In Penang GH, any changes in prescription will be made only after consulting the doctor, so don't generalized all pharmacist in Malaysia likes to do whatever they like either in public and private setting.

Newer medications never means better to me, again, don't generalized pharmacists as we know how to evaluate with evidence based study whether which drugs is suitable for which conditions.

About pharmacist dispensing right, I am done arguing with greedy doctors. I just want to say, a Volvo can get you from point A to B as also a Kancil. People won't feel any difference (ignore things like comfort, performance, handling) if their sole purpose is just to get to their destination. However when a serious car accident happen only those in Volvo will know the difference because Kancil driver may no longer have the chance to know the difference.

You can find the research from UK and US yourself, or ask any pharmacists did you ever encounter doctor's errors in your life and you will get a definite answer.

A competent pharmacist only lack knowledge in differential diagnosis (a doctor's job), but certainly not lacking knowledge in disease management in common diseases like STEMI, NSTEMI, CHF, DM etc on what drugs should be given in the treatment regime based on guidelines. Some of the more complicated disease like lymphomas, neither a normal Medical Officer or pharmacist can claim they have better disease management knowledge than a consultant oncologist/hematologist.

If the doctor can do a pharmacist job why the hell do I still need to go back to the hospital in the middle of the night to conduct theraupeutic drug monitoring and deciding the appropriate amount of antidote to be given for poisoning cases? Mind you it is only one of the things that I want to point out both Dr and pharmacist have their roles to play and Dr should mind their own business on where they can perform best or trained to be good at (diagnosis, surgery).

On the matter of not enough pharmacist, it is just about supply and demand. Similarly when there is pharmacist dispensing right it doesn't mean community pharmacy are going to earn more as there will be competition to keep the price low, especially competition from those large chain like Guardian.

Have you find out the research done in US and UK about how many prescription errors pharmacists caught in a year as I have ask you to do it in previous post ? Before you did that stop living in ignorance saying that there are no clear advantage of pharmacists dispensing medicine because you simply want to deny it due to stubbornness.

Do you understand what supply and demand means? If currently there are no demands for 24 hours pharmacy why should anyone in their right mind would open their pharmacy 24/7 ? Same as a doctor in rural area won't open their clinic 24/7 just to serve possibly only one fever patient in the middle of the night out of the whole month.

Fine you want evidence, here you go:

Pharmacists at the forefront: reducing medication errors. Consult Pharm. 2006 May;21(5):380-4, 387-9.

Pharmacists are in a constant battle to prevent medication errors. It is something most pharmacists do not even realize they are doing every day. Some people call it "pharmacist radar." As pharmacists review charts, talk with patients and staff, and interact with prescribers, they are constantly filtering information about medications from numerous sources to ensure that something has not "slipped by" that might cause a medication error. Is that the right dose? Why did the prescriber choose that drug? Where has the facility been keeping that medication? These are just a few questions that are part of the internal dialogue swirling around in senior care pharmacists' heads as they try to ensure the highest level of care for patients.



Prescription errors in chemotherapy.Farm Hosp. 2007 May-Jun;31(3):161-4.

OBJECTIVE: To describe and analyse the role of the pharmacy department in detecting errors in the prescription of cytostatic drugs. METHOD: A retrospective study was carried out over a two year period (2003-2004), which reviewed the errors detected by pharmacists in chemotherapy prescriptions. Medication errors were classified according to the system published by Otero et al. in the paper OErrores de medicaci-n: estandarizaci-n de la terminolog a y clasificaci-nO (Medication errors: standardizing the terminology and taxonomy). RESULTS: During the period analysed, 43,188 doses of parenteral cytostatic drugs were prepared for the treatment of 3,959 patients. A total of 135 errors were detected (3.1/1,000 preparations). Errors were distributed as follows: incorrect dose (38.5%), drug omission (21.5%), incorrect drug (11.1%), frequency error and incorrect treatment duration (9.6% each), incorrect patient (7.4%), incorrect administration rate (1.5%) and incorrect administration route (0.7%). All of the errors would be classified with a B level of seriousness, since they were resolved in the pharmacy department before dispensing the drugs. At least 66 of these could be classified as potential adverse drug events. Furthermore, 11 cases of incorrect reductions in doses and 12 cases of omissions of cytostatic drugs were detected and these errors could lead to a possible reduced treatment efficiency. CONCLUSIONS: Despite the low incidence of errors detected in chemotherapy prescriptions, their potential seriousness gives the pharmaceutical validation process a key role in improving safety for patients.

Impact of pharmacy validation in a computerized physician order entry context. Int J Qual Health Care. 2007 Oct;19(5):317-25. Epub 2007 Jun 28. Links

BACKGROUND: Computerised physician order entry offers a potential means of reducing prescribing errors, and can also increase the feasibility of pharmacy validation as a secondary filter for eliminating errors. The impacts of these two benefits have never been evaluated in combination. OBJECTIVE: To describe (i) the pharmacists' interventions during validation of drug prescriptions on a computerized physician order entry system, (ii) the impact of these interventions on the prescribing process and (iii) the extent to which computerized physician order entry was responsible for the identified errors. METHOD: Prospective collection of all medication order lines during five days in a tertiary care university hospital using computerized physician order entry for drug prescription. All orders were reviewed by a pharmacist. We described the frequency of pharmacy alerts and their short-term impact on the correction of potential prescribing errors (modification of the prescription). An independent committee reviewed their type and link with the computerized physician order entry system. RESULTS: About 399 (11%) prescription order lines, corresponding to 222 (52%) patients, required a pharmacy alert during the study period. Among the 81 pharmacy alerts targeted to the prescriber, 21 [26% (IC95% = 17-37%)] resulted in a modification of the prescription. Among the 95 potential prescribing error, the independent review committee judged 16 (17%) as potentially life-threatening and attributed 47 (49%) to the use of computerized physician order entry system (unit error, no use of typical order prespecified, prescription inconsistency or other). CONCLUSION: Pharmacy validation produced only a moderate short-term impact on the reduction of potential prescribing errors. However, pharmacy validation may also provide ongoing benefits by identifying necessary improvements in the computerized physician order entry system. Those improvements would allow pharmacists to concentrate on the most relevant interventions.


Survey of medication documentation at hospital discharge: implications for patient safety and continuity of care. Ir J Med Sci. 2008 Jun;177(2):93-7. Epub 2008 Apr 15. Link


Background Medication discrepancies at the time of hospital discharge are common and can result in error, patient/carer inconvenience or patient harm. Providing accurate medication information to the next care provider is necessary to prevent adverse events.
Aims To investigate the quality and consistency of medication details generated for such transfer from an Irish teaching hospital.
Methods This was an observational study of 139 cardiology patients admitted over a 3 month period during which a pharmacist prospectively recorded details of medication inconsistencies.
Results A discrepancy in medication documentation at discharge occurred in 10.8% of medication orders, affecting 65.5% of patients. While patient harm was assessed, it was only felt necessary to contact three (2%) patients. The most common inconsistency was drug omission (20.9%).
Conclusions Inaccuracy of medication information at hospital discharge is common and compromises quality of care.


Predicting the rate of physician-accepted interventions by hospital pharmacists in the United Kingdom

Prescribing errors in hospital inpatients: their incidence and clinical significance

The Role of Managed Care Pharmacy in Reducing Medication Errors

Take your time to read it up, no more spoon feeding

---

Added on December 9, 2008, 10:20 pmShould be changed into this :

Doctors are not scared, it's just that you pharmacists are too desperate to fill your own pockets or vice versa

I wonder how a pharmacist overseas with dispensing rights reading the thread will respond, probably what he see is that kid A that took away kid B's toy and refused to return the toy to kid B when the kid B wanted it back and saying " prove it to me it's yours, no name there see? Why should I give it back to you? You don't need it anyway..."

This post has been edited by Yeapy: Dec 9 2008, 10:24 PM

Glad that you accepted the evidence, we just want to give constructive comments, all Malaysians and the world may be laughing at two so-called made in Malaysia professionals when they see this thread or in newspaper (The Star comments) if both Dr and pharmacist are just arguing like a kid.

This post has been edited by Yeapy: Dec 9 2008, 10:32 PM