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发表于 3-12-2013 11:25:16|来自：新加坡
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The Straits Times 01 Jan 2005 MOH to stop docs from selling drugs
[size=-1]Move will take years as their income closely tied to medicine sales
SINGAPORE is slowly moving towards separating a consultation with a physician from his selling the medicine he prescribes, a practice common in developed countries, the Health Ministry revealed. The goal departs from MOH's usual stand of supporting the existing set-up, which has opened doctors to the criticism that some prescribe drugs that give them a better profit, rather than ones that are cheaper but just as good. However, MOH told The Straits Times, it will take years before the two functions are done by different people, as the income of a doctor in the private sector is linked very closely to the money he makes from selling medicine to his patients. The ministry's director of medical services, Professor K. Satku, explained: 'This is something that touches people's rice bowl, so you cannot charge in and change it. We must prepare our doctors.' Without phasing in the change, patients could be slapped with heavy consultation fees as doctors try to make up for their lost income and overall health-care costs could go up. He said though that doctors would still be allowed to sell certain medicines, such as those that need to be administered quickly. The change is prompted by the expected heavier call on doctors' services as the population ages. Removing the task of selling medication, Prof Satku added, would allow them to 'concentrate more on the care and counselling of patients, rather than the prescription of the drugs'. In countries like the United States and Australia, doctors charge only for consultation. They prescribe what patients need and the patients have to buy the drugs from a pharmacy. This way, doctors are not swayed by the possible profit they could make from selling a drug directly. A general practitioner (GP), who has a clinic in Bukit Timah, argued that changing to such a method could cut both ways. 'If I have no interest in the cost of the drug, I'd just prescribe 'the best', which may be the most expensive. I can't do that today. The market is very competitive and patients vote with their feet,' he said. The change will have little impact on medical groups, said Parkway Shenton's executive director, Dr Goh Jin Hian, as his group would simply set up a chain of pharmacies. While the change may make doctors appear more impartial, a GP in Jurong pointed out that many patients like the convenience of getting their medicine from the doctor. He said: 'My diagnosing food poisoning in a patient at 9pm on a Saturday night is one thing. For him to have to go to the nearest pharmacy that is still open for his prescribed medicine, while suffering bouts of diarrhoea and vomiting, is another thing altogether. 'Any of my patients will say: Just let the GP give me my medicines, and let me go straight back to my flat in the next block and crawl into bed.' But Prof Satku argued that Singaporeans need to learn that they should have some medicines at home for common ailments like diarrhoea and fever. He also foresees the setting up of more pharmacies to cater to people's needs, with at least one in each suburb, and that these would stock generic drugs, something such outlets in the private sector rarely do. 'Generics save the patient considerable cost. We need to address this too as we roll out changes in policies,' he added.
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