Materia Medica Malaysiana

Doctors need a health minister, not a lawyer: "I am disturbed by the recent call from Health Minister Chua Jui Ming for the Malaysian public to take legal action against doctors suspected of abusing antibiotics. Although I agree that the increased resistance of bacteria to antibiotics is a concern, his drastic move is unbefitting of a health minister.
The duty of a health minister is to ensure that the Malaysian public is provided the best standard of medical care. Proper prescription of antibiotics is thus an important issue that ought to be tackled. He must ensure that continuing education of doctors, in particular, general practitioners, be emphasised. He may want to look into ways of monitoring prescription practices or even penalties for violation of certain codes, in particular relating to antibiotic prescription. He should also stress on educating the public on the use of antibiotics for bacterial infections and the importance of its judicial use.
He should not however, confuse law with medicine. As health minister, he should not encourage the public into taking legal action against doctors suspected of abusing antibiotics. This may lead to upward spiralling of medical costs. He should not make statements that will damage the credibility of the medical profession and thus erode the trust of the public in their very own doctors. He should not base his statements on hearsay but on concrete facts.
How bad is the situation? What are the resistance patterns of bacteria in Malaysia? How is the public able to discern when an antibiotic has been appropriately prescribed?
From the viewpoint of a government medical officer, I do agree that antibiotic resistance is a growing problem that needs to be addressed urgently. Although general practitioners are being targeted as the bad apples, they are unfortunately not the sole prescriber of antibiotics.
Medical assistants and pharmacists have the authority to prescribe these drugs without a doctor's prescription. Most medical assistants are employed in government clinics, and antibiotic abuse is rampant. Should legal action be taken against them or the doctor in charge of the clinic? Even pharmacists prescribe these drugs to willing and asking customers. What is the government's opinion on this?

Even the public should the chastised for the problem of antibiotic abuse. I once covered as a locum in a private clinic. A father brought his child complaining of fever and cough. After the necessary assessment, I mentioned that it is a viral fever for which only symptomatic treatment is warranted. The father then demanded that his child be given antibiotics. I stressed again that there is no need for antibiotics and mentioned the rationale behind it. At this point he became annoyed and rudely asked for the antibiotics. I had to comply with a paying customer.

The point is that the medical profession needs a health minister, and not a lawyer, to represent, advise, listen and most importantly to defend them if necessary. We are, after all, imperfect mortals.

(above is a letter to Malaysikini )