Doctors should stop dispensing medicines
I AM writing in response to the proposal to raise doctors’ fees. The public understands that this is to look after the welfare of medical practitioners in the private sector.
This goal nevertheless ought not to be pursued at the expense of consumers with the cost of healthcare in Malaysia already soaring.
Whilst the need to review and revise the consultation rates is not disputed, what the authorities should look into urgently is how the medical profession is quickly evolving into a “medical industry”.
The fusion of prescribing and dispensing in Malaysia places doctors in strong bargaining positions in the marketing and pricing of drugs.
Numerous reports have been made of pharmaceutical companies granting “exclusive rights” such as rebates and lower prices to doctors in return for their prescription and dispensing of drugs with brand preference.
Medical practitioners complained that such measures are necessary to make up for their meagre consultation fees. The exercise of judgment by private doctors appears to weigh heavily towards enhancing their own economic welfare rather than the healthcare of those they have pledged to uphold.
Section 10 of a World Health Organisation (WHO) report titled “Promoting rational use of medicines: core components”, states that “Prescribers who earn money from the sale of medicines, for example dispensing doctors, prescribe more medicines, and more expensive varieties than those who do not; therefore the health system should be organised so that prescribers do not dispense or sell medicines”.
If the fee hike proposal is being considered, we should also consider the separation of dispensing from prescribing.
Another possibility is to do away with the practice of setting a fee schedule, which deprives the public of the benefits of price competition.
The quality of services would not vary drastically in such an environment.
If private doctors argue that the reality of their profession cannot be divorced from the economics of costs and profits, shouldn’t they then be made to compete just like any other business?
PENNILESS PATIENT Petaling Jaya