A bitter divorce
A recent frontpage announcement of the separation of duties between prescribing and dispensing has caused much furore especially among doctors. There is little doubt that the most affected group will be the private practitioners, who will stand to lose if they are to be denied dispensing rights.
Prescribing remains the sole domain of doctors although some pharmacists have been known to encroach onto this area, where they are certainly not trained for. Dispensing medications, however, is a battleground where each would like control of an abundant piece of real estate.
A doctor's training encompasses not only about diagnosis and treatment but certainly an allocation of hours for pharmacology in the early years. Prescribing medications without knowledge of the drugs that are being prescribed is certainly grounds for negligence. So despite the fact that the pharmacists may perhaps have a more indepth knowledge of the pharmacokinetics or pharmacodynamics of the drug, a doctor possesses the ability to correlate drug treatments with the clinical scenarios.
Uncoupling prescribing and dispensing is not about competence but rather about improving the efficiency of healthcare delivery. In a busy practice where a doctor may not have sufficient time to explain about the spectrum of side effects, a pharmacists may be of importance. A pharmacists should play a role of assisting doctors in delivering an exemplary standard of healthcare.
It is my personal opinion that doctors should be allowed to continue dispensing medications. There is no compromise in patient care by doing so. However, in areas where doctors may be overburdened, for example in tertiary care centers, uncoupling prescribing and dispensing is certainly of benefit.
Pharmacies plays in a role in allowing patients a more varied selection. Patients can be given a choice of getting the medications from the doctor or a nearby pharmacy. Such a choice should be left to the patient concerned and not muscled through via legislations.
Pharmacies remain poorly regulated where the standard of practice is suspect. Many are driven solely by profit margins, making temptations of unorthodox practices too juicy to resist. Some venture into a lucrative tradisional medical practice for which they are certainly not trained for. Even providing blood pressure and sugar checks without proper counselling may only distress patients unnecessarily. Allowing pharmacies to promote alternative healthcare or products apart from those specifically prescribed, may only confuse patients.
If dispensing rights are to be solely given to the pharmacists, then a level of service commitment needs to be in place. For example, a 24 hour service or being on call duties may be necessary in tandem with that in the medical field.
A divorce of duties now will surely be bitter. Although it appears inevitable at this time, careful thought needs to be invested and loose ends tightened up. Anything less and only patients will stand to lose.
Prescribing remains the sole domain of doctors although some pharmacists have been known to encroach onto this area, where they are certainly not trained for. Dispensing medications, however, is a battleground where each would like control of an abundant piece of real estate.
A doctor's training encompasses not only about diagnosis and treatment but certainly an allocation of hours for pharmacology in the early years. Prescribing medications without knowledge of the drugs that are being prescribed is certainly grounds for negligence. So despite the fact that the pharmacists may perhaps have a more indepth knowledge of the pharmacokinetics or pharmacodynamics of the drug, a doctor possesses the ability to correlate drug treatments with the clinical scenarios.
Uncoupling prescribing and dispensing is not about competence but rather about improving the efficiency of healthcare delivery. In a busy practice where a doctor may not have sufficient time to explain about the spectrum of side effects, a pharmacists may be of importance. A pharmacists should play a role of assisting doctors in delivering an exemplary standard of healthcare.
It is my personal opinion that doctors should be allowed to continue dispensing medications. There is no compromise in patient care by doing so. However, in areas where doctors may be overburdened, for example in tertiary care centers, uncoupling prescribing and dispensing is certainly of benefit.
Pharmacies plays in a role in allowing patients a more varied selection. Patients can be given a choice of getting the medications from the doctor or a nearby pharmacy. Such a choice should be left to the patient concerned and not muscled through via legislations.
Pharmacies remain poorly regulated where the standard of practice is suspect. Many are driven solely by profit margins, making temptations of unorthodox practices too juicy to resist. Some venture into a lucrative tradisional medical practice for which they are certainly not trained for. Even providing blood pressure and sugar checks without proper counselling may only distress patients unnecessarily. Allowing pharmacies to promote alternative healthcare or products apart from those specifically prescribed, may only confuse patients.
If dispensing rights are to be solely given to the pharmacists, then a level of service commitment needs to be in place. For example, a 24 hour service or being on call duties may be necessary in tandem with that in the medical field.
A divorce of duties now will surely be bitter. Although it appears inevitable at this time, careful thought needs to be invested and loose ends tightened up. Anything less and only patients will stand to lose.
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