for frontliners, tax relief incentives for health insurance purchase
and nation-wide vaccination programme. In the Covid-19 recovery phase, the
government raises budgets for R&D in healthcare and health tourism industry.

Undeniably, Malaysian healthcare workers have to cope with patients from diverse
population daily. Thus, an effective communication should be established in the

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healthcare sector as it increases patient enablement and satisfaction, improves internal
teamwork and enhances interaction between healthcare workers and patients. However,
effective communication in the sector is hampered by language differences, cultural
differences, perception and conflict in the healthcare team. These barriers can be
overcome by learning others’ languages, hiring healthcare staffs that are representative of
patient demographics in the targeted service area, using non-verbal communication and
conducting weekly meetings in the healthcare organisation. If these barriers are
addressed, the patients can develop trust with the healthcare practioners and feel satisfied
with the healthcare services provided.

1.5 References

Malaysia Healthcare Travel Council. (2020, February 2). The healthcare system in
Malaysia. Retrieved from :https://www.mhtc.org.my/2020/02/02/the-healthcare-
system-in-malaysia/

Husna Hasri. (2022, August 18). Effective communication skills a boon for doctors.
Retrieved from:https://www.nst.com.my/opinion/letters/2022/08/823234/effective-
communication-skills-boon-doctors

Sibiya, M. N. (2018). Effective communication in nursing| IntechOpen.

Retrieved from: https://www.intechopen.com/chapters/59779

Dawn Chan & Dhesegaan Bala Krishnan. (2021, October 29). Increase in Health
Ministry’s allocation a boost to medical, public health.
Retrieved from:https://www.nst.com.my/news/nation/2021/10/741099/increase-
health-ministrys-allocation-boost-medical-public-health-says

Ram Anand. (2021, October 13). Malaysia committed to reforming healthcare system
post pandemic. Retrieved from:https://www.straitstimes.com/asia/se-asia/malaysia-
committed-to-reforming-healthcare-system-post-pandemic

Cindy Yeap. (2021, September 30). Expectations of higher healthcare and R&D spend
may rebalance DevEx allocations in 12 MP
Retrieved from:https://www.theedgemarkets.com/article/cover-story-expectations-
higher-healthcare-and-rd-spend-may-rebalance-devex-allocations-12mp

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SDSU Global Campus. (2019, December 20). What are the benefits of effective
communication in healthcare? Retrieved from:https://cesblog.sdsu.edu/what-are-the-
benefits-of-effective-communication-in-healthcare/

Ratna, H. (2019). The importance of effective communication in healthcare

practice. Harvard Public Health Review, 23, 1-6.

Mohammed, E. N., Onavbavba, G., Wilson, D. O. M., & Adigwe, O. P. (2022).

Understanding the Nature and Sources of Conflict Among Healthcare Professionals in
Nigeria: A Qualitative Study. Journal of Multidisciplinary Healthcare, 1979-1995.

Tideman, V., & Tengelin, S. (2019). How Malaysian nurses deal with language barriers
during meetings with patients with another language.

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ONLINE CLASS PARTICIPATION

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