Sunday, March 30, 2008

你认同吗?事实是什么?

这文章很长,请看完,对你有益的。
大约用十五分钟看完吧。
谢谢您。
对不起,若我说错。

Doctors to be disallowed from dispensing medicines!!(NST)

配藥權利“歸還”給藥劑師,不允許診所醫生配藥!!(SIN CHEW)

No decision to stop doctors from dispensing medicine!!! (NST)
Docs to go on dispensing medicine (THE STAR)

指報導錯誤引述‧廖中萊否認醫藥分家
(SIN CHEW)

这两天里,看到的报纸最令我感到吃惊的是以 上的大标题了。
walau ye,哪里可以这样。?
当我看到时,我心里就一直想写篇文章来评论下。
我知道,当你们看着这篇文章时,有些人会觉得我很骄傲!
有些人则会觉得我很有道理!!
但,就有部分人会觉得我很不好!!!
无论如何,我只是纯粹把我所知道的、所了解的拿来分析,告诉大家我们的工作,
为什么我本身还是认为这工作还是由医生来吧。

在我还没进入医学系的时候,我总是认为医生很能赚钱,
(这不是我读医学的原因)
他们总能从中牟利,
但,
自从我进入了医学系,真正了解到它的奥秘时,
我才真正自己相信我自己以前的想法是错的。
原来,一个手术为什么是那么的贵。
就让我来说说吧,好吗?
我想若我有哪个部分说错,请提醒、原谅下:

当某人病倒,需要到手术时,他的手术费包括手术室的maintainance, 手术室的仪器、手术的刀、它的刀又得清洗(叫autoclave)费,手术后的治理,手术的医生费用(开刀和麻醉师),手术的护士。。。。。等等好多好多。。
那请问一下一个几万的手术费是医生的全部吗?
没有。
往往病人不知原来他的手术费是为了买些贵的仪器。
手术室的maintainance和清洗都是很贵的,
所以,希望您能清楚了解到。
所以,医生不是从中牟利的。
我们所做的一切都有大马医药协会来监管,一旦犯错我们的事业将在那一晚失去了。
每位医生之所以而怕犯错,
从中,
他们对他的病人都抱着我要给他痊愈的机会,
心想
“再不好,我也要精神上的支持他。"
近年来,医学系的学生都被训练成什么叫做holistic approach
之所以有这教学是因为我的教授为了训练我们能成为一个不只能医治病人的医生,也是位能把病人的病看成不是病,而是医治他整个人:也就是说treat the patient as a whole, and not the disease only。
当一个病人,他能有这病时,他的生活环境如何?有被影响到吗?他的家人有谁也是有此病?有去治疗吗?
他住院后他的工作如何?需要社会福利吗?
这就是所谓的holistic approach。
当然,有些“医生”还是不会想到这一点。

每当我们给药时,你会相信我们吗?
会。。。
为什么?
因为你了解到,医生很清楚的知道你的病例,你对什么有敏感,你对哪种药物,多少的分量才有效,因为我们慢慢的加给你。
就拿个case来看:
当你有了糖尿病后,我们会慢慢的给你药,看你本身要吃多少才有效。
慢慢的monitor你的变化,问看你的症状有改变吗。。等等。。。
但,若说这两者的工作分开后,那我们只是问爽做不到决定要加还是要减,
而是有我们的药剂师做决定,那病人不是烦上加烦?
“大哥,有病了已够烦,现在又要两边跑,不是烦上加烦?”
为什么其它国家所做的我们就得学呢?
每样东西都有原创者,才有人家跟随。
那为什么我们就是要永远跟随人家呢?
为什么我们自己不能有主见呢?
就如早前我们听到外国用laptop去记录病人病例成功,
但一旦在我国实行就弄慢了我们的医药系统,
因为我们国家的typing很慢,电脑不方便,
所以在某医院听说失败了
换回写进那厚厚的file,容易点。
所以还是看回我们的国家,
不要盲目的跟随,
哈哈。。
会被人取笑的。

哈哈。。。
想象下吧。。。。
要说医生从药中牟利,那交到药剂师手中就不能?
太天真了吧?
大家都是人啦。。
是人格的问题。。。
我想从中牟利的早就被我们的医药协会铲除掉了吧?

能真正了解病人的还是医生。
要病人拿那个药单(只是写着什么药,没清楚交代病人真正整体十年以来的病),请问你相信谁给你药,若你是个高血压者??
药剂师只看到你病什么,
什么药。而你十年以来的病例呢???


根据我们医学的教育,在外的any healthcare centre(any lab,any clinic,any pharmacy。。。)是不可打广告说他的是最好什么的。。。
但,请问你是不是时不时都看到“有人”“乱打广告呢”?

身体检查更惨!!!!!
一些的检查是不必要的,却被某些lab拿来“骗”人。
check一次的血糖就能说你有糖尿吗?
check一次的血压就说你有血压高吗?
如果那么容易,就不用开启那么多间医学院、用那么多年来读了啦。。。
请看下nst: http://www.nst.com.my/Current_News/NST/Sunday/Frontpage/2199368/Article/index_html
注意这句话:
some pharmacists were already dispensing medicines and treating patients, especially after checking their glucose level and blood pressure.

也许我过分些,说出不该说的,、
但,我就是希望我国的病人能有更好的医学知识。
不要容易的受骗。
也许大家也是为了一口饭,但影响到病人的健康,我就不能袖手旁观了。
最后,对不起,若我说错,得罪某人。


以下是这几天的报纸:
来自:http://www.nst.com.my/Current_News/NST/Sunday/Frontpage/2199368/Article/index_html
http://www.sinchew.com.my/node/59692?tid=1


KUALA LUMPUR: The Health Ministry has not decided to disallow doctors from dispensing medicines.

Health Minister Datuk Liow Tiong Lai said yesterday he would like to meet the Malaysian Medical Council, doctors and pharmacists to discuss the matter.

Liow said he was aware of the Malaysian Pharmaceutical Society's proposal for pharmacists to dispense medication to patients.

"At the moment, we are still looking at the proposal.

We have not made any decision yet," he said after his first official visit to the Kuala Lumpur Hospital yesterday.
Liow was commenting on a New Straits Times report yesterday headlined "Doctors to be disallowed from dispensing medicines" that quoted health director-general Tan Sri Dr Ismail Merican as saying that the move was in the pipeline.

He had also said that a pilot project on the proposal would be launched soon.

He said the move could not be implemented earlier because of logistics problems, especially the shortage of pharmacies and pharmacists.

Liow said the most important thing was for the people to have a good healthcare system.

"That is the responsibility of the government. We do not want to burden the rakyat with extra costs," he said.

The Malaysian Medical Association is against the proposed move to disallow doctors from dispensing medicines.

President Datuk Dr Khoo Kah Lin said the public should decide if they wanted to get medication from either pharmacists or doctors.

He said a doctor's primary role was to diagnose and treat which included giving appropriate medication to patients.

"Therefore, doctors cannot give up their right to dispense medicine," he said.

Dr Khoo said doctors were already separating the consultation fee from the cost of medication, to avoid being accused of profit-making in dispensing medicines.

The MMA's recommended fee for consultation is RM30 for minor ailments. However, doctors generally provide consultation and medication for less than RM30.

Dr Khoo said pharmacists should not be allowed to prescribe medications without a doctor's prescription.

In another development, a senior medical consultant, who declined to be identified, said some pharmacists were already dispensing medicines and treating patients, especially after checking their glucose level and blood pressure.

"This is already affecting our business," he said

He said pharmacists should refer patients to doctors for diagnosis and treatment.

"Their work is only to dispense medicines prescribed by doctors. Pharmacists cannot become doctors. They cannot prescribe medicines based on basic tests," he said.

A doctor in Klang, who only identified himself as Dr Rahim, asked if pharmacies would be open around the clock to cover prescriptions issued by doctors at 24-hour clinics.

"So who is going to dispense medicines in this context, the doctor or the pharmacies?" he asked.

The Malaysian Dietary Supplement Association, however, said the proposed move to disallow doctors from dispensing medicines was long overdue.

Its president, Jagdev Singh, said pharmacists were best suited to dispense medicines because they were more knowledgeable about "drug to drug interaction, drug to health interaction and adverse reactions".


星洲:
如果當局貿然執行這個方案,病人將面對生病時兩頭忙的不便,即要看醫生,又要另外向藥劑師領取配藥,而不是目前在接受醫生診治後,直接領取藥物,方便、快捷且節省時間、金錢。

他說,為了免除醫生配藥從中牟利的指責,醫生已把診金及藥物收費分開,醫藥協會建議普通門診包含藥物,收費不超過30令吉;醫藥協會建議醫生對超過30令吉以上的診金,詳細列明各項收費,讓病人瞭解藥物的真正價格。

对不起!!!


1 comment:

Bombomba said...

em...听你的讲解对医学界有一点改观了...
原来是这样的...
这就是为什么那么昂贵了.