I find this insulting

WVUPharm2007 said:

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Granted, the pharmacist in this case is an *******...but this NP can ****ing go to hell. You're damn right its my right to know why a drug is being dispensed. It's part of my professional judgment. You went to school for 2 years and studied pharmacology for maybe 8 weeks. You can't even attempt to approach my drug knowledge.

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Who is the bigger idiot here? The NP who doesn't understand HIPPA or the law or the ******* pharmacist who would not fill the prescrition because it may have been used after an elective abortion.

Quick question.....how would it be a breach of HIPAA if both the nurse practitioner and the pharmacist are BOTH HIPAA compliant?

They are both ******ed. The pharmacist has all the right to know why a drug is being prescribed for numerous reasons to obvious to list. The nurse is a crackhead for coming off as a self-righteous blowhard and not knowing how HIPAA functions and the pharmacist for not filling it becasue he believes in zombie Jesus and a millennium old book. But reading the letter, the nurse wins becasue she spelled HIPAA wrong in the text which makes her king idiot of the situation. I'm also sick of people evoking HIPAA as some sort of magical card that allows them to do and say all sorts of dumb things

HIPAA not HIPPA

My bad....so would it be fine for the pharmacist to discuss with the NP about something like this since they are both compliant?

Shimmery said:

My bad....so would it be fine for the pharmacist to discuss with the NP about something like this since they are both compliant?

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It wasn't directed at you. It was for the buffoon who posted before you.

I'm beginning to think pharmacists and nurses are natural enemies - pharmacists are more academic, while nurses are about process & getting the job done.

On Monday, I got the dr to change an rx from erythromycin to azithromycin because the pt was on methadone. I was away on Tues, and yesterday, I discovered a nurse got the other dr to change the script back to erythromycin because she was concerned that erythromycin wouldn't be strong enough because it's only given once a day (dr went along with this because he figured, erythromycin is cheaper, saving the taxpayers money. Of course, the real problem here is the dr doesn't read the charts - slows him down.)

Pharmavixen said:

I'm beginning to think pharmacists and nurses are natural enemies - pharmacists are more academic, while nurses are about process & getting the job done.

On Monday, I got the dr to change an rx from erythromycin to azithromycin because the pt was on methadone. I was away on Tues, and yesterday, I discovered a nurse got the other dr to change the script back to erythromycin because she was concerned that erythromycin wouldn't be strong enough because it's only given once a day (dr went along with this because he figured, erythromycin is cheaper, saving the taxpayers money. Of course, the real problem here is the dr doesn't read the charts - slows him down.)

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You mean Zpak..

Unless of course E-mycin was used for GI Pro-kinetic to increase gastric motility...

Its Z said:

You mean Zpak..

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The generic of such

Its Z said:

Unless of course E-mycin was used for GI Pro-kinetic to increase gastric motility...

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The pt is an otherwise-healthy 25 year old guy who probably just has a cold - the zpak was a compromise since the dr didn't want to just d/c the AB altogether.

Its Z said:

It wasn't directed at you. It was for the buffoon who posted before you.

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I gonna HIPPA you upside your head

This is a knee jerk response from the NP with a bruised ego attempting to get back at the pharmacist. I don't let these things insult me at all. After all, that is one of the responses the instigator would sadistically enjoy.

You smile... and say.. "I hope you change your mind how you feel about pharmacy and pharmacist.." then move on.

While not trying to take the obvious side on this battle, I do want to point out that typically people try to make themselves sound absolutely in the right whenever making a formal complaint. They never want to outline something that could be conceived as screwing up.

While some pharmacists do have religious beliefs about medicines (plan B being the major one) I believe most pharmacists would refuse to dispense a medicine for medical purposes. I find it more likely that the pharmacist asked for more information or said they refused to fill it until knowing the purpose because of other drugs on the profile that could have possibly negative impacts. Heck, the pharmacist could have flat out said that they didn't have the medicine in stock and the NP took it as an excuse to not fill it. The pharmacist *could* be a prick but the opponent's side is never given full credit when someone makes a formal complaint.

Just throwing it out there. Being pre-pharm and all, I reserve the right to be totally wrong in this case with some of the drugs/medical parts


Oh and I agree with Z. She probably wanted to make the pharmacist pay because she is usually "top dog" since she has the word "practitioner" in her title. Nurses are great and all but every profession has one of those...

As a pharmacist for 20+ years, I have seen the evolution of the profession from "lick-stick-pour" drug warehouser to more active involvement in pt care. Attitudes like that of this NP put us back to square one.

While I don't know the situation I can liken it to this hypothetical situation. Someone calls in quinine for a patient and you ask what it is being prescribed for and the prescriber refused to tell you and tells you to just fill it. I wouldn't fill it without knowing the situation and while methergine is less murkey for it's uses it still warrants a diagnosis when the pharmacists asks. If I can't ensure the drug is being used in a safe manner (which the diagnosis may help me decide) then the patient is not getting it

Pharmavixen said:

As a pharmacist for 20+ years, I have seen the evolution of the profession from "lick-stick-pour" drug warehouser to more active involvement in pt care. Attitudes like that of this NP put us back to square one.

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LOL..c'mon. No it don't, yo.

It's when we thump our chest and say "I'm a druggist so I know more than you" puts us back to square one.

Health-care is multidisciplinary. And the first and foremost, patient care comes first...not your religious belief or whatever.. I mean, not "you"...

I don't think Methergine can be used for an abortion, and if it can, it would probably kill the mother too. If the patient DID have an abortion, and is bleeding excessively afterwards, hey, the procedure is over and done and now our job is to take care of the mother.

I don't believe in abortion, but I'm not qualified to make that decision for anyone else.

WVUPharm2007 said:

What I find amusing is that this is being sent to the Idaho Board of Pharmacy.

That's a great way to get what you want. Send a letter to the board of pharmacy telling them how pharmacists don't have the right to know what a drug is being prescribed for.

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mmmm if you had a complaint against a pharmacist, where would you send the complaint to?

Board of pharmacy isn't there to protect pharmacists. They're there to protect consumers.

owlegrad said:

But to include in the letter that to tell a pharmacists the patient's reason for needing a drug would be a HIPAA violation, and besides that it would be bad practise/breaking confidentiality to tell her? Know your audience, I doubt the board is going to agree with her on that one.

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Oh, I know...

On the other hand, I wonder how the board handled it?

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If they're bored, they'll investigate. If they're busy... then nothing.

WVUPharm2007 said:

What I find amusing is that this is being sent to the Idaho Board of Pharmacy.

That's a great way to get what you want. Send a letter to the board of pharmacy telling them how pharmacists don't have the right to know what a drug is being prescribed for.

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Being Idaho and I wouldn't be surprised if there was 1+ members that would be opposed to abortion and see this as a victory

This is yucky all around. The NP is clearly dumb and doesn't understand HIPAA or what pharmacists do, but the pharmacist wasn't asking for the diagnosis for a legitimate medical purpose. She wanted to know so she could be judgmental and exercise her right to conscientious objection. Which I find very distasteful.

All4MyDaughter said:

This is yucky all around. The NP is clearly dumb and doesn't understand HIPAA or what pharmacists do, but the pharmacist wasn't asking for the diagnosis for a legitimate medical purpose. She wanted to know so she could be judgmental and exercise her right to conscientious objection. Which I find very distasteful.

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If in fact the pharmacist wanted to know for the sole purpose of judging, then that is absolutely wrong, imho...I take orders and fill them and counsel to best of my ability with one thing in mind...that patient care is my number 1 priority...That is it...

well it sounds like hippa in real life im pretty sure people will get what youre talkin about if you say HIPPA on an online forum

All4MyDaughter said:

This is yucky all around. The NP is clearly dumb and doesn't understand HIPAA or what pharmacists do, but the pharmacist wasn't asking for the diagnosis for a legitimate medical purpose. She wanted to know so she could be judgmental and exercise her right to conscientious objection. Which I find very distasteful.

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Agreed. Which makes no sense. I mean, apart from the nonsense that is "conscientious objection," the drug is given after the fact; it doesn't cause the abortion.

That's a great way to get what you want. Send a letter to the board of pharmacy telling them how pharmacists don't have the right to know what a drug is being prescribed for.

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Sad part is, in my home province, such a complaint might actually have legs. My college takes "customer service" to supine lengths.

Doctor M said:

If in fact the pharmacist wanted to know for the sole purpose of judging, then that is absolutely wrong, imho...I take orders and fill them and counsel to best of my ability with one thing in mind...that patient care is my number 1 priority...That is it...

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If the pharmacist in question truly did what the article said:

The pharmacist then asked if the patient had undergone an elective​

abortion.

-and-

The pharmacist then stated that if the patient had an abortion, she would​

not fill the prescription.

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Not cool.

I also don't think this case would fall under any legit conscientous objector clause anyway. Saying, "well you had an elective abortion, therefore you deserve to bleed to death and I refuse to participate in your care" is not pro-life. The pharmacist had no legit reason to know whether it was 1) an elective abortion 2) termination to save the mother's life 3) spontaneous abortion (miscarriage) 4) stillbirth or 5) bleeding after regular childbirth. At least not any reason that I can think of other than being a judgmental religious whackjob.

It's interesting that someone who would obviously claim to be pro-life doesn't care if someone dies without the necessary medication. The idiocy on both sides here is impressive.

owlegrad said:

Not completely unlike that wackos who physically attack abortion clinic staff.

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True. Even though here it's not terribly likely the patient would have actually died due to the pharmacist refusing to fill the med, the idea that they both prioritize some lives over others is something they have in common.

All4MyDaughter said:

This is yucky all around. The NP is clearly dumb and doesn't understand HIPAA or what pharmacists do, but the pharmacist wasn't asking for the diagnosis for a legitimate medical purpose. She wanted to know so she could be judgmental and exercise her right to conscientious objection. Which I find very distasteful.

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However we only have the disgruntled NP's word for that. And if, as the NP herself stated, the abortion had already taken place, what point would there be for even a Jesus Freak to refuse the Methergine?

Naidim said:

However we only have the disgruntled NP's word for that. And if, as the NP herself stated, the abortion had already taken place, what point would there be for even a Jesus Freak to refuse the Methergine?

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Like I *already* said, IF the pharmacist truly did what the NP said she did, then the pharmacist was in the wrong (although the NP is still dumb). We have no way of really knowing, do we? The story as it is told makes them both look bad.

But, just for fun, let's assume the NP is not telling the whole truth. Can you propose an alternative reason that the prescription was not accepted by the pharmacist? It's not b/c methergine causes abortions b/c it doesn't.

Would there be a problem with the duration of the drug if the NP was telling the truth?

WVUPharm2007 said:

Idaho Board of Pharmacy closing case. Citing stupidity of allegations.

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Nice

People complaining about HIPAA who can't spell "HIPAA" makes me laugh. HIPAA. 1 P, 2 As. It's not that hard people.

HIPAA is horribly misunderstood. One time, a nurse called in a prescription. I asked for the patient's date of birth, and the nurse told me she's not allowed to tell me the date of birth because that would be a HIPAA violation. I didn't even know how to respond.

As for refusing to dispense: Regardless of what the law says about conscientious refusal, pharmacists should be allowed to refuse any prescription for any reason, or even for no reason at all.

If you own something, you get to decide whether or not to sell it. The pharmacist owns the drugs, so he gets to decide whether or not to sell them. It's really just a question of property rights.

torchbearer said:

HIPAA is horribly misunderstood. One time, a nurse called in a prescription. I asked for the patient's date of birth, and the nurse told me she's not allowed to tell me the date of birth because that would be a HIPAA violation. I didn't even know how to respond.

As for refusing to dispense: Regardless of what the law says about conscientious refusal, pharmacists should be allowed to refuse any prescription for any reason, or even for no reason at all.

If you own something, you get to decide whether or not to sell it. The pharmacist owns the drugs, so he gets to decide whether or not to sell them. It's really just a question of property rights.

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Walgreens owns the drugs in this case. Either way, i always put my beliefs aside and do what is best for the patient.

WVUPharm2007 said:

Perhaps we should show tolerance for all beliefs and try not to judge before walking a mile in their shoes.

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Unless they are Christians who believe in the sanctity of human life, right? THOSE people are okay to bash.

I am a Christian myself, and one who firmly believes that abortion for any cause other than saving the life of the mother is murder. I also believe that as a Pharmacist it will be my job and duty to dispense medication in a safe manner in accordance with the prescribing physician's instructions. I won't necessarily know most patients or their circumstances as intimately as the physician will and it doesn't serve anyone for me to second guess their directions unless there is a safety issue. My opinions on Planned Parenthood's eugenics program should never be an issue with my duty as a Pharmacist.

But that's just my humble opinion.

Naidim said:

Unless they are Christians who believe in the sanctity of human life, right? THOSE people are okay to bash.

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This wasn't someone refusing to sell Plan B. The implications of the pharmacist's thinking in this scenario are far more concern for worry on the part of any patient.

It's been pointed out ad nauseum that he was letting his personal judgment interfere with the safe and legal dispensing of a medication.

Suicide is a sin to religious people, isn't it? If someone attempts suicide, and then arrives at the pharmacy after being prescribed something, would it be okay for the pharmacist to say "I think you're a sinner. Leave."

I don't think people are bashing the pharmacist for being a Christian. They're bashing him for being a jerk.

owlegrad said:

So if I don't like black people I can hang a sign "No Blacks", right? Your understanding of your rights as a retailer is flawed. Refusing to dispense medication for non-medical reasons (imo) violates professional responsibility. In this case it is particularly horrible as the medication doesn't even cause the abortion. It would be like refusing to give activated charcoal to someone who deliberately ODed because they don't deserve treatment. Bad, bad, bad.

You are spot on about HIPAA though. It is sad how badly people misunderstand both the intent as well as the letter of the law.

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What if the person is verbally abusive? That's a non-medical issue as well.
I think pharmacists should always have the right to refuse to fill.

As a trained practitioner and a licensed nurse, I am fully capable of determining treatment regimens that are appropriate to the medical condition at-hand and ensuring that those regimens do not negatively interact with concurrent prescriptions.

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Isn't she adorable! I just want to pat her on the head. I also lol'd at "conscious clause." ConsciENCE, dear, not conscious.