Malaysian Medical Resources

First the insurance bashing and now a piece on doctor bashing regarding the use of generic medication in the Star newspaper. I wonder if this is propaganda as a prelude to 1Care?
What is disturbing is that a Dobbs member pointed out that his reply to the Star’s doctor bashing article was not published at all, and this is no ordinary doctor as it is no less than Dato Dr. Lee Yan San, a respected senior member of the profession and past president of the MMA. If the Star will not publish the letter, then the MMR will:

Dear Editor,
I am referring to the news in the Star 2nd Feb “Generic Meds Just as Good. Experts: Doctors & GPs being tempted into selling branded ones”. I was most shocked by such biased statements towards doctors especially by a Professor of Pharmacy who should know better than to make such unfounded accusations of doctors in public.
Doctors have one year of training in Clinical Pharmacology but it does not end there as doctors further also learn therapeutics during their clinical years which is even more practical and important. It is not easy to become a doctor as it takes 6 years and housemanship to be qualified because human being varies so much from one another and thus doctors need to know a lot of basic and have clinical experience to be able to diagnose and treat the patients and prescribe medicine proficiently. Pharmacists only learn the basic science thus are not qualified to treat patients and should leave this to doctors. Before doctors prescribe any medicine they will have to go through their minds many factors such as their patients’ past history, tolerance, sex, age, etc before making a choice of the medication the doctors decide to use. He will also only use the medicine he is familiar with and have made in-depth studies of it.
Doctors usually store both generic and branded ones in their clinics and give patients who cannot afford branded ones a choice of the alternate generic brand. Some patients who can afford prefers branded original product as they only have faith in original products. Just like some people prefer to buy branded products while others are happy with any brand. When doctors use a generic product, the safety of their patients comes first and they will make certain it is produced by a reputable established company who will have frequent quality control of their products. In very recent news, in Punjab a generic medicine was found to have killed many people and the generic medicine was later found to be contaminated with some lethal ingredients.
In Malaysia, patients prefer to get their medications from their doctors. This will be cost effective as doctors normally do not have to make profit from selling medicine and thus medicines will cost less. Patients also do not need to travel to another place to purchase them.
Doctors are smart and ethical enough not to be easily bought or convinced by drug companies using incentives to use any medications the doctors do not find suitable for their patients as their reputation which is the most important is at stake. Doctors want their patients to trust them and to continue to return to their care.
Thank you,
Best Regards,
Dato’ Dr. Lee Yan San

You can read more about the generic medication catastrophe in Punjab which Dato Dr. Lee refers to here:
Punjab drug reaction kills 2 more; toll at 121
Free ‘life-saving’ medicine kills 32 patients in Punjab

The names of drugs causing the deaths have been made public and include: Concort (Amlodipine), Cardiovestin (Simvastatin), Alfagril (Clopidogrel), and Soloprin (Asprin). Notifications have been issued to all medical professionals not to prescribe these drugs until a probe is completed in the incident. Owners of the pharmaceutical companies supplying these drugs have been arrested and their pharmacies sealed.

The message is that not all generics are good or reliable. Unfortunately only the minority of generic drugs in Malaysia have undergone Bioequivalence studies so it is not easy to determine if they are just as good as original drugs. If a generic drug works well and saves costs, then well and good. If it doesn’t then it may produce less than satisfactory outcome (e.g. a doctor may notice that blood pressure control is less effective after switching to a generic anti-hypertensive medication) and fortunately uncommonly, disasters like what happened recently in Punjab. Some people (doctors and patients alike) may not want to take their chances and prefer to use original branded medication and it is their choice.

Exellent series of Blog posts by Dr. David Quek, past President of the MMA.
The posts:

Malaysian Health Reform Socio-Economics I
Malaysian Health Reform Socio-Economics II
Malaysian Health Reform Socio-Economics III

A must read if you want a insightful analysis of the healthcare scenario in Malaysia and the implications of 1Care or any financial remodelling of the Malaysian healthcare system.

The past couple of weeks has been a busy time for us. Firstly I made the decision to move our hosting services and so far I think it is a great move as the previous one’s service and features were lacking. The new host gives me better value for money and so far the support has been tremendous. Let’s hope things continue as they are.
Now the major change and work for us is the migration of the Malaysian Doctors only forum (fondly known as Dobbs which stands for Doctors Only Bulletin Board System) to a completely new format. The previous Dobbs was located in the MMR Forums but in the Doctors only section. I have now put it in separate site of it’s own, and it takes us back to the year 2000 when Dobbs also was a purely Doctors only site.
Here’s a screenshot of Dobbs in the year 2000

Those days, Dobbs was a hand coded data base (Cold Fusion) driven discussion forum. It served it’s purpose but was difficult to expand and customise.

This is the era of the social network with the proliferation of services like Twitter and Facebook. Why not take Dobbs to the new level and make it the “Facebook for Malaysian Doctors”? Indeed the new Dobbs does just that. With the new Dobbs, we not only have extensive discussion groups (forums) but also the ability for Doctors to post status updates, make friends with other doctors, “Like” activities, upload pictures and documents, personal Photo Albums and more. The discussion groups are the usual general forum and special interest ones which can range from medical (specialty focus, consultation between doctors) to financial matter and hobbyies (e.g. photography) etc. The big difference from Facebook is that Dobbs is a private community and doctors won’t have the same privacy issues as they would if they use Facebook.

Here’s a screenshot of the new site:

How do you access the new Dobbs? Just head over to http://mydobbs.net. If you are already registered just login with your username and password, otherwise you can use the registration form on the same page to apply for access. Dobbs is free but registration is restricted only to Malaysian doctors.
If you like Dobbs, we’d appreciate it if you show us some love by Liking our Facebook page here.
The MMR page about Forums and Blogs has been updated accordingly.

We have moved servers and the migration exercise was just completed. There might be minor glitches which need cleaning up since this is a huge blog. The database size alone was about 30 Mb and it was not exactly a smooth transfer but the new host support has been great!
I’ve temporarily removed the Shoutbox as it was giving some formatting problems.

Please note that we are about to perform a host migration exercise. There may be a downtime period which hopefully won’t take more than a day or so.

David Agus an oncologist has some provocative ideas regarding the treatment of cancer after a few decades of research in the field. Last week he released his controversial book, The End of Illness, and here’s the talk he gave at TEDMED 2011 as a preview:

Here’s the book in Amazon

Good post by Dr. Pagavalan

If you look at the MPS website announcement below, it is clearly stated that the government will outsource medication dispensing services under the 1 Care scheme to community pharmacist. A standard list of drugs will be provided and paid by the National Health Scheme under 1Care. So, I am not sure where the GPs dispensing rights will stand. Probably, they may ask GPs to hire pharmacist if they want to dispense medicine but then the statement “Pharmacy premises not to be shared by non pharmacy related services” is clearly stated.
Whatever said, the change is coming for better or worst! Just be prepared. It is not the rakyat alone who is going to be affected but also the doctors. And don’t think that the government doctors will not be affected! “The current Govt Hospitals and Health Clinics will be given autonomy and will operate like private entities” is again clearly stated. This means that government hospitals and KKs will eventually be corporatised and will decide on their own how many doctors they will employ/pay! Probably, this is the reason why government is increasing the salary as a prelude to corporatosation. All doctors will eventually work on contract basis under corporate companies.

Separation of consultation and dispensing is a given.
Doctors becoming contract workers – already happening.

It is strange that the original MPS link cited in Dr. Pagavalan’s blog has “disappeared”. Is someone trying to hide information?
In this day and age of digital technology, you can’t hide everything. For instance, there is always Google Cache!

February 4 is World Cancer Day. This year’s theme is “Cancer can be prevented” and how apt for we still see folks with late stage cancer at diagnosis. What can you do? You certainly can stand up and do something!

visit http://WorldCancerDay.su2c.org

Site may be down for a while as we plan to do an automatic WordPress update.

Who ever vetted this ad didn’t scrutinize the picture as carefully as Jimbo did. I agree, it’s Uninspiring

Do you know what the common allergens are in Malaysia? This is a often encountered scenario in the clinic yet there are so few clinical immunologists in Malaysia. The Malaysian Society of Allergy and Immunology has useful information in their website. Too often we only think about food allergens (not surprising given our food orientated culture. We musn’t forget about other home allergens which include not only house dust mites but cockroaches and animal dander.
Here’s a useful infographic about bed bugs and house dust mites:

Via: Allergy Asthma Technology

from TakNak1Care in Facebook