since when is lim kit siang a doctor?!!

bottom line is, it's all about money......gp's/private clinic based specialists earn significant percentage of their income from medicine markups.......

pharmacy is a 'new' profession in msia, and hence doctors given the right to dispense from way back, when there were few or NO pharmacists in many towns........

it's a bit like a right/privilege given which benefits a group......now you want the group to give up that privilege.......you think malays will give up bumi rights willingly?..........

it will only happen when the pecuniary advantages of dispensing is removed........and that will only happen when a centralised, gov funded healthcare delivery system is in place.......eg nhs in uk and medicare in oz........ie professionals are rewarded and compensated for their EXTERTISE........not their PRODUCTS........

like i said, it is a turf war.........and all about money.......

if there is no pecuniary benefit dispensing medicine, doctors will be quite happy to leave that to the pharmacists......

just ask the gov doctors.......and docs in private hospitals (NOT allowed to dispense in MOST hospitals).....

perhaps it is pertinent to note at this stage, that separation of function will inevitably increase the cost of a consultation........

that is fine in the context of nhs or medicare (uk, oz).........the consumer is not affected directly.......

i wonder how this will work out in msia, where private consultation (that's the issue here, it is NOT an issue in the public sector) is overwhelmingly paid for out of pocket......the consumer's pocket, that is.........

the issues mentioned by lks is actually true, and correct......these ARE the issues affecting the private healthcare sector at the moment......

it will be wishful thinking to think that some noise by the opposition in parliament will change anything the bn gov wants to do, past history proves otherwise.......the proposal faces significant resistance from within the bn, consumer bodies and the general voting public.......that is the reason why it was shelved for the moment.....nobody wants the cost of their healthcare going up significantly overnight......

the rethink now will tie the separation of function with the national health financing scheme.......yes, there is something like this in the pipeline......has been for 20 years, but NO political will to see it through, (and a lot of fear amongst the professions, seeing how such schemes often become 'get rick quick' projects for some cronies....eg formema).......

there are so many other 'patient safety' issues facing msia at the moment........top would be the mass production of doctors locally and overseas, some very poorly trained, some very poorly qualified even to enter med schools......second would be junior doctors working hours and the mistakes that fatigue will inevitably bring......

i think dispensing problems would be quite low in the pecking order of issues for the dg of health to tackle.........

that is also lks's view in his article, if you read carefully....

ie......this is an issue of PRIORITISATION.......

there are many other issues dragging on msian healthcare provisions, not least of which is basic access to, and equity of health care........in many rural areas people still have no access to doctors, the rural clinics are manned by ma (medical assistants, or the old name dressers) and nurses, and not a private clinic in sight for miles.......

yes, unfortunately, msian lifes are cheaper, msia is still very much a 3rd world country.......that is a fact........that is why cheap and accessible (in the sense of physical access) health care, NOT quality, is wanted.......if you can get cheap and cheerful, that's even better!

This post has been edited by limeuu: Dec 13 2008, 11:41 AM

just another comment.......it's quite pointless to do any trial........we all know in an ideal world, there WILL be separation of function.......it works, and it IS better.......

we just need to find a way to implement it without crashing the entire private healthcare system of msia.....

and that will be the day when we implement the national healthcare financing system, if it ever comes to reality......

that is why 'barefoot doctors' msian style, ie the ma's and nurses, are diagnosing and treating patients in many rural clinics.....so there is NO monopoly of doctors to diagnose.....

makes no sense, as the shortage is in the rural and remote areas.......where no doctors, nor pharmacists wants to go.........and there is relative oversupply of doctors in the klang valley, especially in the private sector.....

This post has been edited by limeuu: Dec 13 2008, 06:47 PM

i think you all have a mistaken understanding of what the asean thing is about.....there will still be barriers.....

it just say that there is cross RECOGNITION of qualifications, and right to register and practice across member states......it does NOT say they you actually CAN work, as there is another barrier which the agreement cannot breach, ie immigration laws.......

so effectively, someone graduated from thailand in medicine will have his qualification recognised, and can be registered to work in spore.........IF he can find a job, and hence apply for a WORK VISA......

the effect is just like the new immigration rules in uk.......a msian student who graduated from say leeds, can do the 2 years foundation, and then be FULLY registered with the GMC......BUT he will NOT be allowed to be offered a job, and get a work visa, unless the employer can prove that they cannot find another doctor from either uk, or the eu to do the job.........

wanna bet something like this will be used to control the movement of people?.......remember, asean is NOT like the eu.........a non-citizen/pr needs to have a visa/permit to work in another member country........

This post has been edited by limeuu: Dec 14 2008, 06:58 PM

this is of course incorrect.......misinformation..........

you don't have to put down another profession to promote your own.....

eh.......actually they do have a choice, even now........they can ask for a scrip and go buy at any pharmacy.....and some do, especially when prescribed from specialists in hospitals (generally they do not dispense so no skin off their nose)......

the thing is, if they do that in the usual gp consult, they quickly realised it cost more separating the two, so they are quite willing to take the medicine from the clinic.......convenient as well.......

the pharmacist wants exclusive rights to dispensing lah......ie no choice for patients, cannot/not allowed to get from doctors, but must buy from pharmacists........

that is a very old article from 2006. The situation has gotten worse, with several new ipts med schools coming on line, and increase of students going to india/indonesia/eastern europe. msia will reach the targeted ration of 1:600 by 2013 at current production rates........then we are into surplus.......and you can't just close a med school when you have enough doctors........

see my earlier post no 6 - http://forum.lowyat.net/topic/860725?author=limeuu

that is why i said, this dispensing issue is of LOW priority at the moment.......there are much more urgent and important issues to face........