Day 1: Community Pharmacy in Vietnam

Following our journey to Da Lat, we began working at the Louis Pasteur Polyclinic. The clinic has approximately 50 employees including doctors, pharmacists, and nurses. The setup of the clinic consists of general medical practitioners, a lab for blood work, an injection room, a pharmacy, and specialists in areas such as: ophthalmology, pediatrics, dentistry, dermatology, radiology/imaging, cardiology, and OBGYN. 

Our day began with a meeting with the director of the clinic where she outlined the program and elaborated on how we would spend our time. We will be splitting our time primarily between the pharmacy and vaccination room, with a little time in the microbiology lab where we would see and participate in numerous rapid antigen/antibody tests for infectious diseases and other diagnostic testing. 

After our meeting with the director, we went to the pharmacy and it was truly eye opening. The general process of filling a prescription was surprisingly similar. A patient would be seen in the clinic by a nurse or doctor and then drop-off the prescription at the pharmacy. The pharmacist then inputs the prescription information into the computer to a generate a price for the medications and then proceeds to fill them. Once finished, the pharmacist calls the patient over and reviews how to take the medication & the patient then leaves the clinic. However, the differences significantly outweighed the similarities. These differences include a lack of a patient database in order to run interaction checks, DURs, or patient-specific dosing. There is also no formal scheduling of prescription medications to deter abuse, and a lack of patient privacy expectations. When the pharmacist makes a label for the prescription, it is on a tiny, photo-copied piece of paper that indicates when to take the medication, how many to take, and whether to take the medication before/during/after meals (that’s all). Once the label is filled out, it is then placed on to the blister pack/ziploc bag/stock bottle with a piece of tape. The “final verification” is done when the pharmacist counsels the patient.

While taking note of the similarities and differences between the practice of pharmacy in Vietnam and in America, Colin and I also got to assist the pharmacist with filling and labeling prescriptions (in Vietnamese). As we filled prescriptions, we noticed that it took significantly less time for a prescription to get filled in Vietnam (approx. 2 minutes) than it does in America (at least 15 minutes at most drugstores). Part of this is due to that most patients in Vietnam (almost all patients seen in our clinic) do not have forms of health or prescription insurance, so there is no insurance adjudication required. Patients will pay out of pocket for their medications, which are extremely reasonably priced when you compare to the US (more information on Rx drug pricing to come). We were exceptionally thankful that we did not have to deal with insurance problems, as January in the US is the most dreaded month for all pharmacies because of changes to insurance plans.

The highlight of our first day came when an American man arrived at the pharmacy with a number of prescriptions from the clinic. After filling his medications, our pharmacist asked us to counsel him on the medications because she did not know enough English to counsel. The gentleman was surprised to see other Americans working at the clinic, but was grateful we were able to communicate so thoroughly regarding the directions and common side effects of the medications he received.

When our first day at the pharmacy came to end, we returned to our hotel with a great amount of excitement for the remainder of our time at the clinic and a readiness to learn more.