i agree too, in the US it is worse.. let's say u are on a drug forever but do u know u need to get a prescribtion every once in a while? the pharmacist can give the drug unless a doc writes something. and there goes 50usd for a piece of paper!

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.

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.

3. Patients get increased safety. And of course, safety comes with a price.

If patient do not wanted safety, I strongly suggest they go consult a bomoh instead (will accept any amount of red packet as payment or may be even a chicken or duck?) or pick some wide herbs on the road side which is free.

There's no clear advantage of pharmacists dispensing medicine, on top of that the pharmacists are lacking here. Have you seen any 24 hours pharmacy around? What if patients need medication at night? Are you going to open shop just for them?
You are talking as if patients will die if pharmacists don't dispense medicine. 

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Added on December 9, 2008, 3:43 pm
In some rural area, I do not see even a single clinic. What if patient need to see doctor at night? Are doctor going to open clinic just for them? Or should we also let bomoh do the job of treating as well in rural area? If not, the patient can die. So if your answer is yes to bomoh, then doctor should not have sole right to diagnose and treat. Same principle applies to pharmacist.

Doctors are human and will make mistake. Period.

Pharmacist are also human and will also make mistake. Period.

There is no 100% fool proof safety procedure. In fact, there is no 100% of anything in this realistic world.

Going by logic and rationality, an extra layer of safety is better than none. And unless all those developed countries are run by fools, we can only assume the role of pharmacist does has it's place in those countries.

On actual proof. May be there is or may be there isn't any studies. I don't know and may be you can try to search on google?

But 1 thing I do know. There are many actual studies about the numerous amount of mistake occurring due to wrong medication taken. In fact, a army of lawyer makes their living suing against these mistake so you can imagine how wide spread mistakes must be. And this is in developed countries so in 3rd world, multiple that by a couple of folds.

Your argument has basis. But it does not apply when you reject the separation of prescribing and dispensing even in areas with plenty of pharmacies like in Klang Valley. By doing so, using blanket 'lack of pharmacist' excuse shows the writer to have ulterior and less noble motive. And that is what I really wanted to put across.

As for me, I think my life is worth to pay for someone to have a 2nd look at my prescription because the alternative is some Form 5 school leaver in the clinic.

That is why I know some people will take their medicine to the retail pharmacist asking questions. In fact, even with doctors, I like to have a 2nd opinion and yes, it cost extra because I have to pay all over again.

And by doctor selling the medicine..how are pharmacy going to survive?without pharmacy who will employ pharmacist?without employment who will want to become a pharmacist?

anyone that here as medical student..please change the situation next time...I think alot malaysian are poisoned by antibiotics...you come to klang any clinic and say you flu....they straight give you...

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..."

Look, i am not saying that our health care system is superb. In fact, our health care system is lacking behind. Therefore, as i have mentioned numerous times, such change can't be done right now as our country lacks pharmacists. How can you pass the dispensing right to the pharmacists when they are even fewer than the doctors here (which is also lacking in numbers)? Wouldn't it be a chaos scene?

In other advanced countries, the number of pharmacists is greater than that of doctors, therefore, as logic dictates, it's all right to give them the dispensing right. However, the same can't be said for msia, not at the moment.

I strongly advise you do a google and see how many medication mistakes there are out there. I have given you some links before. As I said before, of which you always tends to forget, an ENTIRE lawsuit against doctor industry were built on medical mistakes.  So what is this 1 example of yours compares to the other thousands and thousands of medical mistake involving doctors? Look at the big picture please.

As for Lim Kit Siang. Old habit die hard. He is born to oppose everything without thinking. But let's for a moment accept what he said is correct, we are poor and can not afford to pay extra for patient safety.

Putting that argument further and may I ask,  which is more expensive, to see a doctor or a bomoh? If cost is the primary concern, then one should opts to see bomoh and remove the sole right of diagnosis to the doctor. If you remember correctly, this is where the 'bomoh' part comes in. Which, again, you forgot.

Back to LKS again. You are correct we must have proof of what we said so let's ask LKS for it. I would very much like him to provide proof of what he said because AFAIK, no such trial has ever been done in Malaysia before. I am sure the Health Ministry has their study. Let's see what has LKS's got for saying what he said. Or may be on the other hand, LKS is also a oracle like you. So no need for trial 

Furthermore, LKS's title "Doctors Prescribe, Pharmacists Dispense, Patients Suffer" does not take into account increased patient safety. Once again confirming that life is cheap in Malaysia as compared to advanced countries. This is the mentality of Malaysia's doctor and opposition party. Very sad 

Noteworthy but Untimely Move

The Ministry of Health is set to draw a dividing line between the physician’s role and the pharmacist’s, restricting physicians to prescribing and according dispensing rights solely to the pharmacists.

Such a move virtually has its effects only upon doctors in the private practice and particularly the general practitioner who relies on prescription sales for much of one’s revenue.

Doctors prescribe and pharmacists dispense. It’s the international role of each profession and very much the standard practice in most developed countries.

The Ministry of Health however, has failed to take into account the local circumstances in mooting this inaugural move in Malaysian healthcare. The logic and motive behind the Ministry of Health’s proposal is in fact laudable, but only if the Malaysian healthcare scenario is more organized and well-planned.

Where do you think the NHS get their money? From the sky?

Think about that. Money all come from the people. Either direct to doctor or indirect through tax. You know about the tax thing, do you?

I know LKS have many reasons. I am just wondering why SAFETY is never one of his reason mentioned so my conclusion is that he think Malaysian life are cheaper than developed countries. That's all.

Let me make it VERY clear.

I am NOT ready to make dispensing right PERMANENT.

I just want to see what the trial result says. Until we have a trial, all we talked here are mere hot air without meaning and substance.

Then the question I would like to ask is, why he never mention safety but only money?

Sometimes, it is not what's said that is important but rather what is not being said. And all I hear is money. Of course, on what is not being said, your guess is as good as mind.

May I ask how do you know we are not ready for the trial? If I have to choose between words of the Health Ministry and you, sorry, I think they are more qualified than you because they have better credential. Not unless you show me your credential to be better than theirs. This is just plain logic. When in doubt, pick the words of those who has better credential or expert. This is the same answer I gave to Hypermax.

I do not know what number of pharmacies is considered sufficient. And I believe part of the reason for the trial is to find out that answer. Without that trial, you guess on numbers is as good as mine and anyone else. On the other hand, may be we should ask Hypermax for the answer because he already know the number is insufficient. The unfortunate thing is, he refuses to give us the figure.

But I don't see LKS talking about those data so I presume number of pharmacies is not an reason for his objection. I can only see money being the issue from LKS.

Let talk about the other issue you said he mentioned.
1. unequal distribution of service
We know there are insufficient pharmacy and unequal distribution in many part of the country. But the most highly developed part of Malaysia, Klang? I am not so sure LKS is right about Klang.

2. Quality of personnel.
I believe all these personnel are qualified and licensed doctor and pharmacist. So I am not sure what quality problem, if any, LKS is talking about.

3. medical system
Isn't this the purpose of this trial?

On government conspiracy theory. As I said before, let's discuss as to what are the possible ulterior motives. So far, I could not think of any. Can you? If there is money to be made, it's does not go to the government so they have no motive. If gov did not give dispensing to only 1 pharmacy company, then there is also no motive there. The Health Minister is not a pharmacist so he has no motive there either. So please come up some ulterior motive to share with us.

1.  Not enough pharmacist. Again, HOW DO YOU KNOW there is insufficient? Your words vs HM? I take HM's.

2.  Doctor can do the job. By general consensus now, pharmacist are the better person.

3. Cost. But without a proper cost vs benefit ratio study, we don't know, do we?

Since No.1 and 2 has been discarded, that only left with cost vs benefit ratio to work out and that calls for a trial.

You are saying our doctors and pharmacists are not very qualified and of low standard. Assuming that is a valid reason, then this very reason for not giving dispensing right to pharmacist is also the very reason why we should withdraw diagnosis right from doctor. They are all sub standard professional so should not have exclusive rights. It's only logical.

Since we are not using this reason to withdraw doctor diagnosis rights, it should not be the reason not to do the trial also.

This is the part I do not understand.

Not enough doctor. But doctor still given sole right to diagnosis.
Not enough pharmacist. This is the reason why pharmacist should not have right to dispense.

Both not enough. So why use "not enough" as reason not to give right to pharmacist? Or is this called double standard?

Tell me, in rural areas with no doctor, what should we do? Let the patient die so you can have your diagnosis right? What sort of a doctor are you?