The Malaysian Pharmaceutical Society and the Health Ministry of Malaysia are conducting a trial on the separation of roles between pharmacists and private practitioners. Pharmacists are allowed to be the sole dispenser while doctors provide patients with the prescription.
The response from the public has been generalle y negative. Heris one article ran by Lim Kit Siang.
Here is my response to the article:
With the current system, it is not economical to open so many pharmacies within the community as our role as a healthcare provider is only limited to minor ailments and non-prescription drugs. However, in the proposed system, Pharmacists can play a role in the medication process by opening up pharmacies practically everywhere! By then, it will also be viable to make pharmacies 24 hours. A certain law/regulation/code can be done to ensure that there is a pharmacy available within the vicinity of a clinic or such.
Pharmacies are bounded by the Code of Ethics as stipulated by the Pharmacy Board of Malaysia. It states that “The Pharmacist shall not by words or deed or by inference thereof discredit or disparage the professional integrity, or judgement, or skill of another pharmacist or of a member of an allied profession”. This means that if a patient comes to the pharmacy with a prescription for Panadol, pharmacists are not allowed to dispense any other brands of Paracetamol other than Panadol. As such, when pharmacists are in a situation where they are uncertain of the prescription ordered by the doctor, it is only professional of them to consult the doctor without alarming the patient. In the case of the Patient above, her re-filling of prescription is by order of the doctor. The pharmacists have to follow the prescription unless he suspects any non-compliance or medication errors. Whether or not he suspects anything is the onus of his professional conduct. To say that the pharmacist will overrule the doctor’s prescription is not true at all.
In addition to that, private clinics usually lump everything as “consultation and medicine fees” onto the receipt. As some have mentioned, we all don’t know the exact breakdown of the prices. Perhaps the Ministry should enforce such breakdown requirements, and then only we can compare the prices between a clinic and a pharmacy.
Certain medical ailments also do not require a doctor’s attention. The pharmacies role is to counsel the patient on his/her current condition and to recommend a therapy for him/her to follow. If you have seen patients talking to the pharmacist and pharmacist recommending some medication, the pharmacist is not going beyond his roles as all these are minor ailments. Unless the pharmacist suspects further underlying causes, he is obligated to ‘refer him/her to a doctor’. Yes pharmacies can help you measure your BP, measure your body temperature, check for scabies, dandruff or sunburn. Are these what you refer to as physical examination? In economic sense, this definitely reduces the patients’ financial burden to pay for consultation fees. Pharmacists do not charge for consultation.
My point here is, the physician-pharmacist role with regards to proper medication usage and patient safety can be greatly enhanced through such a system. Of course, there are other factors to consider like whether current pharmacists in Malaysia are equip through their professional education to dispense and counsel the patients appropriately? And whether patients are ready to trust pharmacist as much as how they trust the doctors.
FYI, you don’t have to get the medicine from the clinic itself currently. If you request for a prescription, you can always bring a prescription to your friendly neighbourhood pharmacist!
Comments are greatly appreciated =)