Jan 5, 2005
SHOULD CLINICS CONTINUE DISPENSING PRESCRIPTIONS?
Stopping docs from selling drugs a bad move
I REFER to the Ministry of Health (MOH)'s move to stop doctors from
selling medicine that they prescribe ('MOH to stop docs from
selling drugs'; ST, Jan 1). I am not a doctor but I am surprised
that MOH would introduce such a move without consulting those that
would be most affected, that is, members of the public.
We have not been told the severity of the problem of doctors
prescribing drugs that give them a better profit, rather than ones
that are cheaper but just as good. However, I suspect that the
problem has been exaggerated and those who levy such criticisms are
a minority, who can easily go to another doctor.
Let me first say that the move is discriminatory against general
practitioners and private doctors. If the move is in response to
criticisms about doctors making money from selling drugs, then it
should extend not just to individual doctors, but also to medical
groups and hospitals as well because it is also possible that
doctors in such entities will be influenced by considerations of
their employer's profitability as this will ultimately have a
bearing on their bonus and promotion prospects.
One has to be reasonably pragmatic. I do not think that a doctor
who repeatedly prescribes medicine not stocked by his employer
because 'they are cheaper but just as good' would do very well in
his career. There should also be safeguards to prevent medical
groups and hospitals circumventing the restriction by setting up
another company to sell medicine.
More importantly, unless MOH expects doctors to take a pay cut
(which will not happen because doctors are highly trained
professionals who can easily move abroad in order to maintain their
standard of living), it is inevitable that the move will result in
higher consultation fees and inefficiencies, no matter how MOH
phases in the change.
With the change, instead of paying for one set of overheads at my
doctor's clinic, I will now have to pay for two - the clinic and
the pharmacy's, and incur additional transport expenses to
boot.
Personally, I see nothing wrong with doctors earning some extra
income from selling medicine that they prescribe. Apart from
keeping consultation fees down, I see it as a value-added service.
When I am ill, the last thing I want after visiting my GP is to
have to go somewhere else to get my medicine. This is no joke if
you are taking your sick aged parent or bawling feverish child for
a consultation.
So what if I pay my family doctor a few bucks more? If I don't, I
probably would have to spend it on transport for the extra trip to
the pharmacy.
The argument put forth by the Director of Medical Services,
Professor K. Satku - that Singaporeans need to learn that they
should have some medicine at home - seems to fly against the
repeated admonitions about the dangers of self-medication.
Am I supposed to know the difference between the medicine I have at
home and the ones my doctor prescribes? And how does stocking up on
medication that will likely expire before I get to use them lower
my overall costs?
We should not follow blindly US or Australian medical practice. Let
us not forget that the cost of medical care in those places is
among the highest in the world.
Cheung Phei Chiet