Wow, looks like i am being bombarded by hordes of pharmacists here. Well, i have nothing more to say atm as i haven't done enough research on this particular topic. However, i once came across an article regarding such issue in MMA magazine, and it stated all the disadvantages for pharmacists to have the dispensing right. Can't recall as it has been a long time.

Anyway, i have to stress on one point: without enough pharmacists in Msia, the situation is unlikely to change. You guys want the dispensing right, you have to pray that more people join pharmacy course. No offense but facts of life.

well, its not bombarded, its just a good discussion.

i did say, its like the chicken and egg thing, something has to change before it happens... and btw, if im right, pharmacist is 1 of the highest starting salary as well and i think you are pretty much guaranteed a job imho in any sector you go to.

regarding the report you mentioned, what did you expect from the MMA? of course they'll side their interest, dont you think? 

just something crude to ponder before im supposed to stop doodling and get on my work , if pharm dispensing is bad then why so many courtries adopt it? they all cant be making the wrong decisions right?

This must be a 3rd world head of department? Because I don't think such thing is supposed to happen in developed world. I think if the pharmacist wanted to change anything, different drug or dosage, they have to called up the doctor. Just like they have to call up the doctor should they spotted any mistake in the prescription. Otherwise, you should report that pharmacist to the pharmacist association's disciplinary board. For not doing so, that head of medicine of yours should be shot.

3. I worked in UK and I called the doctor numerous times daily to correct their mistakes (from simple error e.g. legality of prescription to less likely but common issues e.g. wrong dose, or used of short term medication for long term, irrrational prescribing etc). that is my evidence. living proof. i dont blame them, i am working with them, not just pointing out their errors, hence they dont just blame me either if i make a mistake, but work out how both can minimise it.

in a well regulated healthcare system, e.g. a country with dispensing right for pharmacist, it is illegal for pharmacist to alter the prescription without doctor concern. so what you mentioned doesnt happened in a country with a well regulated system with dispensing right for pharmacist.

according to your article,

and you are right, wrong prescription and medications could be a rampant if well reported. unlike msia, even something wrong happened in clinic etc, do you think they will be reported and a record is kept by the healthcare system. and no record in msia to show how or to what pattern is wrong medication given to patient doesnt means our healthcare system is perfect/good.

and wrong medication and prescription is not pharmacist mistake alone sometime. wrong thing dispensed by pharmacist from a clinically right prescription is an absolute pharmacist fault. but wrong prescription and error not spotted by pharmacist hold both doctor and pharmacist liable.

and you missed that,



the injury include doctor prescribing the medications incorrectly. so should we also take the prescribing right away from doctor, since they do mistake as well as pharmacist filling the wrong dosage?

by the way, you are a healthcare professional too, but i think you should visit those first world country and work for yourself to see how their healthcare system is like. i have worked in both msia and uk, and i have seen and experience that msia is way lacking behind. you can't just bump in and said, what right do they have to dispense? doctor should do it all. dispensing right in those first world country is not given to pharmacist because the country has higher human right sense, but that is how the professions should work in a healthcare system. leave the right people to do the right thing, and have respect of each other area.

but i strongly agree that msia is not prepared yet. healthcare system is way lacking behind, pharmaceutical profession is poorly regulated too.

no offense, just that i feel plain wrong to see the statement that pharmacist shouldnt have the dispensing right. maybe not in msia yet, but doesnt sounds right if you generalize with your poor evidence that all pharmacist shouldnt have the dispensing right. i dont see the doctors in UK complaining about dispensing right for pharmacist. we know what we good at, and we work together for the best benefit of patient. and the doctor is still making good money despite w/o dispensing right anymore (might not apply to msia due to differences in healthcare structure).
well i dont see money involved in such error. medications are paid by nhs anyway, so make no profit to either party (well to be honest, pharmacy make some money from the difference of buying the medication at slight cheaper price and payment at monthly revised rate from the nhs). the doctor is earning via registration of new patient and professional fees per patient/per prescription/ per consultation meanwhile the pharmacy is earning from professional fee per item dispensed.

just that, like mentioned above. wrong item dispensed by pharmacist from a clinically right prescription written by doctor = 100% pharmacy/pharmacist fault. but if start with a clinically wrong prescription an dis obvious but failed to get noticed by pharmacist and hence dispensed, both parties hold responsibilities. hence the case you mentioned above.

There are still not enough doctors in our country so does that means doctors should not have sole diagnostic and prescribing right as well? So why the double standard?

Wow, looks like i am being bombarded by hordes of pharmacists here. Well, i have nothing more to say atm as i haven't done enough research on this particular topic. However, i once came across an article regarding such issue in MMA magazine, and it stated all the disadvantages for pharmacists to have the dispensing right. Can't recall as it has been a long time.

Anyway, i have to stress on one point: without enough pharmacists in Msia, the situation is unlikely to change. You guys want the dispensing right, you have to pray that more people join pharmacy course. No offense but facts of life.

Allow me to use your own answer to answer your question: If pharmacist can't dispense, who else can? Enlighten me pls.

Hence the 'double standard' Lack of doctor has never been used to stop giving doctor sole diagnosis right. So why use that to stop the pharmacist?

In developed country, I think this is called 'specialization".  And it must be done for a good reason, either efficiency or safety.

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Added on December 5, 2008, 7:12 am

From your answer, I can see that you are a open minded person and not afraid to admit 'mistake'. I respect you for that. A lot of people, for the sake of 'saving face', will argue continuously. Anything but to admit possible mistake.

IMO, your views are typical of someone who has not been exposed to superior practice of more advanced countries. Can't blame you because you haven't been in those countries.  But if our society wanted to advance, there are a lot of things we can learn from them and separation of prescribing and dispensing is one of them. The evidence for that is all around us. The main thing holding us back are the self interested doctor and lack of public education. The former being money and the later being in possession of 3rd world mentality. And we can't blame the general public because even highly esteemed leader like Lim Kit Siang has that 3rd world mentality when it comes to this issue. All they can think of is inconveniences and money (both true) but totally blinded to safety. That is why they say, in 3rd world, life is cheap.

actually the main reason is not the mentality...lim kit siang hiself is doctor...and own lots clinics...nothing to do wif mentality lol...

First of all, doctors are trained in both diagnosing diseases and giving medications. Although we might not have extensive knowledge in medications as the pharmacists, nevertheless we know quite a few things, enough to ensure patient's well being.
On the other hand, pharmacists are not trained in diagnosing diseases. Therefore, i would be hazardous for the patients if the pharmacists were to diagnose (or rather misdiagnose) diseases.

So far, I don't think there is any pharmacist here saying they could do diagnosis. I believe the pharmacist themselves acknowledge doctor are the better person to diagnose diseases. Therefore, it's merely in the fantasy mind of doctors to say that.

Now let's look at your so called 'extensive knowledge in medication' issue. Pharmacist spend 4 yrs in university solely on medication.

As for doctor, they spend 5 yrs in university learning from Anatomy to Biochemistry to psychology to whatever. Would it be logical to assume that, out of that 5 yrs, may be not more than 1.5 to 2 yrs worth of time be devoted to study of medication? And assuming doctor are 50% smarter than pharmacist, then the equivalent time for doctor to spend time studying medication increases to 2.25 to 3 yrs worth. That is still short of the 4 yrs pharmacist spend time studying medication.

The point I wanted to make is. No matter how well informed doctor are in medication, logic dictates that pharmacist should be even more informed than doctor when it comes to medication. That is a fact. Just accept that and in specialization, you should let the best person handle whatever he/she is specialized in. And that means, doctor doing diagnosis and pharmacist checking on the prescription written by doctor.

I looked down on those doctor who think they are god and can make no mistake otherwise why don't they allow others to double check their prescription for possible mistakes? Because AFAIK, all human can make mistake. So I believe all they have in their mind is money, not safety of patients.

So far, I don't think there is any pharmacist here saying they could do diagnosis. I believe the pharmacist themselves acknowledge doctor are the better person to diagnose diseases. Therefore, it's merely in the fantasy mind of doctors to say that.

Now let's look at your so called 'extensive knowledge in medication' issue. Pharmacist spend 4 yrs in university solely on medication.

As for doctor, they spend 5 yrs in university learning from Anatomy to Biochemistry to psychology to whatever. Would it be logical to assume that, out of that 5 yrs, may be not more than 1.5 to 2 yrs worth of time be devoted to study of medication? And assuming doctor are 50% smarter than pharmacist, then the equivalent time for doctor to spend time studying medication increases to 2.25 to 3 yrs worth. That is still short of the 4 yrs pharmacist spend time studying medication.

The point I wanted to make is. No matter how well informed doctor are in medication, logic dictates that pharmacist should be even more informed than doctor when it comes to medication. That is a fact. Just accept that and in specialization, you should let the best person handle whatever he/she is specialized in. And that means, doctor doing diagnosis and pharmacist checking on the prescription written by doctor.

I looked down on those doctor who think they are god and can make no mistake otherwise why don't they allow others to double check their prescription for possible mistakes? Because AFAIK, all human can make mistake. So I believe all they have in their mind is money, not safety of patients.

Secondly, you asked me who can dispense medications if pharmacists can't. In my previous statement, i was trying to explain that doctors can do pharmacists' job, while pharmacists can't do doctors' job. Right now in our country, are pharmacists the ones dispensing medications? Therefore, it is safe to say that pharmacists are replaceable to a certain extent in clinical setting, at least at the moment in Msia (no offense, but facts of life).
We study about medications for more than 4 years, including pharmacology (1 year) and clinics (3 years) where we learn about various therapeutic and adverse effects of the drugs. Therefore, i had stated that doctors know adequately, although not extensively.

actually the main reason is not the mentality...lim kit siang hiself is doctor...and own lots clinics...nothing to do wif mentality lol...

IF you guys say doctors in the 3rd world are bad and think lives are cheap, then can i say pharmacists in the 3rd world are naive and emotional not capable of doing their jobs properly? Come on, grow up pls.

It all comes down to respecting each other job. Pharmacist are well train in drug dose/duration/freq/drug-drug interaction. Doctors are well train in diagnosing and coming up with a medical plan to trat patients. So lets not cross the border whereby the doctors or pharmacist wanna do more than they are able and train to do.