Monday, March 31, 2008

Doctors & Pharmacists....

..and to whom should you go to get your medicine?

There is an ongoing debate on this issue following the statement last week by the Health Ministry's director-general Dr Ismail Merican that soon, doctors would only be allowed to issue prescriptions but patients needed to obtain their medication from pharmacies.

Currently, doctors especially at private clinics diagnose diseases, prescribe medicines and dispense them to patients.

That is about to change.

I think I am comfortable with the current arrangement -- visiting my doctor and getting the medicine from him (at his attached dispensary). So easy and convenient. No hassle.

Doctors and pharmacists, of course, have differing views on this. Read this and this.

In arguing the case, the point on profit-making by either side has been made.

As far as I, the consumer, am concerned -- it should be about my convenience.

If patients have to get their medicine from pharmacies, make sure that the pharmacies are located near clinics and that pharmacies and clinics have the same operating hours.

I remember that some time ago, I needed to get a particular medicine after 6pm at a particular pharmacy but I was told that the pharmacist was working from 10am to 6pm.

So, my point is that any change to the present arrangement should only be effected when everything is in place.

You know how we are so good at introducing changes and these changes fail to meet the desired results because of poor management and administration and because not everything is in place.

Dr Ismail said "soon" we, the consumers, will have to do two things in order to get better -- 1. to have our condition diagnosed by a doctor who will prescribe the medication and 2. head to a pharmacy to get our medication.

Let's hope by the time that "soon" takes place, consumers will not be burdened.

Doctors and pharmacists can argue till kingdom come about the merits and demerits of the issue but ultimately, it is the interest, well-being and welfare of patients that are paramount.

By the way, this proposal is not new.

36 comments:

James Joyce said...

Hi

If I know the Malaysian business ethics, there will be no problem. The properties next to the clinics or the pharmacies will have a boost in their rental.

Malaysians are naturally born lazy. They want (sorry - demand) convenience. And there will always be someone that will cater to this demand.

I do not see any problem with this arrangement.

Navi said...

Each time a new legistlation is passed we end up losers. In this arguements who dispenses best which translate to cheapest is subjective. Most people are happy with the current arrangement where doctors prescribe and dispense the medicine. The moment this responsibility of dispensing is passed to the pharmacies, the chances are that the consultation fee by the doctor will shoot up.
Added to that will be the hassle of the SICK travelling from clinic to pharmacy, the lack of pharmacies in rural areas, the ones suffering will be the poor. Until the facilities in the country are brought to that of a developed nation, let things be. We are still lagging behind.

bona said...

Is this a normal thing for developed countries? I'm not sure. KKM should do 'trials' before take this into action. If KKM try to emulate Ministry of Education, it will only bring hell to people.

Tomas Lai said...

You are very right, Nuraina. It should be about the patient's convenience. Imagine, you are already feeling very sick or you have a sick child and after seeing the doctor, you have to go hunting for a pharmacy which has a pharmacist in attendance at whichever hour. Not to mention, the parking woes or additional taxi fares etc!
The pharmacists' frequent claim of helping us to lower our medical bill is that much bull as we all know they are not being altruistic. It is all about business and they want a cut of the pie.
In fact I believe such a move will definitely increase our cost of being ill, as obviously the doctors cannot then cross-subsidise their fees with the medicine and we get hit with a higher "approved" visit fee.
If the DG is still insistent to bow to the pharmacists, maybe a better solution is to legislate a choice for the patients ie we are given a choice to either buy the medicine from the doctor or go to the pharmacy after the visit.
Prominent signs allowing a choice are to prominently displayed and doctor to be required to offer the choice after his examination.

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rational thinker said...

dear kak,

this has been the operation method for clinical practice in oversea for YEARS. Yes, business and practical sense would means pharmacies and clinics should be closed together. the law should also prohibits co-ownership of pharmacies and clinics, as that would only defeat the purpose of the separation in the first place. don't you worry kak, if the law comes along, and give the industry 1-3 years staged implementation, it ll happen, and your convenience would not be ignored.

Question to ask is:

(a) are our pharmacists capable?
(b) is there sufficient pharmacists to go around the country?

how about public hospitals? they have been practicing this system for ages without any prblem. :)
Foreign methods don't mean it's better, but for this issue, it warrants soem thoughts.

malaysianpolitics said...

This issue, I believe, had been brought up quite some time ago, when I was still in the country(I left for NZ in Aug 2006). In NZ, this is the practice, where we go to the docs to get diagnosed, and go to the pharmacists to get our meds.

One thing about it being difficult for Malaysia, which I can see, is that there are a lot of clinics that run 24 hours, and hardly any pharmacies that do the same. And then there is the issue of all those existing clinics which are no where near a pharmacy, which then complicates things even further due to the need of having to build a pharmacy nearby.

Here in NZ, clinics (or health centres as they call them), operate with an appointment system, where the doctor is only available if you make an appointment in advance, and they close at the exact same time as the pharmacies do, at 5 pm. And these pharmacies are located at no more than 5 mins walk from the clinic.

So what you say is true, that the most important thing to consider is what is the most convenient for the people who are going to be using those services.

donplaypuks said...

the 'ostrich with head in the sand' Min of Health is finally moving to the practices of the West.

i say this (ostrich) becoz an Act was pushed through Parliament by BN which the doctors did not want. directly in contradiction to promises by the Minister, a doctor is languishing in prison for only failing to register his clinic in time.

as is normal in M'sia, they have not done their homework since we do not have high-street Pharmacists in every street corner. most will agree that it is common to find 'Pharmacist Not In' signs at most outlets - just try Guardian & Watsons after 6 pm at KLCC, Sg.Wang, USJ, Subang Parade etc.

also, with the usual absence of affordable and convenient car parking facilities at most town centres (e.g. USJ 9 & 10), the sick patient is going to get sicker and possibly kick the bucket while waiting to buy his medicine.

the age old system of consultation/prescription/
dispensation has not ben found wanting at all at government owned GHs. The ordinary people(the masses) prefer it, as it is cheaper and do not need to be flogged with high priced brand names as opposed to generic ones.

so, why must the system that works be changed? all the Ministry has to do is get its enforcement team off its a..e and crack down on private hospitals and pharmacies to ensure that profiteering is minimised.

but no. instead it is the people who must be inconvenienced. consumer rights gets no attention and is pissed upon by these mindless Ministers and Ministry big-wigs.

guess how mant ex-Min of Health DG's & Directors have interest in Drug Dispensing Chain Stores?

Anonymous said...

I think it's a good idea, original or not. I normally avoid going to the clinics because the I feel the doctors are pushing their medicine (labeless reddish pink liquid stuff etc). Sometimes they insist I take and pay for the antibiotics when I really don't want to. And they always don't give you enough. You always end up going back again for the 2nd dosage. It's no wonder why they all (with a few exceptions) have such a bad reputation. Nowadays for minor illnesses, I prefer to go direct to pharmacy and forego the consultation altogether. With a bit of careful planning, I think we can do it. In the end, it will benefit the patients.

Tun Teddy said...

Kak aina,

we the regulators have discussed meticulously on the subject matter which u raised. actually the current arrangements will only encourage anti-competitive practices and malpractices of the health officers in prescribing certain prescriptions based on the medical products.

we know in the open market, there are lots of medicine that can be obtained, but the choices are abundant too... such arrangements in the future for malaysian doctors is to prescribe what type of medicine should be used and not the medicine based on product brands beacuse such practices will only encourage anti-competitive practices in pharmaceuticals industry.

the cons of it is that now despite the increase of the consumer spending, we have to pay more i.e. transportation in going to the nearest pharmacy. it its open at 12'00 midnight...

Hi&Lo said...

I think the idea of separate dispensing right is to prevent docs from overprescribing.

But I don't support the Health DG cos as many had stated the inconvenience and infrastructure not in place.

Anonymous said...

why change something when there is no complaint from - consumers, the sick. the problem arises because pharmacies want to make more money lo. i have been to some pharmacies and they dispense me generic drugs. all these arrangements will foul up if there is no scincerity in the first place. when a doctor prescribes generic drug you can get back at him but when a pharmacy does so, it can say, i told him so. i wonder why there should be a fuss about this other than the fact that some parties want to patronise on the sick and needuy.

Anonymous said...

Doctors and medicines
Straits Times Editorial - Sep 24, 2007

NOT everyone will agree with Health Minister Khaw Boon Wan's view that doctors should continue to be allowed to fill as well as write prescriptions. Citing consumer choice, market maturity and patient welfare, some wonder whether Singapore should be moving towards the norm in developed societies by doing away with what they consider an outdated practice. Yet barring doctors from dispensing drugs has implications, not all of which may be of benefit to patients.
The cost of a doctor's visit is most likely to increase, for at least two reasons that are not necessarily related. First, even if many physicians would not acknowledge it, they probably can charge less for consultations because they are making a good profit on the drugs they prescribe and dispense. Second, even if patients may be sceptical about it, doctors maintain they keep medicine costs down by passing on savings by buying in bulk from drug companies. They like to say they are in the best position to bargain with their suppliers.

Whichever is the actual or bigger reason, patients are likely to see their medical bills go up if pharmacists only can fill prescriptions. Indeed, in some countries where doctors prescribe only and do not dispense, pharmacists add a professional dispensing fee to the price of drugs they sell. Requiring doctors to give patients itemised receipts and legible prescriptions will bring some transparency, but probably is still not enough to enable patients to make informed choices.

How many patients in public hospitals and polyclinics, which issue printed prescriptions, go to a druggist elsewhere to buy their medicines? Cost considerations aside, again not everyone will necessarily go along with MP Halimah Yacob, even if they agree with her opinion that patient safety in having pharmacists double check doctors' prescriptions overrides the convenience of having medicines sold by the attending doctor.

Money, time, convenience and safety - these variables interact. Clearly, whoever is to do the dispensing, only an objective study can establish where patients' interests in fact lie, particularly where market forces actually act to lower prices, what level of convenience is acceptable, and what degree of safety is optimal. For now, patients have the choice of asking their doctor for a prescription but purchasing their drugs at a pharmacy. Before patients can know for certain which approach will serve their interests best, there is no rush to separate prescribing from dispensing.


Doctors in Singapore are still dispensing medicines and they have the right idea. If it aint broken dont try to fix it.

Anonymous said...

Doctors and medicines
Straits Times Editorial - Sep 24, 2007

NOT everyone will agree with Health Minister Khaw Boon Wan's view that doctors should continue to be allowed to fill as well as write prescriptions. Citing consumer choice, market maturity and patient welfare, some wonder whether Singapore should be moving towards the norm in developed societies by doing away with what they consider an outdated practice. Yet barring doctors from dispensing drugs has implications, not all of which may be of benefit to patients.
The cost of a doctor's visit is most likely to increase, for at least two reasons that are not necessarily related. First, even if many physicians would not acknowledge it, they probably can charge less for consultations because they are making a good profit on the drugs they prescribe and dispense. Second, even if patients may be sceptical about it, doctors maintain they keep medicine costs down by passing on savings by buying in bulk from drug companies. They like to say they are in the best position to bargain with their suppliers.

Whichever is the actual or bigger reason, patients are likely to see their medical bills go up if pharmacists only can fill prescriptions. Indeed, in some countries where doctors prescribe only and do not dispense, pharmacists add a professional dispensing fee to the price of drugs they sell. Requiring doctors to give patients itemised receipts and legible prescriptions will bring some transparency, but probably is still not enough to enable patients to make informed choices.

How many patients in public hospitals and polyclinics, which issue printed prescriptions, go to a druggist elsewhere to buy their medicines? Cost considerations aside, again not everyone will necessarily go along with MP Halimah Yacob, even if they agree with her opinion that patient safety in having pharmacists double check doctors' prescriptions overrides the convenience of having medicines sold by the attending doctor.

Money, time, convenience and safety - these variables interact. Clearly, whoever is to do the dispensing, only an objective study can establish where patients' interests in fact lie, particularly where market forces actually act to lower prices, what level of convenience is acceptable, and what degree of safety is optimal. For now, patients have the choice of asking their doctor for a prescription but purchasing their drugs at a pharmacy. Before patients can know for certain which approach will serve their interests best, there is no rush to separate prescribing from dispensing.


Doctors in Singapore are still dispensing medicines and they have the right idea. If it aint broken dont try to fix it.

Roslina said...

This arrangement is common overseas - I remember being surprised that they even practise this in Pakistan. Apparently it is to ensure that doctors do not "over-dispense" medication. I remember that pharmacists work longer hours where this was practiced so I expect that it would be similar here when this is put into operation.

Question is - Can they understand the doctor's handwriting?

Anonymous said...

Sorry kak, but I work with people with enduring mental health problems who have to pay through their noses for inappropriate prescribing. Private psychiatrists in this country do not follow any established prescribing guidelines and tend to over-prescribe and tend to favour expensive brands rather than generic (and equally effective medications) because they get commission from the drug companies to prescribe branded medicines. Having the prescription filled by a pharmacist provides a check on and a balance against this abuse of power by psychiatrists. I would suggest that people with long term illnesses such as diabetes, epilepsy, schizophrenia, asthma, cardiac problems, depression, bipolar disorder, etc. i.e. patients who have to take their medications for the rest of the lives, be allowed to have their prescriptions checked and dispensed by qualified pharmacists. These pharmacists know much more about the medicines than the doctors ever will. Please do not complain about inconvenience just because you are blessed with good health.

Anonymous said...

I dread to think what happens when at night, a person is very ill [ say, serious diahoera, or even serious stomach pain] and he has to find a pharmacy that is still open an get his medication. What happens if he can't even find a cab to take him there? Or is the MOH assuming everyone has his own transport, or he has someone to send him to the doc, or people don't fall sick after office hours? Makes me puke to think we have leaders and policy makers of that calibre.

mekyam said...

Fight it Malaysians!

Trust me on this, I've lived most of my life abroad in so-called developed nations and have never failed to appreciate how much easier and kinder (it's not even so much about convenience) the way ordinary Malaysians get regular medical help is in comparison.

You have a good - naah, better! - system going there, one that puts the patients first. The split in the two services, seeing the doctor and buying your medicine, will mean double the cost for patients. Regardless whether the pharmacies are next door to the physicians, the overheads will double and the costs will be passed on to the clients.

You bet with that system in place, it won't be long before everyone has to have medical insurance to be able to afford medical help.

Just because this bleeping system has been practiced by developed countries doesn't mean it is necessarily a good thing. In fact, it is NOT a good thing. Not for the patients. This works in the interest of the pharma and medical insurance companies. For the doctors too, of course.

Please read/research about the chokehold the pharma and medical insurance industries have on US citizens. Do NOT go that way, Malaysians. You don't want to end up paying through your noses for prescribed medicines. Neither do you want to see those who can no longer afford visits to the local GPs start overdosing on the pharma companies' OTC garbage and destroying their poor kidneys.

God, when will we learn not to ape every rubbish way of the West!

Jue said...

Living in the UK make me miss Malaysia dearly. Going to the doctor for consultation, then to the pharmacy for the medicine is really a burden for those who have sick children! With limited parking space, one has to drag his/her child along to the pharmacy, and usually made to wait for about 20 mins - 1/2 hour before given the medicine!

I really hope our government will not pursue this idea. Why don't they just improve the existing system?

NURAINA A SAMAD said...

Tun Teddy: I think I have lived in this country long enough to see whether such a proposal is workable. At this point, I don't think so.
As far as the issue of malpractices is concerned, shouldnt that be dealt with by the authorities. Also, shouldn't patients have a choice? If there is a whole wide range of medicienes and drugs in the open market, then a patient can go to the doctor for consultation and then choose to go to the pharmacy, but really, how many people would do that. and how rampant is the malpractice?
if a patient suffers from a chronic medical problem, I know that he can choose to buy his medication from the pharmacy. in fact many do.
hospitals are not affected by any change in the system because such a system is already in place there. this is because of the very set-up of hospitals.

like i said, any change should be in the interest of the patient/consumer.

thank you for commenting, I appreciate it.

anon@10:58PM: thank you for commenting. no, i am not complaining about inconvenience because I am blessed with good health. I am asthmatic. I keep with me two inhalers all the time. I get them at the pharmacy.
When I have a bit of headache, I use "koyok" (tokuhon -- the japanese plaster), if it persists, I use minyak angin. If it's really bad, I just take a couple of panadol or ponstan. If I feel that a flu is coming, I'll just take whatever medication that I need. I don't go to the doctor at all. I have with me (in my fridge) a supply of panadol, ponstan, immodium, clarinese/clarityne. I used to have this huge "nebuliser" (for asthmatics) but since the introduction of inhalers, I don't seem to need it. (My kids are also asthmatic)
I suppose I am one of those people who know my own health and medical condition. I self-prescribe. but safely.
I have never been hospitalised except twice -- when I delivered my babies. Alhamdulillah. And Insyallah, I can maintain my health.
The one time that I visited the hospital (but not hospitalised -- although almost) was when I returned from Pakistan from a working visit in 2005. I suffered a bad bout of enterogastritis.
I had taken the usual medication but it did not help so I needed something more potent.

The thing is...mental health patients are not ordinary patients. Of course, they need specialised medication. If your issue is the cost and over-charging, then yes, you need to get the drugs directly from the pharmacists.

We are talking about the general population here.

In the case of mental health patients, i would definitely support any step to help them get cheaper drugs.
thank you.

mekyam/jue:

I have had experience living abroad for a couple of years in 1979/80s when i was in Boston, Mass to do my graduate degree program.

I was (and still am)asthmatic. But, the thing is I never ever got sick (enough) that I needed medical attention/treatment.
I remember I had mild flu but I got ok after getting something from the drug store. I would have done the same thing here in Malaysia for something ordinary like that.

In 2001, when I was in London for work, I caught a flu and it worsened and I got a bad asthmatic attack. If I were in Malaysia, I think I would go into any clinic and get medication -- easily.
But I was not a Brit, nor a resident, neither did I have any medical insurance. I was staying at a hotel. Silly me, I left my inhalers back home. I tried my luck, I went to the nearest pharmacy to buy the inhalers but I couldn't becos I needed a doctor's prescription. So, I needed a doctor to examine me, yet I couldnt just walk into any clinic. So I had the hotel call up a doctor. He came. examined me and prescribed me some ubat plus the inhalers. Cost me a bomb...

So...i agree...we have it good here in Malaysia.

NURAINA A SAMAD said...

james joyce,

tsk tsk tsk....

i'm sure you're joking....not about your view that you do not see any problem with this (proposed) arrangment, but about that bit about malaysians being born naturlly lazy.

tsk tsk tsk....

you must be in real estate..

Anonymous said...

I attach below a paragraph from the Malaysian Community Pharmacist Association and this must have been written many years ago. Surely they will ask for more today.

How much should the Dispensing Fee be?

Everyone works for a living. Pharmacists’ professional service in dispensing the medicines and providing pharmaceutical care must be appropriate paid. How much is the appropriate Dispensing Fee for a dispensed drug? Germen paid Euro$5.00 to $10.00, Australian paid A$4.81, and British paid 6.30 Sterling Pounds. Is it reasonable for Malaysian pharmacists to charge Rm3.00 per dispensed drug to their patients’ prescriptions? Should it also include the costs of containers, labels and leaflets? How do we calculate the medicines’ charge? Cost prices or a 15% mark up prices? Who shall regulate the medicines’ prices? Who shall determine the generic or brand drugs and subsequent payment?

We will have to pay for the inconvinence.

warrior2 said...

Currently, the pharmacy world operates based on existing market demand. It is not a big world, it operates maybe 10 am to 10 pm. You may find them only shopping complex most often than not and not on the street level.

THATS JUST IT!. Under current system, and environement!. ALmost everybody dreads and lements about availability when they dont bother to think that IF the rule is enforced, we will have a mushrooming of pharmacists everywhere operating 24 hours because of demands etcetc, just like those kopitiam shops, 24 mamak stalls. When we base our opinion on current scenario and environment ofcourse we dont get it right and/or we dont paint the real picture for everybody.
We cant have parallel systems in place because that would mean there wont be ENOUGH DEMAND for the pharmacy system to work as people will naturally go for the clinic dispensing system once they are in the clinic.

For all we know, they may be more phamacists than clinics later on than there are just clinics currently available.Wouldnt that be better perhaps?
SOme here have highlighted why there is a need to have seperate system and I dont have to go into that.

Anonymous said...

Am a doctor but even I can't buy motion sickness tablets in a pharmacy because there's no pharmacist then, during daytime. Can you imagine doing the pharmacy with a pharmacist hunt at night for controlled drugs?

BZ said...

One of the most commonly reasons sited by people who are worried about the inconvenience that may arise due to the non availability of a pharmacy nearby the doctor clinic. However over time once this policy of the separation of prescribing and dispensing of medicines is enforced pharmacies will be opening near to doctors clinics to meet the expectations of the patients. Currently with doctors dispensing would you expect many pharmacies to open near doctors clinic when there are no prescription forthcoming? It is just not feasible business wise to have that many pharmacies operating near clinics given the present scenario. In any case the current proposals is a trial run in big cities where there are sufficiently large numbers of pharmacies and with the policy to separate the roles I am very sure more pharmacies will open and definitely there will be pharmacies opened 24 hours in areas where there are clinics that are opened 24 hours. Under current situation where they are no prescriptions to dispense do you all really expect the pharmacies to open 24 hours?

Anonymous said...

Fee for dispensing

The pharmacist is asking for RM3 per dispensed item. This may not even include the price of containers and labels for packing the medicines.
Does it mean that I will have to pay RM12 more if my doctor precribes 4 items for my illness.I am sure my doctor is not charging me now as RM28 gets me 4 bottles of medicine with consultation and medication.How much more will I have to pay when they saperate dispensing.

Mother

donplaypuks said...

Hi Nuraina

I'm surprised to read here that there are some who prefer this 'pilot project' to the status quo.I suspect that these are city folks who have one foot in UK, Australia or NZ.

My final say:-

Why fix it if it ain't broke?

AND

We all know that in M'sia we have as many progressive laws as in any leading Western nation, but the enforcement record of 3rd world countries.

So, get the enforcement unit of Min oF Health and Domestic Trade which oversee import and distribution of pills etc off their collective a..es to turun gelanggang and do their job. This must be done 7/30/365 days and not just for the tv cameras when the Minister goes walkabout on his PR stints.

AND

Ask NGO's to make noise and find out why the general public's opinion was not sought b4 the Gnomes decided to launch a pilot project.

Hana said...

Have we forgotten something here?

We, rakyat is the boss in this country. If we the rakyat does not think this is a good arrangement for us, so for heaven sake, MOH please listen to us.

Do not push something down to our throat just because MOH feels it is a good move for us. Please don't put unnecessary burden on us anymore. Our pocket is not deep like those who is proposing it therefore, kindly retain the current practice.

malayamuda said...

when there were street demonstrations few months ago, the organises were chided saying " this aint our culture "

" this ain't our culture, it is western culture, we have to do things the Malaysian way ".......... this was the mantra on practically every BN politicians lips.......

now what happened to our culture and our proud Malaysian unique ways ?

BobSam said...

THIS IS BAD NEWS for the RAKYAT.

Right now, we pay the Doctor for his/her medication and his/her consultation fees.

The moment, we are asked to buy the drugs from the Pharmacist, then Doctors will have to raise their consultation fees to cover the shortfall in revenue. (There is a mark-up that they put on the medication).

So assume, that you fall ill. You first go to the Doctor. He charges u a fee for his consultation. Then you have to go driving around looking for a Pharmacist that is open. Finally after visiting 10 new Pharmacists, u find 1 guy open. He charges you RM5 for a RM2 strip of Panadol. Becoz he has to open at night mah!
Dont forget the Dr charged u extra becoz he has to open at night.

This is a bloody money making scheme. I thought after the lesson BN learnt in the elections, they will be more cautious with this type of money making schemes.

The lesson seems not to have been absorbed by the students. Either we the electorate have not enunciated our choice and concerns clearly to the politicians.

Please help me get this message across to the politicians, especially that young chap at MCA who is now the Minister of Health.

BobSam

Berita dari gunung said...

nuraina.
Hmmm.... Anwar.

Hi&Lo said...

Doctors are licensed to cure and to kill. We shld not put docs on too high a pedestal.

Many docs succumb to gimmicks by pharma giants. As a result they may overprescribe. This is quite universal.

WHO had stated more patients die of side-effects of drugs than the disease itself.

It's up to us to be well informed, esp concerning our body and health.

Salt & Turmeric said...

Kak Ena, u kno whc will be my preference in this case. ;)

It is funny tht some ppl complaint abt the doc pushing for a certain brand of medicine or anti-biotic. I never had such problem back in Msia. I didn have to take the med and pay for it if i dont want to. If so happen tht iv taken a certain brand of medication whc is not carried by my doctor, id ask her to write a prescription and off i go to the pharmacy and buy it myself. Id only pay for consultation whc of course didn cost me an arm and a leg nor did i need to have a health insurance plan.

And, yes even the doctors/hospitals here prescribe u with medicine produced by pharma co. tht theyv certain agreement with. Its all abt money between them. So id rather Msia stick to wht we'v always had!

Farina

donplaypuks said...

Perhaps the Ministry of Health and this Merican chap who pops up everywhere in MSM and TV (a sure sign of someone with political ambitions), should focus on fundamentals, and not the commercial profit-motivated world of pills driven by MNC's like Pfizer & Astrozenecca.

My intention is not to attack Bumis, but that genuine highly qualified Bumi doctors should not be put on the defensive by bad/ poorly executed BN govt. policy.

I would like an answe from Dr. Mahathir first, and then AAB.

Perhaps, Nuraina, you should have a separate blog on this very important subject. The last thing we want is to to be asking our doctors to show us their Resume b4 treating us!!

Quote Malaysiakini:

'Slab scheme for doctors needs review. Product of the System | Apr 2, 08 4:15pm

I can accept many features of the NEP, albeit swallowing them like a bitter pill. I will never be able to accept the Skim Latihan Akademik Bumiputera (Slab.

For those who are unfamiliar with the Slab scam scheme, it is basically a training programme tailored for ‘outstanding’ bumiputeras with professional qualifications to embark on an academic career.

The privileges accorded under this scam scheme are plentiful and far-reaching, available to ‘bumi’ graduates in medicine, law, sciences and IT. I shall only touch on the medical careers, drawing from my own personal experience lest I make wrong generalised statements about other fields.

Under the Ministry of Health (MOH) ruling, all doctors are required to serve at least four years before being eligible to apply for specialty training in the Masters programme in local universities. No one is exempted from this ruling as in this noble profession of medicine; all doctors are equal in this fair nation regardless of the ethnicity.

Some are more equal than others, nonetheless.

These are the supposed outstanding bumiputera doctors. They only need to serve one year of government service before being offered a range of clinical disciplines in which they desire to specialise in and later on, lecture in. While the rest of their non-bumiputera colleagues serve the district folk, these privileged lot are bypassing everyone else to begin a premature training as a clinical specialist.

On the outset, it would appear justified to reward these ‘prodigies’ with a shorter route to specialty and thereafter a career in academic medicine. If one scrutinises the Slab candidates however, the ugly faces of discrimination, cronyism and shortsightedness will become obvious.

Despite its namesake, the Slab programme is almost exclusively reserved for Malay Muslim bumiputeras. There is a reasonable pool of qualified and talented non-Muslim bumiputera doctors in Sabah and Sarawak. They, however, are denied the chance to become academics through this supposedly noble training scheme. It’s bad enough to label Malaysians as bumi and non-bumi. To further differentiate between Malay and non-Malay bumiputeras is an act more despicable that the apartheid NEP itself. It is racial egoism.

In principle, the by-invitation only Slab programme is open to outstanding, phenomenal Malay bumiputera doctors. In practice however, the candidates are far from it. My Malay colleagues who can hardly string a proper sentence of English together are being accepted into the programme.

They can’t even present a simple case summary to the consultants during ward rounds and now they are expected to lecture medical students? Pretty preposterous isn’t it? The quality of Slab trainees ranges from those with minimal knowledge in basic pharmacology to those who cannot handle common medical emergencies without descending into a state of panic.

Are we confident to let our children learn and train under these pseudo-lecturers? A great number of my colleagues who failed final year MBBS exams in Universiti Malaya were invited to join the Slab programme! It gives one a general idea of the quality of our future lecturers. The majority of these Slab products have either failed the external Royal Colleges exam or were never confident to attempt these exams in the first place. There were also two Slab trainees in UM who were dropouts from Australian universities. The future of medical education does not look bright indeed.

Like most other NEP privileges, the Slab programme has been hijacked by well-connected Umno loyalists. A great number of trainees are accepted into the programme because they carry a ‘bin Datuk-something’. The truly qualified bumis are denied an opportunity while mediocre, below- average children of Umnoputras are offered a silver platter to quasi-professorship.

More than being another Umno racist policy, the Slab programme is one that is dangerous. Clinical acumen in the profession of medicine comes from years of experience and there is no other way. A pre-university student who enters medical school without battling it out on a level playing field is already a cause for concern. Now, the same person is expected to perform the clinical duties of a lecturer-specialist after serving just one year of housemanship. In our feudalistic healthcare system, the specialist is always regarded as correct and infallible, even when he has less experience than his medical officers who are subordinates merely because they were not born with a privileged skin colour.

The intentions of the Slab programme were never to provide a helping hand to aspiring bumiputera doctors. It was also never the intention of the Slab programme to provide our universities with a steady source of well-trained lecturers.

The way it is carried out, the aims and purposes of the Slab programme is to mass-produce as many Malay bumiputera specialists as possible and in the shortest time, as well as to inhibit the careers of non-Malay doctors.

It is already punishing enough that non-bumi students enter university one year later that their bumi counterparts (two years if one is from a national-type school).

Now they even have to wait four years later than their Malay colleagues before being eligible to apply for specialty training. A Slab product will become a full-fledged specialist by the age of 30 with an almost guaranteed pathway to sub-specialty and professorship by 40.

His non-Malay colleagues meanwhile, will only be a newbie specialist at 35, assuming the doctor was successful in his application for specialty training at the very first attempt.UNQUOTE

Anonymous said...

- Its not the pharmacist fault if patient 'kick the bucket' while waiting for medication.If the patient can kick the bucket while waiting for medications from the pharmacy, then it's the doctor fault for misdiagnosing and do not judge it to be serious enough to warrant hospitalization. If its so severe ie the 'serious diarrhea", then the doctor would have admitted the patient to a hospital for further observation. People do die from dehydration caused by diarrhea.
- You don't need to have a pharmacist around to buy motion sickness pills. Pharmacists are needed when it involves 'controlled items' and motion sickness pills are not "controlled items"!
- Doctors are humans and they make mistakes. Having a pharmacist to screen through the prescription serves to minimize the mistakes that can happen
- Other doctors can't even read some doctor's atrocious handwritting. But don worry, don't you know that pharmacists are pro when it comes to reading doctor's handwritting?
Do not just point out each and every one single 'mistakes' the pharmacist makes without getting further clarification from a pharmacist.

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