eddiescott said:
Well its like this, as far as the drug interactions,,,,,, thats what that 40 page printout is for. You know, the one that they put your pills in that unfolds like a US map and you are expected to read it through, and its not like the lamen could even pronounce 60% of the words or understand the nomenclature !!!
1,2,3,4 damn....1,2,3,4,5,6.....damn.......1,2,3,4,5,6,6,6.....damn
better let the tech count it !!
Ok, some corrections.
Most of what you're saying about the pharmacy profession is grossly inaccurate. Almost every situation you are referencing has to do with retail pharmacy (and outpatient pharmacy in the hospital setting). You asked what other skills or positions a pharmacist could have besides counting pills all day. Clinical pharmacy is one, where a pharmacist practices in a licensed health care facility (hospital, hospice, long term care facilities, nursing homes) and manages patient cases and how they are responding to their current drug regimens and takes action if need be. Clinical pharmacists have the power, under protocol from the facility, to "initiate and adjust" patient drug regimens accordingly. Yes, they can even initiate a drug regiment under protocol. This type of care helps to manage patients with long term complications to diabetes, hypertension, patients managing HIV/AIDS, and cancer patients currently undergoing chemo.
I'm not saying pharmacists have the power to prescribe, and in fact, they should not because we are not trained to diagnose disease. But clinical pharmacists work IN CONJUNCTION with physicians who diagnose and then refer patients requiring more in depth management of their disease and (most importantly) their meds to the clinical pharmacist. So if a patient who has been diagnosed with Type II diabetes walks into the clinical pharmacist's office, they can sit down and talk about options for meds, potential side effects, and which med is the best suited for the patient. Often times patients with these ailments do not only have a single disease...complications always arise. This leads to patients managing multiple prescriptions, each with a probably drug interaction with another, and it's doubtful that they could manage on their own. This same care is important in nursing homes and patients requiring long term skilled care. Patients in these facilities often times have BAGS full of different meds, so you can probably see the potential problems that arise.
Aside from that, you failed to mention the importance of PharmD's in pharmaceutical research, both in clinical trials and the bench research that leads to the formation of new drug structures and possible substrates in our own physiology. It's not all PhD's working at Genentech, Chiron, and Pfizer. In fact, there are quite a few PharmD/Phd's as well as just PharmD's. Of course the people who are most skilled in knowledge of drugs, drug mechanism, drug structure, and drug kinetics would be a valuable resource in a company that manufactures and develops drugs. But I guess that fact escapes some.
There are also branches into government positions, both at the state and federal level. Medications and drugs are one of the most tightly regulated substances available in the U.S. (and will be even more tightly regulated after the Vioxx recall from a few months ago, you might recall), and so obviously PharmD's are needed to head up trials that ensure drugs are safe (as safe as can be assessed) before coming to market. They are also needed to follow up drugs after they come onto market to assess whether potential risks of the drugs are found after coming to market. Sometimes problems escape clinical trials (the sample sizes are too small, the time needed to pass a drug too short, and you cannot predict drug interactions sometimes until you can see patients who are using them together) which was the case with Vioxx. It's also interesting to note that when the position for director of the FDA opened up a few years ago there were several PharmD's on the list of cantidates, and if you look up the FDA hierarchy, PharmD's hold several positions.
There are many other career branches for the PharmD., but I leave it to you to go ahead and indulge your own appetite by heading to the
www.aphanet.org, official website of the American Pharmacists Association and finding out more.
I am not bashing retail pharmacy certainly, because there is need for it to be there. Drugs have to be stocked and distributed. Who's going to do that? Doctors? Nurses? Techs? By law, all work done by pharmacy technicians must be reviewed by the supervising pharmacist, and a ratio of 2:1 techs to pharmacists must be in place at any pharmacy. This is to decrease the liability of med errors, which occur a lot. You could say why not just let the techs stock and dispense by themselves? Well if you ever walk out of a pharmacy with the wrong prescription in hand and take that med then you can come back and complain that you want the tech's work supervised. And your logic about the drug interactions (getting a 40 page printout or whatever) is mind blowing. How many patients read their drug interaction sheets? How many patients actually follow their med instructions? Maybe more importantly: how many patients actually know what their med does, possible side effects, and what ADE's to look for after their doctor has prescribed them their med? Even after the doctor has described all of this to them, will they remember? I would venture not, as patient compliance and patient error in taking meds ranks pretty high in why some meds "don't work." By law, all new prescriptions dispensed in a pharmacy come with a mandatory consultation from a licensed pharmacist. But the patient has to accept it, so what does the pharmacist do when a patient doesn't want to hear a consultation and just walks away? You tell me. But the pharmacist, in the retail setting, has a lot of potential for valuable health care information and other services (immunizations, blood glucose readings, cholesterol readings, etc.). It's up to the retail chains to realize this, and for patients to realize that they could be getting so much more care. I don't even want to go into retail pharmacy, but to say "as for hospital pharmacists that mix formulas and compounds, they have my upmost respect and they are TRUE pharmacists unlike the ones out there counting tylox and Z-packs ......gimme a break!!!" was so utterly insulting I couldn't help but reply.
I have nothing against dentists or doctors. No, I wouldn't want to be a dentist. I do not want to be staring into patient mouths all day, and I hate going to the dentist anyways, probably as much as you would hate standing around talking about drug interactions all day and dispensing meds. That is my preference, and your preference, but that does not mean I lose respect for either profession. We are all professionals, meaning we all have responsibilities to care for those who seek our help and to do so in a manner that upholds our respect for them and respect for what we do as a profession. Doctors/pre-meds that bash dentistry are not being professional. Dentists/pre-dents that bash medicine are not being professional. Pharmacists/pre-pharms that bash either one are not being professional. It applies to all of the health sciences, and this ranking of "who is better" is a product of insecurity, ignorance and keeps us from doing our jobs.
I apologize for the long post. I have nothing against you, EddieScott, but I felt compelled to respond. Hopefully you will endeaver to find out more about pharmacy and realize that it's not what you (and in some cases, the general public) has stereotyped it to be and realize the role in plays (and could potentially play) in our country's health care system. I will also to endeaver to make the same effort to find out more about dentistry and medicine, and hopefully one day all of us can reach some point of mutual understanding. We should all be working together.
And that's what counts! (jk)
