APHM said the treating physician, in practice, always takes into account a patient’s overall condition, existing comorbidities, and the specific risks associated with the procedure to prescribe the appropriate choice of anaesthesia.

“The clinical judgment of treating physicians is important as inappropriate anaesthesia prescriptions can result in serious morbidity or even mortality,” it said in a statement.

“Payers can always request clinical justification for the use of GA or LA and must not override the clinical judgment of the treating physician, as patient safety must always remain the highest priority.”

The statement follows reports that a third-party administrator is recommending surgeons prioritise local anaesthesia over general  anaesthesia for surgical procedures through a directive.

The directive was criticised by the Malaysian Medical Association, with its president, Dr R Thirunavukarasu, saying that such directives amounted to interference in clinical autonomy and were a clear breach of medical ethics.

Separately, the Malaysian Society of Anaesthesiologists, and the College of Anaesthesiologists, Academy of Medicine of Malaysia described the directive as a profit-driven intrusion into medical decision-making, saying it represented “an unethical attempt to dictate patient care”.

This morning, the Private Medical Practitioners’ Association of Selangor and Kuala Lumpur also criticised the directive, calling it “unacceptable” and “deeply troubling”.

It said such directives compromised patient safety and undermined the integrity and autonomy of medical practice.