The Effects of the New Thai Drug Bill
SUKHIT PHAOSAVASDI, MD*, SURASAK TANEEPANICHSKUL, MD*, YUEN TANNIRANDORN, MD*, AURCHART KARNJANAPITAK, MD*, CHUMSAK PRUKSAPONG, MD*, PINIT KULLA V ANIJA Y A, MD**
Affiliation : * Member of Thai Medical Association. ** President of the Royal College of Physicians of Thailand.
Two of the most popular and convenient approaches in obtaining medicine to relieve one's illness in Thailand are direct purchase of medicine from the local drug store or pay a visit to the rhysician at the clinic near their home for consultation. However, to prevent any misuse of medicine which can be hazardous or life threatening it seems appropiate that a new and improve legislation on medicine should be introduced for the maximum benefit and safety of the consumers. But the new drug bill may have adverse effects on the public especially article 13 which prohibits physicians from dispensing medicine in their clinic. For many decades Thai people have relied on local medical clinics for their basic health need so much so that over 8,000 clinics sprung across the country. Most clinics will have only one physi cian and one or two assistants, some clinics have regular office hours while most clinic open only in the evening or late afternoon and also on weekends or official holidays. This set up works well for many physicians who work in the government health care facilities during the regular office hours and supplement their income by providing the service after official hours. It also works well for the patients who can consult the physicians without having to take leave of absence from their work. Since the public voluntarily pays for the service out of their own pocket, it relieves burden put on the government to some extent and becomes a win-win situation for all parties, ie, the govern ment, the public and the physicians. The proposed article 13 of the planned legislation, if enacted, will revolutionize the grass root health care service as it will cause inconvenience to the public who are accustomed to the pre sent arrangement which is like one stop service, by paying a visit to the local clinic, the doctor goes through the usual ritual of history taking, physical examination and provide the necessary medications for the patient to take home after the diagnosis is made. What will happen when this arrangement is interrupted? In the urgent or emergency situa tion. the local clinic will be unable to provide adequate first aid service or necessary medication to relieve the life threatening situations such as asthma, heart attack, labor pain, severe cut and bruise. Under the proposed bill, after the examination, the physician has to write a prescription for the patient or their caretaker to buy at the drug store which may be miles away. What will happen if the store does not have the specified item in the stock? Will the patient have to go back and forth for the new prescription? Will the delay cause the loss of life? If so, who will take the blame? For the nonemergency situation like vaccination, the physican will have to write a prescrip tion for the parents to buy from the local drugstore and may have to carry the ice cooler for transport of the vaccine, not to mention the time loss. Contraceptive, especially of parenteral form, will definitely cause inconvenience and may result in poor compliance which will result in poor birth control and unfortunate sequelae that follows. The Thai society has gradually developed their health care need to arrive at the present con venient health system of acceptable quality. It has become a Thai brand of basic health care system suitable for all Thai. Why rock the boat when everything is going as smooth as it is?
Keywords : Drug Bill, Common Sense
