Bukit Batok Polyclinic *Cough Cough*

So I started my preceptorship at the Bukit Batok NHG Polyclinic.

Preceptor is defined as an identified experienced practitioner who provides transitional role support and learning experiences within a collegial relationship for a specific time, while continuing to perform some or all of the other responsibilities of their position.

I’ll be attach to the Pharmacy for 6 weeks, fulfilling the Republic’s requirements prior to obtaining a license to practice. Workload has been pretty hectic, working six days a week, with minimal allowance and non-existing welfare benefits.

I will load some pictures and blog about interesting events during my attachment.

I feel a bit annoyed that many people do not know the exact roles and responsibilities of a Pharmacist, what’s with the recent reply on YB Lim’s Blog. In addition, I have also been enlightening friends and acquaintances of mine on what we really do when I tell them about my attachment.

During one of the counselling sessions I sat in with the Pharmacist, the patient actually thanked us after the session by saying “Thank you ah, Doctor”

My mentor quickly replied the patient by saying “I’m not a Doctor, I’m a Pharmacist”

I feel that there is a need to ‘publicize’ the pharmacist among Pharmacy students and registered Pharmacists alike. Many a times, I get questions like “So this degree will just allow you to give them the medications? How hard can that be?” or even “Doesn’t it bother you that you know you’ll never be on top in the healthcare scene, since Doctors are the most likely ones to be the final decision makers”

It’ll be quite hard for patients to see what we really do, since we work behind the counter most of the time. And since we’re the final personnel they see upon collecting their medication, they’ll probably channel all their perceptions and frustrations to us as ‘being the bad ones’. There was one patient, with sore throat, runny nose and fever (typical symptoms of the common cold aka flu by the way) insisted that there was a mistake on the Pharmacy side for not giving her antibiotics, although it was the doctor who decided not to prescribe her with them.

The other problem is of course we can’t go around putting big signs saying “Look at me! I’m a Pharmacist” as the law only allows us to put one mini sign showing our name and our title e.g. Aaron J Lam, RPh, BSc. (Hons?) Pharmacy.

FYI: Just because you have sore throat and everything doesn’t mean that you need to undergo antibiotic therapy. Antibiotics are only given if you’re diagnosed with an infection from bacterial origin. Viral infection will warrant antibiotics useless.

The Media Is At Stake

When Raja Petra Kamarudin (or known as RPK) was arrested for his article on the Malaysia-Today website, I thought I checked out the website on what it was all about.

I got hooked onto the website since. If you value freedom of speech, and freedom of the media. Then support RPK by donating for his bail. The family is requesting $1 per person/blogger. I donated $10.

————- UPDATE ————

updates 16:16 - Account statement made by RPK’s wife on the donation as at 4pm today

From CIMB bank account : RM24,500.00
From Paypal account : $3,283.61 USD (net total, after deduction of fee charges by Paypal services)

Would you look at the sum! And it’s only today the fund was started! Looks like I’m not the only one who thinks this way =)

U2 + U19 = U21!

Just got invited to participate in the “Universitas 21 (U21) Undergraduate Research Conference” from my recent research on “Complementary and Alternative Usage among Breast Cancer Patients in Singapore”.

Will update you guys again on WHAT THE HECK IS U21! I don’t even know currently as it was my Professor who submitted my name =p

But in any case, I’m awaiting for “Good luck” and “Congratulations” on my comments yeah *boasts*

Can Pharmacist Be the Sole Dispenser in Malaysia?

The Malaysian Pharmaceutical Society and the Health Ministry of Malaysia are conducting a trial on the separation of roles between pharmacists and private practitioners. Pharmacists are allowed to be the sole dispenser while doctors provide patients with the prescription.

The response from the public has been generalle y negative. Heris one article ran by Lim Kit Siang.

Here is my response to the article:

With the current system, it is not economical to open so many pharmacies within the community as our role as a healthcare provider is only limited to minor ailments and non-prescription drugs. However, in the proposed system, Pharmacists can play a role in the medication process by opening up pharmacies practically everywhere! By then, it will also be viable to make pharmacies 24 hours. A certain law/regulation/code can be done to ensure that there is a pharmacy available within the vicinity of a clinic or such.

Pharmacies are bounded by the Code of Ethics as stipulated by the Pharmacy Board of Malaysia. It states that “The Pharmacist shall not by words or deed or by inference thereof discredit or disparage the professional integrity, or judgement, or skill of another pharmacist or of a member of an allied profession”. This means that if a patient comes to the pharmacy with a prescription for Panadol, pharmacists are not allowed to dispense any other brands of Paracetamol other than Panadol. As such, when pharmacists are in a situation where they are uncertain of the prescription ordered by the doctor, it is only professional of them to consult the doctor without alarming the patient. In the case of the Patient above, her re-filling of prescription is by order of the doctor. The pharmacists have to follow the prescription unless he suspects any non-compliance or medication errors. Whether or not he suspects anything is the onus of his professional conduct. To say that the pharmacist will overrule the doctor’s prescription is not true at all.

In addition to that, private clinics usually lump everything as “consultation and medicine fees” onto the receipt. As some have mentioned, we all don’t know the exact breakdown of the prices. Perhaps the Ministry should enforce such breakdown requirements, and then only we can compare the prices between a clinic and a pharmacy.

Certain medical ailments also do not require a doctor’s attention. The pharmacies role is to counsel the patient on his/her current condition and to recommend a therapy for him/her to follow. If you have seen patients talking to the pharmacist and pharmacist recommending some medication, the pharmacist is not going beyond his roles as all these are minor ailments. Unless the pharmacist suspects further underlying causes, he is obligated to ‘refer him/her to a doctor’. Yes pharmacies can help you measure your BP, measure your body temperature, check for scabies, dandruff or sunburn. Are these what you refer to as physical examination? In economic sense, this definitely reduces the patients’ financial burden to pay for consultation fees. Pharmacists do not charge for consultation.

My point here is, the physician-pharmacist role with regards to proper medication usage and patient safety can be greatly enhanced through such a system. Of course, there are other factors to consider like whether current pharmacists in Malaysia are equip through their professional education to dispense and counsel the patients appropriately? And whether patients are ready to trust pharmacist as much as how they trust the doctors.

FYI, you don’t have to get the medicine from the clinic itself currently. If you request for a prescription, you can always bring a prescription to your friendly neighbourhood pharmacist!

Comments are greatly appreciated =)