远在澳洲Monash大学的弟弟写了一篇很热血关于药剂师的blog文。在Manchester大学的我也深有同感。从我的角度,觉得英国的药剂有制度有系统,最近甚至药剂师开始可以access病人的医生full medication history record,也不少药师成为Independent prescriber或supplementary prescriber。个人经验方面,2009年A Level那时在community pharmacy placement的所见让我对马来西亚的community pharmacy有些质疑;相反的,大学期间在英国Boots Pharmacy的placement让我获益不浅。
我知道马来西亚还是有很多药剂师很热血地为大众在幕后默默付出。
我也知道马来西亚的药剂业有个死结(医生还是可以dispense,不用写prescription),但我希望药剂师同行不要气馁。在英国pharmacy遍布很广,因此只有药剂师有dispensing right(当然,也因为药剂师是药物的expert),其实英国有些没有pharmacy的偏僻地方,还是有rural dispensing doctor的。随着药剂师的数量增加,病人可以越来越方便地找到pharmacy,到时就是时候不再让医生dispense。当然,病人和大众利益是我们的首要的考量,我们努力的目标是希望大众可以得到最完善,和先进国一样的医药服务。至于整个profession被under-utilised这个问题,反而是次要。不过,我们药师真的有能力可以提供大众很多免费的专业知识,帮助他们更妥善地照顾健康。
我们不该只是独善其身,更应该鼓励其他同行为了更好的明天做出改变。我知道现在有很多药剂系毕业的新人,你们都是改革的力量;新人的热血加上前辈的经验,大家一起努力吧。Together, everyone achieves more。就借用Hellen Keller的quote: "Alone we can do so little; together we can do so much."
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我弟弟的blog文:
"拿着JPA国外奖学金出国读药剂,我觉得自己是很幸运的。有些朋友会说,这里的药剂和马来西亚做的药剂是不一样的。这里有制度,有系统,病人看了医生,得去药剂那里拿药,以得到完善的辅导。可是,在大马,连医生纸(prescription)都不需要,都可以拿到药,辅导(counseling)更是少见得很。在大马做药剂师还真没成就感。
听后,我是伤感,但是对明天更有前进的动力。我知道自己的力量不大,有可能渺小,但是我对大马的药剂师们是有信心的,我相信大家读了四年的药剂,不就只是想轻松摇着脚,什么都不做地受工钱过日子。我相信,不只是我,情况不怎么好,因为我相信在大马许多处,有着想把最好的服务提供给社会的药剂师。他们一直默默地努力着,就是没被看见,而被大家忽略了。
再者,讲师时常说:“要经营一个药剂生意有许多方式。但是,我经营的方式就是把最好的服务提供给顾客(解答他们对医药的疑惑,告诉他们该如何服用药物,有什么该注意的,告诉他们需不需要去看医生等)。虽然我卖的药物不比某些药剂店便宜,甚至有时候我还会劝他们去那里买,但是他们却会一直来寻求我的专业意见,甚至买比较贵些的药。记得有一次,不小心犯了个错,把错的药交给了病人。那时侯的我在想,到底该怎么办。最后,我决定去病人的家。但是,病人已经入院。那时侯,心真的很慌,不知道该怎么办,但是最后决定负起责任,每天下班或若有空都会去病房探访病人,直到病人出院。出院的时候,我对病人的女儿说,病人的医药费我会负责。病人的女儿却说,她从来就没遇上过这样的药剂师,而且她是做保险这一行的,若药剂师犯错,都千万不可以承认错误,我的作法令她很意外。过后,因为这件事,她把她的兄弟姐妹,亲朋戚友都介绍来我这里。”
我想,不管制度多么不完善,至少要做到自己认为是一个好药剂师就足够了,因为我相信一个人的力量并不小。"
From
(
http://soonsenglim91.blogspot.co.uk/2013/11/blog-post_10.html)
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Additional Information (added on 21/5/2014):
A very important message to get across is that current practice of using clinic assistants/nurse to give out medicine is actually illegal ... IF doctor want to keep their dispensing, they have to do it by themselves (they have to hand the medicine out to patient by themselves)...
In 2013, Eisah A Rahman, the ministry’s director of pharmaceutical services, said: “ Dispensing separation already exists in hospitals, both in the public and private sector. It’s only in stand-alone clinics where general practitioners and private specialists prescribe and dispense medicines from within their facility.”
She explained that provisions under the Poisons Act 1952 (Act 366) only allow doctors and licensed pharmacists to supply medication classified as “scheduled poisons”.
“Prescription medicines includes‘scheduled poisons’ and the law does not provide for doctors to delegate the dispensing of such medicines to patients via clinic assistants,” she added.
Eisah stressed on the words “does not” because there are doctors who are illegally dispensing drugs which fall in this category.
(Read more at
http://www.freemalaysiatoday.com/category/nation/2013/01/11/healthcare-changes-will-benefit-patients/)
To quote Malaysian Pharmaceutical Society (MPS) council member Dr Yeoh Peng Nam:
“Pharmacists go through four years of rigorous training to learn how to handle drugs. And here doctors are claiming dispensing separation will deprive them of their income from drug revenue.”
“That income is not rightfully theirs to begin with!”
(Read more at
http://www.fz.com/content/dispensing-doctors-patient%E2%80%99s-interest)
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From the book "Pharmacy Practice" by Dr Jason Hall published by Oxford University Press in 2013:
2009年Malaysian Pharmaceutical Society推动了“Know Your Pharmacist” 活动:
英国Royal Pharmaceutical Society对于药师的Vision绝对值得马来西亚的药师参考:
(From
http://www.rpharms.com/about-us/our-vision.asp)