Simple. Whoever is the better person around, he/she should do the diagnosis.

If there are doctor around, then the doctor should do it. If there are no doctor around, then the bomoh can do it.

If there are pharmacist around, the pharmacist should dispense. If there are no pharmacist around, then the doctor can do it.

So the next question is, are there sufficient pharmacist in Klang Valley to do dispensing. Hypermax says it is not enough but he flatly refuses to back up his claim so I believe he probably lying. On the other hand, the Health Ministry obviously think there may be enough so wanted to do a trial. So who would you want to believer, the HM or someone who pluck his figure from thin air and hence, a possible liar?

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Added on December 14, 2008, 8:59 amIt was suggested that such ulterior motives exist by others. I am merely spelling it out so don't shot the messenger. Hypermax think every government action must be suspect but the reverse can also be true, i.e., some of the policy may be good. In this case, I fail to see what ulterior motives there could be.

On transparency. I don't think I hear people asking for the rationale behind HM's decision. If they ask, may be HM will give. But all I heard are automatic blasting by doctor and DAP. So why don't DAP go ask HM for details?

I believe we are all born with a brain and should use it or loss it. And there is no harm in trying to figure things ourselves which I think is a failure of our education system.

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Added on December 14, 2008, 9:04 amLike I said, has anyone asked HM for the figure? May be they have but nobody with substance (like DAP) wanted to ask. Let DAP ask for the figure first before blasting because doing so is unbecoming of an opposition figure.

On the actual figure. Hypermax keeps saying he know there are insufficient pharmacies. Why don't you go ask him for his figure?

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Added on December 14, 2008, 9:08 amOnly in my mind? You bad lah. How can you treat Hypermax as a non-person? Bad boy

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Added on December 14, 2008, 9:11 amObviously you have never heard of the saying "it takes 2 hands to clap".

When someone repeatedly say he knows there is insufficient pharmacies in the Klang Valley, I have to repeatedly ask him for the figure to back it up.

BTW, I am here for the fun. May I ask why are you here?

This post has been edited by Optiplex330: Dec 14 2008, 09:14 AM

The proposed trial was in Klang Valley if I am not mistaken. So we should concentrate on Klang figure and country wide figure is totally irrelevant to this discussion. Think about it. If you were to do a trial, which area in Malaysia would you pick? If not the most developed Klang, where else?

Hypermax said Klang has insufficient pharmacies. So unless he can show us the figure, I will have no choice but to say he is talking through the wrong orifice.

BTW, let get the record straight. I said I do not know the figure for Klang. But I am basing my opinion that the HM very probably must have those figure before even contemplating doing a trial. Allow me to ask you a question, choosing between HM and Hypermax figure, which would want to take?

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Added on December 14, 2008, 10:01 amGood article but it does not shine any light on present discussion. If you read carefully, he said this system is not ready for implementation in the (whole) country.

So what that article says is nothing new. We ALL know the whole country is NOT ready for pharmacist dispensing long time ago.

In this tread discussion, we are talking about ONLY the Klang Valley and it is ONLY a TRIAL. Not IMPLEMENTING in whole country. A very significant differences.

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Added on December 14, 2008, 10:04 amAll work and no play makes Jack a dull boy. Heard of that proverb? So let down your hair and lighten up. You should try it for your mental and health sake. And I am deadly serious about this friendly advise and NOT trying to be funny.

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Added on December 14, 2008, 10:14 amThis is exactly the reason why I am confused. If government can never condones the less qualified person to give medical diagnosis, then why are government condoning the less qualified person to do the dispensing?

There are lack of doctor in Malaysia but that will never be the excuse to allow bomoh to do diagnosis anywhere, let alone the big cities.
Going by the same logic, lack of pharmacist in whole of Malaysia should never be the excuse to allow less qualified person to do dispensing. Unfortunately people are still using that flawed logic to disallow dispensing by pharmacist even in the BIG CITIES!

What sorts of double standards are these?


Let's just look at the above logic. And not bring in "lack of pharmacist etc" here.




This post has been edited by Optiplex330: Dec 14 2008, 10:14 AM

Ha. This really shows how ignorant you are. Typical frog in the well mentality and the sky is going to fall on your head in 2013 and you still don't realize it. I bet you don't even know what I am talking about. If all doctors in Malaysia are like you resistance to change, you will go extinct when 2013 comes. Ya, you don't want to change but changes is going to be involuntarily squashed onto your thick skull. And I will very much enjoy watching from the sideline and shout "I told you so"


Here is a hint for you, heard of ASEAN Free Trade Agreement?

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Added on December 14, 2008, 2:42 pmI sure would not want to be handled by a doctor who think he is a god and can make no mistake. Would you?

Never mind, come 2013 there will plenty of options to choose from

This post has been edited by Optiplex330: Dec 14 2008, 02:42 PM

I was right
Like many other things, you know absolutely nothing yet too arrogant to ask. You are so full of it and yet didn't realize your own ignorant. Typical close minded "frog in the well mentality". Totally unlike jchong who is here to share his view and ask for others view. Isn't that what this forum is for?


http://www.hunton.com/files/tbl_s47Details...ngaporeFTAs.pdf
"Mutual recognition arrangements covering accountancy services and dental and medical practitioners were
signed at the Singapore meeting. The arrangements allow professionals licensed in one ASEAN member
state to practise in other member states."

.......For your info, it was supposed to take effect 2010 but now pushed back to 2013. Malaysia verified this agreement in 1997 so unless we can pull a Houdini trick, we are stuck.

Klang Valley is part of this country but Klang Valley is NOT the whole country.

Therefore YOU missed the point. The point is NOT about the whole country so why drag in data of the whole country? Ignore that. It's irrelevant and has no place in this discussion on Klang Valley.

On bomoh vs doctor. It was brought up to illustrate my point. But truth be told, in the middle of the jungle and away from civilization and if the bomoh is the person most qualified, bomoh it is. May be you people might want to take your chance with a monkey but I don't.

The Key word here is "whoever is most qualified" at that particular time and place.

BTW, there really are some places without any medical personnel, not even a dresser.

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Added on December 14, 2008, 4:15 pmI thought you gone already. Still here?

Yes, they will want to practice in Klang Valley. And we are talking about the Klang Valley, aren't we?

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Added on December 14, 2008, 4:16 pmI am so glad that you have accepted your identity as a frog

This post has been edited by Optiplex330: Dec 14 2008, 04:16 PM

It is so easy to make a frog happy

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Added on December 14, 2008, 4:23 pmLet talk on the ASEAN agreement.

What effects do you think it will have on our medical professional (not just the doctor)? Will we be swamped by doctors from Burma who are willing to charge a fraction of the normal price? Do you think our standard of care will deteriorate?

This post has been edited by Optiplex330: Dec 14 2008, 04:24 PM

You are too shallow and short sighted just like a frog.

In globalization, the strong or advanced nation often win at the expense of the weak and less advanced.

If Malaysian government is being responsible, she should make sure our banks and industries and service sector (of which health is one of them) are strengthened with up to advanced country's standard. And dispensing right is one of them.

Do you know what I am saying? Or are you still sleeping inside your coconut shell, frog?

Even though we are not ready, we still have to make it ready by 2013. The alternative consequences is worst and our competitor doesn't give a damn as to whether we are ready or not. In fact, they will be even happier that we are not ready. This is a fact as thing stand.

IMO, the only way out of this situation is to make ourselves ready. And to be ready means to upgrade our service and system up to their standard. Doesn't matter how it is done or why it can't be done etc. It just have to be done. Period.

If we can have a wholesale change of system to centralized health care system, good. If we can't, even piece meal change is still better than not doing anything at all. We can't just say.....dispensing is just small corner of the whole system so it can not have much impact so let's not do it. But the fact is, if you change just a small corner of the system, you can change the whole system as well.

An example. We often say before Mar-08, my 1 vote is useless. But after Mar-08, we realize that one vote of yous can change the whole system. Same logic.

BTW, we do not have the luxury of time. 2013 is a mere 4 years away. Time is running out fast. Turning around the entire system to centralized system is like turning around a big ocean going ship and it takes a looooong time, assuming we have the money and political will.

In fact, I reckon we are already running out of time. I further reckon this trial may already be too little, too late. And yet, we have people resisting that.

Look at it another way. If you can't have the whole cake, at least part of it is still better than nothing. And try to look at the interest of this country and not just one profession's.

I reckon those non-bumi wanting to go to Singapore has already gone there. Just go to Mt.Elizabeth and you can see them there.

As for Singaporean coming here. Are you so sure they couldn't come here? The main thing preventing them coming here is because we don't really allow them (from what I heard....legal, ownership %??). FYI, there is already a Singaporean owned hospital in Sarawak and they probably would love to do the same in KL.

The main differences between the election and ASEAN thing is this: With election, the people wanted to change. With ASEAN, changes will be forced on you so you just have to prepare for it. Like it or not.

Seems like doctor are not doing what they are trained or sworn to do, that is, practice evidence based medicine and being ethical (do things in best interest of the patient). But are more influenced by advertisement and money instead.

So are doctor really the best person to be given free hand to prescribe? How can they be influenced by drug companies with ulterior motives if not for the money or are they simply stupid? What can be done to prevent such abuse? What sort of check and balance can there be to stop such unethical practice by doctor? If they are god, then nobody can stop them. But if they are mere human, then patient must be educated that they are human and some will be unethical and mistakes will be made and that includes mistake in diagnosis (hence 2nd opinion needed) or prescribing mistake (need pharmacist to double check) and lack of choice (doctor may have limited range of drugs and will only give you what he has in his clinic and not necessarily best or cheapest drug for you).


"Many experts have told doctors for years that diuretics, a type of medicine that costs just pennies a day, are the best drugs to treat high blood pressure.

But those recommendations have been nearly drowned out by the major drug companies, which have poured hundreds of millions of dollars into marketing their newer and higher-priced blood pressure medicines, particularly calcium channel blockers and ACE inhibitors."

http://query.nytimes.com/gst/fullpage.html...751C1A9649C8B63

This post has been edited by Optiplex330: Dec 18 2008, 09:58 AM

Where did you get the crazy idea that pharmacist are also god and more ethical than doctor? Another of your brilliant statement no doubt. I don't see anyone here saying that but you. FYI, they are both human and need supervision. Here is a new term for you: Check and Balance.

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Added on December 18, 2008, 2:34 pmPublic need education. Once educated about the pro and con, then do a survey.

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Added on December 18, 2008, 2:40 pmhttp://www.sunderland.ac.uk/study/course/1...y#coursecontent

Topics Include:
Pharmaceutical Chemistry:
Kinetics
Analysis, and Quality Control
Diagnostic Tests
Natural Products
Pharmacogenetics
Macromolecules
Clinical Pharmacy and Therapeutics:
* Physiology
* Pharmacology and their application to body systems and diseases
Pharmaceutics:
* Formulation
* Microbiology
* Sterilisation
* Aseptic Procedures
* Advanced Drug Delivery and Quality Assurance
Pharmacy Practice:
* Pharmaceutical Calculations
* Communication Skills
* the Role of the Pharmacist
* Public Health
* Law and Ethics
* Supplementary Prescribing
* Complementary Medicines
* Chronic Disease Management


Do doctor studies all these or part of these? And do they to the same depth as pharmacist like how many man hours etc.

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Added on December 18, 2008, 2:53 pmUsing my favorite hawker mee goreng as an example. There are thousand of hawker selling mee goreng but they sure don't taste the same even thought they have the same name and ingredient. So if there are variation with simple thing like mee goreng, I am sure there are more to mixing medicine. Do doctor learn such thing?

This post has been edited by Optiplex330: Dec 18 2008, 03:01 PM

You not reading what is "Check and Balance" mean lah.

What can the pharmacist do if they have no right to decide what drug to give? Or are you now saying pharmacist can now also prescribe? A change of heart now?

BTW, you the who says there is no need for anyone to check on possible doctor mistake so that makes doctor god who can make no mistake. Not me.

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Added on December 18, 2008, 3:24 pmSo you now agree there is a need for a trial. Good good. We have a breakthrough. Unfortunately, your trial is tomorrow and tomorrow never comes. And using "lack of pharmacy in Klang as an excuse".

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Added on December 18, 2008, 3:26 pmI have also learn those thing myself. I learn about it for 1 minutes just now. So that will make me an expert in medicine also?

The same reason why you are not answering the other part of my question: How many hours do doctor study those thing? 1 month? 1 year? 2 year? 4 years? AFAIK, pharmacist study those for 4 years.

May be hard for you to believe but amount of time you spend studying a subject does make a big difference.

This post has been edited by Optiplex330: Dec 18 2008, 03:28 PM

Let me see.....

Possible scenario 1
Doctor prescribe very expensive but unnecessary medicine. Since he also dispense, nobody knows. Doctor got away with it.

Possible scenario 2
Doctor prescribe very expensive but unnecessary medicine. Since the prescription has to be dispensed by the pharmacist, doctor will have 2nd thought because his ethical reputation may be on the line.

Possible scenario 3
Doctor prescribe medicine. By law, the pharmacist can not substitute it with something else that is more profitable. Patient benefit.

Is that called Check and Balance?

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Added on December 18, 2008, 5:02 pmYou may be dirty but not everyone else is dirty.

And please accept my apology for questioning your 1st posting. I reject your comment that pharmacist can be more ethical. I now realize that I was wrong. I now agree with you that pharmacist is more ethical

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Added on December 18, 2008, 5:04 pmUnfortunately, you can not back up your claim with any figure. Or may be you are blind not to be able to see the many pharmacies in KL city. We now have blind doctor. Malaysian medical service is worth than I could possibly imagined

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Added on December 18, 2008, 5:11 pmI am sorry. I did not realize you study nothing else but pharmacology for 1+3 years. That means you do not have time to study the other stuff like anatomy etc that other normal doctor studied. Therefore, you are not a doctor. AFAIK, doctor must have time to study the other stuff like anatomy or whatever. But on the other hand, since you studied 4yrs full time only pharmacology, you must be a pharmacist yourself. No?

On the other hand, despite studying nothing else but pharmacology for 1+3yrs, you can still learn the other doctor stuff in your dreams, that is a godly miracle. My apology again, I originally thought doctor are not god but I guess I am wrong again. To be able to do full time nothing else but pharmacology and still become a doctor must be a god

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Added on December 18, 2008, 5:18 pmNo use. According to your earlier comment. Even your 3rd world mentality head of department of medicine will not report wrong doing despite knowing malpractice

This post has been edited by Optiplex330: Dec 18 2008, 05:23 PM

You don't get it do you? I am having fun with you. Great entertainment.

BTW, the figure you gave me for Malaysia is useless because we are talking about KL. As a scientist, you should know what is relevant and what is irrelevant information. Frankly, I am disappointed you do not know that. Well, nothing perfect in this world.

On the trial. Nobody know whether it's going to to be a success or not. But assuming KL trial is a success, I presume the authority will try it out on other bigger town that has SUFFICIENT pharmacies only.

On length of studies. Doctor have more things to learn than pharmacist (but you sounded as though you do not know that and I am shocked ). You could say doctor is the best jack of all trade in health. BUT when it comes to medicine, pharmacist learn more about medicine than doctor and they are therefore the specialist of medicine. These 2 are facts.

Taken together, therefore, doctor is the better general rounder and hence rightly should be the better person to diagnosis and prescribe because he can see the whole body system. But pharmacist role is more specific to medicine and thus is the better person to dispense medicine.

Who belittle who? The person I belittle are those doctor who think they can make no mistake so need nobody to double check for possible mistake. Now AFAIK, only god (even this is debatable) can make no mistake so I suppose I belittle those doctor who think they are god. To those doctor who think they are also human, I hold them in high regards

Ever heard of uneven distribution pattern? Every scientist worth his salt would know that. Do you?

Taken a walk around KL lately?

OK. Let's admit it. You don't know how many pharmacies there are per 1000 people in KV or KL and neither do I. It's your guesses and mine. But the person who has that figure is the Health Ministry. So who are people here gonna believe, your figure? my figure or the MH?

If HM think there are sufficient pharmacies in KV, they will do a trial. If they don't think there are sufficient, they will not do a trial. End of this "how many pharmacies in KV" guessing game.

May be UK has sufficient or may be they don't. I don't have the figure. But assuming they do not have enough pharmacies, then what you are saying reflects: UK people has 1st world mentality and we have 3rd world's mentality.