E-DRUG: Empowerment of pharmacists in India
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Dear Sunitha Srivinas and all on E-drug,
I was interested to read your piece in the INRUD Newsletter July 2011,
in tribute to Dr Hogerzeil who has just retired from WHO:
"On the first day [November 29, 1999] of the course [on drug policy
issues in developing countries], when we were introducing a colleague on
the course, I saw Dr. Hogerzeil busy making notes and I wondered how he
would summarize the "introduction of colleague" session. little did I
know that my wake-up call was being prepared! Dr. Hogerzeil summed up
the stats of the countries and categories of health care professionals
that were represented. then he asked, "If from most countries, almost
equal number of doctors and pharmacists are represented, why is it that
in India, it has the most unequal representation" (my paraphrased
version). then came my wake-up call he
asked, "are the pharmacists in India sleeping?" I have NEVER forgotten
that sentence!"
This reminded me of my own wake-up call with regards to pharmacists in
India. I have little experience in India - just 2 months, spent
interviewing primary health personnel in Tamilnadu, including
pharmacists. My wake-up call was when I asked a pharmacist in a primary
health centre what he would do if the doctor wrote the wrong dose on the
prescription. He replied "When I was young, I pointed it out to the
doctor, but they would tell me to shut up and prescribe what is
written". I asked, "So what do you do now if, say, there is a wrong
dose, maybe even dangerous to the patient?" He replied, "I prescribe
what is written, it is not my place to question doctor." I have never
forgotten that sentence.
I have no idea whether this was an isolated case or if it is indicative
of broader issues relating to the professional dynamics and power
balances between pharmacists and doctors. If this is systemic, it seems
likely that large numbers of patients are at risk of harm due to
prescribing errors. The pharmacist I interviewed had clearly been
demotivated and put down early in his career through lack of opportunity
to exercise his professional knowledge. I hope other E-Druggers can shed
more light on this, in India and/or in other countries.
Best wishes,
Neil
Dr Neil Pakenham-Walsh MB,BS, DCH, DRCOG
Coordinator, Healthcare Information For All by 2015: www.hifa2015.org
<http://www.hifa2015.org>
neil.pakenham-walsh@ghi-net.org