Without the White Coat
Prescribing medications
Maybe all doctors and physicians in Metro Iloilo are wondering what happens after they prescribe medications to their patients. Is it properly filled up by the drugstore pharmacist or clerk?
As physicians, we never know or we never have the knowledge what is happening in the drug store counter. Is our prescribed medication being changed? Or a low quality drug is being sold as a substitute for the right pharmacological agent?
In this country of ours, my dearest Philippines, over the counter transactions are so common in the drug store industry. Medications (drugs, medicine, "gamot" or "bolong") are given left and right without any form of prescription from a doctor or a physician aside from the "over-the-counter" medications (OTC, non-prescribed medications that can be "freely" purchased in the neighboring drug store or pharmacy).
The pharmacist or sales lady or clerk will just recommend some medications to the patient without any medical knowledge or background. I believe that it can be the warranted opinion of the pharmacist which is valid. But for the saleslady or pharmacy clerk to give costumers medical advice or suggestion is hitting below the belt, especially in the practice of Medicine. The pharmacy clerk or sales lady should stay, refrain and avoid giving medical advice or suggestion to the buying public.
Does the sales lady or the pharmacist have the right to question a physician's prescription? As in the case of a bed-ridden elderly patient in which there is an ease and comfort of giving a liquid form of medication per Orem (by mouth) as the best choice that a physician has and writes down a prescription for a suspension or syrup form of medications. Thus, the argument of the pharmacy clerk that this preparation are just for pediatric patients is just a plain ignorance.
The prescribing power or writing down prescriptions for the pharmacy to be filled is the sole responsibility and obligation of a licensed (PRC) and qualified physician. In the US, they put a lot of emphasis on this part that they are so strict. In fact, it is a criminal offense in the US and hopefully it will find its way to the Philippines when it comes to the prescription of the medications. Why can't we do it here in the Philippines?
I have seen and witnessed the selling of antibiotics and some cardiac medications just like "OTC's" in some drug stores. By just watching what is happening in our pharmacies we are just too far and beyond our counterparts in the US.
The Filipino mentality of relying on self-medication had been so destructive wherein we have seen some infections that had been resistant to treatment regimen. In such case, a higher class of drug is needed reflecting a higher price and a greater expense. Maybe we have never seen the dangers that self-medication had brought about. One of them is resistance. Side effects and complications will then come its way.
Relying on air time advertisements (our air waves are just full of them as you switch from one AM radio station to the other), they just make a killing by endorsing a certain herbal preparation that promises cure for all the maladies and illnesses of this world. As professionals and educated media practitioners, we should refrain from making any claims on herbal medication.
Remember the statement and word " it is approved by BFAD as a FOOD supplement", or "BFAD approved, no therapeutic claims". So what do these statements alludes to? If we have time to browse down a copy of the Philippines MIMS or PIMS, 2006 edition (Philippines Index of Medical Specialties, est. 1968), there are a lot of information we can get from it like a comparative price on all the medications, the side effects and complications on all medications .One of the essential duty of a respected and professional mediaman is to further educated his community to show to him/her the pitfalls and dangers of medications sold over the counter, that are not suppose to be.
In part, the pharmacy stores and chains should also protect the health of its buying customer. We never viewed our customers as consumers, but a bunch of suckers or fools.
The sole right of prescribing the necessary medications to our sick patient is the sole responsibility of the physician and doctor. The right and sole responsibility of the pharmacy and its sales lady or clerk is the correct dispensing of the right prescribed medications or drugs that is rightfully accompanied by a prescription from a physician. The pharmacy clerk and sales lady should refrain from giving any consultations and suggestions to the customer. They should stick to their job description because the physician totally knows what he/she is doing. So fill up my prescriptions.