Dr Trần Thái Sơn, Deputy Head of the General Planning Department at Bạch Mai Hospital. Photo courtesy of Bạch Mai Hospital

The Ministry of Health has introduced Circular 26, which allows doctors to prescribe up to 90 days of medication for outpatients, instead of the previous 30-day limit. Dr Trần Thái Sơn, Deputy Head of the General Planning Department at Bạch Mai Hospital, told Vietnam News Agency that the policy could greatly benefit patients if applied with careful, individualised consideration.

The Ministry of Health has issued Circular 26, which includes a new provision allowing up to 90-day prescriptions for outpatients covered by health insurance. As one of the country’s top-tier hospitals, how has Bạch Mai Hospital prepared for this change?

Bạch Mai Hospital was involved from the early stages. We were among the medical institutions invited by the Department of Medical Services Administration to help draft the content of Circular 26. That gave us a strong understanding of the policy’s intent and direction.

Even while the circular was still in the public consultation phase, we proactively briefed our doctors on the expected changes. Once it was officially issued, we were well prepared.

We’ve updated our electronic medical records system and integrated the new regulations into our management software. Professional guidelines have been communicated across all departments. We've also conducted both in-person and online training sessions. This is mandatory not only for front line doctors, but also for administrative and support staff to ensure full and unified implementation throughout the hospital.

This is a very positive change. Under the new regulation, doctors may prescribe up to 90 days of medication for chronic conditions listed in a catalogue of 252 specific diseases.

The biggest beneficiaries are patients, particularly those with limited mobility or living far from healthcare facilities. They will save on travel costs and time, and avoid the burden of frequent hospital visits.

From the physician’s side, nothing changes in terms of medical responsibility. We continue to treat patients based on clinical guidelines. But now, the policy creates more convenience for patients and that’s something our medical staff fully supports.

Does this new policy mean doctors must apply stricter criteria when issuing long-term prescriptions?

Yes, absolutely. Just because doctors can prescribe up to 90 days doesn’t mean every patient should receive that much medication.

Doctors must assess each case carefully. If a patient’s condition is stable, then a 90-day prescription might be appropriate. But for others, especially those with acute symptoms or unstable health, five or ten days may be more suitable to allow for close monitoring.

Overprescribing could lead to risks if a patient’s condition changes and they don’t return to the hospital in time, or it could result in unnecessary waste.

That’s why we strongly advocate for individualised treatment plans. Each patient has their own protocol. Avoiding a one-size-fits-all approach helps ensure better patient outcomes and more efficient use of health insurance funds.

Currently, health insurance prescriptions are only valid for up to five days after being issued. In contrast, prescriptions for self-purchased medicines come with no specific recommendation on when to fill them. How is the hospital guiding doctors and patients to avoid delays in treatment?

The five-day validity for insured prescriptions is carried over from previous regulations, so doctors are already familiar with advising patients to collect their medicine within this time frame to avoid the prescription expiring and having to return for a re-examination.

For prescriptions where patients buy their own medication, the absence of a recommended time frame is a significant change. Doctors must pay special attention when advising patients in these cases. It’s important that physicians clearly explain the ideal window for purchasing and using the prescribed medicine.

At Bạch Mai Hospital, we’ve thoroughly communicated these updates to all doctors, especially those working in outpatient departments who interact directly with the public. Clear and detailed communication at the time of prescribing helps minimise errors during medication use.

With Bạch Mai’s large patient volume, how does the hospital ensure prescription quality and safety?

We’ve had systems in place for years. First, we ensure doctors are fully updated on all Ministry of Health regulations, ranging from approved medication lists and clinical indications to diagnostic techniques and lab procedures.

We also conduct regular training sessions to update staff on new regulations. On the procurement side, we review all drug purchases carefully to exclude any substances not on the approved list, preventing wasteful spending.

Our hospital’s management software includes alert features such as warnings for drug interactions or medications that are easily confused, which helps doctors stay in control and reduce prescribing errors.

Additionally, we conduct weekly prescription reviews. After doctors issue prescriptions, a specialised team evaluates them for accuracy, checking for duplicated drugs, incorrect indications or unnecessary supplements. Any discrepancies are flagged for correction and used as a learning opportunity. This process not only ensures safe treatment but also reduces preventable risks.

Under Circular 26, how are prescriptions handled when a patient visits multiple specialities in one appointment? Who is responsible for finalising the prescription?

Under the previous Circular 52, the task of consolidating prescriptions was assigned to the head of the outpatient department. With Circular 26, that responsibility now lies with the primary consulting doctor.

If needed, the primary doctor can request a hospital-wide clinical council to review and decide on the final prescription. This approach has proven effective because the primary doctor typically has the most comprehensive understanding of the patient’s overall condition.

Having a single point of coordination helps avoid duplicate medications, ensures that all necessary drugs are included and enhances interdepartmental collaboration. As a result, patients receive more holistic and streamlined treatment. — VNS