HOW TO OPEN A MEDICAL OFFICE PRACTICE IN ETHIOPIA

Did you know a licensed general practitioner or health officer with zero years of experience can open his/her own medical office practice in Ethiopia?

One of the latest installments in the fight against the high unemployment rate of health professionals is the establishment of medical office practice, which has recently passed through the Ethiopian Standards Agency to successfully get requirements and approval ready.

Medical office practice refers to an outpatient or an ambulatory medical care whereby the general medical practitioner or health officer take history, performs medical examination and sends patients for investigation (laboratory and imaging service), prescribe medications and give referral service.

What are the services given by a medical office?

The medical office practice shall provide service at outpatient/ambulatory level only.

Disease preventive, health promotion and health maintenance services.
Provide assessment, diagnosis, follow up & referral of ambulatory patients with acute and chronic conditions
Medical checkup and screening
Consultation on service consisting of
- - Maternal and child health services including preconception, family planning, antenatal care, postpartum care, infant feeding and growth monitoring.
  - Adolescent and youth health consultation service.
  - Short term family planning service.
Potential source of accidents shall be identified and acted upon like slippery floors, misfit in doorways and footsteps and
Diseases under national surveillance shall be notified to the appropriate organ through the proper reporting channel. A suspected ADR cases shall also be reported to the appropriate organ and all adverse medication effects shall be noted in the patient’s medication record.
The medical office practice shall have functional referral system which includes at least:
- - List of potential referral sites with contact address (i.e., referral directory)
  - Referral forms
  - Referral tracing mechanism (linkage)
  - Feedback providing mechanism
  - Documentation of referred clients

The medical record of patients shall include, but not limited to pertinent history, physical examination, investigation, diagnosis and management. Patient/client assessment shall include:

Comprehensive history
Physical examination including at least:
- Vital sign (BP, PR, RR, To, pain assessment) height and weight
- Clinical examination pertinent to the illness
- Diagnostics impression
- Other medical workups when indicated (outsourced)
- Management: The medical office practice shall keep documentation which shows medicines source, date of purchase and receipt, inventory records, medicines waste disposal records and other relevant information. The prescription paper shall contain at least:
  - Office practice name
  - Name of patient, sex, age and medical record number, address
  - Diagnosis and allergy, if any
  - Name of the drug, strength, dosage form and total dose given and route of administration
  - Prescriber’s name, qualification and signature
  - Dispenser’s name, qualification and signature
  - Date dispenses

These services given shall be available depending on the professional convenience and working hours shall be posted at a visible place to the public.

N.B: The practice shall avail updated reference materials, treatment guidelines and manuals.

Rooms required

Room required	Number of rooms	Area required
Reception, recording, waiting area
Examination room	1	12 sq.m
Toilet can be shared with third party	1

Professionals required

The number and type of technical staff shall be determined by the volume and type of work carried out. But the following requirements should be maintained.

The medical office practice shall be directed by a licensed general medical practitioner/health officer.

Professionals required	Minimum number required
General medical practitioner / health officer	1
Nurse (optional)	1
Receptionist (optional)	1

Equipment and supplies required

Vital sign and diagnostic set:

Thermometer
Stethoscope
Sphygmomanometer
Otoscope
Fetoscope
Pulseoxymeter
Reflex hammer
Glucometer
Examination couch

Weighing scale
Height scale
Tap meter/MUAC
IV stand
Spatula, surgical and disposable gloves, antiseptics, cotton, gauze
Office’s furniture (table, chair, guest chair, shelf)
Based on the scope of practice emergency medicines (adrenaline, diazepam, glucose 40%, IV fluid, nifedipine, salbutamol and hydrocortisone).
ORS
IV cannula (different size)
Resuscitation kit (ambubag, guedl’s airway)
Wound plaster
Snellen’s chart
Safety box
Waste bin

About waste management

Health care waste shall be managed according to health care waste management guideline. Health care waste disposal can be outsourced with formal agreement.

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This article on medical office practice in Ethiopia is from Ethiopian Standards Agency (ESA) which is the national standards body of Ethiopia established in 2010 based on regulation No. 193/2010. ESA is established due to the restructuring of Quality and Standards Authority of Ethiopia (QSAE) which was established in 1998. It provides minimum requirements for the establishment and maintenance of medical office practice with respect to practices, premises, professionals and products put into use for the office practice as described above.

Download Medical Office Practice – Requirements.

For further information contact through the following address

Phone numbers: 011- 646 06 85, 011- 646 05 65, 011-646 08 80

Postal: 2310 Addis Ababa, Ethiopia

E-mail: info@ethiostandards.org,

Website: www.ethiostandards.org