Doctors strongly against prescription of medicines by pharmacists

A.Fenech

May 2nd 2010, 17:01

For the people who think that pharmacist prescribing is a bad idea let me explain a simple thing. I am reading the B.pharm course. Pharmacists have superior knowledge regarding drugs than medical practitioners. The course spans 5 yrs which covers all the drugs that are available in Malta and many that aren't! Students must know all the doses, indications, cautions, side effects of drugs, pharmacology (How the drug actually works), how drugs are excreted from the body and what not. Students also study Pathology, Anatomy and physiology amongst other subjects. Now Medical students study with a greater focus Pathology, anatomy and physiology..and some drugs that can treat diseases. They have great knowledge about how the body fuctions and what can go wrong but less knowledge regarding drugs than pharmacists.
My point is that doctor should diagnose the patient and pharmacist decides which drugs should be administered to the said patient. Every professional to his own expertise.

Audrey Costa

Mar 27th 2010, 21:57

Conscientous and well trained doctors and pharmacists are both trustworthy, as long as they practice within their knowledge. My concern is that I have, on so many occasions, witnessed the purchase of antibiotics without any prescriptions.

John P. Casaletto

Mar 27th 2010, 19:27

At the risk of over-simplifying this argument. Why can't both professions share the role of caring for patients as follows:

- patient gets sick
- patient visits doctor who scribbles down a diagnosis
- patient goes downstairs to pharmacist
- pharmacist reads doctor's diagnosis and chooses what to prescribe

This way each profession sticks to their own area of expertise.

I am neither a doctor nor a pharmacist. But the above seems logical enough to me.

John Azzopardi

Mar 27th 2010, 17:57

Only doctors should prescribe medicine. To allow phamacist to prescribe medication is insane. I have seen may pharmacies in Malta as well in Gozo giving people medicine out just by having someone presenting a box that contained prior medicine. Is this right. I doubt it.

L Vella

Mar 26th 2010, 14:28

Mr or Dr Xuereb.... what a shame... i'm more than sure that you would not even know about half that is going on should it not be for the 'nuisance 'medical reps!!

Andrew Agius

Mar 26th 2010, 14:18

After spending some time in the UK I returned to Malta and saw a Doctor for some minor ailments.
I was prescribed three items - all brand named.
I took my note to the pharmacist (in the next room) and was told in hushed tones "It's OK you're better off with generic versions of these, but please don't tel the doctor".
I was then charged less than a third (!) the cost of the medicines the doctor had prescribed - the ingredients are of course - identical!
Sorry Doctor but I've deprived you of a bit of commission there eh? No wonder you want to maintain the monopoly on prescribing...

Laura Mason

Mar 26th 2010, 13:43

As a UK pharmacy student (3rd year) whose family live in Malta i have been following this article with vested interest. Those who think clinical pharmacy is not taught are very much mistaken. This may have been the case of old, but not now. I expect when I graduate to be a prescribing pharmacist. This does not mean that I will prescribe outside my knowledge base, that is a professional requirement in the UK for prescribing Dentists and Nurses currently. For standard conditions, minor ailments and those on controlled medication programmes, dispensing pharmacists are a great idea to save time, money and maximise resources.

Lisa Schembri

Mar 26th 2010, 13:22

I think patients should be responsible enough to know that:- you should go see a doctor when you think your symptoms require medical help and that you should go to a pharmacist when you have the flu ...jew andek bzonn l'imodium!!!

Your not gonna go to your local pharmacy if you've just woken up from unconsciousness due to a heart attack are you??

KJ Tabone

Mar 26th 2010, 11:06

@ all those saying that pharmacists aren't trained enough...

Please note that in the UK, pharmacists wanting to become prescribers had to follow an additional course followed by an exam. Also, not ALL pharmacists became prescribers. It's not as if the law would be changed and suddenly everyone can prescribe! It's not like that at all. It takes time and extra training, and only those who feel they're capbable would actually go through with it. If I'm not mistaken, as it's been a while since I tackled this subject, the prescribing pharmacists had to be assigned to a clinic where they wouldn't actually dispense the medication themselves (ergo, no conflict of interest).

I strongly believe that different medical disciplines should work closer together for the benefit of the patient using each's area of expertise, rather than checking who's treading on whose toes. Having a solid healthcare system is so important.

H Zammit

Mar 26th 2010, 09:23

I would rather trust a pharmacist than a doctor. I don't see any conflict of interest since I know that
1. most pharmacists will not sell you any over the counter medicine based on the price but on what the patient needs; there responsibilty is so high that they cannot afford mistakes, unlike the doctors who can always come up with some excuse;
2. manytimes pharmacists contact prescribing doctors to correct their prescriptions because what they prescribes is outdated, out of stock medicines and wrong doses or conflicting medicines. It is the pharmacist who is protecting the patient not the doctor and this is done FREELY - indeed they dont even charge you for the phonecall!
3. Pharmacist are more uptodate on medicines and interactions and through their continuous contact with patients can understand their needs better.

I think the real reasons why the MAM "is objecting strongly" are to protect their little niche, and to continue making money so that they can build their villas. Their real concern is not the patient - you only have to look at some recent changes such as the way to be admitted to hospital to realise that all they want is money.

j grech

Mar 25th 2010, 23:57

continued court action for gross medical negligence especially when she began not eating due to being drugged up with valium and asleep all day and yet started to put on weight, he said of course she must be eating or she would not gain weight it turned out that she had an under active thyroid gland undiagnosed so untreated, the greedy sod soon ran once we told him of our intentions, i also hold a yellow card now in the uk this means a repeat prescription each 2 months but here i have to go to a doctor and get him to sign it at a feewhy? my consultant did not change my prescription at all so untill then why is my prescription not computerised so i just go and collect every 2 months,also the doctor said my emphysemia was not under controll how can it be when 10 yrs ago i was taken off certain drugs and put on the latest drugs to suit my condition it was lovely to feel so good again, only to come to malta and be told they are not avaliable here so put back on old drugs of 10yrs ago.(qaucks not doctors)

j grech

Mar 25th 2010, 23:40

i would rather go to a pharmacist here in malta than a doctor as maltese doctors have a long way to go, i have lived here for 10yrs now and used to hear moaning about the nhs back in the uk but after experiencing the maltese doctors way of practise i look forward to my holidays in the uk just to have a complete medical check up,the pharmacist here have often had to point out to me about certain drug interactivity with other drugs prescribed by same doctor and when mentioned back in the uk the pharmacist has always been right,doctors prescribing is down to marketing here,my husband has a pink and yellow card so when he needed the doctor why?did the doctor not refer him back to hospital for blood test instead he came to the house and took them himself?my mother-in-law a constant attention seeker instead of being refered was in a constant drug induced zombie state for years as she called the doctor daily with her imaginary ills, he was not prepared to lose his LM2 daily fee, that is untill we came to malta and threatened continued

Albert Borg

Mar 25th 2010, 21:56

with all due respect,

what pharmacists learn in 5 years isn't only related to patient pharmaceuticals and they have very little knowledge of human of most human ailments, but if people would rather go for the easier way (if they so believe) let it be so... just don't complain afterwards of the problems which WILL arise.

let's just not mock ourselves, if pharmacist were apt to prescribe medicines on their own accord they would be doctors. everybody has a role and everybody should stick to it.

John Caruana

Mar 25th 2010, 21:32

First the MAM declaration - what a load of nonsense. What sort of conflict of interest are doctors protecting patients from? Is it not public knowledge that doctors get gifts for prescribing certain drugs? And what sort of ethical principles reserve prescribing rights for physicians? Is it not the law that limits this only? And what on earth is MAM saying about patient safety? The Crown report for the UK NHS states clearly that better treatment outcome and improved efficiency are among the benefits to be gained. MAM's reaction was predictable just like the BMA. We can all read on the successes being made by independent pharmacist prescribers in cardiology, diabetes and respiratory medicine. Pharrmacists in the UK now prescribe heparin, wararin, and TPN in hospitals while others in Primay care write antimcrobials, inhalers, drugs for pain and diabetes and deep vein thrombosis. And all this independently from physicians. The success UK's NHS is reaping from this profession is written on the wall for al to see. Change the law to allow pharmacist prescribing, start specialist registration for pharmacists as the present law requires, and introduce a competency assessment framework. It can be done.

Silvan Azzopardi

Mar 25th 2010, 19:47

Comparing the number of years of studying or the social status of professions reflects at best poor insight about what is being discussed here.
The prescribing of medicinals is not solely based on knowledge of a drug, its mode of action or its interactions with other drugs but very importantly a prescribing clinician should be able to assess the physiological effects a drug has on the body. This will also involve examining a patient and interpreting investigations to a greater depth then what a degree in pharmacy will train an individual.
The two professions have equal importance in the care of any patient, nevertheless they are complimentary as much as they are different and their respective undergraduate training curriculum reflects this fact.
The term multidisciplinary approach refers to the collaboration of different expertise not substituting one for the other.

Frank Portelli 2BFRANK

Mar 25th 2010, 19:35

As a matter of fact studies have shown that both Pharmacists and Nurses increase safety http://www.resourcing.uk.com/news/pharmacy-news-/pharmacists-and-nurses-saving-patients-from-prescribing-errors.aspx Dr Frank Portelli

Robert Cuschieri

Mar 25th 2010, 18:16

My opinion is that this will lead to some serious problems and fatalities. Even though pharmacists have training, clinical experience of locally trained pharmacists is little. One cannot compare with pharmacists abroad because there training is different.

I also think that when the prescriber sells the medicine himself, there is a strong conflict of interest.

Frank Portelli 2BFRANK

Mar 25th 2010, 18:02

ETHICS of the Medical Profession - Fflouted every day - by an increasing number of Doctors


LEGAL NOTICE 303 of 2008.

7 a) No practitioner shall accept a commission or consideration for the introduction of a patient to a consultant, to a private hospital or other institution, or to a medical practitioner, chemist, nurse, midwife or other person or company and he shall not pay a consideration for the introduction of patients to himself.

7 (b) A practitioner shall not participate in any division of sharing of fees of
which the patient is not aware, excluding a normal dental clinic partnership, and this shall apply to consultations between practitioners or medical practitioners.

22. Practitioners shall not participate in any division or sharing of fees of which the patient or the client is not aware.

Dr Frank Portelli

Charlotte Sant Portanier

Mar 25th 2010, 17:02

Multidisciplinary approach to patient care - doctors, pharmacists, nurses & allied health professionals play an important role to provide optimal management to patients; each professional role must not be underestimated; the patient is at the very centre - all health professionals must work together to optimise the management of the patient.

Community pharmacists play a very important in patient care: they are primary care providers available at any time, and know when a patient is best referred. Unfortunately this role is taken for granted, and no professional fee is honoured; furthermore, many a times advice is provided without a sale of a medication.

The role of a pharmacist is variable depending on the interests & expertise of the individual - from a primary care provider, to a clinical pharmacist in a hospital, to performing medication reviews by referral, and prescribing pharmacists for chronic disease management - where the practice & prescribing of medicines is based on Evidence Based Medicine to improve the Quality Use of Medicines.

Re prices of medications - please note these are regulated fixed prices.

A regulated list of Pharmacy Only, Pharmacist Only, Prescription Only and Controlled Drugs is in dire need.

C Caruana

Mar 25th 2010, 16:38

Quoting the local Medicine's Act

"81. (1) It shall not be lawful for any pharmacist to dispense
any medicinal product except on the prescription of a medical or
dental practitioner, veterinary surgeon or other person authorized to
prescribe under this or any other Act, unless the medicinal product
is deemed not to require a medicinal prescription by the Licensing
Authority.

(c) the provisions of articles 44, 45, 66(1), 71, 75(3),
75(4), 76(1), 81(1), 91 and 98, to a fine (multa) of not
less than four thousand and six hundred and fifty-eight
euro and seventy-five cents (4,658.75) and not
exceeding forty-six thousand and five hundred and
eighty-seven euro and forty-seven cents (46,587.47) or
to imprisonment for a term not exceeding three
months, or to both such fine and imprisonment;"

A Zammit

Mar 25th 2010, 15:23

For those interested in learning more re pharmacist prescribing in the UK, visit the website - http://www.rpsgb.org.uk/worldofpharmacy/currentdevelopmentsinpharmacy/pharmacistprescribing/index.html

Excerpt from aforementioned site re role of 'independent' pharmacist prescriber:
"While a pharmacist independent prescriber will be able to prescribe any medicine (excluding Controlled Drugs at present) for any condition, it is not anticipated that pharmacists will be consulted by and prescribe for all patients who need treatment with medicines. Some pharmacist independent prescribers will have a role in prescribing for patients who PRESENT WITH MINOR AILMENTS or a DEFINED RANGE OF SELF-LIMITING CONDITIONS. Other pharmacist independent prescribers will specialise in the management of patients with IDENTIFIED CLINICAL CONDITIONS." (i.e. conditions already diagnosed by a doctor)

"An advantage of pharmacist independent prescribing is that in addition to the management of the presenting condition, the pharmacist will be able to respond to the signs and symptoms of an additional clinical problem and make a professional decision on whether to treat the patient or refer to another practitioner."

A doctor is therefore still required for almost everything, apart from the diagnosis and management of a minor condition such as the flu.

John O Scerri

Mar 25th 2010, 14:58

When it comes to Who is qualified and Who is authorised to prescribe drugs I would not hesitate to say that the full responsability lies in the Doctors' hands .

A pharmacist although qualified is NOT authorised to prescribe drugs, based only after proper diagnosis of any illness , which is the doctor's role .

Pharmacists take great lengths in decoding the Horrible handwriting of most doctors thus making them responsible on whether or not they are reading the correct prescription.

They also give free advice when patients are taking more drugs at one time in guiding them when to take what .

Drugs can cure or kill .
Are pharmacists ready to take this risk without visitng a patient? They are bright enough.

Doctors and consultants must learn that what they write down on that piece of paper for the pharmacist to dispense should be written CLEARLY .

Patients SAVE money if doctors prescribe the GENERIC name of the drug
example: Paracetamol , Cetirizine, Aspirin etc. and not the tradename.

It is up to the patient to chose which to buy by asking the pharmacist.

Many do not know that different trade names may have the same active ingredient.

Frank Portelli 2BFRANK

Mar 25th 2010, 14:57

I am in full favour of utilizing the professional expertise of Pharmacists

Prescribing Pharmacist have been practicing successfully in the US for a quarter of a century ( since 1986 )

In Britain Practicing Pharmacists have been licenced since May 1986 and they are playing a key role in the NHS

Pharmacists are after all qualified medical professionals

As to Ethics – here I am in full agreement with MAM.

We Doctors could start leading by example and remove this growing cancer of “commissions” which is eroding our profession.

Here's a short list where the Medical Council has been impotent

Commissions for referrals
Commissions for blood tests
Commissions for CT scans
Commissions for MRI's
Commissions for prescriptions

Dr Frank Portelli

Michael Miller

Mar 25th 2010, 14:23

These doctors feel threatened that they will lose business if pharmacists are given the power to prescribe! They are just trying to protect their own pockets. Pharmacists are much more experienced professionals when it comes to drug use and have enough knowledge and expertise to be capable of prescribing.
Regarding the point MAM made about a conflict of interest, I think the NHS would have discussed this in great length before implementing pharmacist and nurse prescribing in the UK and decided to give them prescribing rights anyway.
The pharmacist's role in healthcare is constantly on the increase and any opposition to improve the quality of primary healthcare is a detriment to the patient.

Joseph Farrugia

Mar 25th 2010, 14:00

Certain medicines that can be given over the counter (OTC) in England are registered as prescription only medicines (POM) in Malta. This is restricting the service that pharmacists can give to their clients.

KJ Tabone

Mar 25th 2010, 12:19

Not being able to utilise my medicinal knowledge to the full is one of the reasons I do not work in a community setting. Pricing orders and dispensing medication because I am told to do so is not my idea of a fulfilling profession. I do miss the giving advice to my patients, however.

What strikes me as funny, though, is that people would rather go to a doctor and wait, and pay through the nose, for a common cold, whereas then they come to ask for prescription-only items over the counter!! The amount of times I've seen prescriptions for cough syrups is astounding. I'm pretty sure that it is well within the pharmacist's professional capability to recognise such symptoms and treat accordingly, thus freeing the clinics for patients who need them more. I'm not quite sure why doctors feel so threatened by this.

I do believe that if pharmacists were allowed to prescribe (within limits, obviously) patients should be registered with one pharmacy and said pharmacy to be able to keep patient records. I believe it would help identify chances of drug interactions much better in situations where patients are not exactly sure what they're taking.

Alexander Wright

Mar 25th 2010, 12:10

It is my personal standard to always seek a second opinion from the pharmacist before acquiring the prescription made by the doctor. Second opinions are a duty we owe to ourselves!

Let me touch upon a taboo in Malta:- doctor incompetence or negligence is never seriously questioned, so much so that no one seems to remember when the last practitioner was struck off the list.

Pharmacists are duly qualified in Malta so they stand on the same 'pedestal' as doctors, otherwise what have they been doing for those odd years at University?

I believe Associations representing the health profession (in the widest sense of the word) should place the patient interests before any other interest.

How about giving MAM a real purpose to life? How about starting to assess the standard of service being offered by practitioners nationwide? Monitor and be accountable. (Another national taboo!)

Despite current tendencies, where the medical profession has become a medical industry, it is not always a question of making a quick buck on the patient's skin. The Hippocrates Oath was not just a ceremonial token – it has some worth, to some.

S. Camilleri

Mar 25th 2010, 11:53

This is funny... I like the part about the doctor's union declaration where they say that preventing pharmacists from prescribing creates a potential conflict of interest. I'm sure a good number of doctors know the feeling, given the way they prescribe certain medicines right after having been pampered with freebies and parties by pharmaceutical companies. I think they best stick to more defensible arguments. After all Dr. Cassar did say 'certain' medicines....

Michael Zidonov

Mar 25th 2010, 11:52

Doctors have about six months of Pharmacognosy in School ... They push whatever the Detail Man gives them Free Samples of ... Pharmacists have Six Years studying the BioChemistry of Drugs/Pharmaceuticals ... Who better to Prescribe ? Clinical Pharmacy should be Re-developed into a worthy practice ... Pharmacists should make Rounds with the Doctors, and make whatever adjustments necessary for the Highest & Best care of Patients ... But the AMA and the Drug Companies have this little game they play, to generate Income for themselves, and it has become a fight because the damned Insurance Companies are the ones practicing medicine anymore, which is the main reason Healthcare is so fouled up in the States ... And now, we've got this pitiful joke of a Government wanting to step in and take it all over ... There is a sensible, sane and efficient solution, but the people who run Medicine in the States, and the people who WANT to, won't have it because it will cost them Control, and all that lovely money ...

Mrs.Doris Biggs

Mar 25th 2010, 11:35

@Ruth Gatt yes my dear you are absolutly right, we know the system in the UK although we have lived in Malta for the past 12 months we are finding it very difficult to obtain the necessary medication and also the local doctos don't seem to keep the same filing system or any records on computer, so we are neither here nor there, they have alot to learn, although we moan as usual about our N>H>S. in the UK, now we firmly realize after living in Malta and other med. countries that our system in Britian is one of the best, hence now we are preparing to return, we know were we stand and also everything is still on records at our local GP, Malta still have alot to catch up on, but were people's health is concerned one has to be on their toes and know where they stand with the Maltese way of doing things, rather primitive sorry to say, but in time i suppose things will be on the same level as ours its a question of time and expertise.

C Micallef

Mar 25th 2010, 11:17

....AND PHARMACISTS STRONGLY AGAINST BEING IL-PASTAZ I TAT-TOBBA! When doctors, specialists and other health care professionals make use of a private pharmacy's clnic rooms, they should pay something in return to the pharmacy owner and they should also be responsible for their own fees they charge the patients. Because of most doctors' selfishness, the over-worked, employed pharmacist often ends up keeping track of the doctor's fees (sometimes 50Euros for every10 minutes appointment!!) PLUS having to charge the poor patients a clinic fee to make up for the electricity and other expenses used by the doctor.

Ramon Casha

Mar 25th 2010, 10:44

It's no secret that doctors are very carefully "cared for" by pharmaceutical companies in order to push specific brands. In one particular case I was prescribed a specific brand that costs just over 4 times the price of a less-known brand. It's clear that doctors have a vested interest in retaining this monopoly.

Pharmacists are not necessarily any better, but at least one doesn't have to pay an additional fee for having "seen the doctor". Many pharmacists are very helpful and I've received better advice from some pharmacists than both a GP and a hospital consultant on the medication they prescribed.

Ruth Gatt

Mar 25th 2010, 10:37

I have been lucky enough to have the opportunity to experience seeing prescribing pharmacists and nurses in the UK. These healthcare professionals were not there to overtake the doctor’s role in the healthcare system. Rather, they were providing their expertise in such a way as to support the doctor and to improve the patient’s healthcare experience. For example, the pharmacist would review the patient’s medicines regimen every few months and possibly suggest to the doctor which medicines would work better for the patient and which drugs might be added/removed to improve the patient’s quality of life. Pharmacists study medicines for 5 years, which makes them a rich source of medicines information. This source just isn’t being taken advantage of in Malta as other countries are doing.

i.cilia

Mar 25th 2010, 10:31

and here we go again..

doctors, doctors, do not want to lose any of their clout..

i was told of a situation in the past, i do not know if this is true but if it is so, it is a disgrace...

I am referring to the fact that doctors are not always available on ambulances... take the case of a heart attack.. a nurse is not authorised to use the defibrillator, because only docs are authorised to do so... so in this case the nurse can only perform CPR on a patient with a heart attack....

so the chance of recovering from a heart attack depends on whether a doc is on board the ambulance because the nurse cannot use a piece of equipment...
and please do not give me the story that they are not trained to do so..

I think that this has been done away with with the introduction of automatic defibrillators that even kids can use... since it does pretty much everything on its own..
but it goes to show that docs are very hesitant to relinquish any of their "powers".. patients first indeed...

and now docs invoke ethical principles.. ahjar ma nghid xejn...

Matthew Borg

Mar 25th 2010, 10:31

Pharmacists also sacrifice 5 years of there life’s studying like doctors do, so I don’t see any reason why they are objections to prescribe certain medicines. Doctors have to get over this, they are not the only ones sacrificing there time to study!

Ch. Scicluna

Mar 25th 2010, 10:28

I think MAM should better shut up.

Isn't there a conflict of interest too when doctors congregate for sumptuous lunches and dinners (not to mention fully paid lavish holidays) courtesy of pharma companies? Isn't pushing one type of medicine over another also a conflict of interest?

This is a well-known practice fully accepted by both the Authorities and MAM itself and it goes to the extent that doctors and consultants in our state hospitals even accept to meet pharma company reps during working hours in their state-funded offices during state-paid working hours.

Jeffrey Sammut

Mar 25th 2010, 10:09

I agree with Christina Borg's comments. Doctors are very fond of their role in our society - they are viewed as Gods and all people admire them simply because they're doctors! However we're now talking about our healthcare and safety! I feel much more secure getting a prescription from someone who has studied medications; pharmacology; mechanism of action etc for 5 years than from doctors who only have a semester or 2 of pharmacology! Of course if i needed something serious diagnosed like a heart condition id go to a physician but i would expect my physician to collaborate with my pharmacist so that the pharmacist can make the best medication decision for me based on diagnosis! Pharmacists are strongly under-rated in Malta both within society and receiving extremely low wages when compared to other professionals! It is about time they start getting a better role in our healthcare system which they deserve and which they can help improve for the general good! This is something that can actually help unlike thePOYC Scheme which just causes confusion!! Doctors should be supportive of this if they want a better healthcare system for their patients and not oppose it!

Timmy Farrugia

Mar 25th 2010, 09:54

Doctors just dont want competition!!!! Certain minor ailments I always ask a pharmacist what I can take instead of wasting time and money at a doctor!!!

j azzopardi

Mar 25th 2010, 09:42

well, medicine like the type we have on a regular basis ,which we have to go to a clinic and wait hours on end for a doctor, to waist his time and our money( in his wages ) and who knows what , because the doctor could be attending patients in need, just to copy from a previous prescription that has not changed for years. to the doctors that are complaining and want liberalisation of pharmacies for competition it work both ways if pharmacist start writing prescriptions the doctors be in competition too so the doctors fee for just writing a prescription go down too

Christina Borg

Mar 25th 2010, 09:25

Pharmacists are trained as long as doctors are trained 5 years with the difference that they mostly study medicines and therefore are much more equipped at noticing interactions; Side effects and choosing the right medicine for specific patients. I believe that pharmacists are already doing some OTC prescribing - I go to a pharmacist for all my minor ailments! Doctors need not feel threatened by this! When it comes to more serious conditions there should be a doctors diagnosis but i strongly believe that the pharmacist is much better equipped at prescriing based on the diagnosis of the physician! ... Have you never noticed that your doctor always prescribes the same 1 or 2 things because maybe they receive bonuses from medical reps or they do not know enough about other medicines! They are trained to diagnose! We need to start looking towards a future where healthcare workers work together for the good of patients & not their personal gain! Its called multidisciplinary collaboration!! Mr. Grima I also live in the UK and there are indeed prescribing pharmacists - your knowledge of the NHS system is obviously lacking so i suggest you do some research before speaking!

M. Grima

Mar 25th 2010, 09:03

Certain medicines like what? please expand!
I currently live in England and I have never been prescribed medicines by pharmacists and to my knowledge never heard of such a system.

Actually the British system is stricter that the Maltese one. First of all you have to be registered with a surgery and one of its doctors and secondly it is only this doctor that prescribes you any medicines. In British pharmacies medicines are available on shelves (supermarket style), however, prescribed medicines are all over the counter. Without a doctor's prescription you will not get any medicines!

Traceability is also an issue due to drug abuse and as a result every prescribed medicine issued from a pharmacy carries with it your name, doctor's name and bar-code that contains its origin. Without such a label, certain drugs will be deemed illegal due to their heavy use in drug abuse. Caught without a prescription with such drugs can result in an accusation of being in the possession of an illegal substance.

The starting point of such a system is always the doctor!

victor vella

Mar 25th 2010, 08:28

Pharmacists and Doctors and need to stop looking onlt at the profits.I wouldnt go to a pharmacist without a doctors prescription, but on the other hand I do not expect to be at a doctors clinic and see a medical rep giving doctors thier shall we say encouragment kicks.and if anyone says anything I would ask why would a medical rep from import companies wait for hours at doctor's clinincs.

Carmel Cilia

Mar 25th 2010, 08:26

When I was young we rarely went to the doctor for minor ailments. In fact the pharmacist used to be our source of reference for every day ailments. Certain pharmacists had more clientel than others for the very reason that they were trusted by the community and more easier contacted than a doctor; besides giving advise for free.
No I think they should be allowed to issue certain medicines. The way they are working today is merely as salesman/girl. Remember in my days they used to make the medicines themselves. What did they go to university for just to be medicinal salesman.
This would really help bring down the doctors fees which in certain cases are skyhigh.
It is quite normal to spent 60 euros or more on a common cold.
What about specialists fees: 50,60 and even 70 euros for a setting is the normality.
By the way is there any doubt that doctors issue certain medicines in favour of others because they are given a commission by agents. Health has become quite a multimillion euro business from A to Z.
The people should be protected against all odds. Well done min ister.