Which is More Important? Health or Opinion?

Parent came to collect medicine and when I told her the patient need to take half a tablet, she started telling me her child does not take tablets. In consideration that her child is still quite young to be swallowing tablets, I advised her to crush the tablet and mix it with some water. She then started telling me that her child would not take the tablet because it tastes funny. When I told her to mix with syrups, she said her child only drinks water and does not take syrups.

Really pissed me off when she said that and started asking me if there is another medicine that has similar effect but in the syrup form. What is wrong with her. If the child does not take the medicine, the condition would not improve. Which is more important? The health of her child or the child's opinion that the medicine tastes bad? Anyway, even if the medicine tastes bad, I had already suggested mixing it with syrups. If there is a syrup formulation available would I purposely deny her the option to change?!

Note: Parent is an ang moh...

Not All Malays are Called Ahmad

The bus was super crowded today and when it reached my hospital, I heard this lady saying, "Eh Ahmad, open the front door?" For goodness sake, not all Malays are called Ahmad. Can you imagine people calling you Ah Huay or Ah Lian just because you are a Chinese?

It's the same with this patient who mistook my technician to be a Malay and decided to call her Fatimah without bothering to ask what her name was. She's a Philippino by the way.

A Coffee Bean Story

Was at Takashimaya's Coffee Bean this afternoon with a friend. Coffee Bean's crowded as usual but I managed to spot a table for two so I went up to it. There was this girl (let's call her Yellow since she was wearing a yellow shirt, doesn't deserve a better name anyway) who took a table for 4 next to mine, but I think the cleaning auntie thought she was alone so she separated her table to make 2 tables for 2.

Okay that's fine except when her friend (Red) came, she was wondering why they cannot have a table for 4, so she wanted to join my table to theirs. Took quite a while for the dense kid to realise that I am occupying the table. Singaporean kids are as stupid as the adults; there's no hope for this country.

After they got themselves settled, they took out their homework to do. The cleaning auntie who was there earlier to separate the tables came back and told them to adjourn if they need a place to revise their homework as this is a cafe for people to eat and drink. Red then shot a disgusted look at the auntie and banged her drink down saying she's a customer there as she had ordered a drink and therefore had the right to be there. Okay, fair enough. However, there was no need to get nasty. Yellow started shouting at the auntie, asking for her name yada yada. The auntie couldn't take it anymore and just told Yellow in her face to go ahead and complain. *Big round of applause for auntie*

Half an hour later, the manager came along and asked them if she could separate their tables as they are only 2 but occupying a table for 4 and there are many people waiting for seats. Those 2 lied through their teeth saying their friend was coming soon. Waited another 15mins, and the manager came back to ask if she can separate the tables. Red repeated the lie about their friend coming soon. The manager repeated that there are many people waiting for seats and patiently asked them to let out 2 seats. Should their "friend" arrive she would arrange for the "friend" to have a seat.

Yellow started getting angry and asked to speak to the manager. She did not realise she WAS speaking to the manager. When she found out who she was speaking to, she started accusing the manager of chasing them out of Coffee Bean, questioning the way Coffee Bean treats their customers and asking the manager if she knows that as customers they have the right to be there etc. Look kiddo, you're totally off tangent here. Nobody's chasing you out. The manager was just telling you to count the no. of butts you have and occupy only the necessary number of seats. *roll my eyes* Do you seriously think people would be scared of you just because you take down their names?

Anyway, after the manager left, Yellow started f***ing everything. Such loose morals and she's still young; to think she can f*** in public for all to see and hear. *blush*

No Refund Means No Refund

Parent called up to ask if there is a refund for 2 bottles of syrup that she collected for her child as the doctor has stopped the medication and she has no use for the medication anymore. She had called up the main pharmacy and was informed that the hospital has a no refund policy should the doctor discontinue the medication. Nevertheless she must have thought I would give a different answer so she decided to call up my pharmacy, but unfortunately for her I gave the exact same answer. I mean, it is the hospital's policy if different sections of the pharmacy give you different answers then something must be really wrong with us.

Anyway, I tried explaining that there are only 2 conditions for refund:
1. Patient develops known side effects with the medicaiton.
2. Patient develops allergy with the medication.
In both cases, the doctor would still have to examine the patient and write a memo saying they've examined the patient and have concluded it is either case 1 or 2 before we can actually do a refund.

Besides, for patients' safety sake when we take back refunded medicine our hospital chooses not to resell to another patient because we cannot guarantee that the first patient has kept the medicine in good condition. The parent insisted she kept the medicine in good condition, but that is absolutely not the point here. Putting yourself in other people's shoes, how would you feel if you were to receive medicine that another person has brought home for over 6 months, and you really have no idea what kind of condition the medicine is stored in except the words of somebody who is desperate for a refund. As pharmacists we tell patients to keep the medicine away from direct sunlight and heat, but frankly speaking, Singapore's weather is not ideal for storage of medicine no matter how away from direct sunlight and heat you are keeping your medicine unless you're telling me your house is air-conditioned at 21 degrees C 24/7.

Anyway back to the story, she then said she had to write off $300+ worth of medicine which I find puzzling as each bottle only costs $30+. When I told her the price of one bottle, she insisted I got the price wrong. Got really pissed off with her by then, told her to check her receipts and she got snotty and said she had already submitted her receipts for claims. I mean what can I say, I had the computer right in front of me and I was looking at the price from the system. If she chooses not to believe me I am not going to try and convince her; she did not sound like she wanted convincing anyway.

In such cases whereby we cannot do a refund, we usually would offer to help them arrange for their medicine to be donated to needy patients. I have personally encountered parents who generously donated their unused medicine (we are talking about 20+ bottles of medicine NOT just 2 bottles) to needy patients and were really understanding when we explained that there is a no refund policy. This idiotic parent had to distort the whole offer by saying the hospital is doing charity work with public money. That is really funny, I did not recall forcing her to donate the medicine so what was she so uppity about.

I know it is unfair that the doctor had stopped the treatment and patients are left with unused medicine, but hospitals cannot absorb these kind of costs. If the public really wants the hospitals to absorb such costs they can expect healthcare costs to increase tremendously to cover for such loss in income as the hospitals cannot afford to go into the red every financial year. There is no such thing as Progress Package for the hospitals when they go into the red.

She then complain that she had to pay the full price of the medicine and nobody ever asked her if she wanted to only collect part of the medicine nor inform her that there is a no refund policy. Big time lair (that's what I hate about Singaporean patients). She mentioned earlier that she submitted the receipts for claims so how did she suddenly end up paying for the medicine. WE DO NOT FORCE PEOPLE AT KNIFE POINT TO COLLECT ALL THEIR MEDICINE. The choice is always the patient's to collect all, or part of it, or none at all. If you got all the moolah and wanted to collect all the medicine we cannot be wasting time convincing you not to collect the medicine can we. As for no mention of no refund policy, pls read the receipts. It is printed on every single page that there is no refund for medicine. Oh, how forgetful of me, she submitted the receipts for claims hadn't she.

The worse thing was she threatened to write to the papers. Her exact words were, "There are many ways to get to the media okay, and I hope they publish this so that other patients know what it means to collect medicines from your hospital." What can I say, I agree there are many ways to get to the masses, and I am doing it one step ahead of her by publishing on my blog while hers wait in line for approval.

To end this post, I just want to ask the Singaporeans out there:
Do you go to Guardian or Unity pharmacy to buy medicine, use it for a week or two and then go back to the pharmacy to ask for refund for the remaining unused medicine? If you've done it before, be thankful that pharmacies are run by civilised people who do not chase you out with a broom.

So What if You're A Lawyer!

Doctor ordered a painkiller for a patient in the middle of the night. No problems here except this particular painkiller, let's call it TC, was recently reclassified as a controlled drug (CD). Nurse was unable to obtain TC from A&E pharmacy, and paged the oncall pharmacist (me) for supply at 6AM. Told the nurse this drug is reclassified as CD so there is no way for anybody to supply after office hours because oncall pharmacist does not hold the key to the CD cupboard. Best bet is to ask the oncall doctor to change the order to some other painkiller or for that matter to some other CD that is already available in the ward.

Nurse then started telling me that the patient's husband was barking in the ward; he was not happy why he cannot get the drug and started telling anybody who is interested that he is a lawyer. Excuse me, so what if you are a lawyer. Is a lawyer above the law? How can you be a lawyer and do not know that the use of medicine is controlled by the Poisons Act, Medicines Act, and Misuse of Drugs Act in Singapore. I'm not even asking you to quote me sections or chapters from the acts, but fact is these laws are set in place to protect the public from their own stupidity when it comes to the use of medicines because Singaporeans have a tendency to think they know-all.

CDs, by the way, comes under the Misuse of Drugs Act. This is the very same act that states that if you dare come into Singapore smuggling cocaine, morphine or the likes, you'd be hung especially if the amount brought in exceeds that stated in the law. In the hospital, every single tablet and millilitre of controlled drug has to be accounted for, be it ingested by patients, or accidentally dropped onto the floor. Nurses hate it when accidents with CDs happen cos they have to fill up forms to account for every single step that led to the wastage of the CD. After filling up the forms they have to bag the CD and return to the pharmacy for the Central Narcotics Bureau officers to come and destroy. Everything is official, and has to be documented in black and white. It is that serious. Okay, I've side-tracked.

I am really pissed off when people abuse their positions in society. So what if you are a lawyer, am I suppose to be scared that you may be able to sue me? Can I counter-sue you for threatening me? It's ludicrous how people still live with such an ancient mindset that their profession gets them VIP treatment. Just imagine this, I go to Popular bookstore and the queue is super long, so I use my profession to threaten the cashier, "I'm a pharmacist, and if you don't speed up or don't let me go first, I will first, complain to your management and then make you wait just as long when you come to my pharmacy to collect medicine."

Back to a more serious note, the moment somebody says he/she is a lawyer, you immediately sit straighter, take longer to answer questions (you got to be sure you are not using inappropriate words that would land you in court), and 90% of the time you would acquiesce to their requests (we are just earning our daily bread, no need for bloodshed that is going to be paid with year end promotions and bonuses). As in any argument, usually the more vocal side wins, and these guys are trained to argue with logic. Pit your average stupid Singaporean, who cannot even speak standard English much less talk with logic, against these guys there is no need to guess who get their way in the end.

And the "I'm a lawyer" statement is just a ploy to scare the silly shit out of the average Singaporean so they do not even argue in the first place. Got to conserve the energy to argue with the likes of me who does not give a damn lawyer or not. Got to go catch some sleep. Stupid lawyer barking in the ward and disturbing everybody's sleep...

It is the Same Medicine!

Patient was prescribed diclofenac 75mg, but upon dispensing she said that that was not the medicine she showed the doctor. She then proceed to show me a strip of medicine. Took a look at the strip of medicine and told the patient it is the same medicine except the one she was holding is a 50mg tablet. Essentially it means when you're in pain, you need to take the medicine more frequently than a 75mg tablet.

Simple concept right? No. She insisted it was a different medicine despite me and her husband trying to explain to her that it is the same medicine, but of a different strength. Just when we thought we had finally gotten through to her, she started asking me if the 2 tablets are the same medicine. This happened about 3-4 times. Really wanted to tell her to shut up and ask her if she was paying attention to what I was telling her. If not for her sensible husband I would have done just that.

What's Ur Hurry?!

Was alighting from the bus yesterday and there was this lady trying to scan her EZ-link card before me although I was physically standing in front of her at the bus steps. The bus door was already opened, and instead of letting me scan my card and then alight first she had to fight to scan her card first. She still ended up having to wait for me to scan my card and alight before she can alight from the bus since there was no way for me to move aside to let her alight first. She's either being rude/ an air-head*.

*Delete where applicable.

Seats Are Not For Your Feet

This is an observation. They had done nothing to directly irritate me, but I just cannot stand their behaviour.

Took a bus home from Orchard yesterday, and there was this couple sitting in front of me propping their feet (with shoes and all) on the seats in front of them. (I'm talking about the first 2 rows of seats which usually face one another.) No doubt the bus is not crowded and other passengers probably can get seats elsewhere on the bus, it is still inconsiderate to be propping one's feet on the seats. Seats are intended for the butt. How would you feel about sitting down on a seat which has been dirtied by other people propping their feet on it? Luckily the couple have not stepped on some turd else it'll really cause a nuisance to other passengers and to the driver.