SDN Pharmacy Forum Makes the Blogosphere Thanks to Anti-Pharmacist Rhetoric

[Caverject]

Hey guys!

I was going through some old posts today?s and decided to click on a fellow SDN members signature that was linked to his personal blog site. I have to admit, I was appalled with what I saw. We are compared to "Nazi's" in the way that we practice pharmacy. The funny part is that I had a profound respect for this person's posts cause I've always have found them interesting; good, bad, or indifferent.

For some reason, from what I get from this person's post is that pharmacist's want to take complete control over prescribing. This is just utterly wrong. The pharmacy profession is trying to create a better healthcare team by having pharmacists participate more in the selection of therapeutic agents. In no way, shape, or form are we trained to diagnosis a patient. It was noted in another post that this person has seen a patient that had shingles, get treated for poison ivy with hydrocortisone cream by a pharmacist. Well, a pharmacist is the most open health professional there is in the health care industry. You are right in the fact we do not have years of dermatology experience. Most pharmacists will not physically handle a patient either; more like just eyeball the problem for this instance. If it itches, go ahead and recommend an anti-itch cream. If it doesn't go away in a few days, go see a doctor. What, may I ask, is the problem with that? Keep in mind; it usually takes a few days in order to see a physician. What does the patient do in the mean time?

In the last part of this person's initial rant, he compares pharmacists to untrained non-medical professionals. I just find this statement being said by this person hard to believe. How can you honestly say that about a *Pharmacist*?? Part of patient health care is to work well with a team. In the hierarchy of things, the attending physician is always first. There is no doubt about it. Then comes everyone else from nurses to pharmacists. I am sorry if this person feels that the physician's main duty is to boss everyone around and let everyone else on the team play "Stooge".

Normally, stupid BS like this person's post wouldn't bother me cause usually people that talk this way, don't really have a clue. It bothers me when a person that usually writes very good, well thought out posts goes and pisses on our profession. Oh well, C'est la Vie

Well, due to my confrontation with the nazi pharmacists on the pharmacy forum at SDN, I have successfully been banned for a period of 2 weeks there. I just could not sit by and listen as these pharmacists sat back and tried to influence people to believe that a pharmacist is capable of prescribing. There is so much more to prescribing than simply understanding the medicine. You simply have to be able to make a diagnosis, which these people are not taught to do. I get so sick of groups like psychologists banning together for script rights, and now pharmacists. Who will it be next, medical office managers, those that answer the phone in medical offices, or hell, how about we just create a state of "Pharmacy Marshall Law" where you can get whatever you want over the counter without a physician. I swear I would vote for this before I would allow untrained non-medical professionals to prescribe. Take a look at this thread for a bit of comic relief.

http://nontradmedjournals.blog-city.com/read/897131.htm

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[GravyRPH]

Did you just find this? I've been checking it since he started ranting in here about how uneducated we all are. There's been a pharmacist who has been defending our position at that blog site since he got suspended. Unfortunately, Matt has been deleting all comments that don't support his opinion. There was at least one other med student who said Matt's post was a load of crap and didn't agree with one iota of it. Guess what? Deleted. Another poster said how they were sad that this educated professional takes such a narrow minded point of view. Yep. Deleted. Apparently, only his point of view counts. Even though one of his earlier blog posts talks about how he created this site to open up all different points of view and that he welcomed everyone to participate. Just not the "nazi pharmacists". Heh.

I try not to wast too much time on people like this.

I think we all know how much respect and help he will get from the pharmacy community in his home town.

 

[baggywrinkle]

Hey guys!


http://nontradmedjournals.blog-city.com/read/897131.htm

Comeon now Matt was misquoted

What he really said was

? H ? Matt Messas Blogs :: Matthew M :: email link
導演：湯尼葛立夫
演員：羅曼杜里斯,魯比娜阿茲巴爾
2004/法/35mm/Colour/103mins
2004 坎城影展最佳導演

這部片將在金馬影展映演，場次如下：

金馬奔騰到台中
時間:11月28日 11:00 地點:台中德安華納威秀 1廳
時間:11月29日 18:00 地點:台中德安華納威秀 1廳

台北金馬影展
時間:12月2日 14:20 地點:台北信義華納威秀 12 & 13廳〔售完〕
時間:12月3日 15:00 地點:台北信義華納威秀 17 廳
時間:12月5日 12:15 地點:台北信義華納威秀 12 & 13廳〔售完〕


官網是這樣介紹的：過去以吉普賽音樂題材享譽影壇的湯尼葛立夫，這回以兩個異鄉子女重返祖先流亡之路，再度喚醒流浪靈魂的經歷，開啟了一段從法國穿越西班牙、回到阿爾及利亞的旅程。他們的隨身行李只有音樂，從吉普賽、techno、佛朗明哥、安達魯西亞，到非洲回教蘇非派狂喜音樂，震撼動人。這是個瘋狂的念頭，卻讓原本生命充滿沒有未來的茫然年輕人，享受了前所未有的自由，而找到自己的路。湯尼葛立夫以本片榮獲今年坎城影展最佳導演。

我沒有看過這個導演最精采的作品，"過客"(原文片名我得再查&#35657。

片頭為一對男女，男主角向女主角表示要回到阿爾及利亞尋根，女主角覺得男主角這念頭真是荒謬，接著他倆放棄既享資源，踏上了邊打工邊抵達目的地的旅程。藉由影像，導演有意將大批由非洲往歐洲遷移的心態與旅程，由此兩位法國裔阿爾及利亞人的以回溯的方式返鄉。然而返鄉之後，卻只是遭逢更大的文化衝擊，就算構成血統的是純正阿爾及利亞DNA，成長的環境影響已經大於遺傳的原始組成。而影片中特別是女性遭受的衝擊更加劇烈，成長在崇尚自然提倡人權的法國女孩，回到處處以可蘭經受限的回教國度，緊張的氣氛無時不在，我想現實之中也必然如此。片中的女孩很有勇氣堅持以她在法國的教養與當地人應對，我不知道現實中若是如此，是否可行。�BA�生。

前天看到一則在伊拉克已經以人道立場協助過許多伊拉克人的英國女性，遭到不知名人士擊斃的新聞，更加令我了解到文化的鴻溝是如何存在於人與人之間。那一為英國女性已在伊拉克進行人道救助之工作長達二十年，為融入當地生活，她改信回教並嫁給伊拉克人，在當下情勢緊張的狀況下，進行救助工作的外國人皆已離去，但是她卻選擇待在伊拉克，如此的情操，真是相當偉大，不過最後還是以悲劇收場。血統不相同，不能被接受。生活文化有差異，也是不能共相處。人與人之間的衝突何其多。

此片說實在並沒有什麼特別之處，攝影表現平平，故事也沒有什麼衝擊性，卻得了坎城最佳導演。片中有一大段企圖以阿爾及利亞的神秘儀式誘使女主角回歸其血統文化之情節，更是冗長到令人無法忍受。音樂倒是相當好聽，昨天在唱片行已經看到這部影片的原聲帶了，是由上揚唱片公司發行的，一張約430元。

影片放映有位老師說：年輕人遇到生命中一些重大的挑戰時，就是無法跨過那一道限制...

而我的看法是，當一個人的成長環境已經背離自己原生血統的傳統時，觀念的差異、信仰的不同、生活方式的不一樣，就算情感上認同血緣的傳統，實際上的確很難"道道地地"如同先輩一般過活。

posted 20 November 2004, Saturday

...a clear case of spatula envy

 

[GravyRPH]

He writes in other languages too? Impressive.

Hmm. I thought you just screwed up the cut and past at first, but it looks like someone hacked the blog and screwed it up. I hope that wasn't any of us. He should have the right to say what he wants, even if it is misguided and hateful.

 

[ultracet]

He writes in other languages too? Impressive.

Hmm. I thought you just screwed up the cut and past at first, but it looks like someone hacked the blog and screwed it up. I hope that wasn't any of us. He should have the right to say what he wants, even if it is misguided and hateful.

I went to the main website and got this...

Blog-city is down for maintenance. A hacker has effected a number of blogs and we are in recovery mode. Please accept our apologies for the delay we shall be back shortly.

 

[ultracet]

On another note.... Things like this just really make me mad... I'm so glad there are "real" doctors out there who do not feel this way....
It has been my experience that when an MD has had a positive experience with a pharmacist they will call and as the pharmacist EVERYTHING...
ironically some of the older MDs are the ones who seem to be coming around the fastest in my hospital. the younger ones just expect to write things like....
APAP- pharmacy to dose..... and they don't even take the time to call and ask.

Thank goodness for MDs with some since and respect for other professionals involved in patient care.

 

[Oneday_9]

Wow, these anti-pharmacist points of view are nauseating.

I can't believe what I was reading, and it seems some agree.

Glad he was banned...unprofessional all around, how old is this brat?

 

[GravyRPH]

I can't believe I'm actually going to do this, but I'm going to defend the guy a bit. I have met a few doctors like this in my travels through many pharmacies, and the one thing I noticed is their underlying motive is actually based in concern. Concern for the patient. They truly don't want to see their patients harmed and only want what they feel is best for them. Sure, it could have been said in a better way; done without degrading an entire profession, but to be honest, you can see that his motive perhaps is a noble one.

 

[bananaface]

Glad he was banned...

He was not banned but placed on temporary post-hold, which has now been lifted. If he chose to, he could take part in this conversation. To his credit, he has not replied to any of the remarks made about him in this thread or in other areas of the forum.

Something to think about: If we turn our back on other professionals that treat us poorly or speak of us poorly, will we ever win them over? And, if we give up, isn't it partly our fault that the problem remains unfixed?

 

[kwakster928]

Please note, I do not really know what exactly what pharmacists are lobbying for. I wrote this with assumption that pharmacist are trying to get the generalized prescribing rights. I apologize for lack of specifc knowledge in this matter.

Here is my thought on this issue of prescribing rights. I have to say i have to defend PACtoDOC on his position of not giving pharmacist general prescribing rights. I have to say however, way how PACtoDOC gone about making his point was not professional.

I believe that we are concentrating on the wrong issue here. Many of us might feel that since our degree has gone some changes BsPharm to PharmD, we feel that we are more capable of being in the clinical role. That is true but it is not completely to the point that we have the right knowledge and experience to have prescribing rights. in order to prescribe, you need to make a diagnosis, reviewing pt's symptoms and vital signs. we as pharmacist not only lack sufficient skills to do so, nor know all the disease states as well as physicians do in their regular day of practice. it is physicians job to find out what disease the pt has, and what ways he/she wants to go about treating that pt. our job is to interpret his/her choice of drug treatment and make sure it is safe to the pt also drug treatment that was assigned to pt gives maximum therapeutic effect.

I think the general conflicts arise when one?s profession?s territory is not respected. Perhaps we as pharmacists had too many incidences where our recommendations were shut down in front of physician, or putting our job on the line to defend our interventions or recommendations. I believe that these conflicts could be minimized if physicians and pharmacist understand that our goal here is to maximum positive outcome for the pt. Two of us happen to have different knowledge specialty, let us all listen to what we have to say, lets us and pt both decide where we can go about treating this pt. After all, we all serve under our king the pt.

Instead of putting so much our effort on getting prescribing rights, let us the pharmacist worry about where we can be more beneficial to healthcare team and strengthen our territory. Everyone knows here everything ultimately depends on economics. What saves money on what. So we say ourselves we are more clinically oriented than ever before thanks to our new curriculum in the pharmacy school. What have we done to prove such a claim? I want to share with you guys with a except from an article that I have read in October issue of the ?Pharmacy Practice News? written by Al Heller, it reads ?if you re spending $1 million on that drug class, hire an FTE (full time clinical pharmacist) at $100,000 to make him save $300,000 a year? It is sad to see that only way to show our progress is to integrate our performance with a dollar value, but it drives the point home. We as pharmacist must show the public and other healthcare profession or the organization that we stand here for reason. Unfortunately putting the dollar value not only makes everyone understand, but that is the only way it seems like. Let us argue our position in respect to pt?s outcome and economics. If we can strengthen that, I think we will have less time dealing with getting prescribing rights. Overall, don?t we have enough to do on our side of territory already?

 

[Oneday_9]

I am not necessarily defending that we as pharmacists should have prescribing rights, if I wanted that responsibility I would have gone to medical school. As far as I know, the opporunity for such things arise in specialty clinics. We have a HIV clinic, where the pharmacist works closely with the physicians, so much so that the doctor often times simply allows her to prescribe what is necessary to alleviate ADE's and interactions, when reviewing how to improve a particular drug regimine with the patient.

I am sure everyone's problem is the utter contempt and disrespect that was shown behind a valid point. It is hysterical in voice and degrades the other profession. I might add, addreessing a callous remark, tt is not our job to correct medical errors. I know at my former employer, a mail order facility, too much time was spent by pharmacists tracking errors by techs mixed with errors from medical doctors, and honestly, given the intense environments of the modern pharmacy, handling many insurance issues, the last thing the pharmacist should have to do is worry about a PCP prescribing the wrong dose or medication. That was a problem I had with what was said.

Finally, I am unaware of a huge population of pharmacists ravenously campaigning fior prescription rights. I think the place where it is necessary, again, is in specialty clinics, or when the physician feels comfortable allowing the pharmacist to select a specific drug regimine. PERIOD.

So if this individual is reading this, I am glad he was not banned indefinitely, I simply wish him to realize many of us respect the physician, as I have many friends who are physicians. We don't want to step on toes, only help in alleviate many problems that surround patient's health in today's medical world.

We don't need this type of division because this is why the patient is suffering in every facet today, and, right now, this is not our healthcare system anymore, it is the insurance companies. To get through such times, we must all work together.

Simply put, sir, respect us, we'll respect you, and try to maintain a professional demeanor at all times, even in anonymity.

 

[jdpharmd?]

Speaking of concern for patient, I'd like to share a recent (attempted)intervention on behalf of the patient.

PT comes in for Alprazolam (Xanax) 2mg, 2QHS prn insomnia (total 4mg), and another script for Provigil 200mg 1qam. Set off anyone's mind as to a possible reason? Yeah, the poor guy is taking so much benzo at night to sleep, that he can't get going again in the morning because he's still drugged!

When the patient came to pick them up (provigil copay was $150+), we asked him if he thought that it was possible that he was drowsy in the am from so much xanax. He agreed that it was very likely, and we offered to call his doctor for him. Our idea was to change his Alprazolam 2mg to Ambien 5mg or 10mg qhs, and eliminate the provigil all together. We left a message at the office and waited for a return call. When Dr. XXXXX called back, he spoke to a pharmacist who wasn't familair with the situation, and left this message. "I'm not changing anything. The patient is not taking provigil becuase of the sleeping pills, he's taking it because he is 'low on energy'!! And for your information alprazolam is a short acting benzo! Goodbye"

Fast forward to the patient calling us back. We relayed mr friendly doc's message to the patient and the patient replied with something like "I'll call him! He's taken enough of my money, he can at least help me!"

And now a little kinetics for you: Alprazolam has a 6.3-26.9 hour half life. Anywhere from 1/2 to 4/5ths of the original dose is STILL active in this guy's body when he wakes up 7 hours later in the am! How would you do after a 2 or 3mg dose of Xanax daily before breakfast?

Ambien has a half life of about 2.5 hours. Therefore, about 1/8th of the original dose will still be active in the patient when he wakes up, and even that will be gone in just a few hours!

It's clear to me that this doctor doesn't want to work outside his limited scope of knowledge. "Can't sleep?"=Xanax until you can. "Can't get up?"=Provigil until you can.. Outside suggestions will not be accepted, as they might actually reveal how little this guy knows...

 

[Oneday_9]

Great example!!