I REFER to the letter, “Work together for better care” (NST, May 13), by Professor Dr Mohamed Azmi Ahmad Hassali.
I have to raise points to correct the learned academician. I have the greatest respect for him as a professor at the School of Pharmaceutical Sciences, but his article has points that favour pharmacists exclusively.
The article states the merits and benefits of separating dispensing to pharmacists in patients’ best interest, but one important part of the equation is not mentioned: the cost incurred.
The article alleges weakness in professional standards, poor continuous medical education and lack of quality control in the private sector. This is inaccurate.
The Health Ministry has addressed these concerns and private clinics are well run.
He described how a successful healthcare system should be, but our general practice doctors fulfilled all of them years ago, including superior care that’s effective, safe, timely, patient-centred and efficient.
He said a sustainable healthcare system should have three attributes: affordability for patients and
families, employers and government.
This is contradictory, when in the later paragraphs, he mentioned that patients should have pharmacists to dispense.
This will have an extra cost to patients. Medication and consultation are lumped as one fee and there is the ease of collecting them under one roof.
Doctors in private clinics have a small amount of medication that is prescribed and dispensed.
In rare incidences, there will be a special medication prescribed and the doctor will get it dispensed or referred to another person.
As a doctor and a previous medical lecturer, I can assure you that doctors have adequate knowledge of prescribing and dispensing medication. We understand the academic evidence one may have, but it makes no sense to patients and doctors in the general practice to only prescribe but remove dispensing from their practice.
Pharmacists are trained in detail on medication safety but this does not create a practical environment for patients, particularly in a general-practice setting.
Public and private hospitals with multiple specialties do have pharmacists dispensing and that is acceptable, as a lot of complexities are involved in multiple medications.
Let’s leave pharmacists in the hospital environment. The general- practice type of dispensing does not warrant pharmacists.
We have no evidence to support the claim that general practitioners cause severe adverse effects to patients with medication.
Doctors in the general practice have the best acumen to manage their patients from diagnosis, investigation and dispensing, which no other profession should try to do.
Doctors practise evidence-based medicine.
Community pharmacists are no match, even though they claim to have the knowledge.
Let’s not try to emulate a Western system when we have a proven system in general practice that has worked well for the last 60 years.
As much as there may be a demand for more information from patients, primary-care doctors are ready for this.
The bottom line is the general- practice fee is affordable, inclusive of medication, and, in the interest of patients, there should not be any attempt made to indirectly increase the cost, despite well thought-out reasons.
DATUK DR KULJIT SINGH,
Kuala Lumpur