User Voice : From Dr.Vtharavath : D Pharm Pharm D going to replace doctors
-oOo-
A speech by a senior official of IPA forced me to write this article: I request you to spend few minutes for reading this article.
Is there anybody clearly aware of the PharmD course? If not, here are some points and it is the time to think about it.( Another headache for the doctor community.)
It is approved by the Government of India, Ministry of Health vide letter No. V.13013/1/2007-PMS dated 13th March 2008 announced in the Gazette on India dated 10th May 2008.
Being a doctoral degree, a person with PharmD qualification can keep Dr. as the prefix to his name. So he becomes a Doctor. It is a course of six year duration after +2 (more than that of MBBS course and imagine the situation of BRMS course!!!) and it should be conducted in a teaching hospital. It is a clinically oriented, community pharmacy course. According to the rules and regulations given by the PCI, the institutions which are starting the PharmD course should provide 300 bed hospital facilities. It is as good as starting a medical college.
As per the PCI guidelines: For PharmD Courses
Hospital posting. Every student shall be posted in constituent hospital for a period of not less than fifty hours to be covered in not less than 200 working days in each of second, third & fourth year course. Each student shall submit report duly certified by the preceptor and duly attested by the Head of the Department or Institution as prescribed. In the fifth year, every student shall spend half a day in the morning hours attending ward rounds on daily basis as a part of clerkship. Theory teaching may be scheduled in the afternoon.
One can understand the truth behind it while going down this article.
According to IPA, the justification for introducing this course is that (recently I came across a speech by a senior official of IPA) in the present days the pharmacists are not getting the required acceptance from the public and health community, because of the existing structure of syllabus and curriculum of the pharmacy courses. According to him there are around 60000 formulations in modern drugs. Hence it is difficult to remember all these formulations and its dosages by a doctor (will it be possible by a compounder to remember all these formulation and its dosages? If he is that much intelligent enough to remember all these formulations, he would not have become a compounder) and hence to eliminate any possible medical errors, the pharmacists must be well equipped with the subject that is clinically oriented and hence the new course. It is designed in such a way that it is more clinically oriented, community based pharmacy course. According to him main job of a PharmD person is to function as an interface between the doctor and the patients and to be with the doctors always during the consultation of patients. That means – that a PharmD person will be always with a doctor to advice the patients on drugs and its dosages.
He said that the Pharmacists are the back bones of the health care system (that means the doctors are peripheral isn’t it?) I heard the above quoted words directly from the IPA official’s speech. That indicated their ambitions and future plans. In practical, according to them, the doctor should only diagnose the disease and give a note to the so called PharmD doctors about the disease and health condition of the patients. Then these pharma doctors will prescribe the medicines (Imagine the situation of the doctor?).
Some of the roles of PharmD (community) pharmacists are as follows:
1. Patient medication history interview
2. Medication order review
3. Patient counseling regarding safe and rational use of drug
4. Adverse drug reaction monitoring
5. Drug interaction monitoring
6. Therapeutic drug monitoring
7. Participating in ward rounds – (what are they going do to there??)
8. Providing drug information at the drug information and poison information centre
That means ultimately doctors are going to loose the entire control of medicines and so called pharma doctors are going to gain the total control of medicines. In such a situation no medical representatives are going to meet the doctors and there will not be any up gradation in the drug information to a doctor. A doctor in the future is going to be unaware of any drug formulations. Doctors need only to diagnose the disease or carry out any clinical procedures and rest will be done by these Pharma doctors. Now the said course is introduced in India as if it is a doctoral qualification for pharmacy students and also to upgrade the Indian pharmacy education standard to the International level. But see that each improvement in this field is, definitely, at the expense of professional importance and freedom of doctors.
Actually this is to bifurcate or to reduce the medical importance of present day’s doctor. Definitely these pharma doctors are the old wine in a new bottle. In olden days when the doctors were less the compounders were practicing modern medicines. I have seen in my child hood days many compounders practicing modern medicine. I believe that this is the latest move by PCI to bring back the extinct “medicine practicing compounders” again. Definitely a tough competition between doctors and pharma doctors will be created in respect of powers, position and importance in the health sector, in the future.
Really we should be ashamed of speaking about our greatness after degrading ourselves by promoting a 3 1/2 year BRMS course. Considering the PharmD course, our MBBS degree must be renamed as DBBS— Bachelor of Diagnosis and Bachelor of Surgery!!! This situation must be considered and must be thought of at the beginning itself. A remedy must be formulated to save the future of the entire doctor community.
It is high time to reorganize and upgrade the structure of modern medicine. Why we are not taking any positive steps in this regard? While every sector in the health care system are trying to upgrade or reorganize their structure and curriculum, we are traveling in the reverse gear— Going down for 31/2 year BRMS course.
In my opinion, MBBS should be of 7 1/2 years duration and the curriculum should be modified to compete with and to maintain the importance of the doctors in the health care system of India.
Or even abolish the Bachelor degree and make the medical degrees as an integrated postgraduate specialized degree instead of mere MBBS graduation.
We cannot stop others from changing, but we have to reorganize or restructure ourselves to go atleast one step in front of others.
In the pdf file (also attached herewith) you can see the following sentences: The file is from the following link:
http://www.acpi.in/CPE%20Mangalore%202009/Current%20Scenario%20and%20Future%20Prospectus.pdf
While going through the above file, one can judge to what extent a doctor will be loosing his freedom, importance and involvement in the health care of the people.
•The perception of government toward pharmacists received a setback when in the year 2002, when a Government committee suggested review of the licensing conditions that there is no requirement of pharmacists in distribution and sale of drug.
•If the kind of regulation proposed by the Government of India comes to force probably medicines will be distributed by trained assistants through public Distribution System shops (Ration shops).???????
These words shows that they are really scared of their future and the sentences imply that the govt was planning to take off the licensing system for trading drugs. They are well aware that this situation is going to arise in the future. It is very clear, that the pharmacists are trying to find out some means for their existence in the future. Hence they try to enter in to the clinical practice by modifying their structure of curriculum to more clinically oriented ,saying some justifications for defending any objections or resistance from any side. They will definitely have a claim on clinical practice too; similar to the one they are having now for dispensing medicines. It is the fundamental behavior of Indian pharmacists which spurts out of their egos.
http://www.pharmainfo.net/interviews/executive-interview-qa-drbsuresh-pharmd-program-india
You may please concentrate on the answer of first question in the above link which I quote below. What does it mean?
“This experience will enable the pharmacist to advise, consult & help doctors in dispensing medicines to patients, to play a role that is based on KNOWLEDGE and NOT JUST POSITION of the individual and also provide the pharmacist with a role at par with doctors.”
That is their ambition.
They are really at par with the doctor at least as per the guidelines by the PCI. It is neither mentioned any where in the guidelines stipulated by the PCI nor in the PharmD syllabus that a student must “help” or “assist” (they purposely avoided the word “help” or “assist”) the doctor during their hospital postings. They are trying to be “at par” with the doctors.
Came to know that PCI is having a plan to, gradually, phase out BPharm Degree in few years, by giving opportunity for existing BPharm Graduates to attain PharmD by some method, as done in USA earlier.
The pharmacist’s associations and their community itself working hard towards the firm existence of their future and better placements of future pharmacists, but in the contrary, doctors are not even aware of their present situations. Many of the doctors may be feeling that they have achieved every thing but are not aware of what they are loosing gradually. By introducing PharmD course (no one can say no to it) the pharmacists widened their scope of the profession in the manufacturing and trading drugs and also in the clinical side of the health care system. They are trying to become the back bone of the health care system. Apart from the above, the following are some of the numerous and diverse career options available to PharmD Graduates:
v Community Pharmacy
v Hospital Pharmacy
v Pharmaceutical Industry
v Pharmacy Education
v Bio-medical research
v Geriatric Pharmacy
v Governmental Agencies
v Home Healthcare
Where are we, the doctors???
The doctors should be the back bone of the system. No body should try to be or even dream to be at par with the doctors. We have to take the initiative to force the govt to redesign the MBBS curriculum immediately otherwise no one can predict the doctor’s fate in the future, because…. we live in India.
Please be kind enough to patiently go through the article in the following links.
http://www.opas.org.br/medicamentos/site/UploadArq/who-pharm-97-599.pdf
http://www.pharmabiz.com/article/detnews.asp?articleid=19835§ionid=50
From the above link few sentences are quoted below.
“A closer look at the current pharmacy practices would make it clear that there are either very slow or no reforms in laws affecting pharmacy profession in the country. There is no separation between prescribing and dispensing.”
“There is an urgent need for integrating pharmacy training, education and human resource planning. Such a move can bring in the dignity and equity to pharmacy profession on par with other health care professionals. Such a dignity would automatically sensitize the population on the ”legitimate need” for having pharmacists as an integral part of the health care system.”
Also see the following link
From this link the message is:
“The pharm D course will enable graduates to assist doctors in clinical practices and help them suggest better drug protocols and dosages”
“Unlike the existing three-year B Pharm course which limits the role of pharmacy graduates to the industry or the drug store, the new course will enable pharmacists to assist doctors in clinical practices and help them suggest better drug protocols and dosages. This would make them competent to measure blood pressure and glucose levels or even suggest alternate brands of the drugs to patients. “
If it is so, then there is no need of representatives of medical manufacturers to enter into the OP of a doctor. Doctor’s situation will be just like the
“JADAYU IN RAMAYANA”- The wings chopped off
Whatever the philosophy the pharmacists speak, the requirements and ambitions of the pharmacists are very clear from the above few quotes from the respective links shown.
My language and expressions may be different, but I will be much privileged, if this mail becomes an eye-opener to our community.
If you are interested, may please go through the site shown below. One can see how much the pharmacists are active and involved in health matters, nationally and inter nationally, trying to keep their importance always in the forefront.
i’m a 1st yr MBBS student n feel dat ds artcl s so infrmativ n t shud b bring 2 d attension f respctd authritiz,media,entire medico community n socity 2 unveil ds peril…
is nt t so..???
good work by d author..!!!
Hello Dr.Vtharavath!!!
Do u even understand what u r trying to speak out? U sound like a loser, who is jealous of other people succeeding in life. How can u be so SELF-CENTERED, SELFISH and egoistic! U are speaking as if we will get PharmD without any hardwork. Sorry sir! the scenario is way different out here. Have u even tried to know ABOUT the course rather than comparing it with MBBS? U are more bothered about loosing ur HOLD (so called ‘respect’) on the society, rather than realizing that there 1000s of patients suffering due to the wrong prescriptions (mostly, the reason being that they are unaware of the new formulations). So u please respect other professions too. They help the public in some way or the other. And every1 has worked as hard as u sir in the process of getting their respective degrees. Comparing Pharma doctors and MBBS doctors is really not a good idea and will end-up in a big quarrel. It should work hand in hand for the proper functioning of the health-care system.
THINK ABOUT IT!!!!!!!!!!!
live and let live
Proud PharmD
sir! its not point to debate,,, who is better……. we are here to serve patient…… we are not going in field of war,…… doctors to dignos and pharmD to prescribe, whats wrong with it…….
i’m 1st year Pharm D student n i feel dat d real job of MBBS doctor is to diagnose a disease and not to prescribe medicine and dat is the way it shud be.And introduction of pharm d course is for the betterment of the society and not to jeopardize the status of medicine doctors.moreover both d doctors(Pharm D n MBBS) shud work together to improve health care system in INDIA.
Sir/Mr/Dr(as u like it),
I am a first year PharmD student and i would like to tell you that this course is not to replace u guys, so just chill.We are here to fuel the growth of the health industry and it’ll be our synegy that’ll be helpful to the patients.If you really want to know as to what we(pharma docs)do in ward rounds,plz join a hospital which has this course.We are not at war with the physicians(‘doctors’ as u prefer it).
so last but not the least,
WE ARE OLD WINE IN A NEW BOTTLE!
bcoz old wine is more precious(if you didnt know).
I am a PharmD(PB) student and As I see this , a physician will always remain the ‘captain of ship’ if we consider healthcare system as a ship. so M.B.B.S students dont require to be insecure. Your course is rocking and high class …no doubt about that… u people study anatomy and physiology in detail like no one else… but hey we PharmD people are not that bad either … we r no fools and we study… THE DRUGS -in detail.The drug induced diseases, adverse effects, Drug interactions etc .. other many aspects all related with Drug….
Me iam a pharma student and All i can say is that a MBBS student learns diagnosis, surgery and also drug actions and all and all together in just 5 years that too with internship and where as a Pharma.d go on with drugs mostly from the begining to the end of his course of 6 years with internship so relatively he will be a specialized in serving the communtity with the specialized knowledge not with just a basic knowledge. just Its a specialization course nothing to deal with the jealous agitations….be happy as the almighlty rewards to all.
I think add few subject and make it MBBS plus so that the crisis is over may their speculation be answered as a good for the society and health care system this is to done by MCI & PCI this will give a better result for health care and this will solve unemployment in future rather than introducing 3 yr MBBS
hi iam V th year pharm.d student,our PCI is very very very worst so we faced all those problems.
hello sir, we, the great PharmD students r learning about the drug throughout, whereas, u r learning it as a part. so, it is very evident that v wil b better in the knowledge about drugs, than u people. knowledge plays a major role, than the profession. Wait and see. V hav a gr8 knowledge about drugs nd dosages than u. V r no more less than u. Ur words sounds as if u r a looser. Dont b scared. Try to treat every1 equal.
Pharmacist to Public was the slogan for the pharmacy week 2012
Why not Pharm-D (PB ) Plus Diagnostic skill During Internship after a Test for Qualification- shall be greater than MBBS .And it shall be solution to the following problem which is the greatest problem for country like India- (there is less than 0.5 Doctor per 1000 people compared to 5 per 1000 in US and west and less than 0.3 Pharmacist per 1000 people compared to 5 per 1000 in west this shall remove the disparity to a greater extent at a greater speed in health care scenario then waiting for people to learn and come.) Today India need more service personnel than speeches of pastry.” Pens don’t heal only medicines do”