Doctors to be disallowed from dispensing medicines
Well, this is a good news for all the pharmacy students and pharmacists in Malaysia. Finally, dispensing separation is carried out, where only pharmacists can dispense medicines while doctors can only prescribe medications.
Malaysian pharmacists have fight for this for almost 20 years. However, from the past few years, we always heard that dispensing separation will be carried out in 5 years time. Yet, a lot of pharmacists think that it is difficult to carry out as lack of pharmacists in this country. And some of them also said that, most of the members of MOH are doctors. They won't put their careers into high risk.
As we know, doctors earn money mostly from the medications they prescribed and dispensed. As dispensing separation occurs, doctors can only earn money from consultation and not from the medications. This will finally led to lower incomes for doctors.
However, if think more deeply, it is a good way for both pharmacists and doctors. Doctors can now more focus on their job, such as diagnosing and precribing, while pharmacists can reduce the workload of doctors, by handling dispensing and counseling on medications use.
And from this mutual cooperations from both pharmacists and doctors, the final comsumers, the patients will be benifited the most.
However, this will only be launched at selected major towns for this time-being with close monitoring by the MOH. But I believed that, dispensing separation will occur soon in someday in the future but not too far away from now. I believed......
more information, pls visit http://www.nst.com.my/Current_News/NST/Saturday/Frontpage/2198656/Article/index_html
29/3/08 11.30pm
Latest news, an article on "No decision on docs dispensing medicine" was published in The Star stated that the MOH has denied the report/article published in the NST.
Further information, pls visit
http://thestar.com.my/news/story.asp?file=/2008/3/29/nation/20080329181846&sec=nation
1/4/08 11.39am
Conversation between John Chang from MPS and Datuk Dr Khoo Kah Lin from MMA.
http://www.nst.com.my/Current_News/NST/Monday/Frontpage/2200105/Article/index_html
11 comments:
for me. i not totally agree of what has been suggested.
the reason is that, do the pharmacist really know that the patient's diseases? the patient's allergy?
mostly, when the prescription being given to the patient, there will be only the drug name.
and the patient will go to buy the medication from pharmacy and it will making them feeling very difficult and need to travel to another place to buy the drugs. then, as stated earlier, the prescription only have drug names, and doctor need to tell the patient that because of the patient's condition is such like that, so he need to take such drugs and the expected side effects are like that. then, will the pharmacy really understand the patient conditions with just ONLY THE PRESCRIPTION??do the pharmacy really understand why the medication being prescript? it is because that patient is a human, they need a holistic approach and not only drugs can help them. since now the job being taken by doctor and said that doctor don need to advice on the medication parts, then do u think that doctor feel easy? no..NO...
because that most of the doctor, not ALL, will uncontrol themselves to advice patient, as they care the patients.
ok..say that pharmacist really more expert in side effects of drugs and the mechanism. then, do the doctor are not sure of the medication? doctor if not sure of the medication, how can they prescribe the medications? my prof always ask me the side effects and the mechanism of the drug. we study also based on the cpg, and we are care of the patient holistically and not just the medications.
why pharmacist so happy with the role of prescription? because they can earn the money more,is it? i'm not sure.
who is really more understand the patient's feeling? who spend more time with the patients?
i think is better go back to doctor.
of course, we are trained to be profesional and have the law to control us, so do u really think that doctor will cheat patient's money to sell the most expensive drug to them?
finally, sorry if someone being hurt here.
if u r the patient, who will u trust more on your disease caring?
a person who are being trained to understand the diseases in 5 years medical school and then many many years of practice, and can relate the diseases to human as a whole and thinking of how to manage him either from prevention, medication, mentally, socially....?
i think doctor as a leader of healthcare as they know this patient need what kind of management, like physiotherapy, then refer, because we are not learning physiitheraphy. refer for social welfare, because we are not sure of how to give the welfare.
but, we learn medications in 5 years, it is part of our life. so , should doctor get the rights for medication?
i hope u all understand.
or a person who just study for one year pathology and diseases, then most of the time in medications structure,medication chemical part,side effects?do u trusting the person in advising u regard the medication? because he is not sure of your diseases.....
sorry again.
To anonymous,
I partially agree to what you had said.
I agree that most of te prescription given have only the drugs name, some with the diagnosis and without others information. Pharmacists might feel difficult to counsel the patients.
However, based on the experience, the pharmacists can know what illness the patients have based on the drugs prescribed. You might say the pharmacists are merely guessing what illness the patients have. ya, is true, it may be not nice to the patient. But, if the pharmacists are not sure with the diagnosis or having any doubt, they can call back to the doctors. So, doctors should fill in the prescription completely if possible. And mutual communications between pharmacists and doctors take place here.
As i encounter in some hospital, the doctors are so busy with their rounds and clerking, and not even have the time to chat with the patient, and discussing patients' ilnessess. Do you think that doctors can counsel the patient well enough?
In normal GP, do you think the doctors counsel the patient on those side effects of drugs preceribed? I think most of the patients went to GP outside will agree to what I said. The dispensing is done by the assistance without any knowledge on medications. What they tell is "this medicine take 1 tablet twice a day after food". Thats all. Do you think that the doctors done their job on counseling patients?
I agree that the patients need holistic approach. But why don't we give the job to someone is more professional in it? Why doctors can refer to dietitian, physiologist and not to pharmacists since they are not so professional in it?
Ya, doctors also know the side effects of most of the drugs. But again, do the doctors have enough time to counsel the patients? Doctors have so many things to do, need to do diagnosis, clerking, etc. Do they free to do this? I think time is the matter that stop the doctors from doing so.
Some of the doctors will think that pharmaicsts in hospital like supervising them and finding errors of doctors on precriptions. That's why some of the doctors are not so happy with the presence of pharmacists. We are there to make sure all the drugs given to the patients are in correct and appropriate dose.
But think it twice, what are the roles of pharmacists? And what are the final goal we wan to achieve for all health care providers? Our goals is the same, for patient own good. Why pharmacists and doctors can not co-operate in achieving this goal?
And lastly, if i am not mistaken, medicine only study 1 year of pharmacology. Do they really know how the drugs act in our body? There are so many drugs available in the market, do they know how each of the drug act? I agree that pharmacists are also not really know how every drug act in the body. But this is the role of pharmacists, they should find out if they do not know.
And for your information, pharmacists study on medications structure is for better understanding on how the drug act. And they study 4 years on pharmacology and drug use and also on basic human anatomy and physiology. Do you think that the pharmacists are not professional enough on dispensing medications?
And i agree that this is still not the time for dispensing separation to occur as they are few pharmacists and pharmacies nowadays. As more and more pharmacy course started nowadays, I think it can be carried out in a few years time.
Sorry, if I hurt someone...
If you have anything want to add on, feel free to do so....
I think better u go to have a round for whole country before u conclude that doctor have no enough time to educate patient regarding the medication side effects and etc.
It is very hard for doctor of not advising patient regarding the medication as diseases and medication is as one, hei, doctors are treating the patient and not the diseases merely.
Can u imagine that “oh,my part is only up to diagnose u have hypertension, and medication I cannot tell u anymore. As Malaysia system said I cannot do like that.”
Ha ha ha ha ha
Why doctor can refer to physiotheraphy, dietitian, but why not pharmacy?
As doctor has been trained to use the medication for 5 years, everymoment/seconds, they are learning diseases and medication.
And the role of physiotheraphy and dietitian is for recovering and preventive, means that they are not in the acute line/ or not as emergency part.
Why doctor learning medication? As they know they need to use it, especially for acute case.
Why we have CPG? As we want to educate our doctor regarding how to use medication.
I can’t imagine if one day that this system has been implemented, then the medical student will be taught that:”because your job is diagnose, then u don need to pay full attention as doctor before on the medication”
Walau yeh, such system if come out……BAD day, Malaysia!!
Why other country can have such system,and why not us?
Yes, we can learn from them.
But, is it suitable?
Our public transport ok?
Our facilities ok?
Our shop house ok for us to do that?it will increase the cost, brother!!!
Moreover, we are moving forwards, why we ALWAYS want follow others?
Why this time, we have our own idea?
One best example is that everybody in healthcare system are almost disagree of using laptop in their clinical ward round and clinic (as far as I know). WHY?
Because they are slowing the ward round, need long hour of typing, and is quite hard for doctor to flip through all the pages compared with the current case notes, easier, faster.
Please compare:
If pharmacy call doctor to ask patient case history,in which may be 10 years history, is it easier compare to doctor calling pharmacy to ask the medication side effects once in a blue moon, which one is easier.?
In addition, since few years back, there are SOME non-doctor already diagnose patient diabetes/hypertension etc, is it ethical?
Doing promotion for healthcare, is it ethical?
Why always said doctor only know the popular drug and not the new drug?
Because CPG/GUIDELINEs, asking them to follow, as new drug haven’t have good evidence yet.
Sorry if saying wrong anything.
"But, if the pharmacists are not sure with the diagnosis or having any doubt, they can call back to the doctors."----huh?like this then doc's workload will be more heavy instead of reduced,right? of course, there are many pharmacist do so in hospital setting...that's good to clarify...however, not pharmacist follow up the patient's progression what?!or pharmacist want to have another 'clinic session' with patients?that will be burden, not only to patient, but MOH's resource i think......
i'm curious that why use the statement 'doc dispensing medicine to earn more money' as a reason to disallow docs from dispensing it by their own??? it mean pharmacist won't earn 'more' from dispensing drug if they are the only one who can do so?what i mean is pharmacist create a route to earn more?
I think after all is the communications between both parties, pharmacist and doctor.
Both parties are trying to make more money and fighting for the right to do so...
Can doctors and pharmacists co-operate together for the good health of the public? I wonder...
above anonymous,
please don't said us,dr and pharmacist, earning money from medication, it's seem like dr and pharmacist should willing to treat as a volunteer.
hei, bro, they are human la, also have family to take care one de la..
and also, we are clearly not fight for money,but is fight for the right and the benefit of healthcare system.
why not ask the malaysian to decide since for the benefit of healthcare?
brother, i think that sometime to those who are working inside the healthcare system, they will be more understand the whole system. what the others seen one is just the very very superficial one.
not valid!!
what is the proof?
ok, ask u, do u know why a surgery is so "expensive" for "somebody"?
u will surely said is because dr want earn...
sorry!!!!!!!!!!
surgery is also including the operation theater, in which the maintainance need a huge money and also the condition need to be sterile, do u know how much of money has been spent over here?
also, the other staff also get involve ah..
staff nurse, cleaner, technician, radiologist, anaesthesia..bla bla bla....
also the cost also include the other spends...in which i have no time to tell u anymore. c u!!!
\
thanks.
sorry again for above any wrong statement or if hurt u, ha ..
hopefully is no la ..
所以倒底是醫藥分業了沒？看新聞感覺上是說還沒分啊。討論很激烈噢，看樣子我也得在我那兒寫一篇發表看法才是哈。
That's a pretty good idea, because here in the Philippines some doctors sell medicines that they hoard or jack up the price of.
Peace.
This issue of dispensing separation has been on for quite some time. I personally think that this dispensing separation can be implemented phase by phase. Other developed countries have done it well. Why should not we give it a try since we can improve the current health care system.
Pharmacist is the best people for public to get advise on medications. Why? This is because of the openness and the knowledge that they have on medication. Let's say, a person want to know whether he/she can take that particular supplement along with the medicine that he/she is currently taking, the best person to consult is pharmacist.
Anonymous suggest to let Malaysian to decide. Well, do you think everyone know the current situation? They do not know the proficiency or doctor or pharmacist. All they want is the best system. Both doctors and pharmacist should sit down and talk instead of using the media to condemn each other profession. In the end, the public will lose confidence in our health care system. All because of money, two of important healthcare professional argue day and night.
For dispensing separation to occur, I would like to suggest that only places that has both clinic and pharmacy within walking distance be allowed for this to happen. Walking distance means within the same row of shophouses or next row. A lot of places in KL has fulfilled this simple requirement.
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