Carry on serving despite the less than ideal working environment

I WOULD like to respond to Responsible Pharmacist’s letter “Go ahead and ask, pharmacists willing to help” ( The Star, June 16).

While I respect the pragmatic take on the current situation many outpatient pharmacists throughout Malaysia, especially those working in Type 1 and Type 2 government clinics, are in I wish to offer a different perspective.

As pharmacists and public health workers, what do we expect from an “ideal” working environment? The total number of patients per day to not exceed a certain figure? The conspicuous absence of patients who may (intentionally or unintentionally) grate at our frayed nerves especially during peak hours? A significant reduction in the number of side duties (and pressure) heaped upon us by our superiors?

Such an ideal environment does not exist in many hospitals and government clinics. However, we should still strive to achieve the best possible outcome for our patients. Taking our foot off the pedal and passively coasting through our dispensing duties would be a disservice to patients, many of whom still see us as a venerable source of information regarding their medications.

In fact, in this day and age of smartphones and social media, there are no “uneducated” patients but merely wilfully ignorant ones such as those who refuse to know the name of their medications despite being prescribed the same regime for several years.

But pharmacists should admit and shoulder their share of the blame for having allowed this problem to propagate. Too often, we just wave these patients away with a flimsy “you-need-to-knowyour-medications” admonishment without making an effort to properly educate them.

For instance, how many among us would bother to mention the actual name and strength of the medication to our patients during the dispensing process (even during non-peak hours)? Most of us tend to describe the medications using general terms like ubat darah tinggi (blood pressure medication), ubat kencing manis (diabetes medication) and so on.

Patients end up being confused, especially those who may have been prescribed three or more types of medications for the same function but with different modes of action. They might choose to omit certain medications thinking, wrongly, that there’s no purpose in taking them because they perform the same general function as the other.

The speedy but half-baked medication counselling of the past is no longer acceptable, especially when dealing with tech-savvy patients who have Google at their fingertips.

Whether we like it or not, we need to constantly upgrade and improve our counselling skills to remain relevant in this current healthcare system. The idea is not to inundate our patients with a glut of information crammed into hasty sentences but rather to provide bits of “interesting” facts that would pique their interest about their medication.

Using more open-ended questions like “Do you have any issues with any of the medications you are taking now?” or “I understand that you are already familiar with the doses and frequencies of your medications, but have you ever wondered how they actually function?” would make it easier for us to engage with the patient.

Putting ourselves in the shoes of our patients, wouldn’t we be bored if we have to listen to monotonous dispensing talk each time we pick up our medication? Also, educating just a small percentage of our patients is better than nothing at all.

Responsible Pharmacist also stated that we have other work in our job scope, and I am inclined to agree but only to a certain extent.

For instance, I am perpetually at the dispensing counter while juggling a Diabetes Medication Therapy Adherence Clinic with 240 patients to be recruited each year as the stipulated target. I also have to handle therapeutic drug monitoring cases, prepare medication indents for various patients referred by other facilities, and complete the filling and labelling for patients’ prescriptions registered under the Value Added Service programme.

I am required to report adverse drug allergies and issue allergic cards whenever I encounter such cases while being expected to fulfil the duties of an Antimicrobial Stewardship Program coordinator for my district and complete my monthly methadone clinic on-calls.

Even so, I am not the only pharmacist in the government sector with a long list of daily and monthly tasks. But why should we let it get in the way of us competently carrying out our core duty as an educator and medication counsellor for our patients?

In short, we can either make a more conscientious effort to improve the quality of our pharmacy service or simply allow it to stagnate.

The speedy but half-baked medication counselling of the past is no longer acceptable especially when dealing with tech-savvy patients.