What Happen before 0859 Hrs in Gamu, Isabela

From 2009-12-02

In Singapore when we visit the doctor normally is a single visit point of care dispensing we do not worry about finding a pharmacy which is open and stocked with the prescribed items. Control prescribed items like antibiotic are prescribe by doctor, maybe the advantages like in Singapore most practitioners’ extend responsibilities over their supplied items and offer full refund in case of allergies / interactions Patients are less inclined to hop from one treatment to another. I remembered a case study in Singapore involved a 58-year old lady with Diabetes and borderline hypertension develops acute rheumatism Her GP diagnosed rheumatoid arthritis and prescribed a short course of steroids She got better and sought pharmacist who readily offered further supply, even undercutting GP’s cost Over a short period, she presented with weight gain, worsening of diabetes and hypertension. Another benefit if dispensing remains with doctors is convenience: like me if I  down in flue I  do not have to go somewhere else to buy their medicine and do not have to queue to see the doctor, then go to the pharmacy and join another line to wait for their medicine. I just want to see the doctor, collect their medicine and go home and rest. But doctors had, in the past, spoken out against the practice of separating the two functions, simply because the move could seriously affect their bottom line. Much of the profit a general practitioner (GP) makes comes from the sale of medicine.
However in Philippine company like Mercury Drug they stock items from A to Z from antibiotic to Sleeping pill and having competing pharmacies will bring prices down for patients. In Australia, for instance, pharmacists recommend the best deal for patients.





Here's a win-win prescription
Patients with chronic ailments
   THE thorny issue of separating prescription from sale of drugs reared its head again in Parliament last week, and was raised again in a letter to the Forum pages yesterday from Member of Parliament Halimah Yacob. The chairman of the Government Parliamentary Committee on Health said that pharmacists would provide a counter-check to doctors' prescriptions and improve patient safety.
   But doctors had, in the past, spoken out against the practice of separating the two functions, simply because the move could seriously affect their bottom line. Much of the profit a general practitioner (GP) makes comes from the sale of medicine.
   Health Minister Khaw Boon Wan did not agree that all dispensing of medicine should be done by pharmacists, but suggested that private doctors give all patients a prescription and leave it to them to choose between the convenience of getting the medicine at the clinic and buying it elsewhere. Such a move could help keep a lid on health-care costs, particularly for patients with chronic ailments who need drugs for the long haul. It would be to GPs' advantage in the long run too, as they would be able to keep the patients that they would otherwise have lost to polyclinics for cost reasons.
   GPs already have a ready market among patients with acute illnesses such as diarrhoea or the flu: These patients would certainly prefer to see the doctor and get their medicine all at one go - rather than make an extra stop elsewhere - because they are unlikely to need more than a few days' worth of drugs. But for patients with chronic ailments such as hypertension, the cost of medicine is paramount. They need these drugs long-term - most likely daily and for the rest of their lives. They see the doctor so as to monitor their condition, not because they are feeling ill; they see the doctor also to replenish their supply of medicine, not because they are in urgent need of it. So these are the ones who can - and should - shop around.
   Where possible, a doctor prescribing medicine should let patients choose between a more expensive brand-name drug and its generic counterpart. As it stands now, patients take whatever medicine the doctor has in stock. Most clinics would buy one or at most two types of medicine within the same class. With most of those patients with chronic ailments being older and perhaps even retired, this lack of choice could entail their spending more.
   This is likely why increasing numbers of chronically ill patients are turning to polyclinics, where they make up almost half of all patients. Unless means testing is introduced, it does not take a crystal ball to predict that the number of such patients flocking to polyclinics for the cheaper drugs offered there will continue to go up. Already, polyclinics are telling patients that they can expect a wait of up to three hours in the mornings and on Mondays and Saturdays.
   Many patients with chronic ailments have no difficulty paying a private GP's consultation fee, but they are attracted to the polyclinics, which dispense highly subsidised medicines. Figure this: An elderly patient is charged just 70 cents for a week's supply of one medicine - whether the daily dose is one, two or three pills. Patients with chronic ailments tend to have more than one problem. Someone with a heart problem is also likely to need drugs to keep his blood pressure and cholesterol down. This adds up to several pills to pop daily.
   Unless the private sector can find a way to provide these patients with an affordable alternative, it will lose them to the polyclinics - or even to specialist clinics in public hospitals which also offer subsidised drugs. A couple of pharmacy chains that offer competitively priced patented and generic drugs for chronic ailments might be the solution. Only then would it make sense for doctors to charge patients only for consultation, and write them prescriptions to be filled outside their clinics.
   If patients do not make significant savings, the current system where GPs provide both consultation and medicine will not change. Having competing pharmacies will bring prices down for patients. In Australia, for instance, pharmacists recommend the best deal for patients. They stock a full range of drugs and are obliged to inform patients of cheaper alternatives; they also do call up doctors to ask whether an alternative drug would work just as well.
   In Singapore, polyclinic pharmacies could also enter the market to sell close-to-cost-price medicine to patients with prescriptions from GPs. The result: Enormous savings for patients - and benefits for both GPs and polyclinics. Here is why: Patients may prefer to stick to their family doctor if they can buy their medicine at polyclinics. GPs get to keep these patients, even if they no longer sell them the drug. And the queues at the polyclinics might just get much shorter. It's a win-win situation.

By Salma Khalik
The Straits Times
27 Sep 07