Wednesday, 2 April 2008

Pharmacist Dispensing Right in Malaysia

I was just reading the news about the upcoming pilot move to shift dispensing rights to pharmacist. O the controversy!

All the doctors go, "NOOO.. this is going to cost the patients more as they have to pay for consultation fee and also another charge for medicines! The trouble they have to go through just to get their medicines." or "There are no pharmacies placed conveniently near the clinics and not enough pharmacists to go around." or "Pharmacists are just money-grabbing no-good people who want to earn more money out of this."

Few issues I would like to address here:

  1. Pharmacists go through 4 years of studies, if I dare say, intensive study of medicines and their properties. I, as a pharmacy student, do not see myself as stepping over the boundaries of the medical profession. What we do is complement it by giving the best of the two expertise (from doctors in their diagnostics and pharmacist in their medicines) to the patient. Ultimately, it is the patient who is going to benefit the most out of this.
  2. By separating the two roles (prescribing and dispensing), a lot of medication error can be avoided. We are all human after all, so mistakes do happen. But with two people being vigilant in the care of a patient, many errors can be avoided.
  3. There are not enough pharmacists because most students do not even consider going back to work as there is no future. I, myself, have always wanted to go back and work, and managed to convince myself that everything will improve with time. But with some doctors looking down on pharmacists and refusing to give up dispensing rights, how is it possible that pharmacy in Malaysia will improve? If ever that the dispensing rights are given to the pharmacists, more students will consider going back. There would be more pharmacies opening near clinics for better access by the patients. The fact that pharmacists now working in the community in Malaysia are often nothing more than shopkeepers, selling shampoo. Without the need for pharmacist, why do we need a pharmacy in Malaysia? Why go back when here in the UK you are regarded as someone who is a healthcare professional able to give useful advice?

This topic is just what I thought about when I was writing my paper on "Is Pharmacy a Profession?" for my Social Sciences and Pharmacy module. Writing that paper really made me think about what I was doing in Pharmacy when there are such questions being asked. Here is UK, pharmacy is slowly evolving into being a real profession. But in Malaysia, pharmacy can never be considered as a profession if what we study for 4 years for is never being given to us to practice.

This government move is a good chance for pharmacy to be viewed as an actual part of the healthcare system. It does not have to happen overnight but slowly, step by step, better prospects will be there for pharmacists.

Some news and letters:

http://www.nst.com.my/Current_News/NST/Saturday/Frontpage/2198656/Article/index_html

http://www.nst.com.my/Current_News/NST/Wednesday/Frontpage/20080402120749/Article/index_html

http://www.nst.com.my/Current_News/NST/Wednesday/Letters/2201251/Article/index_html

http://www.nst.com.my/Current_News/NST/Monday/Frontpage/2200105/Article/index_html

 

I think I don't make sense in parts of this blog.. who cares.. I have vented out my frustrations and that's that.

 

P/s: Another point made by a person who I shall not name is that there are not enough 24 hour pharmacies to deal with dispensing. Correct me if I'm wrong, since I don't go around Malaysia looking for doctors, but how many clinics in Malaysia are 24 hours? Some pharmacies also open til quite late. The reason why not a lot of pharmacies open till the middle of the night is because for NOW, there is no need for it! As before, lots of changes would occur if the dispensing rights are returned to pharmacists. And I say return because it is always the right of pharmacists!

Is not the healthcare industry big enough for everybody?

Added on 03 April: http://news.bbc.co.uk/1/hi/health/7326856.stm 

News on how pharmacy is evolving in the UK

23 comments:

Anonymous said...

yo ganas-nya

i do agree with ur post!! go emily go, go fight for pharmacy students!!

we dont spend few hundred k and 4 years just to open a shop to sell shampoo. my placement back in msia was so redundant.. showing customers where are the toothpaste, shampoo, vitamins and date check for vitamins. wth..

~em~ said...

lol.. i could've used some of the points i used here in the assignment we did.. haha

Anonymous said...

Dear Miss,
Should learn from singapore government. Let the patients decides for themselves where to buy medications. There are many pharmacists who play the role of doctors, I for once was given giddy medications from a pharmacist and it turned out that I had hypertension. That pharmacist should advice me to consult a doctor and not just dispense medications.
LIM

~em~ said...

hi Lim.. I agree the pharmacist should have referred you to the doctor and this is what we pharmacy students learn (at least what I learn here in Nottingham and i'm sure elsewhere is the same). Minor ailments and major diseases... Different diseases and illness minifest themselves in very similar symptoms so we learn all the warning signs and symptoms that are absolutely urgent to be referred.

~em~ said...

oh ya.. we call that responding to symptoms..

mrbherng said...

To be honest, it's quite difficult and will cost either the patients or the DoH a lot of $$$. The GPs in Malaysia are all private whereas in the UK, they are contractors of the NHS. In the UK, patients (most) don't pay to see the GP and may not need to pay for their prescriptions too since NHS will be footing the bill. In Malaysia, unless the DoH is willing to pay for everything, this system will only add extra burden to the patients.

It will take a overhaul of the health system to implement the speration of dispensing rights.

Anyway, this topic had been brought up now and again for soooooo many years.

~em~ said...

yeap... it's a recurring topic.. i don't see it happening in the near future tho..

ZhiHao Chua said...

noooo~~~~~~ hahahahaha
i think it's a good thing though...
from wad i see, malaysian pharmacists are so "underexploited" that private pharmacists just turned into business people... it's just capitalism

~em~ said...

next time u refer your patients to me k? hahah... thn i'll do the same to u.. :D
anyway, there's nothing for private pharmacist to do.. except business..

ZhiHao Chua said...

hahaha! good idea!
of course!
maybe u should consider taking up some management courses or business as electives! ;)

~em~ said...

yea.. maybe i should.. haha.. r u going to go back to practice?

ZhiHao Chua said...

maybe.. dunno la..
undecisive.. hahaha
i'll tell u few years later! haha
but i suppose i will~

~em~ said...

hahaha... well.. u have to... thn can refer patients to me.. haha

NadraNadia said...

Hi Emily..
I'm Nadiah from Manchester.Just randomly found your blog while google for about dispensing right.
Love this entry.I'm sure you want to know more about this :
Malaysian Pharmaceutical Society - UK Student Chapter.
Click here : http://groups.yahoo.com/group/mps_uksc/

C ya!!

Gabriel said...

Hi! I'm a year 2 pharmacy student from singapore and i chanced upon your blog while looking for dispensing rights. I was wondering if i could contact you? I'm very interested in finding out the dispensing rights situation in Malaysia.

my email is yellowtofuwarrior@hotmail.com

Thanks :)

Anonymous said...

Hi,
I'm a phamacist workin in Malaysia. May I ask if u r a pharmacist workin in Uk? I am interested to work in Uk as a pharamcist. How did u go about working there?
How is the working condition there? Would you say that the grass is greener on the other side? Wat is the living cost like? How much nett..can u save up a month?
Please.need ur opinion
Thank u vy much!

~em~ said...

Hi anon.. i'm not a pharmacist yet but only a pharmacy student. i can only say that as a pre-registration student u get about 1800 pounds a month... i would not really know about the grass being greener as i'm not working yet u see... u can probably get more information if u search the NHS website... they have info about pharmacists.

sorry... not a very big help..

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Anonymous said...

in response to Lim. Not to have anything against singaporeans or singapore. But this is the training that i think singapore should concentrate on. OTC! I have a couple of friends who are pharmacist and who are singaporean too.. that say that pharmacist in singapore clinically is good.. but in the community is kanasai! OTC stuff is very bad.. don't even know what Thiamine is.

So, i do agree that pharmacist should refer things to the doctor. But doctors are not God and make mistakes too. Pharmacist in other countries are given more responsibilities and hence more knowledge. From what i can see here in Australia, pharmacist ( my friends) do so much more.. and give the same advice as my useless GP who could not even diagnose my ailments properly. It comes down to individual, please do not generalize.

Aaron

~em~ said...

From what I've learnt from Thai friends, I would say the situation is similar in countries in South East Asia. Community pharmacists just don't do anything much. I would say hospital pharmacists, at least from what I saw in the general hospital I did a short placement in, that they do clinical stuff.. ward rounds and all that.

Stuff that I see going on in hospitals here in UK.

So, i'm not that keen on opening my own pharmacy when I go home. I'll just stick with hospitals.

Anonymous said...

some docs in 3rd world countries think we are just for advise only.
http://cytusm.blogspot.com/2008/04/10-reasons-why-doctors-should-maintain.html
we should speak up

Anonymous said...

Good article...even now i can see the doctor take place the pharmacist role to open his own pharmacy and clinic too...i really don't know why our Malaysia government can give this things happen...if they really dont care pharmacy carreer,why they still want to open this course to the students.Is it should be doctor take role in diagnosis and pharmacist take role in dispensing drugs?If this thing still happening,i think our country healthcare system quality will become very low compare to other country

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