Angry Doctor

Monday, February 27, 2006

And the assault continues...

It seems like a bad month for GPs.

Here's the latest letter on the issue of clinics dispensing drugs and drug costs:


Liberalise distribution of prescriptive drugs

THE letter, 'High prices for common drugs in HDB heartland' (ST, Feb 21), by Madam Gan Siok Wah clearly shows the price of medicine in Singapore can be exorbitant.


A member of my family was charged more than $40 by a doctor just for a small rash, but the medicine proved totally ineffective. In all, the person spent over $100 with various doctors without success. Instead, the rash was later cured quickly and effectively with a $6 non- prescriptive ointment from a pharmacy which was recommended by the attendant pharmacist.

One way to counter high prices of medical care is to liberalise the distribution of prescriptive medicine via pharmacies. I have already petitioned the Government on this. Other countries that are more advanced medically have done this, so why not Singapore?

Furthermore, university-trained pharmacists are well-versed in the use of prescription medicine so why are they not allowed to dispense them via pharmacies? In the current situation, the pharmacist may need a prescription from the doctor just to use a prescriptive medicine on himself.

If medicine becomes too expensive, more people will prefer to sleep away their common illnesses - but for one thing. If one is working or studying, one's employer or school will accept only a doctor's medical certificate to excuse one's absence.

So even if one is treated by, say, a certified physician of traditional Chinese medicine (TCM), whose charges tend to be cheaper, an MC from him is useless. One must still pay a doctor to get a recognised MC. This adds unnecessarily to the cost of health care.

Why is TCM, which is part and parcel of our traditional Asian culture, not given the respect it deserves - especially when the physician has been certified by the authorities.

Besides, some people respond better to herbal medicine just as some do to Western medicine.

I therefore suggest that the Government liberalise the distribution of prescriptive Western medicine via pharmacies and give legal recognition to MCs issued by pharmacists and certified physicians.

I believe the cost of Western medicine has driven some people in other countries to buy them via legitimate outlets on the Internet, saving them a lot of money.

To give an indication, the demand for online medicine is so great that last year the Canadian government said it could not afford to jeopardise its national supply of medicine by selling it via online pharmacies.

Chia Hern Keng


I won't discuss the merits behind deregulating or liberalising drug prescription. I did try to read through the Medicines Act and the Poisons Act, but found them rather incomprehensible, and in any case not very enlightening - they tell you what the law is, but not why it is so.

Certainly more and more drugs are being deregulated and no longer require a doctor's prescription to be dispensed. I doubt the staunchest supporter of liberalisation will advocate deregulation of all drugs (including opiates and other potentially addictive drugs), so the argument will probably be one of which drugs to deregulate.

What interests me is Mr Chia's lines of argument (assuming the letter had not been edited beyond recognition of the author).

Mr Chia begins his letter by a personal anecdote: a family member was given expensive prescription drugs which did not cure his condition, and eventually a non-prescription drug did the trick.

Assuming that the condition resolved as a direct result of the non-prescription drug and of that drug only, I don't see how this episode argues for the deregulation of prescription drugs. Afterall, isn't that effective drug already 'non-prescription'? How would adding other ineffective drugs to the 'non-prescription' pool help anyone?

In effect Mr Chia is saying: a family member of mine had a condition that didn't get better with prescription drugs and only got better with a non-prescription drug, so the government should liberalise the distribution of prescription drugs. I don't think I quite follow that.

Or is his point: cheaper drugs are better than expensive drugs, so we should make all drugs cheaper by deregulating them?

I do agree with him regarding the need for MCs accounting for unnecessary healthcare costs. The reason for the need for MC is however usually social or legal, and if our employers and schools could trust employees and students to be honest about calling in sick, a lot of unnecessary time and money would have been saved by all sides.

(Some employers are even stricter with MCs, accepting only MCs from government hospitals and clinics, and some even requiring a patient/casualty to be seen at a polyclinic before he can be brought to the emergency department, but that's another topic altogether).

However, his argument for recognising MCs from TCM practitioner is a bit off the mark.

The point of a medical certificate is to certify a patients fitness (or unfitness) for school or work. Whether a healthcare system is part of our traditional Asian culture or not, and whether or not some people respond better to herbal medicine is not really relevant to the issue. MCs from 'Western' doctors are accepted not because they are a part of our Asian culture, nor because everyone respond better to 'Western' medicine rather than herbal medicine. In any case, I don't believe TCM has a tradition of issuing MCs.

Again, it is the social and legal considerations behind the non-acceptance of MCs from TCM practitioners rather than the efficacy of TCM as a means of healing or as a part our heritage that must be addressed.

The final paragraphs of his letter seem to argue for deregulation simply because people can circumvent regulation by buying drugs off the internet anyway. That is like arguing for deregulation of any other form of contraband simply because they are legal in their country of origin and because there are always ways people can smuggle them in. It would apply for alcohol, tobacco, pornography, subversive literature, uncensored movies, and endangered animals. Even if you consider smuggling of prescription drugs a victimless crime, I think this line of argument will not find favour with the authorities.

Labels:

56 Comments:

  • A good month for advocates clamouring for dismantling the docs' privileges of prescribing medication and issueing MCs.

    No wonder I am in such a jovial mood this month.

    Let me assure you that the day is not far off when one can buy all medications off the counter in Singapore save for "opiates and other potentially addictive drugs." In the cities of China, you can just do that and the pharmacist will even explain to you how to use the medication.

    You can't stop the march of progress although I understand why you would want to oppose such a move.

    By Blogger uglybaldie, At February 27, 2006 5:59 pm  

  • This is also a scary month for patients and those needing medical attention.

    Prescribing "Elidel" for a four month old baby???? (S.T. Forum 23.2.06)

    We, the public would most certainly, with bated breath, be interested to know why such a medication was prescribed for an infant.

    By Blogger uglybaldie, At February 27, 2006 6:08 pm  

  • Yep, India too has a very liberal stand on medication. But does that mean China and India are further advanced in providing good medical care? Availabilty or not of medications does not equate 'progress' if people don't it properly and are not monitored.
    The 'Elidel' case is a good example. If it was available without prescription, wouldn't more such cases happen?

    By Anonymous huajern, At February 27, 2006 6:35 pm  

  • Nope. It does not mean that India or China is advanced in providing medical care for its population. But it does mean that the general population has access to many medications without the need to get it through a doctor and in the process, time and most certainly money is saved.

    Most of the time, we don't need to listen to the crap coming from the doc. just gimme the medication because nowadays people are generally well informed. Besides, the pharmacist is always available at the shop to guide you if need be. When I was in Shanghai and had an ear infection, I bought a general purpose antibiotic and was up and running within a day. I paid the equivalent of 3 singapore dollars for the medication. When I was in Hong Kong and had to consult a doctor to get the same medication to treat the same symptom, I had to cough out the equivalent of 150 singapore dollars! Does that make sense to you?

    If "Elidel" was available freely and it came with a medication guide and a "black box" warning which will be followed to the letter by a reasonably educated public, what is the concern? The pharmacist, before selling you the medication will also highlight to you the drug's side effects, efficacy and contraindications. Trouble with the present system is that clinic assistants are usually of a sub standard quality and you don't really get much information from them on a drug and the doc. is most certainly not going to come out from his room to brief you.

    You don't expect the Ah Ters and Ah Kows to go into Guardian to buy Elidel do you? So this class of citizens will still have to see the quack first. :-)

    By Blogger uglybaldie, At February 27, 2006 6:59 pm  

  • Doctors must add value if not they can and will be replaced by people cheaper than them.

    Radiologists be very afraid.
    First X ray, then CT and finally MRI.

    Pls learn interventional radiology. At least U can't outsource that for the time being

    By Anonymous Ang Yee, Gary, At February 27, 2006 11:16 pm  

  • Some personal observation while we're at this (just happened to read the said forum letter first hand).

    1. I get the feeling that not many people will be happy if they consulted the doctor and get only a written prescription (i.e. no meds given). The culture here is such that patients expect to get some form of medication or MC and many would be unsettled by paying for consultation alone. I can imagine the thoughts running through their minds:

    Hey I paid $xx to that lousy doctor and got only a prescription! No medicine! No MC somemore! Pharmacy closed today! What a quack!

    2. More recognition needs to be given to the practice of traditional medicine. The non-recognition of TCM on the issue of MC needs to be re-thinked. 5000 years of history cannot be all that wrong. During my stint in the (western) medical establishment, it was very off-putting to hear consultants after consultants put down the value of TCM. Why are TCM MCs not recognized? I think the perception is that TCM practitioners are not up to standard. But whose standards are we refering to? Remember that the ultimate aim, regardless of training background of healthcare professionals, is the welfare of the infirmed.

    By Blogger andrew, At February 28, 2006 9:25 am  

  • TCM MCs can only be recognized if the training and certification of sinsehs in Singapore are made more stringent. There is also a profusion of TCM quacks from China practising here. No choice, we want to be an open economy and besides our immigration rules are getting more lax by the day.

    Now, it seems most herbalists are qualified to practise TCM.

    Can you imagine the situation when you can just go to your neighbourhood medical hall and ge an MC?

    By Blogger uglybaldie, At February 28, 2006 10:18 am  

  • I am personally all for Singapore going the way of Australia and USA where doctors provide only consultation and do not dispense. Why do you think I have made arrangements to go to Oz to work?

    I think we should do it. But I can understand why MOH will not do it. Mostly because it will cause the cost of seeing a doctor to go up as well as make things inconvenient for patients.

    As it is most GPs DO NOT charge the recommended consultation fees. Many charge way below the recommended minimum of $18. I know most patients would say "What 'consult'? The doctor never even talked to me!"

    That's true! Which is why I welcome the move. Let doctors do what we are supposed to do. Give consultation, counsel, educate, inform. And be paid for it. The culture in Singapore is that they don't want to pay for consults but will only pay for medicine. It's like th consult is a value-added service of a drug selling doctor. That's terrible. Which is why you then see doctors who don't talk to patients but dish out drugs.

    Anyway I doubt Singapore would ever go the way of the west because people here have been spoiled already. The irony is that they don't realise or appreciate the convenience they enjoy. Ask any foregin visitor from the West and he will tell you that seeing a doctor in Singapore is simple, easy, fast, cheap and convenient. $80? That's chicken feed.

    A Singaporean once complained to me that when he went to San Francisco and went to see a GP for fever and sore throat he had to make an appointment, paid US$200 and only got a script for Tylenol (Panadol) and Lozenges which cost US$30. One of his big gripes was....NO ANTIBIOTICS!

    I guess it's a totally different culture here in Singapore. When in Rome you do what the Romans do.

    By Blogger Dr Oz bloke, At February 28, 2006 10:45 am  

  • Actually at present moment quite a number of people go to the pharmacy and buy medicines from them.

    I was once at the pharmacy queuing to get my script filled.

    The conversation between the Pharmacist (P) and Customer (C) went :

    C : I got cough, and runny nose. What do you have for it?

    P : when you cough got phlegm?

    C : got.

    P: your phlegm what color?

    c: Yellow

    P: Ok take this tablet once a day and this syrup 3 times a day.

    So it's already being done now. If you want to, please just go to the pharmacist and tell them your problems and they will assist you accordingly. You don't need to get legislation to solve your problems.

    Someone should tell Mr Chia to just bring his friend/relative to the pharmacist FIRST and see if what they can prescribe (OTCs) solves the problem BEFORE they go see the doctor.

    I don't think we need to change the system. We need the PEOPLE to change their mindsets and be more proactive though.

    By Blogger Dr Oz bloke, At February 28, 2006 10:51 am  

  • Another good example of poor communication in the Elidel case...(refer to the full reply published in the ST Forum 28 Feb 06). Here are some snippets:

    " First, this was not the first time Ms Tan had visited our clinic for her child's eczema. It was their third visit for the same condition.

    A steroid cream prescribed in a previous visit was obviously ineffective. In fact, Ms Tan had mentioned that the rash was not responding to treatment elsewhere."

    " When the US Food and Drugs Administration approved the drug in 2001, the studies were based on children two years and older. Since then, there have been published studies showing that Elidel is safe for use as a topical skin medication in children three months and older."

    " I understand Ms Tan's frustration when her email went unanswered. But she had chosen to email Thomson Medical Centre instead of our clinic.

    We could have clarified the matter and saved her unnecessary worry. We would also have told her that I was called to attend to an emergency Caesarean section immediately after the consultation.

    It was unfortunate but my patients who have further queries will wait for my return, which takes up to 15 minutes. If this had upset her, I apologise."

    Should the doctor have better communicated with Ms Tan regarding the use of the cream - probably so. Could Ms Tan have communicated her concerns to the doctor & gotten an explanation from him directly - again probably so.

    By Blogger aliendoc, At February 28, 2006 10:55 am  

  • If the doc. don't provide the medication, what is there to consult?

    Isn't Dr. Google already doing the job with the help of the friendly (sometimes) but low calibre neighbourhood pharmacist?

    You fellas might as well close shop.

    Having said the above, I must also express my indignation at the poor quality of pharmacists in Singapore. They are a bunch of rejects who most probably couldn't make it into the medical or dentistry faculty and this medication retailing is the last resort.

    By Blogger uglybaldie, At February 28, 2006 11:19 am  

  • "Could Ms Tan have communicated her concerns to the doctor & gotten an explanation from him directly - again probably so."

    I wonder whether Ms. Tan was aware of Elidel's precautions or black box warning when the cream was given to her.

    Most of the time, medication are given to patients without the complete box at clinics. Perhaps it was only after she had applied the cream to her infant that she started doing some research herself and came up with the quite startling (at least to her) revelation.

    Whatever it is, despite the assurances and clarification, I would as a parent, be wary to apply the cream onto my infant of four months if the pharma themselves state that it should not be used on an infant under two years. As a respected and well known pharma, wouldn't they know better?

    By Blogger uglybaldie, At February 28, 2006 11:26 am  

  • Hmmm if I am not wrong uglybaldie, you would advise MOH to ban all pharmacists and GPs.

    They are certainly not needed at all in Singapore going by your comments!

    LMAO!

    By Blogger Dr Oz bloke, At February 28, 2006 12:14 pm  

  • No lah,

    Just encourage them(the useless ones anyway) to go away. To Africa, or Ukraine. You know, an external economy ?

    LMBO (Laughing My Butt Off) Hee Hee.

    By Blogger uglybaldie, At February 28, 2006 12:22 pm  

  • Aiyah I dun think we need to go to those places.

    There are places that are First World that would accept us still.

    But yeah I think why not? Let all the pharmacists and doctors leave Singapore.

    Put yourself in our shoes. Would you want to see people like yourself? Look down on us. Treat us like feces. Don't want to pay.

    WTF? :)

    By Blogger Dr Oz bloke, At February 28, 2006 12:30 pm  

  • OZ,

    You're a good doctor. Maybe not up there with the best, but still better than most.

    I will ask my MP to make sure you stay.

    Maybe give you an offer you cannot refuse? Or take away your singapore citizenship if you disappear to OZ for more than 2 years?

    Hee Hee.

    UY :-))

    By Blogger uglybaldie, At February 28, 2006 12:37 pm  

  • Sorry I'm not interested.

    It's not the money.

    What's the point of being a good doctor in Singapore? Singapore doesn't need good doctors.

    By Blogger Dr Oz bloke, At February 28, 2006 1:10 pm  

  • Suit yourself.

    Don't say we didn't try.

    Singapore will invite all the medical foreign talent from India. No need to outsource to India. Build a big Medipolis here next to Biopolis. Both polis complimenting one another. A pipe dream for Entrepreneurs. Get outsourcing business from OZ, Europe, Japan, US. Underemployed Indian doctors will definitely reduce our medical costs. Maybe from current $18 (recommended) to $3 because of competition amongst themselves. And India also a giant in the field of manufacturing generics. Wah, 50 cents for a month's supply of captopril for my mom. Wah, the money saved can bring her to East Coast for seafood. Wah!

    When you go to OZ, soon, maybe your work could be outsourced back here in medipolis!

    By Blogger uglybaldie, At February 28, 2006 1:39 pm  

  • Sounds good uglybaldie.

    You in charge of this project?

    I wish you all the best sincerely.

    It would be good for all if health care costs can indeed come down by so much and yet maintain good quality.

    I would be happy to see that happen frankly. While I might lose my job or see my earnings drastically reduced, it would indeed be a boon to mankind and I support that.

    I will do what all the other retrenched workers do. Retrain, relearn and get another job. I have confidence in my ability to adapt and survive.

    Good luck uglybaldie I wish you every success again.

    Cheers!

    By Blogger Dr Oz bloke, At February 28, 2006 1:58 pm  

  • OZ,

    No lah, I'm not into any projects lah.

    I'm only interested in golf, karaoke, travelling and fun.

    This idea is just something to think about when all doctors and pharmacists leave singapore. Even the good and dedicted ones like yourself. Then we hope the authorities will put Plan M (medipolis) into action to save us poor wretched souls in need of medical attention.

    India has about 1.1 billion people. China about 1.25 people. Surely, with such a big population base there must be countless eager beavers willing to help us out?

    By Blogger uglybaldie, At February 28, 2006 2:12 pm  

  • Well they may come, but if Singaporeans continue to have the attitude that you have and treat them like feces, well they'll leave too.

    After a while maybe they won't want to come to SG anymore. Then you will go to Africa and Ukraine to ask for help?

    Bottomline is : nobody like to be treated like shit, neither doctors nor patients.

    Can't we just try to make things better for each other?

    Sigh.

    By Blogger Dr Oz bloke, At February 28, 2006 2:50 pm  

  • "but if Singaporeans continue to have the attitude that you have and treat them like feces, well they'll leave too."

    Walio, how can you say that huh?

    I respect you as a good dedicated doc. albeit not the best and I admire my family GP who is amongst the best.

    What is this 'feces" business? I think you have a very pronounced inferiority complex as Dr.Sigmund Freud would wont to say.

    Just a few words of rebuttal to the docs' passing glory days and that's throwing "feces"? Wow, you may be dedicated, care for your patients and all that but you sure ain't thick skin enough to be a successful money making doctor! ;-)

    By Blogger uglybaldie, At February 28, 2006 3:02 pm  

  • Uglybaldie,

    I know you like to be a contrarian but it's really making me confused leh.

    One moment you write here

    "I respect you as a good dedicated doc. albeit not the best and I admire my family GP who is amongst the best."

    Then you wrote this about your GP over at my blog

    "Pay the poor slob 5 friggin' bucks to write the piece of shit with his chop."

    http://www.blogger.com/
    comment.g?blogID=19299890&postID=
    114084176772916121

    Now can you see why I made the reference to feces?

    By Blogger Dr Oz bloke, At February 28, 2006 3:06 pm  

  • Ha, we miscommunicated.

    The fella I got the $5 chop chit is not our family GP. Would I say this of someone whom we have relied on for more than 20 years? And to boot, holds a Masters in Int. Medicine. Would he charge me only 5 friggin' bucks even?

    No man. I happened to past by this little clinic on my way to the pharmacy and just walked in to get the chop chit. I knew it was going to be cheap because the clinic was run down, no one was in sight and his clinic assistant was watching an afternoon matinee on the TV. And he was in his cubicle reading solutions to the day's crossword puzzle. A Sudoku machine was also lying around. Sounds like you? Hee Hee.

    Ok brother, I gotta go and sing. See ya.

    Have a good day, what's left of it anyway.

    By Blogger uglybaldie, At February 28, 2006 3:15 pm  

  • Uglybaldie,

    if I'm not wrong, your family GP (the one with a MMED INT MED) won't even charge you for the prescription.

    Am I right?

    It's not about the money lah. You treat people well, you also get treated well. Whether or not they have a Masters degree or not.

    Tu comprehend?

    By Blogger Dr Oz bloke, At February 28, 2006 3:26 pm  

  • Uglybaldie

    Wld like to hear fr U...
    "... I must also express my indignation at the poor quality of pharmacists in Singapore."

    Why do U find pharmacists in Sg of such poor calibre?

    What is an eg of a fine calibre pharmacist?

    drugged

    By Anonymous Anonymous, At February 28, 2006 8:31 pm  

  • Uglybaldie:

    "Having said the above, I must also express my indignation at the poor quality of pharmacists in Singapore. They are a bunch of rejects who most probably couldn't make it into the medical or dentistry faculty and this medication retailing is the last resort"

    pls use your brains (if u even haf one) to THINK THROUGH before you even make such an IGNORANT and groundless comment. I dunno what it is that triggered this off from you, but FYI, the only reason why most of the pharmacy students aren't in pharmacy is cuz THE INTERVIEWERS shwoed them the red light. and common sense tells you that INTERVIEWS ARE SUBJECTIVE. It doesn't mean academically, we are not up to it. In fact, the pharmacy syllabus is way harder than u think and it takes alot to toil through the course.

    Why are there bad doctors? cuz the interviewers made a misjudged them as a good and competent on in the interview. A pharmacist may be a good doctor if he/she were allowed to do the medicine course. (i repeat again. we meet the cut off point).

    UNless you've been in contact with EVERY SINGLE pharmacist. YOU had no rights to condemn ALL OF THEM. LIkewise for the docs. and FYI again, not all the pharmacists are RETAILING.

    It takes a RUDE n ignorant person to make a degrading comment like this. and i can see you are one.There's a thing called RESPECT in this world.

    By Anonymous Anonymous, At March 01, 2006 1:37 am  

  • To Anonymous,

    Scene One.

    Me: Excuse me, it says here on the label for this medicated shampoo that you should not use it more than twice a week. Why is that so? Is it dangerous?

    The pimply pharmacyst: It is bad for your hair.

    Me: Huh? That's your answer?

    Scene Two:

    Me: I want to buy "Fastum" cream.

    Salesgirl: Come back later. The pharmacyst is not in.

    Later.........

    Me: I want to buy "Fastum"

    Pharmacyst: How many tubes?

    Me: Just one.

    Pharmacyst: Ok. Pay outside.

    Me: Huh? Aren't you supposed to caution me on the use of this cream?

    Pharmacyst: Oh! Sorry. Ok listen.......

    Me mumbling to myself: What The F##@@! 1 hour wasted for nothing!

    Many many more scenes but no time to explain to a loser like you. OK?

    By Blogger uglybaldie, At March 01, 2006 4:41 pm  

  • To Anonymous,

    My brain was already being used at warp speed while you were still bawling in your crib, crying "I wanna be a doc." Instead you ended up being a pimply pharmacyst.

    Please don't blame the interview and selection system if you didn't made it to med. school. The fact is, you FAILED to get in and had to contend with a second choice. Will that make you work with passion? Most probably your pea brain is running at half its capacity and that's why I said you buggers are not up to scratch.

    By Blogger uglybaldie, At March 01, 2006 5:46 pm  

  • Uglybaldie

    Though we are exchanging views on cyberspace, it doesnt mean respect for anyone or any profession can be overlooked.

    Thousands of applicants fail to get their 1st choice-s in NUS @ every intake.

    Yr inference to med sch/ dentistry is totally irrelevant.

    Do U mean failing to get into one's 1st choice will mean he will be a failure in another profession??

    Most of the pharmacy students had pharmacy as their 1st choice, FYI.

    Perhaps U got most of yr '1st choice-s', and U had passion for watever U were doin becoz it was yr 1st choice.

    Even if a person appears to be successful, his character and upbringing can still be lacking.

    In fact, Severely lacking.

    And, pharmacists are not doctors; we specialise in different fields. Obviously.

    drugged

    By Anonymous Anonymous, At March 01, 2006 6:18 pm  

  • To drugged,

    Point taken and please accept my apologies for any unintended offence.

    You deserve respect because you didn't make reference to the capacity of a certain part of my physiology unlike someone who did. That was uncalled for because the objectional comment was directed specifically at me and a personal attack unlike my comments on pharmacists in general. You disagreed with what I said in a restrained and civilized manner.

    Truth be told, sometimes I make controversial comments as a red herring to draw out the morons pretending to be professionals. You're right to say, "Even if a person appears to be successful, his character and upbringing can still be lacking."

    By Blogger uglybaldie, At March 01, 2006 7:27 pm  

  • Uglybaldie I think you owe drugged a BIG apology.

    Drugged asked you simple questions with no emotional overtones :

    "Uglybaldie

    Why do U find pharmacists in Sg of such poor calibre?

    What is an eg of a fine calibre pharmacist?

    drugged"

    And you gave your reply and ended off with "Many many more scenes but no time to explain to a loser like you. OK?"

    You called him a loser unprovoked!

    "Point taken and please accept my apologies for any unintended offence."

    AND

    "Truth be told, sometimes I make controversial comments as a red herring to draw out the morons pretending to be professionals."

    So was your loser comment intended or unintended or both?

    I think you're getting sloppy leh uncle!

    *snort* *snort* :)

    By Blogger Dr Oz bloke, At March 01, 2006 7:42 pm  

  • Oinkle,

    Damn keyboard! type "uncle" came out "oinkle" Sorry hor.

    The "loser" remark was not intended for drugged but the f##king as##le who couldn't get into med. school and out of frustration questioned the size and quality of my brain. Granted I am not up there with you docs. but I am not where I am by being an imbecile.

    The scenario with the pharmacysts was the answer to the ass##le's tirade. If you cannot understand what I am trying to say then seriously I doubt whether you pass your meds with flying colours or just a narrow pass owed to the charity of the prof.

    So to recap just in case you miss the point. The "loser" comment was not meant for "drugged" because he deserves a much better description. The "loser" comment was Intended for the motherf##ker who couldn't get into med. school and who made a hue and cry about how unfair the selection system was! Let's face it, if you can't be a doc. don't be a sour grape and say how good your cut off points were and yet you were a victim of an unfair system. With a character like his, I think the selection panel could not have decided otherwise.

    Hey oinkle. Talk tomorrow ok? Time for my DVD movie, "CRASH".

    By Blogger uglybaldie, At March 01, 2006 9:34 pm  

  • the fact that you attacked EVERY SINGLE PHARMACISTS based on that few unhappy incidents you encountered.. says that YOu dun deserve any respect cuz in the 1st place, you were not showing any of those competent pharmacists any respect out there by making such a degrading and generalised statement like this.

    and why should i need respect from a person who DOESN'T KNOW WHAT'S RESPECT?

    period

    By Anonymous Anonymous, At March 02, 2006 12:51 am  

  • Ugly baldie

    I think you've accumulated too much cynicism over the years.

    If you cannot tolerate other's mistake and choose to insult, then I think you are too hard on yourself.

    you sounded like a perfectionist with a tinge of arrogance because you are rarely wrong. At the same time I think how you treat others would be how you treat yourself.

    I think no amount of karaoke and travelling would save your from your critical accusing self.

    lighten up a bit.

    For your information not all pharmacist are medicine rejects.

    By Anonymous Anonymous, At March 02, 2006 1:01 am  

  • To Anonymous,

    "For your information not all pharmacist are medicine rejects."

    Agreed.

    Apologize.

    but not convinced.

    You are another rational commentator like "drugged". Thank you.

    I am just wondering why you fellas post anonymously. Can't you get a nick or something so we know who the shooters are? Don't worry lah. I'm not "One Eye Dragon" lah.

    He's already safely in the lockup.

    Hee Hee.

    By Blogger uglybaldie, At March 02, 2006 8:49 am  

  • To Oinkle OZ,

    Quote: *snort* *snort* :) Unquote.

    Hee Hee, now I know why my keyboard always throw out "Oinkle" when I type Uncle. Guess it's still serviceable for another couple of years. Damn good keyboard ok, made in the USA, not some friggin' garage factory in China!

    By Blogger uglybaldie, At March 02, 2006 9:38 am  

  • ugly baldie

    I think you are not convinced because don't know much about pharmacist.

    We don't just stand behind the counter to tell you to eat your tablets three times a day.

    In fact there are a portion of pharmacist who are not so clinical do more drug forumlation or go into research.

    Others join the government to ensure quality in the drugs we bring in and to inspect and audit manufacturing plants to make sure that they are of a certain standards.

    Not all who studies pharmacy enters with a perspective of treating the patients. Some are scientist waiting to discover new therapeutic methods.

    You are seldom wrong but this time you are way off the mark. :)

    By Anonymous Anonymous, At March 02, 2006 11:19 am  

  • To Anonymous,

    OKay.

    Fair enough.

    There are good pharmacists behind the scenes.

    But I still think those standing behind the counter and selling medicated oil besides other medication are really the bottom of the barrel.

    So the next time I deal with them, I have to think of what you said and look BEYOND them.

    Thank you for the clarification.

    By Blogger uglybaldie, At March 02, 2006 11:33 am  

  • Yeah, there are some compounding pharmacists in Singapore, although not many and not really popular.

    I think most retail pharmacists in Singapore are under utilized because of the system of allowing doctors to dispense.

    Most likely the only pharmacists uglybaldie sees are the ones in retail pharmacies. Hence his skewed perception.

    By Blogger Dr Oz bloke, At March 02, 2006 11:36 am  

  • Uglybaldie

    Uve been very quick in admitting and apologising.

    I wld like to state that Retail pharmacists are not the "bottom of the barrel".

    The comments U made abt pharmacists are not "controversial comments" at all.

    Do be prudent and respectful when making comments on the pharmacy profession. If U are directing yr 'controversial comments' on an individual rather den a profession, do make it clearly so.

    When one seeks to provoke or insult, the consequences or replies will of cors be likely, angsty.

    I understand Y U dare to make such rude comments and termed em controversial. After all, U are hiding behind a computer and a nick.

    *May I request that Angrydr remove all derogatory remarks abt the pharmacy profession in this post.

    It will be much appreciated.
    But of cors, no offense taken if Angrydr have reservations abt takin' em off.

    drugged

    By Anonymous Anonymous, At March 02, 2006 1:14 pm  

  • Mr. "drugged" pharmacyst.

    Already apologized lah, what more you want to do huh? OK OK, blanjah all of you to Ah Yat Abalone Restaurant, how about that?

    If angry doc. were to delete all comments which are controversial about doctors or pharmacysts, pretty soon there will be no comments and the only guys haunting his blog will be oz and his hamster. I'm sure as an educated person, you are also a liberal and does not eschew free speech?

    You win some, you lose some.

    Relax man. Why get hot under the collar for?

    Everyone is entitled to their opinions ok?

    Pretty soon, I will become an angry baldie instead of an uglybaldie

    By Blogger uglybaldie, At March 02, 2006 7:21 pm  

  • actually my point of explaining it to you about pharmacist not being medicine rejects has nothing to do with the quality of pharmacist but rather to inform you that not all pharmacist are doctors wannabe who failed in their attempt of fulfilling their dream.

    In every profession there are good ones and not so good ones so I really don't need to defend anyone if you think that their service is not up to your standards. One customer might have a bad experience with pharmacist A but another customer might find pharmacist A excellent. Different people have different perception and the pharmacist while aiming to please all, can't really acheive that. :)

    I welcome your criticism maybe you can tell us what is your expectations of a pharmacist so that we will not be perceived as bottom of the barrel species. I also find no correlation between good academic results and providing good service.

    By Anonymous Anonymous, At March 02, 2006 8:10 pm  

  • "I welcome your criticism maybe you can tell us what is your expectations of a pharmacist so that we will not be perceived as bottom of the barrel species. I also find no correlation between good academic results and providing good service."

    Very sensible and constructive comments.

    Firstly, it is true that there is no correlation between good academic results and providing good service. But sadly, retailing pharmacists don't generally provide good service. I suspect that a fair number of them is not cut out to deal with members of the public and do retail sales. Many take the job as a stepping stone to something more in line with their expectations. Hence the tidak apa attitude.

    As OZ rightly puts it, my contact with pharmacists has mostly been from encounters whilst purchasing medication, OTC or otherwise from them.

    The most striking thing I noticed about these pharmacists is that they are arrogant, not knowledgeable and generally not very good communicators. Take for instance the incident about the medicated shampoo. It is a product that should be used not more than twice a week. The reason is that the constituents in the shampoo dries the hair and scalp and consequently, frequent daily use will exacerbate the condition instead of controlling it.And the reply I got from the pharmacist? "It is not good for your hair."! The consumer public is becomming a very discerning one. Such advice is unacceptable and discredits the profession you belong to. You should explain to the consumer WHY usage of the shampoo other than recommended is not good for the hair. That is of course, if you know your product and as a good pharmacist, your knowledge about the pharmaceutical constituents of the shampoo must of necessity be impeccable.

    Frankly, the current law requiring certain OTC medications or creams to be purchased in the presence of a pharmacist is assinine and ought to be repealed. It makes no sense to purchase the product in front of the pharmacist if he does not really give a shit as to whether you will be using it in the proper manner. Maybe I'm unlucky to meet these "bottom of the barrel" types but let me just say that I have never ever been adviced on the side effects, contraindications and usage of an OTC product required to be purchased in front of a pharmacist. What I know, I got the information myself.

    In my view, retail pharmacists in Singapore are redundant and should be done away with.

    Let pharmacists do research, pharmaceutical purchasing and audit but not retailing. They are not trained to be good sales people or communicators, especially with the general public. Maybe as pharma sales people talking to doctors. And let me tell you that there is no love lost between these two groups.

    And pharmacists being well read and know their products like the palms of their hands would be a bonus.

    By Blogger uglybaldie, At March 02, 2006 9:24 pm  

  • uglybaldie:

    i c that u've had some pretty unhappy incidents with the retail pharmacists. This happens almost with every other profession isn't it? What is the chance that we encounter a good ____ (insert blank) all the time?

    BAck to the example of doctors,i'm sure everyone has their fair share of 'bad encounters' with the doctors. which is the reason why angryDr wrote these few entries in the first place.. But are we to condemn all the doctors cuz of these few black sheeps?

    It is really unfair for you to make an attack on the profession itself based on that few black sheeps. I've been to retail pharmacies for attachment and i've seen competent and responsible pharmacists at work. I think it's really unfair to stereotype them as one class of 'incompetent people' based on those you've encountered.

    Always remember, when there's always a good and bad side of things. You happened to see the bad side of the people in retail. But don't insult the thousands out there who slogged through their uni course to be where they are today.

    You may cite your unhappy incidents but there is absolutely for the insults. I can see where some of the anon are coming from. I can see why they are so angry at your very generalised and skewed statement.

    I still respect the people in the medical profession despite meeting many 'incompetent' ones. But they do not represent the whole profession.

    It's unfair to label pharmacists as 'doctors wannabes' too cuz NOT all wants to be doctors in the first place.

    and a large proportion who are the so called rejects does have what it takes to be doing medicine.


    Thank you for your feedback on poor pharmacist service. As a pharmacist to be, i'll bear that in mind. Hope that there's no more of such comments coming from you.

    As much as you find retail pharmacist redundant, they are necessary in the society. Just cos you don't receive good service from them doesn't mean the community doesn't need them.

    As for the law on pharmacists having to oversee the sale of certain drugs. It cannot be done away with.Seems like you don't have enough knowledge of drugs that's why you make such a statement.

    There's a reason why every profession exists. There's also a reason why some of the -quote- medical rejects-unquote- were pushed to pharmacy. The profession needs people.

    hope the case is closed.

    By Anonymous Anonymous, At March 03, 2006 2:01 am  

  • "and a large proportion who are the so called rejects does have what it takes to be doing medicine."

    As a medical student, i have to say this..i absolutely agree with this statement. I am in medicine and some of my pharmacy friends knows medical stuff better than i do. hahaha. furthermore,they ace their medical modules while i don't.(in fact, i'm always struggling to pass!)

    I agree with the subjectivity of the interviews. Frankly speaking, i'm quite lost at this point of time cos the course is kinda overwhelming for me. I'm really starting to have second thoughts of whether i should have even choosen medicine in the first place.. apologies to the interviwers who thought i was competent enough.

    The stress too much. the workload too heavy. the people around me too competitive. I can't breathe. It's like i'm being forced to move by others. not cos i want to make a move.

    and there are many others around me who are starting to question themselves at this point of time.. abit too late to do so isn't it?


    Those who are really passionate about the course and want to 'save lives' are but, a handful.

    I was partly driven by parental pressure and.. urghz, prestige to a certain extent.

    I have coursemates who come in for more absurd reasons which i shall not mention here.

    Also, being from RJ, i felt that i should follow the norm and choose medicine.

    I see some of the other medical rejects (not necessarily only pharmacy) who have more passion than me. I can sense that they really want medicine and who knows, they might be enjoying themselves if they were in my shoes.

    too bad they didn't get selected by the mighty three.

    Life's always unfair i guess.

    Exams coming up in 3 days time. sigh

    By Anonymous Anonymous, At March 03, 2006 2:15 am  

  • To Anoynomous,

    "As much as you find retail pharmacist redundant, they are necessary in the society. Just cos you don't receive good service from them doesn't mean the community doesn't need them."

    Please explain why they are necessary in society when they do not do what they are supposed to and just sell the medication like they would, a bar of chocolate.

    "As for the law on pharmacists having to oversee the sale of certain drugs. It cannot be done away with.Seems like you don't have enough knowledge of drugs that's why you make such a statement."

    Please also explain the purpose of the law if retail pharmacists do not bother to explain to the customer how they are supposed to take the drug or apply the cream when they "oversee" its sale thereof. And also why the law cannot be "done away with". It's either the law is bad or the "overseers" are bad. No two ways about it.

    By Blogger uglybaldie, At March 03, 2006 7:41 am  

  • Uglybaldie uglybaldie uglybaldie....

    Aiyah you don't get it do you? You said so yourself when I talked about patients who want to be told simple lies instead of constructive informative truths.

    "A fool is born every minute"

    You are no fool. But you are the minority.

    For every one of you who wants to hear that by using the shampoo more than twice a week will cause the saclp to dry and make the active ingredients less efficacious, there will be 10 or more customers who just prefer "Because it is bad for your hair"

    Look around you lah uglybaldie. As you put it so comprehensively there are more fools out there than there are smart people like you. So the pharmacists, doctors and what have you generally cater to the majority mah!

    Look at me. I grappled with what to do with all the ah pek, ah mah and aunties, and your advice to me was not to antagonize them.

    So next time when you go shopping, you should wear a sign or better have all your shirts printed with the following words:

    "I AM AN INFORMED CUSTOMER IN A KNOWLEDGE BASED WORLD. I REQUIRE DETAILED COMPREHENSIVE EXPLANATIONS"

    By Blogger Dr Oz bloke, At March 03, 2006 9:27 am  

  • "So next time when you go shopping, you should wear a sign or better have all your shirts printed with the following words:

    "I AM AN INFORMED CUSTOMER IN A KNOWLEDGE BASED WORLD. I REQUIRE DETAILED COMPREHENSIVE EXPLANATIONS"

    No need to. Any retail pharmacist dumb enough not to spot someone who looks like he knows his stuff and therefore should tweak her response accordingly do not deserve to wear white and stand behind the "Pharmacy" counter. She should be at the cashier's counting the pennies or the store stacking up the meds.despite the years spent in Uni. at taxpayers' expenses. Mine included, incidentally.

    By Blogger uglybaldie, At March 03, 2006 7:49 pm  

  • ugly baldie. You know what? Maybe you should just write in a complaint letter to GUARDIAN/ UNITY / WATSONS' (whichever's the pharmacy you've received the bad service from). instead of making generalised and insulting statements to the whole pharmaceutical field.

    Dr oz is right. You do not represent the majority. and i will not take your rude comments personally.

    then again, they do not represent the majority.

    If you write in the guardian what you said in this comment box. Maybe something constructive will come out of it.

    As for why is the law necessary. Why don't you start by reading through the statutes- medicines act, poisons act. then we go analyse it in detail..

    but before you do that. Do make your voice heard to the authorities who can 'deal with' these incompetent pharmacists who have so unfortunately, crossed your path as to land their collegues in the bad light.

    cheers!

    By Anonymous Anonymous, At March 03, 2006 10:47 pm  

  • Hey Uglybaldie,

    In every profession, there are obviously some "less competent" ones. Agree? It is unfortunate you "seem" to always be seeing some of those. Besides, it is usually only in the retail setting where there are practising locums who may not be too "in touch" with dispensing over the counter because they don't do it often! It is only their part-time job. Then again, if you want to know more and the pharmacist happens to perceive that you as the "more informed" one although you are not... then just ask la... it is just as simple as that. Pharmacists don't study ESP in the university by the way.
    As for the topic on pharmacists as medical rejects... not very true. The pharmacy course is very popular these days.. so much so that the cohort has increased tremendously and sometimes perfect grades may not get you there. Really...
    In case you haven't know... besides the graduate medical sch, the Outram campus will also have the graduate pharmacy sch. If pharmacists aren't contributing much, maybe our wise govt would not have set up yet another pharmacy sch. By the way, those students graduating from that pharmacy sch with Pharm.D is going to be having that "Dr" title. A recognition of contribution to the healthcare and the status of the profession.
    Don't blame that poor pharmacist at the counter, you are not even paying any consultation fees to him and expecting so much. He takes a fixed salary (your purchases don't make a difference) and he is human... with any possibility of a bad or tired day.
    The world will be better with more understanding and respect.

    Charlie Brown

    By Anonymous Anonymous, At March 03, 2006 10:52 pm  

  • "No need to. Any retail pharmacist dumb enough not to spot someone who looks like he knows his stuff and therefore should tweak her response accordingly do not deserve to wear white and stand behind the "Pharmacy" counter. "

    How does one "spot someone who LOOKS LIKE he knows his stuff"?

    Anyway just looking at it from another point of view.....

    You poor thing lah uglybaldie....no wonder you so frustrated, everytime dun get the detailed explanations you desire.......you got the LOOK of someone who doesn't know anything!

    Thanks for enlightening me! Now I know why you always kena such bad treatment from service staff.

    You need to see a plastic surgeon (since you can afford it). Get him to give you the "New Look" that makes you LOOK LIKE you know your stuff.

    LMAO!

    By Blogger Dr Oz bloke, At March 04, 2006 4:12 am  

  • Hee Hee.

    Very funny hor.

    FYI, I look like our health minister hor.

    Isn't that the look of someone who knows his stuff.

    Wa, you're one lucky SOB. Post drivel, laugh, play with hamsters, f##k around with all the Ah Pek and Ah Ma and still get a five figure salary!

    Three cheers to my good looks!

    By Blogger uglybaldie, At March 04, 2006 8:59 am  

  • "Wa, you're one lucky SOB. Post drivel, laugh, play with hamsters, f##k around with all the Ah Pek and Ah Ma and still get a five figure salary!"

    And you were saying a doc's life isa dog's life?

    BWAHAHAHAHAHA!

    By Blogger Dr Oz bloke, At March 04, 2006 9:58 am  

  • uglie baldie.

    Stop trying to defend yourself buddy.

    If you havent already realised: The reason why you're being continually flamed for what is obviously a careless side comment is because you continue to defend your stand while making apologies on the side. You attempt to laugh off any angry comments made. Frankly, that just makes people more pissed.

    Issue a single, sincere and unreserved apology without qualification and i'm sure you'll find that the number of flames you get will substantially decrease.

    By Anonymous Anonymous, At March 24, 2006 5:30 am  

  • Oh my god, there's a lot of worthwhile info here!
    do not forget 3 | check 5 | also 1 this 7 | look 4 | nice site superb link | check 3

    By Anonymous Anonymous, At January 04, 2013 4:24 am  

Post a Comment

Subscribe to Post Comments [Atom]



Links to this post:

Create a Link

<< Home