Relieve doctors of the role of pharmacist

PUBLISHED : Monday, 23 April, 2007, 12:00am
UPDATED : Monday, 23 April, 2007, 12:00am

We all make honest mistakes and doctors, for all the training and care that they take, are no different. To err is human, after all. But honest mistakes rarely wash when it comes to our foremost priority in life, our health. The most stringent possible system has to therefore be put in place to reduce medical errors and ensure patient safety.

Authorities claim to have such measures in place when it comes to private doctors dispensing medication. The system is clearly inadequate in light of our story today about a three-year-old girl who was taken to a Tuen Mun doctor and given cough medicine that burned her throat; analysis by the hospital her worried parents had rushed her to revealed the syrup contained the disinfectant Isopropyl alcohol, which can cause death if swallowed in large enough quantities.

Hospital staff were quick to spot the mistake and the girl was sent home after treatment. A Health Department investigation is being carried out into how the mix-up occurred.

Medical authorities have declared the incident to be an isolated one and that we should not worry. Guidelines are in place, they reassure us, that protect patients by indicating that doctors should check the medicine that has been prepared from their dispensaries by assistants for patients before handing it to them.

This would be fine were it not for the incident being the latest in a string of similar ones in recent years. At least 31 children were given an antihistamine wrongly diluted with the same alcohol by a Tung Chung doctor little more than seven months ago and one, a six-year-old boy, ended up in hospital. In May 2005, 152 people with stomach ailments were given a mislabelled drug for diabetes by a Wong Tai Sin doctor and four later died, although whether because of the mistake was uncertain.

These three incidents clearly show that the present system in which private doctors maintain their own drug supplies and have staff dispense them is flawed. As in public and private hospitals and in many countries the world over, proper checks and balances should be put in place by giving the role of dispensing medication to unassociated, registered pharmacists.

This would not entirely eliminate the possibility of errors taking place; even trained pharmacists can make mistakes, just as doctors and anyone else in a position of trust can do. But by clearly delineating a doctors' work into that of diagnosing an ailment and prescribing the medication necessary for it and leaving the dispensing to a qualified pharmacist, the risk of a mistake is lessened.

The errors also highlight the fact that private doctors' clinics are subject to few external checks. While doctors are regulated by the Hong Kong Medical Council, it usually intervenes only after a complaint has been lodged. Doctors also have to undergo continuing education to update their medical knowledge, but no mechanisms exist to ensure that they and their staff adopt best practices and abide by the highest professional standards.

Public faith in our medical system remains high, but it is being eroded by such incidents. Although health-care reform is under consideration by authorities, urgent attention needs to be given to ensuring that the possibility of doctors dispensing the wrong medication is minimised.

Relieving doctors of the role of pharmacist is the simplest way of achieving this.