Wednesday, September 3, 2008

Doctor! My Medication Is Not Enough!

As a Dr in government hospital, I always face patients complain to me that they can't get complete supply from the government hospital which make them upset. Though i tried to explain to my patients, sometimes I do blame our pharmacy making things messy. However, I just read this comment from MMR blog who is a government hospital pharmacy and I agree that his point is valid.


http://medicine.com.my/wp/?p=4295#comments

Quote:

I am only a base-level pharmacist in a small government hospital and these are some of the issues regarding stocking and supply that we face:

We’re unable to give a full supply of medicines (e.g. 3 months) out to patients all at once because:

a) There isn’t enough money to ensure that at any one time, there will be enough medications to provide full supply for every patient that comes to the pharmacy.

b) For most hospitals, there isn’t enough storage space to keep that mega amount of medicines equivalent to every patient’s full supply. With doctors frequently overprescribing and with polypharmacy being practiced, the amount of medicines that need to be stored is staggering. Incidentally, there is also difficulty in securing the necessary budget to increase storage space.

c) As it has been frequently mentioned, the supply of pharmaceuticals to the govt is monopolized by one particular company resulting in us being unable to procure drugs at a (possibly!) cheaper rate from different companies, thus completely cutting out the middleman in many instances. Additionally, woe betide if there is any disruption in that company’s manufacturing process or logistic operations…the whole of Malaysia automatically faces a shortage. This naturally has happened many times.

d) Overprescribing of medicines by doctors. Many patients nowadays are on an average of 6-10 drugs. The prescribing pattern has been described as ‘one symptom, one pill’. Pharmacists have often tried their best to reduce this problem but frankly speaking, after the 10th time of being shouted at by a doctor who’s indignant that a pharmacist should tell him what drugs may be unnecessary, we find it hard to summon the effort to do so anymore.

e) Patient wastage. Many a time I’ve felt like strangling a patient who has ‘lost’ three whole months of medicines worth around RM2k because he/she left it in the car in the hot sun or misplaced the entire supply of medicines or perhaps their pet cat/dog ate it. So much for my goodwill.

f) For certain patients however, making them come back every month for their medicines results in them being more compliant to the medication therapy as we have the opportunity to ‘nag’ them every month when they come to collect the meds.

These are the current issues that are being faced by us pharmacists in the government. However, I have often taken on requests for full supply on a case-to-case basis, especially for those that are going overseas for a holiday or to perform the Haj.

Personally, I hope that no one takes out their frustration regarding this issue on us poor pharmacists as we are only performing to the best of our abilities within the constraints of ‘policy’. Especially doctors who feel that they are doing so on behalf of their beloved patients.

Really, if I could just give them all the medicines and reduce the number of patients I see every month, I would.

Cheers

from, Mark