3 Things pharmacists should push for

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Bloomin Onion

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I'm a pharmacy student at the University of Maryland and our school and state pharmacy organizatoins are pushing for pharmacists to expand our scope of practice into things like immunizations. I'm not opposed to this as long as pharmacists are reimbursed properly, and I mean the individual pharmacist, not like the company makes more profits but the pharmacist still makes the same salary. Some other things I think is important to our profession though....

- The state of Maryland is debating whether to give loan assistance to pharamcists who practice in a "rural area" (here it includes cities of 30,000 that are far from our 2 major metropolitan areas Baltimore and DC.) This is a great idea to lessen the shortage of pharmacists in our smaller towns. I also think that pharmacy students should be required to do at least 1 rotation in a rural area the way our dental and medical students are. A lot of students, especially those from the rich suburbs or from the urban elites have a lot of misconception about small town America and are like oh I will never practice there. I think once a lot of people actually spend time in these towns they wont' be so opposed to settling down there. Also hope that people think more about the future. Living in the city is fun now because of all the bars and clubs but when you have a family you want to raise your kids in a healthy environment where people have good values and the right priorities and less bad influences like gangs and drugs.

I have no problem with the state using tax money toward this end because in my state and in America in general small town Americans have long worked hard and paid taxes and gotten little in return while they subsidize urban programs like public transit, freeways, urban redevelopment not to mention welfare, Section 8 housing, food stamps and other public assistance programs that are heavily used in the city. Its about time urban and suburban taxpayers contributed something to the rural majority of America.

- I think pharmacists should push for improvement in working conditions especially in the chain pharmacies. Some pharmacists for CVS work 14 hour days with no break. I know this is not true for all chains (Wal-Mart has 8 hour days as does Target) but there should be some kind of regulation. After all there are limits on how long a long-haul trucker can drive or how long a commercial airline pilot can fly. When pharmacists are overworked and overburdened the quality of care decreases and medication errors increase just like the potential of an accident increases when a trucker or bus driver is overworked. This is more of an issue in community pharmacies than institutional, managed care or assisted living.

- I believe the state and local government should subsidize independent pharmacies to help them stay afloat in the face of competition from the major chains, the way the government subsidizes farmers and ranchers. I've found independents to play a lot more emphasis on patient care and are a lot more personalbe and comfortable compared to the chains which are only about making a profit. Also small businesses in general help keep the charm of America's small towns and are worth preserving.
 
dude...too many damn words...can you like condense this into 3 sentences?
 
yeah i was about to say, reading is overrated...condensing is a far more important real life skill.
 
I was under the impression that Maryland had already passed legislation permitting Pharmacists to immunize.

Overall, the ideas are good, but I don't know how realistic they are. The only real way to force a limitation in working hours would be to unionize, which would ultimately hold the profession back.

Subsidies for the independents would be nice, but I don't think it would ever work. With Fortune 500 companies sinking, it will be a long time before anyone even thinks about boosting up local businesses.
 
Agreed.

Unions-no. Inherently corruptible.

Legislation-yes. Forces corporations to follow law or pay the price.

Time is better spent convincing local/state/federal officials to change/pass new legislation protecting/preserving our livelihood.

The problem is in "rallying the troops" for the commom good. Any ideas there?
 
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I still don't understand why the f* us---as who carrying a Pharm.D degree should brag ourselves when being able to "immunize". COme on...That's the LVN/RN job, not my job. If I really wanna be hand on, i already went on med school being a surgeon....What's so glorious about holding a needle, finding a vein, and stick the drug in it? 😕

If you really wanna expand our scope of practice--> This is want i want to make my life easier and other pharmacists' lives easier, too:

1. Change med name to the correct one without calling MD (eg, MD wrote : Lizinopril 10mg, or Sensipur 30mg and we still have to call MD to change to Lisinopril or SensipAr).

2. Change dosage if appropriate. Example: MD wrote: Nicotine patch 21mg weekly and we change to the right one: Nicotine patch 21mg daily..

3. And many more....
 
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I still don't understand why the f* us---as who carrying a Pharm.D degree should brag ourselves when being able to "immunize". COme on...That's the LVN/RN job, not my job. If I really wanna be hand on, i already went on med school being a surgeon....What's so glorious about holding a needle, finding a vein, and stick the drug in it? 😕

It changes the public perception of pharmacists rather being merely pill counters. All of my patients whom I've immunized and educated on immunizations see me as a healthcare professional and trust me even more.
 
I still don't understand why the f* us---as who carrying a Pharm.D degree should brag ourselves when being able to "immunize". COme on...That's the LVN/RN job, not my job. If I really wanna be hand on, i already went on med school being a surgeon....What's so glorious about holding a needle, finding a vein, and stick the drug in it? 😕

If you really wanna expand our scope of practice--> This is want i want to make my life easier and other pharmacists' lives easier, too:

1. Change med name to the correct one without calling MD (eg, MD wrote : Lizinopril 10mg, or Sensipur 30mg and we still have to call MD to change to Lisinopril or SensipAr).

2. Change dosage if appropriate. Example: MD wrote: Nicotine patch 21mg weekly and we change to the right one: Nicotine patch 21mg daily..

3. And many more....


It is a public health problem. It opens access and reminds people to get immunized. It keeps people out of the hospital.
 
It changes the public perception of pharmacists rather being merely pill counters. All of my patients whom I've immunized and educated on immunizations see me as a healthcare professional and trust me even more.

A pharmacist = a healthcare professional. So is the CNA/LVN.

As a pharmacist, I have no interest whatsoever for public to recognize me if i can do better than pill counting. Now, if someone with a one or two digit IQ, they'll see me as a pill counter, anyway....why bothering changing them?

Furthermore, I would be feel glorious if they let pharmacists run all code blue during a cardiac arrest, or let the pharmacist doses/changes dosages of all the antibiotics in the hospitals....now that i am impressed. But if u talk about a pharmacist can immunize influenza/pneumovax , that isn't impressive. In fact, a 15 yrold highschool kid....with enough training (10 hours?) can do a much better job.
 
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It is a public health problem. It opens access and reminds people to get immunized. It keeps people out of the hospital.

👍👍 Yep...it is a public health issue which makes it the pharmacist's domain. There are people out there that do not have access to doctors and nurses. This is where pharmacists step and take over for those without the option of making a doctor's appointment.
 
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Agreed.

Unions-no. Inherently corruptible.

Legislation-yes. Forces corporations to follow law or pay the price.

Time is better spent convincing local/state/federal officials to change/pass new legislation protecting/preserving our livelihood.

The problem is in "rallying the troops" for the commom good. Any ideas there?

I don't think unions are such a bad thing and in other industries like steel, auto, airlines, teachers, etc they have done a lot for their members. Someone shouldn't be forced to join a union but there's nothing wrong with that option being open.
 
👍👍 Yep...it is a public health issue which makes it the pharmacist's domain. There are people out there that do not have access to doctors and nurses. This is where pharmacists step and take over for those without the option of making a doctor's appointment.

It's not necessarily access, it's the inability to pay. So you're saying we pharmacists should be doing these things for free? I wouldn't mind doing these services so long as the services were appropriately charged and the RPh's are appropriately compensated, just like their counterparts on the other side of the counter.

I mean, if you can't pay the small fee to see the nurse at the clinic for a flu shot, theoretically this would lock the pt out of seeing the RPh as well.

Personally, I chose pharmacy because I wanted to be involved in health care without physically having to do anything TO a patient. If I wanted to inject something into someone, I would have been a nurse or a physician.
 
I

1. Change med name to the correct one without calling MD (eg, MD wrote : Lizinopril 10mg, or Sensipur 30mg and we still have to call MD to change to Lisinopril or SensipAr)....

You call the MD for that? Are u serious?
 
It's not necessarily access, it's the inability to pay. So you're saying we pharmacists should be doing these things for free? I wouldn't mind doing these services so long as the services were appropriately charged and the RPh's are appropriately compensated, just like their counterparts on the other side of the counter.

I mean, if you can't pay the small fee to see the nurse at the clinic for a flu shot, theoretically this would lock the pt out of seeing the RPh as well.

Personally, I chose pharmacy because I wanted to be involved in health care without physically having to do anything TO a patient. If I wanted to inject something into someone, I would have been a nurse or a physician.

No, I wasn't implying that we should give immunizations for free. I meant that there are many working class people that do not have insurance. Depending on the clinic, many of these people would have to pay out of pocket for a doctor's visit just for flu shot, for instance. It would be much cheaper to pay the 10 or 20 bucks at the pharmacy. (I don't really know how much it would be, but I am sure it would be less than a doctor's visit).

I agree though about not wanting to have physical contact with patients. I would not want to personally give vaccinations, but I am very strongly in favor of allowing pharmacists to vaccinate.
 
No, I wasn't implying that we should give immunizations for free. I meant that there are many working class people that do not have insurance. Depending on the clinic, many of these people would have to pay out of pocket for a doctor's visit just for flu shot, for instance. It would be much cheaper to pay the 10 or 20 bucks at the pharmacy. (I don't really know how much it would be, but I am sure it would be less than a doctor's visit).

I agree though about not wanting to have physical contact with patients. I would not want to personally give vaccinations, but I am very strongly in favor of allowing pharmacists to vaccinate.

Yeah...I'm thinking retail pharmacies with retail clinics. I believe the one attached to CVS charges $35 for them. Physician's offices lost their "monopoly" on the influenza vaccine ages ago.

My only worry with the vaccination thing is that it becomes expected from employers, so essentially you're getting paid the same to do your previous work AND immunizations on top of that.
 
2. Change dosage if appropriate. Example: MD wrote: Nicotine patch 21mg weekly and we change to the right one: Nicotine patch 21mg daily..

3. And many more....

The problem with #2 is that you would be empowered to change therapy without notifying the patient's physician. I presume this is the power you want? I don't think that that would be in the best interests of the patient. It just seems way too open for abuse or would make it that much easier to have adverse events. I mean sometimes physicians write prescriptions that don't follow "protocol" for a reason. I'm curious what other powers you'd like pharmacists to have. I think a good one would be the ability to let certain techs become supertechs in their discretion and give them the ability to take new ones or verify previously authorized refills.

And only in America would the solution to poor working class people's lack of access to physicians and ergo immunizations be to provide them for $10 at Wal-Mart or CVS. Let's not talk about actually giving access to doctors to these people, let's just let them see a nurse and get a ****ty physical then pay $10 for a shot.

Very, very sad.

PS Calling to verify lizinopril? Are you ****ing kidding me?
 
A pharmacist = a healthcare professional. So is the CNA/LVN.

As a pharmacist, I have no interest whatsoever for public to recognize me if i can do better than pill counting. Now, if someone with a one or two digit IQ, they'll see me as a pill counter, anyway....why bothering changing them?

Furthermore, I would be feel glorious if they let pharmacists run all code blue during a cardiac arrest, or let the pharmacist doses/changes dosages of all the antibiotics in the hospitals....now that i am impressed. But if u talk about a pharmacist can immunize influenza/pneumovax , that isn't impressive. In fact, a 15 yrold highschool kid....with enough training (10 hours?) can do a much better job.

thats too bad...
 
No, I am not...Can't believe u take that! Are you serious?

Mispelling a drug name is not a reason to call unless the mispelling looks like it could be another drug or the hand writing is really bad. I never heard of a state board saying you have to call dr if they mispelled a drug. Were not spelling police... When I was in pharmacy school, spelling the drug was the least of my concern... I mispell drugs occasionally, I was never good at spelling but that doesn't make me a bad pharmacist.
 
And only in America would the solution to poor working class people's lack of access to physicians and ergo immunizations be to provide them for $10 at Wal-Mart or CVS. Let's not talk about actually giving access to doctors to these people, let's just let them see a nurse and get a ****ty physical then pay $10 for a shot.

Very, very sad.

I'd rank "a doctor for every person" right up there with the "40 acres and a mule" promise. Promised, talked about, but inevitably you'll get some watered down version of legislation decades and decades later that bears no semblance to the original argument (in that case, affirmative action).
 
What do you guys think about changng the rules so that physicians can just diagnose, and pharmacists are presented with the diagnosis and we choose the drug treatment.

How about this...The Doctor diagnoses the patient and selects the appropriate medication. The Pharmacist dispenses the medication and counsels the patient on it.
 
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What do you guys think about changng the rules so that physicians can just diagnose, and pharmacists are presented with the diagnosis and we choose the drug treatment.

I think it's one of the stupidest things you can say.
 
What do you guys think about changng the rules so that physicians can just diagnose, and pharmacists are presented with the diagnosis and we choose the drug treatment.

This is the ideal world of the pharmacy practice
 
The problem with #2 is that you would be empowered to change therapy without notifying the patient's physician. I presume this is the power you want? I don't think that that would be in the best interests of the patient. It just seems way too open for abuse or would make it that much easier to have adverse events. I mean sometimes physicians write prescriptions that don't follow "protocol" for a reason. I'm curious what other powers you'd like pharmacists to have. I think a good one would be the ability to let certain techs become supertechs in their discretion and give them the ability to take new ones or verify previously authorized refills.

And only in America would the solution to poor working class people's lack of access to physicians and ergo immunizations be to provide them for $10 at Wal-Mart or CVS. Let's not talk about actually giving access to doctors to these people, let's just let them see a nurse and get a ****ty physical then pay $10 for a shot.

Very, very sad.

PS Calling to verify lizinopril? Are you ****ing kidding me?

Have you seen a nicotine patch given weekly? I challenge you to find any cases in this world that implementing a nicotine patch weekly. Obviously, we're all practicing evidence based medicine, here. What i am trying to point out is that pharmacists should be given the authority to change drug regimen if he/she detects errors from the physician's orders...without calling back to MD. I have worked both in retail setting and hospital setting....and i tell u this: Out of 10 medication order from MD (or PA, NP), i would have caught at least 2 or 3 errors (wrong route, sig, etc...dosage form, etc..). And it is extremely annoying to call MD for these when u know exactly what is the right answer/information. Imagine this order from ER, "Toprol XL 100 mg Gtube daily". What's wrong with this order? wrong route! U don't wanna break the toprol XL tablet into the GTube!!!. I called and this is what i got, "Doc ABC already left home. You have to talk to the attending doc!". "WTF?" right? Very annoying.

And no, i don't call MD for lizinopril. I just gave an example , but bad one so i got myself caught with it....dumb idea. But anyway, bottom line is you have to call MD and verify everything in general even though u know the answer. Amazingly, just today, i saw this MD wrote :" Sandostation 100 units, then 50 units/hour"....another case is "protonix IV 20mg TID" wtf?
 
What do you guys think about changng the rules so that physicians can just diagnose, and pharmacists are presented with the diagnosis and we choose the drug treatment.

Common guys, don't bash this students idealized scenario. This type of situation if talked about in pharmacy schools as the "ideal," although it is just as likely to happen as me calling a md about lizinopril haha.
I do think therapeutic interchange in the retail setting is a thought (ie the MD wrote for Lipitor, then sub. 80 of pravachol...esp in cases where pts. cannot afford to pay for lipitor). Please don't bring up studies utiziling lipitor vs. pravachol (trust me, the pt. is better off paying $4 for pravachol than not getting lipitor ).
Finally, I do agree with the previous "lizinopril" poster about relaxing the laws in cases where it is blantly obivious that the md meant to write lisinopril.
 
What do you guys think about changng the rules so that physicians can just diagnose, and pharmacists are presented with the diagnosis and we choose the drug treatment.

There are very few scenarios where that could ever work. By the time all the variables are communicated, it would have just been easier for the physician to prescribe something.

For example, do you really want to have to dig for all the appropriate lab values associated with "Hypercholesterolemia," or would you rather just get a prescription for Lipitor 10mg QD and be done with it?
 
But anyway, bottom line is you have to call MD and verify everything in general even though u know the answer. Amazingly, just today, i saw this MD wrote :" Sandostation 100 units, then 50 units/hour"....another case is "protonix IV 20mg TID" wtf?

Thats how it works. We are the last line of defense before a med reaches the patient. If you start changing prescriptions because "you know whats right", who catches your mistakes?

Why does everyone want to do more than they should? Be a pharmacist and be happy. If you want to do more then go to med school.
 
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What do you guys think about changng the rules so that physicians can just diagnose, and pharmacists are presented with the diagnosis and we choose the drug treatment.

Unfortunately, that can't happen in the community setting b/c there is no electronic database where pharmacists can access diagnosis/lab values/SOAP's. Also, imagine how much more work the pharmacists would have on their hands.

However, I think some settings where this already occurs is PHS, VA, and some hospitals
 
Common guys, don't bash this students idealized scenario. This type of situation if talked about in pharmacy schools as the "ideal," although it is just as likely to happen as me calling a md about lizinopril haha.
I do think therapeutic interchange in the retail setting is a thought (ie the MD wrote for Lipitor, then sub. 80 of pravachol...esp in cases where pts. cannot afford to pay for lipitor). Please don't bring up studies utiziling lipitor vs. pravachol (trust me, the pt. is better off paying $4 for pravachol than not getting lipitor ).
Finally, I do agree with the previous "lizinopril" poster about relaxing the laws in cases where it is blantly obivious that the md meant to write lisinopril.


Ok.. let's play this game.

Friday afternoon at busy Wags. Patient shows up with 3 prescriptions..yet it's really not prescriptions for drugs rather prescriptions with a list of diagnosis from 3 doctors.

Cardiologist wrote,

End Stage CHF.
S/P CABG due to STEMI
A-Fib


Infectious Disease writes,

Aspiration Pneumonia & VAP. Patient has been Abx for 4 days.



Nephrologist writes,

ESRD associated Anemia
Wound ulcer due to diabetic foot.



Ok Mr. Pharmacist... go ahead.. start prescribing.
 
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Oh... you better beef up on your malpractice insurance while you're at it.

And don't forget, you got a line of 10 patients each with 2 or 3 diagnosis and you're the only pharmacist with 2 techs.
 
Oh... you better beef up on your malpractice insurance while you're at it.

And don't forget, you got a line of 10 patients each with 2 or 3 diagnosis and you're the only pharmacist with 2 techs.
what?? they never taught me that in pharmacy school! I was always taught that I should have a cushy office, seeing patients at my own retail pharmacy going thru each medication and making sure my patients understand how to take all of them and list back the directions without looking at the label!
 
what?? they never taught me that in pharmacy school! I was always taught that I should have a cushy office, seeing patients at my own retail pharmacy going thru each medication and making sure my patients understand how to take all of them and list back the directions without looking at the label!

Do not forget show and tell counseling!
 
so no one is volunteering to prescribe here?

I'm waiting!
 
Ok.. let's play this game.

Friday afternoon at busy Wags. Patient shows up with 3 prescriptions..yet it's really not prescriptions for drugs rather prescriptions with a list of diagnosis from 3 doctors.

Cardiologist wrote,

End Stage CHF.
S/P CABG due to STEMI
A-Fib


Infectious Disease writes,

Aspiration Pneumonia & VAP. Patient has been Abx for 4 days.



Nephrologist writes,

ESRD associated Anemia
Wound ulcer due to diabetic foot.



Ok Mr. Pharmacist... go ahead.. start prescribing.

Sweet!!! It's SOAPE note time at Wags!


Posted via Mobile BlackBerry Device
 
Don't kid yourselves. Just because we study medicinal chem and pharmacotherapy little longer than physicians, it doesn't make a pharmacist a better prescriber.

Just because MDs make mistakes on prescriptions and can't spell, it doesn't mean they don't know what they're doing. Everyone makes mistakes.

Not every disease management will be as easy as Strep Throat. Quite the contrary actually.

So, after an entry level PharmD education, you think you can accurately prescribe better than a specialist who is fellowship trained after 3 years of residency after 4 years of Medical School?

Wake up.
 
Don't kid yourselves. Just because we study medicinal chem and pharmacotherapy little longer than physicians, it doesn't make a pharmacist a better prescriber.

Just because MDs make mistakes on prescriptions and can't spell, it doesn't mean they don't know what they're doing. Everyone makes mistakes.

Not every disease management will be as easy as Strep Throat. Quite the contrary actually.

So, after an entry level PharmD education, you think you can accurately prescribe better than a specialist who is fellowship trained after 3 years of residency after 4 years of Medical School?

Wake up.

Of course not.

Being sarcastic. (At least the last few of us were!)
 
Don't kid yourselves. Just because we study medicinal chem and pharmacotherapy little longer than physicians, it doesn't make a pharmacist a better prescriber.

Just because MDs make mistakes on prescriptions and can't spell, it doesn't mean they don't know what they're doing. Everyone makes mistakes.

Not every disease management will be as easy as Strep Throat. Quite the contrary actually.

So, after an entry level PharmD education, you think you can accurately prescribe better than a specialist who is fellowship trained after 3 years of residency after 4 years of Medical School?

Wake up.

but, but... I'm the drug therapy expert 😕


:meanie:
 
What i am trying to point out is that pharmacists should be given the authority to change drug regimen if he/she detects errors from the physician's orders...without calling back to MD.
This is a terrible, terrible idea and your post just comes off as extremely arrogant, FYI. It would also be opening up a gigantic can of liability-laden worms that you would have to eat in the form of higher malpractice insurance. What is so bad about calling the MD to keep him informed of the patient's therapy? It is, after all, his patient. He is the one who physically examined the patient, he's the one who looked at the lab values. He's the one who actually diagnosed the patient.

I'm all for expanded role of pharmacists in certain instances but what you are talking about is not only impractical but possibly dangerous. You are handed a prescription with drug information written on it and you assume to know everything about the patient's pathology, or at least enough to counteract physician orders?

Maybe if you had access to the patient's chart and lab values we could talk about protocol-driven changes, but that already exists in the hospital! What you want is to not get yelled at on Friday night because some ****head brought in his Viagra 40mg Rx at 10 minutes to closing and you feel humiliated because you can't just give him 50mg. Sorry, but until pharmacists are given access to actual patient data, altering therapy and counteracting physician orders is way out of the question.
 
1) Baby Aspirin!

2) Gentamicin!

3) Metformin!

What do I win? (lol)
 
This is a terrible, terrible idea and your post just comes off as extremely arrogant, FYI. It would also be opening up a gigantic can of liability-laden worms that you would have to eat in the form of higher malpractice insurance. What is so bad about calling the MD to keep him informed of the patient's therapy? It is, after all, his patient. He is the one who physically examined the patient, he's the one who looked at the lab values. He's the one who actually diagnosed the patient.

I'm all for expanded role of pharmacists in certain instances but what you are talking about is not only impractical but possibly dangerous. You are handed a prescription with drug information written on it and you assume to know everything about the patient's pathology, or at least enough to counteract physician orders?

Maybe if you had access to the patient's chart and lab values we could talk about protocol-driven changes, but that already exists in the hospital! What you want is to not get yelled at on Friday night because some ****head brought in his Viagra 40mg Rx at 10 minutes to closing and you feel humiliated because you can't just give him 50mg. Sorry, but until pharmacists are given access to actual patient data, altering therapy and counteracting physician orders is way out of the question.

What's so bad about calling MD? well, you are not a pharmacist, so u don't know! Before reaching to the MD, you have to talk to a highschool drop out kid on the other line, being put on hold...then he/she will tell you to fax request over to the office. You and your techs patiently waits....Meanwhile, your patient (customer) keeps nagging "Why the fu* so long to have my medication filled?". Two hours later....after you fax 3 times...still no response....and you, as a pharmacists, feel frustrated when knowing "Nicotine patch 21mg daily", not "Nicotine patch 21mg weekly"....
 
What's so bad about calling MD? well, you are not a pharmacist, so u don't know! Before reaching to the MD, you have to talk to a highschool drop out kid on the other line, being put on hold...then he/she will tell you to fax request over to the office. You and your techs patiently waits....Meanwhile, your patient (customer) keeps nagging "Why the fu* so long to have my medication filled?". Two hours later....after you fax 3 times...still no response....and you, as a pharmacists, feel frustrated when knowing "Nicotine patch 21mg daily", not "Nicotine patch 21mg weekly"....

But it's absolutely impossible to know where to draw the line. The average community pharmacist might not recognize a prescription for Azithromycin 500mg PO TIW as being possible therapy for CF, and would change it to something like a Zithromax Tri-Pak.

However unfortunate or obvious, the pharmacist simply does not have the necessary information to make a change to drug therapy without consulting the prescriber.
 
What's so bad about calling MD? well, you are not a pharmacist, so u don't know! Before reaching to the MD, you have to talk to a highschool drop out kid on the other line, being put on hold...then he/she will tell you to fax request over to the office. You and your techs patiently waits....Meanwhile, your patient (customer) keeps nagging "Why the fu* so long to have my medication filled?". Two hours later....after you fax 3 times...still no response....and you, as a pharmacists, feel frustrated when knowing "Nicotine patch 21mg daily", not "Nicotine patch 21mg weekly"....
Pointing out I'm not a pharmacist is a pretty big cop-out considering I've worked in pharmacies for six years and was the go-to guy in the pharmacy for MD calls when I was working.

But regardless, yes I realize that it is frustrating that MD offices sometimes take a while to get back, but that is just how it goes. Everyone here knows that a lot of prescription mistakes might be as simple as you're stating, but there are also going to be a lot that are specifically written an odd way due to the pathology. If pharmacists had full access to medical records then maybe you'd have a case for a very limited set of circumstances where therapy alteration without MD consult would be ok, but in the retail world this is not going to happen any time soon.

edit: I'm not trying to be a douche but just realistic.
 
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