The gist of the interview was to discover the role of pharmacists, especially clinical pharmacists, in the setting of unique countries around the world. Additionally, there was an interest in delving into cost effectiveness and saving of health care dollars spent in other countries in relation to the high expenditure in the United States with somewhat poor outcomes. What I found particularly interesting is that Dr. Demirkan is currently actively developing clinical pharmacy practice in Turkey as it does not exist. In fact, he is one of only two clinical pharmacists at Hacettepe University Hospital. Therefore the school of pharmacy and the hospital are partnering together to create a masters program which will be similar to completing residency in the United States in order to hone the skills of pharmacists to be able to practice in a more clinical role. This will include checking/calculating doses, developing monitoring parameters for safety and efficacy, looking for drug interactions or duplicate therapies, preventing undesirable side effects, conversion from IV to PO (by mouth) administration, and answering any medication related questions by physicians or other members of the medical care team. By improving patient outcomes through this more interactive form of pharmaceutical care, overall costs will continue to decrease.
Three other interesting facts about healthcare in Turkey:
1. The government controls the cost of medications by taking an average of the price of the medication in five different European countries and setting that amount as the price of the medication. This allows for the price of medication to be significantly cheaper than it would be in the United States.
2. Of all the European countries, Turkey has the highest use of antibiotics. Therefore the government is working to educate physicians, pharmacists, nurses, and patients on proper antibiotic use. Through these efforts it is hoped that usage will decrease to assist in preventing the occurrence of resistance.
3. The insurance system seems to be pretty fantastic. About 90% of the population has government insurance. Those employed by the government have coverage in addition to their spouse and children. Citizens who are privately employed can receive insurance for a small co-pay (I have the impression it is much less money than is spent for insurance in the United States). This insurance coverages almost everything. For instance, working individuals will pay only 20% of the cost of their medications while retired individuals pay only 10% of their medication costs. Hospital visits for the most part are free. The only downside to this system is that taxes tend to be rather inflated.
Overall, the interview was probably one of my favorite experiences I have had so far. Dr. Demirkan was incredibly informative and the conversation was enthralling listening to how he was educated in the United States but elected to return to his home country to help improve the quality of care and the profession of pharmacy in Turkey. Quite an impressive individual and very hospitable to answering any and all questions I had to the best of his ability. Additionally, he provided me with his business card and phone number in case I had any follow up questions and invited me to come back to his office for a visit again before I leave next week (which I will definitely be taking him up on, especially because I forgot to get a picture taken with him!). I cannot wait to get in touch with Ryan upon our return to the United States to find out what his interview experiences were like in each of the other countries he visited. I believe the goal is to publish a paper describing the similarities and differences between .
This morning we left to go to Cyprus for the weekend, our plane was supposed to leave at 9am but was delayed 3 and 1/2 hours so we arrived much later than expected. Therefore today was mostly uneventful, we just arrived at our accommodations and settled in before eating supper at the hospital cafeteria as this trip is sponsored by the Cyprus Student Exchange Program. This evening we will be meeting students from all the exchange programs occurring in Turkey/Cyprus at this time.