HK government's review of public medical charges is nearing completion and will be released as early as the end of this month. It is reported that the charges for non-critical cases in the emergency department may be aligned with those of private clinics to attract such patients to private services. However, the Hong Kong Wen Wei Po found that in addition to legal and compliant private clinics, there are also licensed registered pharmacies that have transformed into "knockoff clinics".
Reporters have visited several registered pharmacies on Castle Peak Road in Cheung Sha Wan for several days. There are long queues of patients every day. The scene is no different from street paramedics. The store clerks who have no professional qualifications in dispensing medicines are "posing as doctors" to diagnose and prescribe drugs for patients. The reporter successfully obtained prescriptions for controlled drugs such as steroids and antibiotics, which cost only HK$50 to HK$60. The colorful pills were not individually packaged but were placed in medicine bags, which could easily lead to accidental ingestion. The medical community in Hong Kong pointed out that the store clerks were responsible for diagnosing, prescribing, and dispensing medicines, which was tantamount to practicing medicine without a license. Department of Health has taken arrest action based on clues from this newspaper.
Poor people buy medicine as if they were "seeing a doctor"
Among the crowd, many people looked sick. Some told their relatives and friends that they had "bone pain all over the body", some cried and complained that their "skin has been bruised for a long time", and some said their "throat was very sore". Among them was a South Asian father who came with his young daughter to "seek treatment".
The South Asian father told the Hong Kong Wen Wei Po reporter that his family is poor and it would cost over a hundred dollars to see a doctor at the clinic. The emergency room currently charges over a hundred dollars and requires a long wait. Instead of waiting in line for most of the day, it is better to come to this pharmacy to buy medicine and "see a doctor". Moreover, the medical expenses for his daughter's cold are only fifty or sixty dollars, which is very cost-effective. He admitted that although he knew these "fake doctors" lacked medical background, "it was better than buying drugs randomly by myself."
The clerk prescribes medicine like taking orders in a tea restaurant
A reporter from Hong Kong Wen Wei Po tried to patronize the restaurant and waited in line for less than half an hour before he was able to see a doctor. However, the clerk acted like a doctor and started asking questions with skillful speaking skills: "What's the matter? How long have you been ill? Do you have a fever? How do you feel a sore throat? Do you have phlegm?" After a simple and casual "questioning", the clerk didn't even look at the reporter twice and just wrote down a "prescription list". The process was exactly like a waiter in a tea restaurant who was more concerned with taking orders from customers than seeking medical treatment. He skipped all the medical examination procedures, including not asking about medical history or history of drug allergies. He hastily wrote the "prescription list" and handed it to another clerk to get the medicine.
Multiple pills without individual packaging and labels
The "diagnosis" process only takes two to three minutes on average, and then the reporter receives a bag filled with several kinds of pills. Each medicine is not individually packaged, and the medicine bag does not have a label with the medicine name and instructions for use. It simply says: "Take one pill three times a day, once every six hours, on a full stomach." The most outrageous thing is that the bag contains several types of pills, which can be easily mixed up. Since there is no drug name or pharmaceutical company name engraved on the pills, if they are accidentally ingested, the rescue workers will not know which antidote to use. Such a sloppy operation completely disregards the patient's medical safety.
Hong Kong Wen Wei Po reporters found that the two pharmacies that openly sold controlled drugs in violation of regulations both claimed to have pharmacists on site. One of them even hung a certificate of a pharmacist named Wu on the counter. However, when the reporter pretended to be unwell and asked to see the pharmacist, the staff immediately evaded the question and said, "He (the pharmacist) has not been here for a long time."
Department of Health and Police arrest man at pharmacy
Pharmacy staff without medical or pharmaceutical qualifications act as "fake doctors" to diagnose and prescribe medicine for patients, which may lead to misdiagnosis at any time, or even neglect of some serious diseases, causing the patient's condition to worsen. In response to inquiries from the Wen Wei Po, the Hong Kong Special Administrative Region Government's Department of Health stated that the department had recently joined hands with the police to launch an enforcement operation against pharmacies in the Cheung Sha Wan area. During the operation, a 51-year-old man was arrested for suspected violation of the Pharmacy and Poisons Ordinance (Cap. 138). The investigation is ongoing. Upon completion of the investigation, the Department of Health will seek advice from the Department of Justice on prosecution matters. In addition, the Department of Health will also refer cases of conviction and/or misconduct of licensed drug dealers to the Pharmacy and Poisons Board of Hong Kong for consideration of initiating disciplinary inquiries.
Conduct surprise inspections on licensed drug dealers from time to time
The spokesman said that the Ordinance has already stipulated the relevant labeling requirements for medicines sold in pharmacies. In addition, the relevant "Code of Practice for Authorized Sellers of Poisons" formulated by the Board also requires that all medicines dispensed by pharmacies based on prescriptions from registered doctors, or over-the-counter medicines dispensed by registered pharmacists, must be labeled and should contain information including the patient's name, date of dispensing, name and address of the pharmacy, name of the medicine, dosage, usage and amount, and precautions.
The Department of Health will conduct surprise inspections on the registered premises of licensed drug dealers (including pharmacies) from time to time. Between 2020 and 2024, a total of about 6,050 surprise inspections were carried out. During the same period, a total of 32 cases involving pharmacies being convicted by the court for illegally selling prescription drugs were handled. Among the 32 cases, the highest fine was HK$72,000 (the total for all charges involved), and some convicted persons were sentenced to two months' imprisonment, suspended for three years.
Some pharmacies ignore regulations and their staff act like doctors, arbitrarily diagnosing and prescribing medicine for patients without asking about their medical history or allergic reactions. According to people familiar with the matter, the chaos has existed for a long time and has become more serious recently. Some pharmacies have even collected a "black market database."
The insider said that to facilitate prescribing, whenever a patient comes with a doctor's prescription to get their medicine filled, some pharmacy staff will secretly take photos of the prescription paper or medicine bag, and save the information in a computer file. Over time, a huge prescription "database" has been formed, containing prescriptions for all kinds of rare and difficult diseases. Whenever someone comes to seek medical treatment, the staff will refer to the database information and prescribe different medicines according to the patient's condition.
Searching for legal medical records has become a tool for personal profit
When the reporter from Hong Kong Wen Wei Po released the snake, he deliberately said that he had been seeking medical treatment from a certain doctor and wanted to get a copy of the cough syrup used by the doctor. The clerk immediately "recalled the syrup" and went to a dark corner. Soon after, he showed the reporter a bottle of cough syrup and said, "This is the cough syrup prescribed by Doctor X."
"Do you think they really understand medicine? They rely on this 'black market database' to copy prescriptions." People familiar with the matter said frankly that these pharmacies have been collecting patient prescriptions for a long time, integrating the details of drugs prescribed by doctors from different clinics and different specialties, and in disguise turning legal medical records into a tool for personal profit. "When neighbors come in with illnesses, they don't need any professional knowledge at all. They can just input some symptoms and retrieve the corresponding prescription from the database. They may even add ingredients based on 'their own experience' and prescribe some extra medicines to increase sales."
Not asking about the cause of allergies and ignoring the side effects of drugs
This practice not only exceeds the legal role of the pharmacy but may also lead to serious misdiagnosis and medication risks. "Doctors prescribe medicine based on the patient's personal medical history, physical condition, and even past drug reactions, but these pharmacies have no idea of the patient's true health status and just blindly copy the 'prescription' from the database." Family doctor Lee Fook-kay criticized the behavior as unlicensed medical practice, which may cause patients to experience serious side effects or drug conflicts.
Scarlett Pong, former president of the Pharmaceutical Society of Hong Kong, recently accompanied reporters to the area for observation. She denounced the methods used by the relevant people as outrageous. "If you walk in and just say 'sore throat' without asking about your medical history or allergies, and someone directly 'prescribes medicine' for you, or even prescribes antibiotics without a doctor's note, isn't this an 'unlicensed clinic'?"
She criticized these store clerks for not being registered pharmacists, let alone doctors, "but they can act like doctors and dispense medicine after consultation. This is an extremely dangerous practice."
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