1 Jul, 2014
I REFER to the letter “Docs’ right to dispense medicine” by Dr Sng Kim Hock from the Association of Specialists in Private Medical Practice, Malaysia (The Star, June 27).
Dr Sng had made some misleading claims. To state that “dispensing of medication is the sacred right of the physician” is indeed erroneous.
Dispensing per se is not taught in medical faculties and medical students have only some lectures on pharmacology.
In any case if dispensing of medication is the sacred right of the physician, why are doctors from most developing countries in the world not allowed to dispense medications to the patients?
Malaysia is among the very few countries in the world where doctors are allowed to dispense medications to their patients.
The Poisons Act 1952 had a provision for the doctors in Malaysia to supply medicines to their own patients.
However, there is no provision in the Act for private doctors to delegate the actual dispensing of drugs to other unqualified staff.
The private doctors are required to physically supply the medicines to their patients.
The Poison Act 1952 had this provision for the private doctors to supply medicines to their own patients as during that period of time there were just a handful of pharmacies in the country.
Dispensing of medication is a privilege accorded to the doctors and this is not the sacred right of the physician as claimed by Dr Sng.
Dispensing separation is not a Western phenomenon.
It had been practised in many countries including several developing countries.
In Asia. Indonesia and India had been having this system in place for a long time and these countries have much larger rural or isolated areas compared to Malaysia.
Taiwan, Korea and Japan had also opted for the separation of these two functions for doctors and pharmacists.
Thus there is no reason why we should lack the commitment to emulate this best practice while denying the public the rights to better care and equitable access of patient medicine counselling.
If the practice of prescribing and dispensing separation is bad or not good for the people why are more and more countries adopting this separation of the roles of doctors and pharmacists?
Have you heard of any country that had reverted back to the doctor prescribing and dispensing after implementing dispensing separation?
A World Health Organisation paper titled “Policy Perspectives on Medicines” listed “perverse financial incentives” as one reason why worldwide more than 50% of all medicines are prescribed, dispensed or sold inappropriately.
It found that “prescribers who earn money from the sale of medicines prescribe more medicines, and more expensive medicines, than prescribers who do not.”
The art of apothecary started with no clear distinction of medical or pharmaceutical practices.
According to Wikipedia, apothecary is a historical name for a medical professional who formulates and dispenses materia medica to physicians, surgeons and patients — a role now served by a pharmacist (or a chemist or dispensing chemist) and some caregivers.
In addition to pharmacy responsibilities, the apothecary offered general medical advice and a range of services that are now performed solely by other specialist practitioners, such as surgery and midwifery.
Apothecaries often operated through a retail shop which, in addition to ingredients for medicines, sold tobacco and patent medicines.
Thus the claim by Dr Sng that the foundation of their practice includes the dispensing of medication, thus ensuring prompt symptomatic and curative care is not correct.
Such claims will mislead the people on the roles of a medical practitioner, which by the way is to diagnose and prescribe medications when necessary. Leave the dispensing to the pharmacists.
GAN BER ZIN