Translation: Who had ruined the pharmacy profession?
Author: Xiao huang
Source: Sin Chew daily 20.7.2012

Please refer to the original article if you have any queries. This translation is only based on my personal understanding from the article.

I just hand in my resignation letter before I wrote this article, telling the government hospital that I had worked for a few years: Let’s not meet again. I still remembered how I had struggled to enter the University for Pharmacy Degree 8 years ago. 8 years had passed, now I can only sigh and wonder why am I so determined to get into the profession way back then.

The public thinks that Pharmacist is a good profession; however, this is not the truth.  In the government hospital, our status is worse than doctors and nurses, and always become the “punching bag” of specialists, nurses and patients. It is the pharmacists’ fault not able to give full supply of 3 to 6 months medications for patients with chronic diseases. It is also our fault to provide generic medications rather than branded medications. Besides that, we often sneer by the senior doctors or even junior doctors when we try to provide recommendation on patients’ management and patients rolled their eyes on our suggestions.

Talking about the wages and welfare, pharmacists in the government hospitals are just like an illegitimate child. We do not have overtime allowance for the 24hours and weekend extended services. It is very common that the manpower in the government hospital is always insufficient and we have to do multitasking & “one man show”. Amidst all this, we still try to do our best. However, the officers in the health ministry are always eyeing on our RM700 critical allowance, using cost cutting as an excuse to try to abolish this allowance. On the other hand, when all other government servants are allowed to take up part time job as long as they get approval from their supervisor and their part time job does not affect the daily job; pharmacists in the government hospitals are not allowed to have a part time job.  Dear fellow officers, do you intend to force the pharmacists in government sector to quit?  5 years ago, when there were not enough pharmacists in the government sectors, the government enforce 4 years compulsory service. As a result, we chose to stay back to service in the government.  After 5 years, the government informed us that the private sectors need more pharmacists, so they have shortened the compulsory service. The government cannot afford our salary?  Or there is really a better offer in the private sector? We feel that the government is taking advantage on us.

In the private hospital, the status of the pharmacists is worse than the medical assistants. Private hospitals only employed pharmacists to fulfil the requirement set by the ministry of health. Only 4 pharmacists are employed in a medium sized private hospital. Is that sufficient? Low wages and welfare, long working hours, the effort that they put in is incompatible with the salary that they get. Who will understand the actual situation facing by pharmacists in the private sectors despite their glamorous status? Besides that, the pharmaceutical companies and factories employed the pharmacists just for their licence. In academic and research field, the role of pharmacists are still very important. However, how long can they survive when they are marginalized by the government?

The community pharmacy which is more related to our daily life and better known by the public has also come to a miserable situation. With the mushrooming of chain pharmacies, independent pharmacies are struggling on whilst at death’s door. Even the multilevel marketing companies want to have a share in the business. Pharmacies are supposed to sell medications and supplements. However, the pharmacies now are similar to the grocery shops where the toiletries, cosmetics and even junk food filled up most of the space in the shops, especially in those pharmacy shops own by the multilevel marketing company. This type of business operation is insulting the pharmacists’ profession. In order to survive, each pharmacy used various methods to attract customers, from the basic customer service to the discounting price war and misuse of certain medications. Is this healthy? Or are we massacring each other?

Next, is the medical revolution proposed under 1 care national healthcare system benefitting our nation or it is just another white elephant project? First of all, the retired government servants can seek treatment in the government hospitals and get their prescriptions filled in the pharmacies appointed by the government, and payment will be given to these pharmacy shops via the appointed contractors. Why the patients can only get their prescriptions filled in certain pharmacies? Why there is a need to pay these pharmacies via certain appointed contractors? Why can’t the government hospitals purchase these medications to supply to the retired government servant? Why do we need such a big project? Since the government sectors are notorious for “fishing culture” we all understand what is happening here. On the other hand, 1 care system proposed dispensing separation, to return the dispensing right to pharmacists and at the same time privatised the government pharmacies. However, there are rules that medications can only be supplied by certain companies. This proposal is only using dispensing separation to support the clique. The assistance provided by the government had made certain bumi companies to monopolize the market. Do we need more of these companies? This policy is definitely going to bring the pharmacy profession to a dead end.

To sum it up, who created the current situation of the pharmacy profession? Who had ruined the registered pharmacists’ professional status? The answers are as follow. Firstly, there is not much restriction in approving more private colleges to set up pharmacy courses, which causes the overload of pharmacist graduates. It is difficult to control the quality of the curriculum of each college and therefore the qualities of the graduates are also uneven.  When there are too many pharmacy graduates enter the job market, the government sectors cannot absorb all of them and the supply of pharmacy graduates are also way more than the demand in private sectors. As a result, the bubbling of the pharmacy profession begins. Unemployment, low income, selling medications in black market, giving discounts in order to survive all begins. Where this profession with hundreds and thousands of years stands?

Secondly, allowing doctors to dispense medications.  The pharmacists are not needed when this policy remains. Dispensing separation would allow the maximization of professional knowledge of pharmacists in improving patient’s management. The pharmacists then have a role to monitor doctor’s management. Also, the dispensing right must be built on the zero benefits of doctors, pharmacists and pharmaceutical companies and it is important that doctors and pharmacists have their own role. The dispensing separation is the right way to go in the future and the dispensing right must be slowly return to pharmacists.

Thirdly, the prices of medications are not controlled. If the 1care system is enforced, the government should set the maximum price or strictly control the price of medications in the market. This is easier for the enforcement sectors to monitor the market and it can also avoid the misuse of medications and the selling of adulterated medications to the public due to vicious competitions. When these problems arise, the patients and consumers are going to suffer in the end. The pharmacy profession needs a healthier environment to survive.

Number four will be the professional qualifications. This problem hit the retail pharmacies the most. All of the retail pharmacies must be owned by pharmacists rather than businessmen without professional background. At the same time, the multilevel marketing companies should be restricted to setup more pharmacies which sell other more of other non medictations. Government should also provide monetary assistance to those pharmacists who wish to open their own shops.

Each healthcare professional have their own roles in building a healthy healthcare system. There is not a single profession can be replaced. In order for the pharmacists’ profession to have a brighter future, we must control the setup of the pharmacy degree, implementing the dispensing separation system and strictly control the pricing of medications and recognized the professional qualifications. Please return a healthier surviving environment and the pride to the profession.