Table 2. Themes and illustrative quotations.
| Themes | Illustrative quotations |
|---|---|
| Pharmacists envisioning their main role as dispensing medications | P3: So again it’s quite dangerous in the sense that you tend to question or query about the safety of the medication because these technicians, they are basically not trained. So they will just follow whatever the doctor has written or ask them to do. P6: We, pharmacist (will) give out the medication instead of the nurses. P11: The pharmacist will be assigned to dispense medication and at the same time provide some advice or information to doctors. P2: I think that will a good thing because if there is any mistake or anything that the doctors do, pharmacists will be able to pick up so they sort of counter check on each other. |
| Difficulty envisioning roles beyond medication supply (i) Limited roles for pharmacist in private GP clinics (ii) Perceived roles similar to pharmacists in public hospitals or clinics |
P11: So pharmacist will be assigned to be the person in charge for dispensing medication. And the same time can provide some advice or some information to doctors. P2: I’m not too sure what other services they (pharmacists) do (in a private clinic). Or perhaps I have not given much thought to it. P11: Maybe you can have some pilot study… see how is the outcome (about integrating pharmacist into clinic). P10: First thing is dispensing separation has to be done first la. Without this, we cannot do any further la. Like change dose, prescribe medication, all of this is beyond our scope. Now the limiting factor is the dispensing separation. P1: By seeing the common illnesses, I (as the GPs) can earn money also so why do I need to put a pharmacist in my store (clinic) just too maybe see what I’m doing. P1: People (will) know what pharmacists do instead of just dispensing (medication)… A lot of people don’t understand actually the role of pharmacist. So this will bring up the value of the pharmacist in Malaysia. P9: Like (in) klinik kesihatan, pharmacist actually do more than the dispensing role… the pharmacist makes an appointment with the patient, have a small group discussion or finding out the (medication-related) problem with the patient before referring to the GP. |
| Lack of support and recognition by consumers and private GPs (i) Poor working relationship with private GPs (ii) Lack of recognition from consumers |
P4: Doctors are protecting their prescribing rights, pharmacist want their dispensing rights. Both are fighting for their own rights so it’s difficult to work closely for the time being because of the dispensing issue. P12: These days, pharmacist and GP are like enemies. We don’t communicate. P2: (The challenge would be) getting the doctors to work with pharmacist. P18: The major problem is the doctors view it as pharmacists trying to share a piece of their cake. P5: In order for this (pharmacist integration) to work, they (GPs and pharmacists) need to be able to work together. P14: For some people they don’t believe in pharmacist because they think that doctor is more superior, more competent. So we have to change the perception of the public. P9: Traditionally, Malaysian patients look up to doctors like God. So whatever the doctors say they will listen. So maybe we (pharmacists) are quite difficult to come in. |
| Cost implications from integrating pharmacists into private GP clinics | P18: I think from the doctor point of view is the cost. Because you may not want to hire someone, another 6 to 7k just to dispense medication. P10: The objective is good but it’s not practical… Even the doctors are cutting budget for their locums. P9: It’s something to think about because at the end of the day, the cost will be passed on to the consumers. So if you are going to adopt this idea, it’s (medical bills) going to escalate even more. P10: The service charge, consultation also will be increased. They have to pay the consultation fees to doctor as well as the consultation fees for pharmacist. P13: I think if you (pharmacists) play your role well, I think yes (for consumers to pay). Why not? P9; Depends on what service (provided by pharmacist). P5: No, because in the first place they are already asking for cheaper prices for medications, what makes you think they will actually pay extra 5 ringgit for consultation. P2: If it’s out of their own pocket, no. I don’t think there’s such thing as pharmacist consultation fee or anything like that. P5: I suppose private clinics could actually get some sort subsidy from the government. |
(Note: ‘la’ is a suffix of no standard meaning used in the Malaysian colloquial)