Professional News

Dear Diary,

At last, HSA did away with some absurdities by putting Hialid 0.1% eye-drops back to where it belongs… Over-the-counter (OTC). Just a few months, this OTC product was shifted into the prescription-only medicine (POM) category which I thought was ridiculous. It is just 0.1% of sodium hyaluronate…. Very harmless in my perception despite some rare inconclusive reports of adverse effects. The biggest irony was that AMO Blink eye-drops containing a higher concentration of sodium hyaluronate at 0.15% was spared the re-categorisation.

Anyway, all has gone quiet at the pharmacy department in NUS regarding their Pharm.D (Doctor of Pharmacy – Clinical) program which they are supposed to launch next year 2008. If I am not mistaken, it is supposed to be a link up with University of Indiana. I wonder if it will ever take off now. The pharmacy profession is in unprecedented limelight yet again with another letter from a pharmacist, Emily Poh. Personally, I feel that such letters to the media should now cease because we are fast being perceived as “whining” and this is definitely not helping our cause. Tomorrow, coincidentally is the start of a medication review campaign in Singapore involving selected pharmacies (yup, my pharmacy is involved!) and whether we prove our worth will depend a little on the outcome of this Pharmacy Week campaign 2007. Godspeed to us!

This bitter pill is why I won't work in Singapore
by Emily Poh

I AM a Singaporean pharmacist trained and qualified in the United Kingdom, where I have been working for the last two years.

I have considered coming back but feel that the industry is not ready for me. Apart from a demoralising environment due to poor staff retention, there is also little recognition of the pharmacist's role as a drug expert.

The choice of medicine prescribed for a patient may be driven by the amount of incentives given to doctors by drug company representatives, instead of a guideline of what drugs are clinically proven to be efficient and cost-effective.

I have spent four years at university getting my degree and another doing my pre-registration year learning about clinical pharmacology, pharmaceutics and therapeutics. Yet I've noticed that Singaporeans would rather go to a doctor than a pharmacist for advice on their medications.

They feel they should get advice from the person who has written the prescription. But when they see a general practitioner (GP), they get their medications at the dispensary from someone who is not even a qualified dispenser. There is no one to pick up any drug interactions and dispensing errors at that point. Besides, the patient might be forgoing some professional advice regarding his/her medication.

How many patients have spent more than 15 minutes speaking to their pharmacists about their medication? Do the pharmacists even explain how the medicines work or suggest having their medicine use reviewed?

Being a pharmacist is not only about keeping the waiting time down. It is also about how to reduce drug-dispensing errors, picking up drug interaction as well as giving best advice about the medication and possible lifestyle changes to go with the treatment.

Most pharmacists are not given a chance to use their expertise. Most of the time — under pressure to keep down the long waiting times at clinics — the most they do is dispense the correct medication according to the prescription and not question it. They only have the time to tell you the dose and frequency of the medication to be taken — all of which is already printed on the label.

That is certainly not what pharmacy is all about. If that is the practice of pharmacy, it would be easier to get an accuracy-checking technician rather than a pharmacist. It would be far cheaper, too!

With the growing number of ageing Singaporeans, we have to look into problems with increasing drug interactions due to increasing aliments.

Furthermore, GPs, polyclinics and hospitals are not linked up properly to create a seamless access to the medical history of patients. As a result, some patients may end up in hospital due to polypharmacy, or taking too many different drugs.

The system is far from mature. The salary, other incentives and opportunities are just not attractive enough to woo me back to Singapore. It will take a long time for the pharmacist profession to be respected in the Republic.

I also feel that it is time to deregulate the following medicines from POM (Prescription-only) status to P (Pharmacy-Only) medicine status:

1. Simvastatin (reduces LDL)
2. Ventolin Inhalers (salbutamol)
3. Steriod creams of all strengths
4. Proton-pump inhibitors (eg. omeprazole)
5. Verrumal solution (Wart treatment)
6. Loceryl Nail Lacquer (Anti-fungal for nails)
7. Postinor (morning-after pills)
8. Oracort E (oral ulcer treatment)

Actually, over the last few days…. I was tinkling with the idea of maybe authoring a book and getting it published. Don’t know why I suddenly have this urge. Just gotta think if it is feasible… and what topic should I write on… something that I have great interest in and will potentially appeal to the general masses. Hmmm… currently interested in Christian apology which I know isn’t a very mass-appealing topic, haha… we will see. Maybe a book to teach laypeople about medicine and supplements? Wonder if I should run some courses at the community centres too. Lots of ideas firing across my cortex neurons. Someone ever told me that I don’t look like a procrastinator. Oh… either she is so wrong or I don’t know myself well, haha…

This evening, the road which my apartment is located at was bursting with festivities. Packed with cars as I returned from my usual evening run. St Stephen’s Church was hosting a dedication dinner at the nearby vast plains in celebration of the completion of renovation works. Looking at that area, it really looks like a cute little European town. Houses line on one side, the convent spans the other side. At the end of the road, a church with a cross standing at its roof just slightly above the stained glasses and the church bells which ring the Angelus. =)

Love my home! The only better place to live in is somewhere nearby Singapore Botanical Gardens, haha…

God Bless,

Andrew