Should pharmacists have basic medical practice rights?

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Are pharmacists under utilized? Why couldn't we train them to be on the front lines of medicine, like an entry-level doc, PA, or NP, to diagnose and prescribe for basic ailments? Their scope of practice would be limited to such certain basic ailments, as defined by law, and they would refer to outpatient or ER, as applicable.

To accomplish this, more clinical experience and pathology could be included in their education, and they would have to complete a 1-year clinical internship to obtain these expanded practice rights.

Just a wild thought.

Why? Some pharmacists are under utilized sure, but i am sure it would first take pharmacists saying that they want more. I don't see any reason to do this. And I would assume the training is actually a lot different so it wouldn't add just a little more school.

Originally Posted by JESSFALLING

In my opinion, pharmacists are under utilized. Why couldn't we train them to be on the front lines of medicine, like an entry-level doc, PA, or NP, to diagnose and prescribe for basic ailments? Their scope of practice would be limited to such certain basic ailments, as defined by law, and they would refer to outpatient or ER, as applicable.

To accomplish this, more clinical experience could be included in their education, and they would have to complete a 1-year clinical internship to obtain these expanded practice rights.

And while we're at it, why don't we train car salesmen as entry-level car mechanics/body work techs so that they can fix certain problems (such as faulty brakes, dirty air filters, and minor dents and hail damage)....

The answer to your question is that the jobs are completely different. They both involve medicine (or cars) but the training and job descriptions have very little else in common. We do, however, utilize pharmacists in clinical pharmacy roles (with a residency) that utilize their excellent knowledge of drugs to assist physicians in ensuring optimal treatment of complex cases.

Originally Posted by FrkyBgStok

Why? Some pharmacists are under utilized sure, but i am sure it would first take pharmacists saying that they want more. I don't see any reason to do this. And I would assume the training is actually a lot different so it wouldn't add just a little more school.

It would be interesting to poll the pharm forum with the same question. I'm not sure what the response would look like. Maybe the majority of pharm students go that direction to avoid patient exams?

I was always under the impression that people went into pharmacy to avoid direct patient contact?

About half of the pharmacists I know (and I know many, I'm a pharmacy tech whose worked both retail and hospital) went into the pharmacy field because they liked the idea of being in the medical field and helping people, but preferred not to interact with patients as close as physicians/midlevels/nurses do (i.e. no looking at blood, secretions, etc).

Plus, they do have plenty of other work to do as it is. I don't know where in between dealing with doctors' offices and insurance companies, verifying hundreds to thousands of scripts, counseling patients of new prescriptions, responding to patient questions and requests for OTC recommendations, etc would pharmacists find time to diagnose and prescribe.

Originally Posted by whatbout2morrow

About half of the pharmacists I know (and I know many, I'm a pharmacy tech whose worked both retail and hospital) went into the pharmacy field because they liked the idea of being in the medical field and helping people, but preferred not to interact with patients as close as physicians/midlevels/nurses do (i.e. no looking at blood, secretions, etc).

Plus, they do have plenty of other work to do as it is. I don't know where in between dealing with doctors' offices and insurance companies, verifying hundreds to thousands of scripts, counseling patients of new prescriptions, responding to patient questions and requests for OTC recommendations, etc would pharmacists find time to diagnose and prescribe.

That sounds reasonable. I don't have any first hand exp. with pharm, which is why perhaps I asked the ? in the first place. Thanks for the reply.

Originally Posted by whatbout2morrow

Plus, they do have plenty of other work to do as it is. I don't know where in between dealing with doctors' offices and insurance companies, verifying hundreds to thousands of scripts, counseling patients of new prescriptions, responding to patient questions and requests for OTC recommendations, etc would pharmacists find time to diagnose and prescribe.

Funny story. I shadowed a pharmacist once in high school, and she would always send me to watch the hospital tech prepare IV bags while she shopped for shoes online

Originally Posted by JESSFALLING

That sounds reasonable. I don't have any first hand exp. with pharm, which is why perhaps I asked the ? in the first place. Thanks for the reply.

Don't get me wrong, they are experts when it comes to drugs, and I know of some pharmacists who went on to become awesome doctors and physician assistants. But for most of the rest, it's just not their thing. Not that retail chains wouldn't like making their pharmacists do more and more for some extra cash. Two years ago, I didn't know a single retail pharmacist who administered vaccinations. Now, not only do they administer them, they are given a goal of administering X number of vaccines before the flu season's over.

well some pharmacy schools actually have physical diagnosis as part of their curriculum and do some procedures like immunizations, BP checks, blood draws (coumadin, diabetes clinic, bmp/cmp)... some pharmds function as midlevel providers at our hospital. i think they do pharm because they want to do pharm.

i dont want the pharmacist doing my job, nor do i want to do theirs.

As a pharmacy student we actually do take a physical assessment class where you are taught the basics of a physical examination. Also any disease state that we study is prefaced with the pathophysiology and symptoms/lab abnormalities associated with said disease state. However I do not feel like pharmacy school in any way prepares you to make any sort of diagnosis (beyond things that can be treated with OTC, such as productive vs. nonproductive cough, uncomplicated diarrhea, or fever.) Pharmacy is slowly shifting into more and more direct patient contact. Its funny because one of our professors who has been teaching for 40 or so years told us that when he was in pharmacy school it was prohibited to discuss the drugs with the patient, and they were taught specific techniques to avoid specific drug related questions if they were ever brought up in conversation with a customer. So needless to say things are changing.

BUT, pharmacists dont go to school to diagnose. I dont think there are any pharmacists who will argue that. However pharmacists are very under-utilized in the area of pharmacotherapy. There is no reason why pharmacists who are part of a hospital medical team shouldnt be allowed to alter or initiate medical therapy in the same way that PAs and NPs can initiate therapy. As long as the MD signs off on it I dont see any problem in it. In fact if there is one thing pharmacy students are really good at, its being able to select the proper medical therapy if there is a given diagnosis. Medical students (as well as PA and NP students) are taught waaay too many things to be able to remember and recognize the different uses for the 10+ types of beta blockers. Sure everyone may know metoprolol, but will your first or second year resident know the different indications for atenolol and propranolol? Maybe, maybe not. Im not arguing that a pharmacist will know more than lets say a cardiologist about cardio drugs. But I am willing to bet a pharmacist one year out of school will know a whole lot more about appropriate pharmacotherapy than a first year resident or PA/NP student. But somehow PAs/NPs have prescriptive authority and pharmacists dont. A lot of people in my profession are unhappy about that, and watch for changes in this arena as collaborative practice gets pushed through into law. Pharmacists shouldnt diagnose, but we sure as hell should get at least some piece of the prescribing pie.

Originally Posted by DOCTAfoHIRE

As a pharmacy student we actually do take a physical assessment class where you are taught the basics of a physical examination. Also any disease state that we study is prefaced with the pathophysiology and symptoms/lab abnormalities associated with said disease state. However I do not feel like pharmacy school in any way prepares you to make any sort of diagnosis (beyond things that can be treated with OTC, such as productive vs. nonproductive cough, uncomplicated diarrhea, or fever.) Pharmacy is slowly shifting into more and more direct patient contact. Its funny because one of our professors who has been teaching for 40 or so years told us that when he was in pharmacy school it was prohibited to discuss the drugs with the patient, and they were taught specific techniques to avoid specific drug related questions if they were ever brought up in conversation with a customer. So needless to say things are changing.

BUT, pharmacists dont go to school to diagnose. I dont think there are any pharmacists who will argue that. However pharmacists are very under-utilized in the area of pharmacotherapy. There is no reason why pharmacists who are part of a hospital medical team shouldnt be allowed to alter or initiate medical therapy in the same way that PAs and NPs can initiate therapy. As long as the MD signs off on it I dont see any problem in it. In fact if there is one thing pharmacy students are really good at, its being able to select the proper medical therapy if there is a given diagnosis. Medical students (as well as PA and NP students) are taught waaay too many things to be able to remember and recognize the different uses for the 10+ types of beta blockers. Sure everyone may know metoprolol, but will your first or second year resident know the different indications for atenolol and propranolol? Maybe, maybe not. Im not arguing that a pharmacist will know more than lets say a cardiologist about cardio drugs. But I am willing to bet a pharmacist one year out of school will know a whole lot more about appropriate pharmacotherapy than a first year resident or PA/NP student. But somehow PAs/NPs have prescriptive authority and pharmacists dont. A lot of people in my profession are unhappy about that, and watch for changes in this arena as collaborative practice gets pushed through into law. Pharmacists shouldnt diagnose, but we sure as hell should get at least some piece of the prescribing pie.

How can you prescribe if you don't diagnose? It's poor form to prescribe for a condition you haven't diagnosed/treated in the patient before. I regularly tell patients, and then witness them being told by the resident and attending that their specialist must refill "those" medications. Rarely, and if its a dire situation, the PCPs will write for the prescription in my experience.

Allowing PharmDs to change prescriptions or prescribe based on a diagnosis adds another level of work to the already voluminous job of a physician. Let the PharmD round and make recommendations; don't allow him or her to change something and add an extra paper for the physician to sign.

Also, graduating from a pharmacy/science school I know a wide range of talents. Allowing simple practice rights without any formal training/standardization would be a nightmare. A lot of my close friends I encouraged to go to medical school because they were brilliant. However, there were many more people in my friends' class that I wouldn't want to come near me with a stethoscope or counsel me on medications.

Why don't we let EMT's run pharmacies since there are so many without a job and we can train them to do it? After all, they have training giving certain shots in the field. What more do they need? A handbook of medications?

The OP takes the cake for worst post around here.

If the PharmD wanted to be utilized more, he or she should have gone into another profession.

Originally Posted by DOCTAfoHIRE

As a pharmacy student we actually do take a physical assessment class where you are taught the basics of a physical examination. Also any disease state that we study is prefaced with the pathophysiology and symptoms/lab abnormalities associated with said disease state. However I do not feel like pharmacy school in any way prepares you to make any sort of diagnosis (beyond things that can be treated with OTC, such as productive vs. nonproductive cough, uncomplicated diarrhea, or fever.) Pharmacy is slowly shifting into more and more direct patient contact. Its funny because one of our professors who has been teaching for 40 or so years told us that when he was in pharmacy school it was prohibited to discuss the drugs with the patient, and they were taught specific techniques to avoid specific drug related questions if they were ever brought up in conversation with a customer. So needless to say things are changing.

BUT, pharmacists dont go to school to diagnose. I dont think there are any pharmacists who will argue that. However pharmacists are very under-utilized in the area of pharmacotherapy. There is no reason why pharmacists who are part of a hospital medical team shouldnt be allowed to alter or initiate medical therapy in the same way that PAs and NPs can initiate therapy. As long as the MD signs off on it I dont see any problem in it. In fact if there is one thing pharmacy students are really good at, its being able to select the proper medical therapy if there is a given diagnosis. Medical students (as well as PA and NP students) are taught waaay too many things to be able to remember and recognize the different uses for the 10+ types of beta blockers. Sure everyone may know metoprolol, but will your first or second year resident know the different indications for atenolol and propranolol? Maybe, maybe not. Im not arguing that a pharmacist will know more than lets say a cardiologist about cardio drugs. But I am willing to bet a pharmacist one year out of school will know a whole lot more about appropriate pharmacotherapy than a first year resident or PA/NP student. But somehow PAs/NPs have prescriptive authority and pharmacists dont. A lot of people in my profession are unhappy about that, and watch for changes in this arena as collaborative practice gets pushed through into law. Pharmacists shouldnt diagnose, but we sure as hell should get at least some piece of the prescribing pie.

Thanks for posting, this is really insightful.

A pharmacist goes to school to become a pharmacist. Nothing more, nothing less. A multi tasking pharmist would be so unproductive.

Imagine a pharmacist that has to diagnose the patient, write the person up a prescription, and then go to the shelf and do all whatever a pharmacist does. Sounds like a horrible plan if you ask me.

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Dr. Lydgate would be rolling over in his grave.

pharmacists are irrelevant in todays world

Originally Posted by TriagePreMed

Why don't we let EMT's run pharmacies since there are so many without a job and we can train them to do it? After all, they have training giving certain shots in the field. What more do they need? A handbook of medications?

The OP takes the cake for worst post around here.

If the PharmD wanted to be utilized more, he or she should have gone into another profession.

IMO that's not too great of an analogy. I haven't really arrived at a final opinion on the subject myself, but I will say that Pharm.D. programs do give extensive education on drugs and pharmacology.

Originally Posted by Holy FranZ

pharmacists are irrelevant in todays world

No.

Originally Posted by TheProwler

No.

what is their value?

In the hospital setting yes I can see value ; at rite aid no. What do they actually do that a computer cannot?

Originally Posted by Holy FranZ

what is their value?

In the hospital setting yes I can see value ; at rite aid no. What do they actually do that a computer cannot?

A lot of people who get prescriptions don't understand what all their medications are for, and are probably not prepared for the side effects. The value of a drugstore pharmacist is not just to evaluate drug interactions and dosages, but to be able to explain to patients what their medications are for and what side effects the patient might see after taking them. It's easy for a bunch of 20-somethings to say, "Oh, just look it up on the internet," but many pharmacy patients are elderly or not computer-savvy and need to talk to a real person who understands their prescriptions. It's not enough just to print out an information sheet.

what is their value?

In the hospital setting yes I can see value ; at rite aid no. What do they actually do that a computer cannot?

Please stop talking before you embarrass yourself even further. I bet youre the kind of guy who doesnt understand why he has to wait so long to pick up his prescriptions at a pharmacy, right? You think all pharmacists do is count pills and put them in a bottle right?

Yes the computer can pick up drug-drug interactions. But computers cant pick apart which drug-drug interacts are important enough to worry about. There needs to be a trained professional there to discern if a potential drug-drug interactions is worth worrying about or if its something that is not likely to happen or not. Using your analogy everyone should be able to type their symptoms into the internet, take the highest probably disease state, and take the pills for that disease state right? Whats the purpose of the doctor?

If you think that techs can run a pharmacy youre insane. Someone with higher education needs to be there to make educated decisions about the appropriateness of drug therapy. I dont know about you but I dont want someone who went to school for 6 months (if that) deciding if my doctor wrote the wrong dose or if that dose has a specific indication for a certain disease state. Sure there are plenty of situations when most prescriptions are written perfectly and everything would run decently smoothly without a pharmacist. But who the hell is going to make decisions if it doesnt run smoothly? Last time I checked medication errors lead to about 7,000 deaths a year and are some of the most preventable healthcare problems. THATS PRESCRIPTIONS THAT HAVE BEEN PUT THROUGH A COMPUTER! There NEEDS to be a double check system to the computer, which singlehandedly necessitates a pharmacist being present.

Not to mention all of the counseling and support a pharmacist can provide to their patients. (Now whether or not he gets the chance to provide such support given the prescription-mill attitude of the big retail chains is another problem...)

What would the advantages be to having a PharmD and and MD?

student loans are the only disadvantage I can think of..

What would the advantages be to having a PharmD and and MD?

student loans are the only disadvantage I can think of..

It all really depends on the individual and your circumstances. I go to a 6 year program so I will get my degree two years sooner than those in the traditional BS > Pharm.D. pathways. Also I got to a state school and got a decent scholarship so my loans are not nearly as large as some of my classmates and peers from other schools.

The advantages are:
-being more knowledgeable about drugs and pharmacotherapy
-having a bad***** part time job during medical school (pharmacists get payed 50-60$+/hour in most jobs and in most areas of the country, and per diem pharmacists are always in need - if you can manage a shift or so per week you can make some decent money)
-being more competitive for residencies (partly theoretical but I do believe that competitive specialties usually have a higher percentage of individuals with other advanced degrees matching into them - of course Step 1/clinical/research will matter a lot more, but im sure a Pharm.D. wont hurt)
-being more prepared for the studying required in medical school (i think its safe to assume pharmacy students study on average more than the typical undergrad)
-having a more (on average) clinical experience coming in (last year of pharmacy school is rotations similar to med school rotations. I will be graduating with 1600+ hours of clinical experience)

However its all a balancing act, and spending an extra 2-4 years in school is definitely not worth it to most people. Its mostly for the individuals such as myself who decided to apply to med school during pharmacy school.

Also current laws prohibit someone from working as both a pharmacist and a doctor so you will not be able to practice with both degrees once you graduate medical school. This is done so that there is a double check system and that the person prescribing is double-checked by someone who is dispensing. Therefore an individual cannot do both.

Originally Posted by JESSFALLING

Are pharmacists under utilized? Why couldn't we train them to be on the front lines of medicine, like an entry-level doc, PA, or NP, to diagnose and prescribe for basic ailments? Their scope of practice would be limited to such certain basic ailments, as defined by law, and they would refer to outpatient or ER, as applicable.

To accomplish this, more clinical experience and pathology could be included in their education, and they would have to complete a 1-year clinical internship to obtain these expanded practice rights.

Just a wild thought.

And how will patients know that they have basic ailments? Is that viral pharyngitis really a peritonsilar abscess? Is that chest pain due to muscle strain from coughing, from cholecystitis, pneumonia, unstable angina, etc?

Last I check, patients don't walk in with "I have a basic ailment" - they walk in with "I have this ..." and it is your job to figure out what it is (before you start randomly prescribing drugs that are meant to alter the physiology of the body)

And diseases don't read textbooks - they can present oddly (take the chest pain example above). All the extra learning in school and residency is to learn how to recognize nontypical cases, rare cases, and how to manage rare cases.

And i'm sorry - a "physical diagnosis course", or an "advanced physical diagnosis course" is no where enough sufficient. If you think it is sufficient to diagnose basic ailments, then you don't know what you don't know, which will make you a very dangerous pracitioner.


*right now, people go up to the pharmacy counter at your local drugstore and ask pharmacists all the time about symptoms and "what is this and what can I take" - I have no problem with this. However, if you start empowering pharmacists, by law, to be able to "diagnose basic ailments", then there are responsibilities associated with that priviledges (such as timely diagnosis - a delay diagnosis of a serious illness due to unrecognized symptoms can lead to major medical malpractice lawsuits).

**and you better have a mechanism in place to ensure timely follow-ups (if you are following hypertension, or diabetes, or dyslipidemia, etc). Failure to adequately follow-up will also open you up to liability if something happens to your patient.

Originally Posted by TheMightySmiter

A lot of people who get prescriptions don't understand what all their medications are for, and are probably not prepared for the side effects. The value of a drugstore pharmacist is not just to evaluate drug interactions and dosages, but to be able to explain to patients what their medications are for and what side effects the patient might see after taking them. It's easy for a bunch of 20-somethings to say, "Oh, just look it up on the internet," but many pharmacy patients are elderly or not computer-savvy and need to talk to a real person who understands their prescriptions. It's not enough just to print out an information sheet.

also the fact that not everything on the internet is correct or universally applicable.

Originally Posted by DOCTAfoHIRE

Please stop talking before you embarrass yourself even further. I bet youre the kind of guy who doesnt understand why he has to wait so long to pick up his prescriptions at a pharmacy, right? You think all pharmacists do is count pills and put them in a bottle right?

Yes the computer can pick up drug-drug interactions. But computers cant pick apart which drug-drug interacts are important enough to worry about. There needs to be a trained professional there to discern if a potential drug-drug interactions is worth worrying about or if its something that is not likely to happen or not. Using your analogy everyone should be able to type their symptoms into the internet, take the highest probably disease state, and take the pills for that disease state right? Whats the purpose of the doctor?

If you think that techs can run a pharmacy youre insane. Someone with higher education needs to be there to make educated decisions about the appropriateness of drug therapy. I dont know about you but I dont want someone who went to school for 6 months (if that) deciding if my doctor wrote the wrong dose or if that dose has a specific indication for a certain disease state. Sure there are plenty of situations when most prescriptions are written perfectly and everything would run decently smoothly without a pharmacist. But who the hell is going to make decisions if it doesnt run smoothly? Last time I checked medication errors lead to about 7,000 deaths a year and are some of the most preventable healthcare problems. THATS PRESCRIPTIONS THAT HAVE BEEN PUT THROUGH A COMPUTER! There NEEDS to be a double check system to the computer, which singlehandedly necessitates a pharmacist being present.

Not to mention all of the counseling and support a pharmacist can provide to their patients. (Now whether or not he gets the chance to provide such support given the prescription-mill attitude of the big retail chains is another problem...)

I used to want to be a pharmacist and have experience from a 2x summer pharmacy internship (I was the dude who counted/bottled) where I got the see first hand what was going on behind the counter. What do you base your thoughts on?

Most patients understand why they are on the medicines they are on and to expect side-effects. They are not always helpless individuals that need their hands held throughout the entire process.

Do you think your father (or any other theoretical person) doesn't know why he is on lipitor? I would bet he does.

People are not always dumb and play a much greater role in their healthcare than you think. I do clinical research and the post-operative patients I talk to are very aware of what they are taking and why they are taking it (for the most part).

I think the person who does my nails should have some medical privileges in terms of being able to diagnose and treat foot problems.

Originally Posted by DOCTAfoHIRE

It all really depends on the individual and your circumstances. I go to a 6 year program so I will get my degree two years sooner than those in the traditional BS > Pharm.D. pathways. Also I got to a state school and got a decent scholarship so my loans are not nearly as large as some of my classmates and peers from other schools.

The advantages are:
-being more knowledgeable about drugs and pharmacotherapy
-having a bad***** part time job during medical school (pharmacists get payed 50-60$+/hour in most jobs and in most areas of the country, and per diem pharmacists are always in need - if you can manage a shift or so per week you can make some decent money)
-being more competitive for residencies (partly theoretical but I do believe that competitive specialties usually have a higher percentage of individuals with other advanced degrees matching into them - of course Step 1/clinical/research will matter a lot more, but im sure a Pharm.D. wont hurt)
-being more prepared for the studying required in medical school (i think its safe to assume pharmacy students study on average more than the typical undergrad)
-having a more (on average) clinical experience coming in (last year of pharmacy school is rotations similar to med school rotations. I will be graduating with 1600+ hours of clinical experience)

However its all a balancing act, and spending an extra 2-4 years in school is definitely not worth it to most people. Its mostly for the individuals such as myself who decided to apply to med school during pharmacy school.

Also current laws prohibit someone from working as both a pharmacist and a doctor so you will not be able to practice with both degrees once you graduate medical school. This is done so that there is a double check system and that the person prescribing is double-checked by someone who is dispensing. Therefore an individual cannot do both.

Thanks for a great response.

Medications and their effects on the body really interests me. I don't have any experience in the pharmaceutical area though. From the outside looking in I would spend my pennies only because I think I would enjoy learning about such. I really enjoy people though and therefore would use an MD when push comes to shove.

I'm a freshman at university, too late to apply to 6 yr programs right? I like schoolwork but would want a family at some point.

Any reading or classes you suggest to satisfy my interest before making drastic moves?

Originally Posted by Holy FranZ

pharmacists are irrelevant in todays world

You do know the largest % percentage of med errors comes from doctors orders right? Guess who corrects their orders and reviews contraindications in charts/MARs so the patient doesn't die? Ya computers can do obvious corrections but that is not always the case especially in hospitals when not so clear orders are pushed to be verified. I hope that you saw enough of this in your internship. Not all patients are "dumb" but health literacy in America abysmal. Spend a couple months on a regular med surg floor do discharge education for meds and treatments, sometimes I am surprised at how little people know about health care.

Originally Posted by PantherPride

Funny story. I shadowed a pharmacist once in high school, and she would always send me to watch the hospital tech prepare IV bags while she shopped for shoes online

Shoes? Cool! The pharmacists I worked with could never answer a drug related question. They always came back with, "I will have to look that up." Then they continue with ......

Originally Posted by HoltMD

Shoes? Cool! The pharmacists I worked with could never answer a drug related question. They always came back with, "I will have to look that up." Then they continue with ......

Please go on with your very informative anecdotes. I am sure you have one for every portion of the health care community and why their job is inane compared to docs. Go on please do tell!

Originally Posted by Dranger

You do know the largest % percentage of med errors comes from doctors orders right? Guess who corrects their orders and reviews contraindications in charts/MARs so the patient doesn't die?

* Walmart dispenses wrong medication...
* New Jersey pharmacy dispenses cancer drug instead...
* Safeway dispenses methotrexate instead of antibiotics...

Should I go on?

Originally Posted by Dranger

Please go on with your very informative anecdotes. I am sure you have one for every portion of the health care community and why their job is inane compared to docs. Go on please do tell!

Yes, doctors are far superior than pharmacists and nurses in terms of their diagnostic skills. Why? Because that's what they are trained to do. If you want to practice medicine, for God's sake go to medical school. It is a pretty simple solution. Don't go to pharmacy or nursing school and then expect to do what doctors are trained to do.

Originally Posted by HoltMD

* Walmart dispenses wrong medication...
* New Jersey pharmacy dispenses cancer drug instead...
* Safeway dispenses methotrexate instead of antibiotics...

Should I go on?



Yes, doctors are far superior than pharmacists and nurses in terms of their diagnostic skills. Why? Because that's what they are trained to do. If you want to practice medicine, for God's sake go to medical school. It is a pretty simple solution. Don't go to pharmacy or nursing school and then expect to do what doctors are trained to do.

Ok Im going to ignore the OPs question and state outright that pharmacists HAVE NO ROLE IN DIAGNOSIS and shouldnt have said role. In fact almost no pharmacist will disagree with this statement. Its not what we go to school for and we know what we are getting into.

However, I have a problem when pre-meds in this thread who know very little about the profession of pharmacy start saying things like pharmacists are irrelevant and people like you try to bring up examples of how pharmacists screw up. Yes, big surprise people screw up. But for example pharmacists at my 100 bed hospital dock THOUSANDS of interventions per year in which physician orders are altered. Do you know that that means? Doctors wrote orders that were no appropriate for whatever reason and needed to be changed.

So please dont try to pull out examples of pharmacists dispensing the wrong drug or whatever. I dont think anyone is going to deny that that happens. What I do have a problem with is people disparaging an entire profession based on random examples they pull off of google. Im sure if you searched doctor medication errors plenty of things can be found as well. For example why do residents keep writing Avelox orders for UTIs? Theres an example of a stupid doctor mistake for you. And that one isnt bad at all compared to more deadly mistakes that Ive seen written.

I used to want to be a pharmacist and have experience from a 2x summer pharmacy internship (I was the dude who counted/bottled) where I got the see first hand what was going on behind the counter. What do you base your thoughts on?

Most patients understand why they are on the medicines they are on and to expect side-effects. They are not always helpless individuals that need their hands held throughout the entire process.

Do you think your father (or any other theoretical person) doesn't know why he is on lipitor? I would bet he does.

People are not always dumb and play a much greater role in their healthcare than you think. I do clinical research and the post-operative patients I talk to are very aware of what they are taking and why they are taking it (for the most part).

My experience is based upon being a pharmacy student who will soon graduate and having worked a combined total of 10+ years at two hospital and one retail job. And tons of rotation hours as well.

In any case this is a silly discussion because we seem to be talking about different things. Patients are no doubt more involved in their medications nowadays and someone being prescribed Lipitor usually knows what its for. However the problem comes in when the computer doesnt give the technician any alerts about dispensing Lipitor, but then the patient ends up with rhabdomyolysis. And then the primary care provider who isnt really talking to the patient's cardiologist doesnt know why the kidneys are suddenly failing. What pharmacists can do is provide counseling for the patient receiving Lipitor and tell them that myopathy can be a rare side effect of the medication. That way that whole situation might be avoided without unnecessary treatment or switches in therapy that dont need to happen in the first place.

Thats just one example and you might say that a computer can tell the patient the side effects. Sure, in fact all patients get a print out of side effects with their meds. But how many people actually sit down and read through that? It has been shown that a pharmacist counseling a patient significantly increases compliance with medications and increases awareness of problematic side effects and how to deal with them.

In your experiences what you probably saw was a pharmacist who was too overworked by the large retail company which was too focused on filling prescriptions. But you shouldnt judge that pharmacist because of what his company expects of him, there is still much knowledge to be shared. Just as you shouldnt judge a doctor who is forced to see more and more patients because of declining Medicare reimbursement. Thats not a doctor who doesnt care about his patients, thats a doctor who is overworked and under-appreciated. Just like the pharmacist.

Also you need to recognize that retail is only a branch of what pharmacists are involved with. Other areas include hospital (and every specialty within), long-term care, ambulatory care, nuclear, and industry. (To name a few).

So while I do understand where you are coming from based on how companies expect pharmacists to work, you shouldnt be so quick to judge a profession as being irrelevant based on what you see.

/end silly ranting

Originally Posted by DOCTAfoHIRE

Ok Im going to ignore the OPs question and state outright that pharmacists HAVE NO ROLE IN DIAGNOSIS and shouldnt have said role. In fact almost no pharmacist will disagree with this statement. Its not what we go to school for and we know what we are getting into.

However, I have a problem when pre-meds in this thread who know very little about the profession of pharmacy start saying things like pharmacists are irrelevant and people like you try to bring up examples of how pharmacists screw up. Yes, big surprise people screw up. But for example pharmacists at my 100 bed hospital dock THOUSANDS of interventions per year in which physician orders are altered. Do you know that that means? Doctors wrote orders that were no appropriate for whatever reason and needed to be changed.

So please dont try to pull out examples of pharmacists dispensing the wrong drug or whatever. I dont think anyone is going to deny that that happens. What I do have a problem with is people disparaging an entire profession based on random examples they pull off of google. Im sure if you searched doctor medication errors plenty of things can be found as well. For example why do residents keep writing Avelox orders for UTIs? Theres an example of a stupid doctor mistake for you. And that one isnt bad at all compared to more deadly mistakes that Ive seen written.



My experience is based upon being a pharmacy student who will soon graduate and having worked a combined total of 10+ years at two hospital and one retail job. And tons of rotation hours as well.

In any case this is a silly discussion because we seem to be talking about different things. Patients are no doubt more involved in their medications nowadays and someone being prescribed Lipitor usually knows what its for. However the problem comes in when the computer doesnt give the technician any alerts about dispensing Lipitor, but then the patient ends up with rhabdomyolysis. And then the primary care provider who isnt really talking to the patient's cardiologist doesnt know why the kidneys are suddenly failing. What pharmacists can do is provide counseling for the patient receiving Lipitor and tell them that myopathy can be a rare side effect of the medication. That way that whole situation might be avoided without unnecessary treatment or switches in therapy that dont need to happen in the first place.

Thats just one example and you might say that a computer can tell the patient the side effects. Sure, in fact all patients get a print out of side effects with their meds. But how many people actually sit down and read through that? It has been shown that a pharmacist counseling a patient significantly increases compliance with medications and increases awareness of problematic side effects and how to deal with them.

In your experiences what you probably saw was a pharmacist who was too overworked by the large retail company which was too focused on filling prescriptions. But you shouldnt judge that pharmacist because of what his company expects of him, there is still much knowledge to be shared. Just as you shouldnt judge a doctor who is forced to see more and more patients because of declining Medicare reimbursement. Thats not a doctor who doesnt care about his patients, thats a doctor who is overworked and under-appreciated. Just like the pharmacist.

Also you need to recognize that retail is only a branch of what pharmacists are involved with. Other areas include hospital (and every specialty within), long-term care, ambulatory care, nuclear, and industry. (To name a few).

So while I do understand where you are coming from based on how companies expect pharmacists to work, you shouldnt be so quick to judge a profession as being irrelevant based on what you see.

/end silly ranting

Thanks for sharing..

I'm pretty convinced SDN has the worst trolls on the internet. Some people are unbelievable. So glad the real world isn't like that.

And OP, pharmacists are trained to do basic procedures like manually take BP, vaccines, etc. Pharmacists know what they want to do, as previously stated. They purposely don't want to deal with old, stinky people like us pre-meds want to .

And if they do by chance want more patient contact, there's this thing called clinical pharmacy that's becoming popular now.

Originally Posted by HoltMD

* Walmart dispenses wrong medication...
* New Jersey pharmacy dispenses cancer drug instead...
* Safeway dispenses methotrexate instead of antibiotics...

Should I go on?

Wow. Now let me find links to all the prescription mistakes doctors made last year. Oh wait, pharmacists caught most of them before the drugs ever reached the patients. So that means those mistakes never happened, and that doctors never make prescription mistakes right?

^Please don't feed the trolls.

Originally Posted by DOCTAfoHIRE

Ok Im going to ignore the OPs question and state outright that pharmacists HAVE NO ROLE IN DIAGNOSIS and shouldnt have said role. In fact almost no pharmacist will disagree with this statement. Its not what we go to school for and we know what we are getting into.
.......

Thank you! Now, you can change your status to "pharmacy student" and stop being undercover.

Originally Posted by HoltMD

* Walmart dispenses wrong medication...
* New Jersey pharmacy dispenses cancer drug instead...
* Safeway dispenses methotrexate instead of antibiotics...

Should I go on?



Yes, doctors are far superior than pharmacists and nurses in terms of their diagnostic skills. Why? Because that's what they are trained to do. If you want to practice medicine, for God's sake go to medical school. It is a pretty simple solution. Don't go to pharmacy or nursing school and then expect to do what doctors are trained to do.

Go on with what? You list random anecdotes yet show no studies. I am pre-med but I do recognize that physicians play the largest role in med errors.

A random study after a second of googling. I can find more on my school's EBSCO host if you want. Take a look at clinical appropriateness and ordering columns...

http://www.ptjournal.com/ptjournal/f...PTJ3003183.pdf

I love random pre-meds acting like they know about other professions. Read what I responded to, it was a poster claiming pharmDs are irrelevant not that they are diagnosticians. durrrr.

The most obvious answer is "No, because they don't complete a 3 year clinical residency." Good grief.

Originally Posted by HoltMD

Thank you! Now, you can change your status to "pharmacy student" and stop being undercover.

Im finishing pharmacy school and applying to medical school. Hence the status. No hiding involved.

Originally Posted by DOCTAfoHIRE

Im finishing pharmacy school and applying to medical school. Hence the status. No hiding involved.

But why? Pharmacy is such a fulfilling career. After all, you help doctors understand drugs. Without you doctors will be nothing.

Originally Posted by HoltMD

But why? Pharmacy is such a fulfilling career. After all, you help doctors understand drugs. Without you doctors will be nothing.

Sorry for the intrusion into the pre-med forum... but after reading your responses i had to post.

All i can say is that you are very immature. As a future physician it is sad that you do not understand and respect the roles of different healthcare providers. If you truly did care about our future patients health, you would understand the reality and necessity of interdisciplinary healthcare. Like it or not, the world of healthcare is continually navigating toward a team approach. It is in the best interest of the patient that their physician, pharmacist, dentist, physical therapist, etc all be aware of their history and treatment plan. Demeaning any one of these roles just shows how much you need to grow up.

Also, if there is any chance that you will be in private practice as a physician... being a d!ck to others and demeaning other healthcare professionals will not generate many referrals for you or promote others confidence in you as a physician. So i would quit now before you make a habit of it...

EDIT: I just realized that you have only been a member of this forum for 3 months, which makes your credibility and posts even more insignificant and laughable.

.

Originally Posted by UltimateHombre

Sorry for the intrusion into the pre-med forum... but after reading your responses i had to post.

All i can say is that you are very immature. As a future physician it is sad that you do not understand and respect the roles of different healthcare providers. If you truly did care about our future patients health, you would understand the reality and necessity of interdisciplinary healthcare. Like it or not, the world of healthcare is continually navigating toward a team approach. It is in the best interest of the patient that their physician, pharmacist, dentist, physical therapist, etc all be aware of their history and treatment plan. Demeaning any one of these roles just shows how much you need to grow up.

Also, if there is any chance that you will be in private practice as a physician... being a d!ck to others and demeaning other healthcare professionals will not generate many referrals for you or promote others confidence in you as a physician. So i would quit now before you make a habit of it...

EDIT: I just realized that you have only been a member of this forum for 3 months, which makes your credibility and posts even more insignificant and laughable.

I guess it is okay for you to demean me because I've been a member for only 3 months? lol Now, that is laughable. Are you saying that there is a positive correlation between time spent on SDN and credibility?

I don't disrespect other medical professionals. I just don't want a nurse or a pharmacist playing doctor. Neither do I want a doctor playing pharmacist.

Originally Posted by Tatiana3325

None of this DNP nonsense or turning CVS into an urgent care clinic.

Originally Posted by holtmd

i think the person who does my nails should have some medical privileges in terms of being able to diagnose and treat foot problems.

Can anyone comment on the difficulty between medical school and pharmacy school?

Originally Posted by HoltMD

Shoes? Cool! The pharmacists I worked with could never answer a drug related question. They always came back with, "I will have to look that up." Then they continue with ......

That was an impressive feat.