Doctors and Pharmacists: Rivals or Allies?

Since time immemorial, the doctors and the pharmacists had always worked together. According to a Greek legend; The God of Healing Ascelpius, had entrusted his apothecary Hyegiea to compound his remedies. In Ancient Egypt, there were two classes of physician-priests; the ones who visited the sick- the doctors, and the one who prepared the remedies- the pharmacists. The separation of duties between herbalists and physicians had also been recognised in the Middle Age in Europe, and in the Ancient Greece and Rome.

The advent and expansion of the medical knowledge and technology in the modern era further separated their roles; doctors-to diagnose, treat and perform medical procedures, pharmacists- trained in giving information and counselling about drugs and devices such as insulin pens and inhalers, preparing drugs (which includes hemotherapy drugs), and dispensing the drugs. In certain sectors, pharmacists are also involved in productions of drugs, drugs regulations, and registration of new drugs, traditional medicines and cosmetics, among others.

In the university, the doctors had been trained mostly in the fields of anatomy, physiology and pathology, with a surface knowledge in pharmacology- the study of drugs.

Pharmacists, on the other hand, had spent 4 years studying pharmacology- the administration, distribution, metabolism and excretion of drugs from the body- pharmacokinetics; and the effects of drugs to the body-pharmacodynamics. To better understand the correlation between diseases and treatments, they also learned anatomy, physiology and pathology, though not to the same extent as the doctors did.

Thus, it is evident that pharmacists and doctors complement each other, and that they are supposed to work together, by merging of the knowledge of pathology and pharmacology, and not by comparing whose job is greater. Surely the doctors can’t be treating patients while doing raids in illegal drug factories at the same time! And surely the pharmacists can’t be doing what the doctors are trained to do too!

At the situation in a private clinic in Malaysia, the doctor will diagnose your illness and you would have to collect the medications from the dispenser, some of which are not properly trained in pharmacology. Thus, you could hear of stories where medications were wrongly labelled and given to the patients.

In the government hospitals and clinics on the other hand, prescriptions will be issued out by the doctors to the patients. The pharmacists will screen the prescriptions, taking notes of the correct patient, drug, dose, route of administration and time/frequency. There were numerous medication errors that were managed to be intercepted by the pharmacists before they reached the patient’s hands, of which without interventions, could lead to fatalities and other serious repercussions.

Throughout the 5 years working as a pharmacist, I had the opportunity to interact with the doctors, specialists and nurses. I had suggested which doses are suitable for a patient with an end stage renal disease, and which medications that could not be given to pregnant ladies. So far, the doctors that I had been working with are very pleasant and cooperative. They too, acknowledged the roles of the pharmacist. Since they know more about disease progression and managements, I would also take the opportunities to ask them about the disease, while they asked me about the effects and actions of drugs.

It is clear that we could learn many things from each other, each sharing our own knowledge for the benefits of the patients. Not because the pharmacists want to become like doctors, and not because the doctors want to become pharmacists.

Since dispensing separation is successfully practiced in the government hospitals and clinics, why can’t the same be implemented among GPs and community pharmacists? The reason why the doctors and pharmacists are at dispute with each other is because there is no mutual understandings on their respective roles, and because the role of pharmacists, who are supposed to handle and dispense drugs, had been taken by the doctors. The pharmacists, on the other hand, proceeded to just suggest and dispense diabetic medications based on the mere reading at the glucometer, without examining more- which is what the doctors are supposed to do. Thus, dispensing separation is crucial, as it allows us to acknowledge each other’s roles, creating synergism and harmonious relationship vital for the well-being of the patients.

Doctors and pharmacists are not supposed to be rivals. We are supposed to be allies, and things like diseases and antimicrobial resistance should be our mutual enemies. :)

UPDATES 30/9/2019:
So I sent this article/essay/whatever you call it to NST and whaddya know, this article got published in their 'Opinions' Section! Woohoo! A dream come true!

I didn't realize my article got published until a friend from another hospital showed me a screenshot of the article with my name and workplace on it. The editor had cut quite a big portion off the original article for ' length and clarity' but the main points are still there.

It was quite surreal, knowing that it got published on a national newspaper. I actually didn't expect to get published as I had gotten so used to rejections, LOL.

Here's the link to the article. They even changed the title. HAHA

https://www.nst.com.my/opinion/letters/2019/09/525682/doctor-pharmacist-conflict

Thanks to my housemate, Dr. Fatimah for this! 

Personally, there's no conflict between me and the doctors. I love my doctor friends. My best friend, Malizah is a doctor, the same goes with my very caring and kind housemates, Fatimah and Laila.  During foundation years, my close friends were mostly medical students. Even when I'm working now, I am closer to the nurses and doctors than I am with the pharmacists. I don't know why. I feel more comfortable with them. I also believe that we should work together as a team. 

I hope this serves as a catalyst for me to write more and just write! I'm actually thinking of publishing my own travel zines, haha.

I would like to say thank you to my family and friends for the support! Thank you to NST for publishing my article. Most of all, thank you to Allah for this opportunity, alhamdulillah.