By Sarah Mori
IT'S for urticaria, the pharmacist said.
I slapped my forehead.
'You used it for mouth ulcers?' he asked.
'Yes, a few times,' I replied sheepishly.
'At least, you're still alive,' he quipped.
No wonder it tasted strange! Ergo, when I went to replenish my medication from another doctor, I consulted the pharmacist there. Both tubes of ointment prescribed by my previous doctor had almost similar colour, size and Japanese name. Besides, I had forgotten that I had discarded the depleted canker sore cream.
Anyway, I was not the only careless one. There was a case whereby a chemist accidentally dispensed a wrong drug to a patient because its name was quite similar to the one prescribed.
In Japan, most hospitals and clinics do not dispense medicine at their premises for outpatients. The pharmacies are in the vicinity.
To avoid liability and for the patient's reference, the chemist issues a printout with the pictures of each medicine, its indication, strength, dosage administration, adverse reaction and precaution to be taken. I used to throw away the printouts after reading the instructions.
For elderly patients, patients with children and absent-minded patients like yours truly, it's good to keep a record of one's medical history and prescriptions in a kusuri techo (medicine passbook). The chemist charges ¥50 (S$0.755) for it and another ¥50 for a label-like sticker (with the names of the medicine, strength and dosage) to stick it on your kusuri techo.
If you forget to bring your kusuri techo, you can stick it on the booklet at home.
With all the information in one book, other specialists can avoid prescribing certain medication that would cause adverse reaction to the medicines you have been taking. Moreover, if you need to seek a second opinion, the specialist can ascertain whether your medication needs to be changed.
The first time I visited a chemist, I was required to fill in questionnaires (in Japanese) regarding my medical history and allergies to any medicine, as a precautionary measure. The chemist helped with those questions that I could not understand.
Being a regular patient of two clinics, the dispensers know me well and counter-check my prescriptions. They keep a record of the medications dispensed. My dispenser once noticed that a certain drug would weaken the efficacy of the antibiotics prescribed together on the list. He phoned my doctor whose clinic is just next door, to change it to another type. When my prescription had new or more medications than usual, he asked me for feedback.
Not all drugstores dispense prescribed medications as they only sell over-the-counter drugs, toiletries and other products. Once, when my eye examination with the opthalmologist ended at 7pm, all the drugstores around that university hospital had closed.
My family and I had to fly off to Okinawa early the next morning for a sightseeing trip. With the list of addresses of dispensers given by the hospital, my husband drove me around to hunt for one that was still open. I found a drugstore near our home that could order the eye drops and keep them for me until I returned.
Later, I discovered that there is a grace period of four days and someone could collect the medication on my behalf with my health insurance card for confirmation. If I failed to do so within that period, I would have to see the doctor again for a new prescription.
As many pharmacies have sprouted up around that university hospital, the competition is so stiff that they have upgraded their services by installing televisions, and stocking their premises with magazines, books, and offering free drinks and candies.
At a big pharmacy which I frequent, a pharmacist walks around to attend to the patients' needs while her colleagues prepare the medications behind the counter. She kneels to talk to a patient sitting on a chair. What marvellous etiquette!
That pharmacy has sped up its service with a machine for patients to feed in their prescriptions. A piece of paper with a number then rolls out. A vending machine provides hot and cold drinks in paper cups at the back corner. On a table beside it are stick sugar, gum syrup, cream, plastic spoons and napkins. The drinks are said to be on the house, but they might be included in the bill whether one drinks or not. Thus, I often drink a cup or two.
Although my husband contributes monthly to his company's health insurance for our family, we still have to foot 30% of the bill. One can opt for available generic drugs that are cheaper than branded drugs. Most drugs are in casings and put in envelopes together with the printout. If they are in loose form, each tablet is packed in plastic envelopes, making them look like a strip of film!
And before the patient leaves, the pharmacist would customarily say: 'Odaiji ni! (Take care!)' Such is the dispensing system and services in Japan.
Sarah Mori is a Malaysian married to a Japanese and has been living in Japan since 1992.