Monday, January 28, 2008

Be mindful of over-prescription and high charges

The News Strait Times 04/11/2007
Hospital apology: Be mindful of over-prescription and high charges

I HAD a bad experience in a private hospital in the Klang Valley when I went to seek medical attention for a slight cough and sore throat on the night of Aug 21.
I was led to a cubicle and sat on a chair for 25 minutes before a medical officer examined me. I had to wait another 28 minutes before my medicine was given to me by a nurse. I noticed a stack of tablets and asked what were they for. She told me that they were for my fever.

I had no fever. My temperature was not taken by the doctor or nurse, so why was the doctor prescribing 30 Panadol tablets? The cashier told me I had a bill of RM215.63 (medical officer’s fees being RM20 and medicine RM184.63).

On checking the billing, I found that I was charged RM1 for the use of the thermometer sheath and RM4.20 for a clinical roll. My temperature was not taken, neither did I lie on the bed which was lined with the clinical roll. I protested but I was ignored.

On returning home, I found that all that was prescribed was in excess, hence the high bill. The Augmentin antibiotic of 625mg each was presribed three times daily for five days and the Phensedyl dry cough Linctus Codeine cough mixture thrice daily at 15ml for five days. According to the leaflet in the Augmentin packaging, the dosage of 625mg should not be taken more than twice daily. The dosage stated on the Phensedyl packaging was between 5ml and 10ml for adults.

I called the hospital and spoke to another medical officer, who agreed that the prescription was in excess.

I decided not to take any of the medicine and saw a physician who does my annual medical check-up at the same hospital the next morning.

He told me that my sore throat was mild and prescribed Klacid antibiotic and Sedilix cough mixture.

I lodged a complaint with the chief executive officer of the hospital on Aug 22.

The hospital said the doctor worked part time at the hospital and worked at a government hospital during the day.

Finally, the hospital gave me an apology in writing and a refund when I returned the medicine.

I am highlighting this with the hope that it does not happen to others.

Ask the pharmacist
1) The writer is smart to read the information leaflets. But how many of the public actually do that?
2) This is how mistake can happens when the pharmacist is not involved in the process. Pharmacist will detect the error at glance for the Augmentin prescribed 3 times a day. Most probably the Dr is confused with the amoxicillin dosage and augmentin.

The patient is not receiving the full pharmaceutical care by a registered pharmacist.
Some of the simple counselling pharmacist can do for Augmentin.
a) This medicine may cause nausea or vomiting. So if the patient experience the symptoms, we will advise them to take small, frequent meals, sucking lozenges or chewing gum to help.
b) For best result, take Augmentin just before meals.
c) Rarely, some people may get slight yellow/brown staining of the teeth. Such staining usually disappears shortly after treatment if teeth are brushed regularly.
d) Report any rash, unusual diarhea, constipation, jaundice, darker urine, unusual bruising or bleeding. (anaphylaxis reaction) Online adverse effect form is available here.

3)If medicines is RM184.63 for 30 tablets panadol, 1 box augmentin, and 1 bottle of Phensedyl, then i can tell the writer, he can get from all these from the community pharmacy for half the price.

4)Always see your familiar or family Dr. He will be the one who understand u better as he has all your past medical record.


Ted said...

Wow, no wonder we are so poor. We are undercharging!

Usage of pharmacist's saliva to explain proper usage of medication -RM5

beyond said...

IF u ask me..Klacid is too strong for him too...Hahahah

Zitrone said...

The last time I had antibiotics for cough and cold was 2006. I self-medicate so that the antibiotics do not kill all my useful bacteria in the intestines.
Yes, I have the same experience at a private hospital when a medical officer attended to me. He could have given me a buscopan but he decided to put my on drip. I argued and he reduced it to a jab on my butt. Of course, it's instantenous effect with $$$ attached.
Frankly, as a pharmacist yourself, you should also complain about the hospital dispensary for being irresponsible. I only realised the responsibilities of a pharmacist after I encountered an instance where a pharmacist noticed my chesty cough and refused to dispense a cough suppressant prescribed by a doctor. I argued with her and I lost. Thank goodness.

Zitrone said...

sorry, i forgot to ask. Since you are a pharmacist, aren't you most qualified to self-medicate? Just take from your shelf lah.