MPS, MCPG: “CPs can define their own roles”
At the recent 2nd Bayer Pharmacist Congress in July, a forum was held to discuss the topic of Advancing the Role of Pharmacists in Primary Care. Panellists Amrahi Buang, president, Malaysian Pharmaceutical Society (MPS); Lovy Beh, president, Malaysian Community Pharmacy Guild (MCPG); and Leong Sook Fun, managing director, Bayer Malaysia, shared their perspectives and fielded questions from the audience. The following responses have been edited for clarity.
Q: How can the public standing of community pharmacists (CPs) be elevated?
Amrahi: I think the government needs to give due recognition to the pharmacist’s role in the community. If you look at the Malaysian National Medicines Policy (MNMP) endorsed in 2006, the term ‘retail pharmacist’ was dropped in lieu of ‘community pharmacist’. This reflects a need for community pharmacy to evolve from a product-based service to a patient-based service. But due to the unique public-private healthcare system in this country, this sort of recognition hasn’t really emerged.
Since the change of government last year, there’s been more focus on promotive and preventive care—not just curative, rehabilitative, and palliative—and the whole span of this involves pharmacists. The fact that there’s more of an emphasis on primary care is already a significant change … How much it would benefit the rakyat also depends on whether CPs are ready to serve in preventive care.
I can say we should play three major roles. First, as medicine experts, because we’re trained in terms of the management of medicines rather than diseases. Second, as guardians of medicine who ensure products are of quality, safe and effective. And third, as healthcare professionals, not drug sellers.
Q: How can the community pharmacy be defined beyond the traditional retail view?
Beh: CPs have the power to define their role. When I first came back from training in the UK, I was shocked to realize there was no separation of prescribing and dispensing [at primary care level in the private sector] in Malaysia, though I had been trained in a system that assumed otherwise. … As a young pharmacist, I could have chosen to be bitter or to blame others. However, I chose to be bold and to change community pharmacy practice by implementing enhanced services in the way my mentors taught me.
To be recognized as important healthcare professionals by others in healthcare, we have to prove our worth by providing those value-added services. The MCPG has provided some training in areas such as cataract screening and flu vaccination consultations; we’re also going to embark on diabetes medication therapy adherence clinic (DMTAC) training, specially tailored for CPs.
Because we currently do not have dispensing separation in this country, we inevitably need some elements of sales and business in order to survive. However, I believe that business is like taking medicine. Do not overdose or oversell unnecessarily. Balance it out. Advise and dispense for the patient’s best interest with conscience and ethics. The patient will automatically value you, especially if it helps to improve their health outcomes.
Q: What expectations do consumers and the industry have of pharmacists? How can the industry help?
Leong: The pharmacist’s role isn’t simply about dispensing medication but delivering optimal healthcare. You need to understand your patient’s medical history, drug interactions, side effects—that’s a big responsibility, the patient’s health is in your hands.
It’s important to note that the pharmacist today is the most accessible healthcare professional to the population at large. Being that touchpoint, they can help Malaysians to become more health literate, and to know how to take care of themselves with guided supervision and advice. That’s the expectation.
What you do on a day-to-day basis in your place of practice can be cascaded down to your peers as well. In this Congress, we have experienced pharmacists with their own unique knowledge of community pharmacy sharing their experiences. From the industry point of view, we aim to help facilitate that co-sharing and drive that journey of professional improvement.
Q: What can the CP behind the counter do in the face of higher public healthcare demands and new innovations?
Amrahi: If you look at how the International Pharmaceutical Federation (FIP) defines the community pharmacy and how it looks like at ground level, you’ll see very different things. People’s perceptions of CPs are quite inconsistent versus their perceptions of doctors. At the moment, they have five images of the community pharmacy: a premise concentrating on products; a discount store; wellness, a professional sort of thing, and all of the above.
So, we need to talk about a new normal. If you want to change public perception, you must change the way you practice. When people go to a spa’s premises, they know what to expect. Similarly, there needs to be a new normal of what people expect when they go to a CP’s premises. We need to bear in mind that there are two types of people who go to a community pharmacy—customers and patients—that require different approaches.
If we want to move forward, the community pharmacy’s overall ambiance must be that of a health hub. Whether as customers or patients, people go there knowing they can get something in terms of health. It’s therefore important for pharmacists to portray themselves as interested in public health. And that’s where new competencies come in.
With self-care and complementary medicine on the rise in the community, the pharmacist is in a prime position to help. There’s a lot of commercialization and new evidence involved in so-called home remedies that people will bring up with healthcare professionals. And the pharmacist must—whether you like it or not—know about them in order to be able to advise them.
One last important area that the pharmacist can make the biggest impact in is ensuring patients are compliant with their medication. No other professional is in a better position to do so. Even in other countries where dispensing separation is in place, data shows a significant population of patients fail to take their medication properly.
Q: As association representatives, what one question will you ask the Health Minister at the upcoming pharmacists’ town hall [on 27 July]?
Beh: Regarding professional consultation fees. Here, doctors get RM30 to RM50 in consultation fees; even plumbers get RM60 to RM80. So, what are we doing [in Malaysia]? Do you value yourself? Do you want people to value you? There has to be a little bit of money paid. We’re not talking about exorbitant fees, but at least something—because CPs aren’t earning much. This is one of my highest priorities.
Amrahi: I want to talk to the Health Minister about giving proper recognition for all pharmacists in the healthcare system. That is the most important thing because pharmacists are the main members of the pharmacy profession. So, if the government gets serious about looking at pharmacists and recognizing their role in the healthcare system, then we’ll be on the right track.