Dispensing Right: Doctors or Pharmacists?

I refer to a blog by cytusm who protested why the doctors should maintain their dispensing rights. Ideally in many developed countries like Europe or US, dispensing rights have been given to the pharmacists. A patient goes to the doctor for a problem, gets a prescription & then gets his medicine from the pharmacy. In the blog, cytusm claims that there are not enough pharmacists & there are no 24hr pharmacies available. Well, how do you expect us to operate a pharmacy when we can't even cover the entire operating costs when patients can get medicines from the clinics? Make sense? If the dispensing rights been given to us, I'm sure the 24hr pharmacies will be mushrooming everywhere. Furthermore, as a pharmacist doing my compulsory services in the government sector, all of us have ensured proper care of how the patient takes his medicine, stores his medicines & uses his medicines appropriately. Cytusm claimed that it is wrong for us to tell him that enalapril must not be taken 10mg OD but 5mg BD. Well, has he done a study on patient compliance? We have! Would you prefer to take medicine once a day instead of twice to control your blood pressure? Duh!

I recently recommended a medical consultant in infectious disease to have a patient already on lamivudine 150mg BD to 300mg OD for better compliance since the pharmacokinetics are equal. He agreed without much thoughts because he knew we the pharmacists are looking at the well-being of the patient. Well, come to think of it, cytusm is kinda arrogant when his pharmacist suggested enalapril an OD dose instead of BD. Even if he does not want that OD dose, he can still continue with his BD dose. The decision comes back to him at the end. We are only giving suggestions. If you don't want the suggestion, just be it.

The blogger also claimed that we the pharmacists are not giving out enough supply of medicines as prescribed by them. Blaming us all sort of quantity or quality of whatever medicine we have given out. Yup, they have been looking at the worst of us. However, they have never thanked us when we spotted their Rx wrongly written with "paracetamol 1mg QID" for a young adult, or tetracycline for a pregnant mother, or sometimes chicken feet written Rx with all sorts of doses & strength beyond our wildest comprehension. Are we supposed to find 1mg QID of paracetamol for patients? How? Crush it & add some syrup & syringe it out to drink?

Seriously, I have met many patients who insist of seeing the pharmacist before seeing the doctor. They will ask the nurse "Mana itu farmasi?" I normally try to see as many patients before they see the doctors so to ensure they have been taking their medicine properly. By then, doctor will have less work to do after reading my report so they can go the point instead of going back to "So, ubat apa makan? Nama apa? Pukul berapa makan?" etc etc

I see no harm on dispensing rights given to pharmacists. In fact, we have detected many prescription errors before they even reach the patients to avoid fatality. Sometimes, even doctors make mistakes. Like many of us, they are just human beings with many patients to attend to especially in the government hospitals.

Dear Doctors, I'm sure in diabetic patients, even after diagnosing them, taking their blood etc....you will be exhausted to teach them the proper way of using novopen or whatever diabetic pen they may be using for another 1 hour & keep your patients waiting. Dont you?

The doctors should see a patient as a whole who needs proper medications care from the pharmacist as well & not protesting unless they have ulterior motives. What could it be?! If I'm earning that income from some generic drugs when patients don't question its quality & its manufacturers, I would want that right all to myself. Not happy if the separation takes place? Just marry a pharmacist. -Peace-