Sunday, April 20, 2008

This dispensing stuff again

I am still not finished with the dispensing issue yet.

I am surprised that after I posted 2 entries on dispensing rights, I received quite a number of interesting comments, especially from pharmacists. Even now, I still get visitors from Google search looking for 'dispensing rights' stuffs.

Before I say more, let's see what some pharmacists have commented.

According to MPS's president, John Chang CP:

"Doctors are only familiar with medicines that they often prescribe, not knowing adverse reactions and drug interactions. However, pharmacists are constantly in touch with the drugs industry," he said. With the separation of functions between clinics and pharmacies, Malaysia will join the ranks of other developed countries around the world which separate the role of doctors and pharmacists." (NST)

These are the many medications I give out to patient with Psoriasis.

I usually diagnosed this disease in a glance. Most part of my consultation is to explain to the patient regarding the disease, as well as various types of medications the patient need to apply, including the various detail steps on how the medications are applied and their various expected side effects.

Am I in no better qualified position to do the explanation and counseling in regards to the medications used and their various side effects?

How much one be sure that the pharmacists could explain how exactly I want the patients to use the way I want them to use?

I can tell you, they have no ideas and that is why I kept a full range of medications on my table to show and teach the patients how to use them.

Here's some comment from one reader:

"My point is that if dispensing separation were to take place, a check and balance system will be in place. The doctors wins, the pharmacists win, the patients win. Win-win for all. Isn't that good?"

My question now is, how are we really be sure that what the doctor prescribes, is what the patient should get?

This was the third time I encountered this on the same day.

I wrote a prescription for the amount of 200 gm, and the patient only received 60 gm. Did the pharmacists understand how much 200 gm is? Did they see the patient and estimate how much the patient need it? NO, and I am so tired of writing new prescriptions again and again just to get the exact amount of cream I wanted the patient to get. I am just so fed up.
Here was another prescription I wrote for a patient.

I wanted to give out the 'cream' form and for 30 gm amount.
This was what the patient received, 'ointment' and only for 15gm.

When I called back to confirm, they admitted it was their mistake.

Therefore, if pharmacists are to check on the doctors' prescriptions, who are there to check if the pharmacists dispense the correct medications and amount or not?

So, does the separate dispensing system really work with the 'check and balance' concept that benefit patients.

I hope doctors would not get new role, that is, to check back on pharmacists.

Read more about my posting over Storyformydoctor 1.0.


Anonymous said...

Like that also got thing to say~

Cytusm said...

Anonymous 3:51AM:
Funny isn't it? Like that also got people read.

Anonymous said...

Pharmt wants to earn more money.

Anonymous said...

The problem about getting medications from the clinic to me is that if i have any questions about my medication, it's hard for me to not doubt the answer given by the nurse dispensing it. some nurses looked like they've just finished high school! besides, the doctor is always occupied, and the nurse will just make guesses and give vague answers sometimes. and how can i be sure that the nurses don't make dispensing errors?

Jason Chan said...

good question anonymous no3.. thats why i myself who explain to patient regrading how to administer the medicine, dosage, timing, side effects etc and my nurse must write down name of the meds on dispensing bag and a log which i will check daily.. and if you have no confidence with the nurse, call to see the doctor lo... or any better suggestion from others

Jason Chan said...
This comment has been removed by the author.
Jason Chan said...

LOL to cytusm for your answer to anonymous no 1!

Anonymous said...

Am i glad, i am not working in Malaysia with doctors like you~

Fat4 said...

Omigod, I haven't blog much for a while and realised that you think i am a pharmacist? Just because I did not stand along with greedy doctors?

Just one quick question, did you graduate from either Malaysia or India and still practises third world medicine and has the belief that doctors are always superior? I am an australian grad who actually first hand experience dispensing separation. I do believe one should only comment on issues when they have full on knowledge of the issues at hand which unfortunately you didn't. A few of your comrades had vouched that you are a good doctor and perhaps I have misunderstood you.

Clearly you ought to study in depth what separation is all about before you continue on crapping. And again, I am not a pharmacist, thank you.

Cytusm said...

Dear Fat4, I am not interested to know whether you are a pharmacist or doctor. Where I graduated from is also irrelevant. What's more relevant is I work in the government hospitals that practice total separation of dispensing. I am illustrating facts that are happening in the local setting. No point keep comparing Malaysia with Australia. I am in no way implying that doctors are always superior but the fact is, the system I am working in right now is nothing more than some "third world medicine". I believe I am more than qualified to comment on what is relevant in my own medical community.

Fat4 said...

It does matter where you graduate from. It does matter when you actually wrote and say I am a pharmacist thus painting a picture that I may have been bias at what I have been advocating. Truth is, whether doctors are more superior, I do not think at any juncture my medical knowledge would be any lesser than you. Just that I do not practise it.

The hospital system in Malaysia practises what I call a half wit-dim wit separation system. And you should before you comment, take a close look at countries with separation of duties, rather than assuming that it would be the same as the hospital system in Malaysia. I believe that the medical school you went to, probably did not teach you how to judge reading materials constructively or critically. I have been telling you time and again, that dispensing separation is FAR FAR different from what you actually imagine it to be.

I don't think you are anymore qualified than myself to comment on what is happening in the medical community as I have been in the local medical community and with the discussions I had with friends and graduates from the Australian system, dispensing separation might be a better choice. Come on, don't just keep dreaming.