Less patients for GPs: Community pharmacists deserve better

on Wednesday, December 22, 2010

Less patients for GPs: Community pharmacists deserve better.

WE could relate a lot with what Dr David Quek, president of the Malaysian Medical Association, mentioned in the article "Some are making only RM10,000 a month", that appeared on Dec 5.

We agree that work in the private sector is becoming more and more challenging as take-home earnings appear to be dwindling.

What is disturbing, however, is the claim that community pharmacies pose a competition with general medical practice by being "unscrupulous" because they "dish out" medication without prescription. Perhaps, it may serve as a reminder to state that community pharmacists are allowed by law to sell certain medications classified as "Group C" and "over the counter" without prescriptions.

They cannot, for one moment, be considered "unscrupulous". After all, they are trained to manage medication. Without the legal separation between the prescribing functions of doctors and dispensing functions of pharmacists, it can be understood that doctors' prescriptions given to community pharmacists are few and far in between. Hence, we cannot fault community pharmacists for doing what they are legally allowed to do, -- dispensing medication in the correct classifications without prescriptions. After all, they have a right to earn a decent living, just like doctors, after the hardwork during the demanding years in pharmacy school and considering the high cost of education.

Furthermore, it cannot be fathomed what exactly is meant by "simplistic point of care" offered. Community pharmacists are expected to provide pharmaceutical care through drug and lifestyle counselling. Their roles have been expanded by the need to promote a healthy lifestyle.

This is deemed to be the expanded role of all healthcare providers whether they be doctors, dental surgeons, nurses or paramedics. In fact, many community pharmacies have been certified smoking cessation service providers through a training programme conducted jointly by the Health Ministry and Malaysian Pharmaceutical Society.

This new role for all healthcare providers demands continuing professional development and certainly leaves no room for simpletons.

While taking cognizance of the fact that general practitioners need to work increasingly harder to cover the rising cost of living, it must be acknowledged that community pharmacists do not have it easy either.

Malaysia is recognised as a country with a successful primary healthcare programme and due credit must be given to GP clinics and community pharmacies as well as other institutions for contributing to that success.

Dr Quek is right in voicing his concern over the push to train more doctors to ensure a better doctor:patient ratio but this effort may create an imbalance between demand and supply. Competition increases with more graduates and, at the same time, eats into the shrinking cake. The scenario for pharmacists is similar and the two professions share a similar predicament.

In order to remain competitive, community pharmacies need to open longer hours. This may result in the need to employ extra pharmacists for shift duties. Presently, employment in the public sector is attractive because of the hours of work and higher salary. Hence, employers in the private sector need to keep pace and offer higher pay to employ pharmacists. Again, this eats into the bottom line.

Moreover, community pharmacists must maintain best practices as custodians of drugs by upholding the laws and regulations .

The rising cost of medication, together with more players, coupled with group pharmacies and private GP group practices enjoying advantages by buying in bulk have all threatened the livelihood of community pharmacies.

But it is laudable that community pharmacists manage to maintain their enthusiasm to serve. The main driving force must surely be their love to serve society and provide quality care.

What remains to be done is for healthcare providers to better understand each other's predicament and support each others' roles in the face of numerous challenges.

After all, we may be poorer in our pockets but richer in the reward of working together to promote health.

President, Malaysian Pharmaceutical Society


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