Separation of doctor/pharmacist duties: Diverse opinions on plan

NST: KUALA LUMPUR: "You have tonsillitis. This is your prescription slip and you can obtain the medication at any pharmacy."
The conversation above may well be too familiar in the future if the Health Ministry decides to allow doctors to only issue the prescription with patients having to get the medication at pharmacies.
According to a recent news report, the Health Ministry will soon launch a pilot project on the separation of functions between clinics and pharmacies, where, in the future, dispensing medications may be the exclusive rights of pharmacies.
"I think Malaysians are not ready for the separation of functions between clinics and pharmacie," said consumer activist Gurmukh Singh.
Gurmukh said the Health Ministry should consider several factors.
"First, at the moment, I don't think there are pharmacies that open round-the-clock.
"If your child suddenly develops fever or diarrhoea in the wee hours of the morning and you rush him to a 24-hour clinic.
"Imagine your annoyance when the doctor only gives you a prescription slip and asks you to get the medication from a pharmacy.
"After that, your blood pressure shoots up when you can't find a pharmacy or any which opens at that particular hour."
Mother of three Zaidah Zainal, who stays in Green Valley Park near Rawang in Selangor, said there were not many pharmacies in her neighbourhood.
"In my area, there are five clinics, but only one pharmacy is in operation.
"If the health authorities decide to separate the functions, then we should have more retail pharmacies around to cater for the expected higher demand."
Contrary to what people may say, separating the functions can be costly to consumers, said social activist Fatimah Mansur.
"The doctor has to charge consultation fees. If you get your medication at the clinic, the total amount charged is definitely less than the whole amount charged for separate consultation fees and medication," she said.
The Malaysian Medical Association (MMA) recommends a minimum fee of RM30 for a doctor's consultation, but most of the time private practitioners charge less than this amount.
Fatimah said the public prefer to go to only one place, and at present, the clinic serves as a one-stop centre.
"You can get your medical check-up at the clinic. Your blood test can be done, as well as X-rays.
"By the time the doctor has finished with them, the patients maybe too tired to go elsewhere to get their medication."
And the move, if implemented, would be time-consuming and related costs would rise.
"Imagine after seeing your doctor, you have to drive around to look for a pharmacy.
"You may find one, but then the medication required could be unavailable, and you have to look for other pharmacies."
Thus, the actual cost is higher, as the public may have to spend more on petrol for their vehicles, she said.
According to Health Ministry's statistics, there are about 1,600 pharmacies nationwide.
Educationist Ikmail Ahmad Borhanodin said the public should allow the Health Ministry to conduct a study to determine whether the separation of functions is suitable for Malaysians.
"Allow the consumers to make their own choice, as at the moment they let the doctors dispense the medication. They have the choice on whether to get branded or generic drugs, so they can save money."
Ikmail said there are some good points to such a move.
He said doctors are only familiar with medicines that they often prescribe, while pharmacists are always in touch with the drugs industry.
"But, bear in mind that the doctors have the knowledge on medical problems as well as their causes. And they are familiar with the patients too".
The priority is for the public to have good healthcare services, said Gurmukh.
"The pharmacies must improve their services. Sometimes when consumers walk into a pharmacy, the pharmacist is not around and nobody else can dispense the drugs. This is wasting the public's time."
Gurmukh said for a start, the "pharmacist not in" syndrome should be discarded.
"In Malaysia, there are many clinics appointed by employers for the convenience of their sick workers. Employers want to make it easy for themselves and their workers."
Under this concept, employers will foot the medical bills of their sick workers. Usually the employers would pay the panel clinics monthly, after receiving the respective invoices.
"Do we need to have panel pharmacies later?" asked Gurmukh.