Advanced Practitioner Pharmacist

[Wellington III]

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PharmDs should be allowed to write prescriptions. We are experts on literally thousands of drugs and how they interact with the body.

I often find myself diagnosing the customer in the back of my mind. Some will tell you their symptoms, lab results, etc etc. More often than not, the MD is clearly wrong. Would I ever question an omniscient God? Lord no!

The "Advanced Practitioner Pharmacist" has the potential to play an important role in America's increasingly strained health care system. We will bring to the table not only expertise in pharmacokinetics and drug interaction, but the humble ability to listen. Many customers have told me they are afraid of their Doctor! The average American does not want to be yelled at by someone who Television taught them to believe is a God.

How long can the AMA ruthlessly defend their turf? I believe in 2009-2010 we will have the right to write scripts after completing a 2-3 year fellowship.

 

[Knickerbocker]

This was a bit over the top, but was it really enough to be banned?

There is some truth to this though, especially in the field of mental health, where psychologists are the ones dealing with the patients the most. MDs will prescribe drugs, sometimes without really knowing enough about a patient's problems. It's sad that even psychiatrists (MDs), who are stereotyped as doing the one-on-one couch sessions, don't do much real patient interaction these days.

As for pharmacists... I'm not sure there is enough patient interaction in most fields to justify prescription rights.

 

[k0ni]

A pharmacist mentioned to me that in WA, some pharmacists are allowed to write certain prescriptions for patients. Anyone else hear something similar?

 

[sdn1977]

A number of us can, but they are under collaborative practice agreements with very strict protocols written & agreed to by physicians.

None of them involve us diagnosing. I'd challenge anyone that the practice of medicine is so easy anyone could do it. I've got one of the most respected PharmDs available & even 3 years of a fellowship would not put me at the level of diagnostic capability a physician has.

My daughter is MSIII & still has so far to go. I probably still know far more about drugs than she does. But, diagnostically - she is growing fast every day.

I think one of the things that you develop as you learn is how much more is out there to learn that you don't know. For us as pharmacists - there is a huge amount out there we don't know. But, within our field, we are tremendously capable & I truly believe physicians respect that.

 

[pharmstud07]

U.F. used to have a joint degree Pharm.D. / Masters of Physicians Assistant Studies.... I wonder what happend to it?

Does any other school offer it?

 

[Omegadramon]

Pharmacists can't diagnosis...period.

However, I've read about how Physicians will make the diagnosis and give the pharmacists a criterion that he wants established (say lower bp) and the pharmacists can reccomend (read: prescribe) the appropriate medications and the MD signs it off.

I read this...somewhere, or did I just make it up😕

 

[twester]

There are some "clinicians" I've met who seem to believe that diagnosis is in the pharmacist's job description. It's funny to listen to some of them and even funnier when an MD calls them on it. I think it's one thing to have an idea of what's going on with a patient and quite another to reach a conclusion and initiate therapy based on that decision. I don't want that responsibilty. If I did, I'd have gone to med school.

Someday, I might be competent enough to tell an MD that he can't give a patient calcium acetate for their patient's secondary hyperparathyroidism because their Ca/Phos product is over 55. Can you tell what I'm doing today? Better get back to it...

 

[cal687]

U.F. used to have a joint degree Pharm.D. / Masters of Physicians Assistant Studies.... I wonder what happend to it?

Does any other school offer it?

University of Washington has a joint PA/PharmD program:
http://www.washington.edu/medicine/som/depts/medex/applicants/degreeoptions_pharmd.htm

It's an interesting idea. I wonder which area graduates end up pursuing, or if they are able to find a niche of their own (and where exactly)?

 

[redbull]

PharmDs should be allowed to write prescriptions. We are experts on literally thousands of drugs and how they interact with the body.

I often find myself diagnosing the customer in the back of my mind. Some will tell you their symptoms, lab results, etc etc. More often than not, the MD is clearly wrong. Would I ever question an omniscient God? Lord no!

The "Advanced Practitioner Pharmacist" has the potential to play an important role in America's increasingly strained health care system. We will bring to the table not only expertise in pharmacokinetics and drug interaction, but the humble ability to listen. Many customers have told me they are afraid of their Doctor! The average American does not want to be yelled at by someone who Television taught them to believe is a God.

How long can the AMA ruthlessly defend their turf? I believe in 2009-2010 we will have the right to write scripts after completing a 2-3 year fellowship.

lol actually pharmacists in Canada will get the power/already got the power to give prescriptions to some medications (read in the news a few months ago)

 

[twester]

This is a golden oldie. It occurred to me the other day that I write scripts nearly everyday. Talked with a doc today who wanted to bump lovastatin to 80mg. No such thing. Patient probably won't be compliant with doubling 40s. Suggested simvastatin 40mg for one tablet therapy and a slightly greater effect on lipids. Plus it's generic and the copay stays the same. Doc said, "Do it." So I wrote the script and filled it.

I realize that's not the same as independently prescribing, but I stand by my earlier post when I say I don't want to do that. My point is just that pharmacists can have a lot of influence with prescribers as long as they're willing to step up and do it.

 

[ruth265]

really pharmacist can diagnose? there are also nurse practitioners who can diagnose and there is now DNP program for nurses? i don't think they will allow pharmacists to diagnosise then physicians will be out of job. NP, DNP, PA, MD? doctors will complain because someone will be stepping on their feet. however, i think pharmacists are just as smart as doctors

PharmDs should be allowed to write prescriptions. We are experts on literally thousands of drugs and how they interact with the body.

I often find myself diagnosing the customer in the back of my mind. Some will tell you their symptoms, lab results, etc etc. More often than not, the MD is clearly wrong. Would I ever question an omniscient God? Lord no!

The "Advanced Practitioner Pharmacist" has the potential to play an important role in America's increasingly strained health care system. We will bring to the table not only expertise in pharmacokinetics and drug interaction, but the humble ability to listen. Many customers have told me they are afraid of their Doctor! The average American does not want to be yelled at by someone who Television taught them to believe is a God.

How long can the AMA ruthlessly defend their turf? I believe in 2009-2010 we will have the right to write scripts after completing a 2-3 year fellowship.

 

[mike36]

really pharmacist can diagnose? there are also nurse practitioners who can diagnose and there is now DNP program for nurses? i don't think they will allow pharmacists to diagnosise then physicians will be out of job. NP, DNP, PA, MD? doctors will complain because someone will be stepping on their feet. however, i think pharmacists are just as smart as doctors

Yes, we may be as smart as doctors, but that is not the point. Pharmacists are not trained to diagnose patients. If that is what you want to do, you need to go into medicine. I am pretty sure that pharmacists are not going to put M.D.s out of a job because you think you can diagnose someone.

 

[mrblah]

Traditionally, pharmacists primary role is to protect the patient's health by checking what a doctor prescribed. Pharmacists are not trained to diagnose patients, and will never do so. Sure some HMO's and hospitals allow pharmacists to prescribe medications as long as they follow strict protocol or recipes, but that is not the same as diagnosing a patient.

I am looking forward to what the future has in store for us, but to me this is a nonissue.

 

[ruth265]

well if you will prescribe who will diagnose then? in order for you to prescribe you need to know what disease Pt has.

Traditionally, pharmacists primary role is to protect the patient's health by checking what a doctor prescribed. Pharmacists are not trained to diagnose patients, and will never do so. Sure some HMO's and hospitals allow pharmacists to prescribe medications as long as they follow strict protocol or recipes, but that is not the same as diagnosing a patient.

I am looking forward to what the future has in store for us, but to me this is a nonissue.

 

[ALLNuclear]

^ They're probably suggesting the same thing pretty much everyone else has been suggesting.

MD diagnoses pt.
MD consults with PharmD: "I want X to happen for this pt."
PharmD suggests X drug for pt or, following facility protocol, prescribes X drug.

I don't see what the attraction factor for diagnosing is. A pharmacist can get away with working in healthcare without much if any bodily fluids contact, etc. You're getting to be a member of the interdisciplinary team and hopefully saving yourself from some of the more gruesome sights (decubes down to the bone, infected catheters, what have you). Diagnosis requires pt assessment and, while I know pharmacists know a ton about what they're prescribing and how the human body works, if you want to do clinical rounds like an NP/MD, shouldn't you be in school to be an NP/MD? Unless you plan to do the rounds and do the MD assessments/client contact (which, sadly, isn't where it should be), how do you plan to prescribe accurately in a clinical setting? And if you DO want to do that, then why are you studying to be a pharmacist?

The grass is greener on the other side?
Anyway, I'm happy to let the MD prescribe. It's not worth it too me just to see my name on a slip of paper. If you're thinking to myself, "It's not just writing the prescription..." then maybe more direct client care is for you.

 

[medicalCPA]

I don't see what the attraction factor for diagnosing is. A pharmacist can get away with working in healthcare without much if any bodily fluids contact, etc. You're getting to be a member of the interdisciplinary team and hopefully saving yourself from some of the more gruesome sights (decubes down to the bone, infected catheters, what have you). Diagnosis requires pt assessment and, while I know pharmacists know a ton about what they're prescribing and how the human body works, if you want to do clinical rounds like an NP/MD, shouldn't you be in school to be an NP/MD? Unless you plan to do the rounds and do the MD assessments/client contact (which, sadly, isn't where it should be), how do you plan to prescribe accurately in a clinical setting? And if you DO want to do that, then why are you studying to be a pharmacist?

The grass is greener on the other side?
Anyway, I'm happy to let the MD prescribe. It's not worth it too me just to see my name on a slip of paper. If you're thinking to myself, "It's not just writing the prescription..." then maybe more direct client care is for you.

👍

My sentiments exactly.

 

[ruth265]

MDs are taking pharmacology courses in med school. If they will heavily rely on pharmD to prescribe then USMLE would have to be cut in 1/2. MDs are still kings and queens in the hospitals/offices. I think PharmD will never be able to prescribe meds. MDs will not let them. I'm not on MD's side though

^ They're probably suggesting the same thing pretty much everyone else has been suggesting.

MD diagnoses pt.
MD consults with PharmD: "I want X to happen for this pt."
PharmD suggests X drug for pt or, following facility protocol, prescribes X drug.

I don't see what the attraction factor for diagnosing is. A pharmacist can get away with working in healthcare without much if any bodily fluids contact, etc. You're getting to be a member of the interdisciplinary team and hopefully saving yourself from some of the more gruesome sights (decubes down to the bone, infected catheters, what have you). Diagnosis requires pt assessment and, while I know pharmacists know a ton about what they're prescribing and how the human body works, if you want to do clinical rounds like an NP/MD, shouldn't you be in school to be an NP/MD? Unless you plan to do the rounds and do the MD assessments/client contact (which, sadly, isn't where it should be), how do you plan to prescribe accurately in a clinical setting? And if you DO want to do that, then why are you studying to be a pharmacist?

The grass is greener on the other side?
Anyway, I'm happy to let the MD prescribe. It's not worth it too me just to see my name on a slip of paper. If you're thinking to myself, "It's not just writing the prescription..." then maybe more direct client care is for you.

 

[PharmDcandidate]

.>Florida.. had a list of drugs that a pharmacist can prescribe from. Well now, almost all of the drugs from that list are OTC. A pharmacist I know who is in FL Board of Pharmacy is trying to add about 40 drugs on this list. The committee has 3 physicians (appointed by Med Board). She has been trying for almost 2 years to get the committee to meet just to update the list and she said they will not even agree to meet on that topic. One MD member said "If it was up to me I wont let pharmacists write for any drugs so why do I want to update this list?".

So I don't think physicians will ever let the power of prescribing go..

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