Alaska BoP: "you guys aren't real doctors. Stop refusing opioid prescriptions"

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CetiAlphaFive

CetiAlphaFive

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CetiAlphaFive said:
Board advises pharmacists: 'Patients first' over 'refusals to fill' opioid prescriptions

This is extremely scary.

These buffoons don't seem to realize that "valid" prescriptions are what got us into this mess of an opioid crisis.
I'm writing a strongly worded letter as we speak to admonish them for this idiotic move.

I strongly recommend everyone here does the same.
Click to expand...

The DEA says we have a corresponding role in determining the appropriateness of controlled drug therapy. Federal law supercedes state law. It's not just insulting and stupid, it's flat out in violation of federal regulations.

What a bunch of doofuses in Alaska. Now their pharmacists have to decide between following the state regulations of " your aren't a prescriber, just fill it" and the federal law of "we expect you to use your clinical judgement."
 
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It really is extraordinary that a state pharmacy board would issue such a letter. Where's a similar rebuke from boards of medicine about poor opioid and benzo prescribing habits? You'll never find one

We get blamed for dispensing too many opioids and we get blamed for refusing to fill opioid prescriptions that are unsubstantiated.
 
How often are you guys declining to fill a script without talking to the practitioner first?

I understand not filling cocktails without talking to anyone, but I talk to the office first before making decisions.
 
Half the time these pain management practices think they are too good to respond to any communication, whether it's regarding a PA requirement or even to verify a diagnosis (LOL @ "G89.4").

I literally have patients who are issued the same combo of prescriptions every month and one of them is not covered and these clinics still won't do a PA or they don't even realize after they purportedly check PDMP that the patient has not been receiving it for the last year.

I've lost track of the amount of times it appears a customer has been initiated on a chronic opioid therapy and we are outright ignored when we attempt to get basic information
 
wagrxm2000 said:
How often are you guys declining to fill a script without talking to the practitioner first?

I understand not filling cocktails without talking to anyone, but I talk to the office first before making decisions.
Click to expand...

When the urgent care down the street sends me the 4th oxycodone 30 mg disp #180 this week. I don't need to talk to the MD.

I'm usually more on the looser end of the spectrum when it comes to this. Unless you are being ridiculous, I'll usually give the benefit of the doubt and fill. But blanket statements like this letter that are against the general sentiment of the DEA stance of equal responsibility with prescribers is something I can't and won't support.

Any "pharmacists must dispence" law pretty much has me auto-against. Just in principle.
 
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I've seen a dentist write for a Hydro/APAP 7.5 on top of a Oxy/APAP 7.5 and the patient tries to fill them both at the same time. I get it, you're too lazy to see a patient again if they think the Hydro7.5 isn't enough. I refused to fill the oxycodone. Told the office that its people like them there's an opioid epidemic.
 
Alaska BOP wants their pharmacists to speak with the prescribing physician before refusing, otherwise it's a sign of "incompetent practice"? Easy fix. I will need copies of the patient's chart along with a detailed pain management plan. We'll also need to see your practices policies on diversion. Every prescription will need a valid diagnosis code along with a justification for each use of the code.

That's what I call practicing at the top of your license
 
wagrxm2000 said:
How often are you guys declining to fill a script without talking to the practitioner first?
I understand not filling cocktails without talking to anyone, but I talk to the office first before making decisions.
Click to expand...
Why would it matter?

Are words coming out of a prescriber's mouth going to change the chemical reactions?

Either you're a professional capable of making decisions based on evidence or you're not.
 
sb247 said:
You all should be able to refuse a Rx for any reason or no reason at all as long as your employer is cool with it.....there shouldn't be any govt force involved there
Click to expand...

I mean you can’t really call Alaska BoP “government”
 
CetiAlphaFive said:
Why would it matter?

Are words coming out of a prescriber's mouth going to change the chemical reactions?

Either you're a professional capable of making decisions based on evidence or you're not.
Click to expand...

So there would never be a reason that would change your mind?
 
BenJammin said:
Alaska BOP wants their pharmacists to speak with the prescribing physician before refusing, otherwise it's a sign of "incompetent practice"? Easy fix. I will need copies of the patient's chart along with a detailed pain management plan. We'll also need to see your practices policies on diversion. Every prescription will need a valid diagnosis code along with a justification for each use of the code.

That's what I call practicing at the top of your license
Click to expand...

Nice

wagrxm2000 said:
So there would never be a reason that would change your mind?
Click to expand...
Hospice or oncology, maybe.

I do my homework before refusing, and I document everything in a "refusals" binder.
There have been instances where oncology partnered with family med, and the PCP was writing the pain management.

But no, I won't accept the vast majority of "reasons", because the vast majority of outpatient practitioners don't have good reasons.
"This 400lb fibromyalgia patient has legitimate back pain, and they've been on it a long time!"

My favorite is the angry M.D. asking "Do you want them to go into withdrawals!!??"
I then ask them if they're illegally treating opioid addiction. L m a o

allantois said:
I mean you can’t really call Alaska BoP “government”
Click to expand...
Why not?
 
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sb247 said:
An exclusive private body whose decisions are enforced by govt to the point of you going to jail if you do something without their approval? That’s govt enough for the principle to apply
Click to expand...

Do you think that medical professionals should be able to establish bodies to regulate their education and professional practice?
 
I don't know how people get on the Alaska BoP, but it sounds like pharmacists in Alaska need to run for the board/write them letters to express their disapproval
 
allantois said:
Do you think that medical professionals should be able to establish bodies to regulate their education and professional practice?
Click to expand...
I don’t like the rent seeking behavior and would be fine if the govt got out of professional regulation altogether. Boards of medicine could become like the better business bureau where they could expel your membership or “ding” your rating but that would not allow the govt to now put you in jail for doing work. You just wouldn’t be able to advertise that you were approved by the BOM
 
sb247 said:
An exclusive private body whose decisions are enforced by govt to the point of you going to jail if you do something without their approval? That’s govt enough for the principle to apply
Click to expand...

It is not within the BOP’s power to send someone to jail. That would require a judge, due process, etc. LOL

Or are there states where the BOP can send people to jail? I have certainly never heard of such a thing but maybe I am wrong?



Sent from my iPhone using SDN mobile
 
owlegrad said:
It is not within the BOP’s power to send someone to jail. That would require a judge, due process, etc. LOL

Or are there states where the BOP can send people to jail? I have certainly never heard of such a thing but maybe I am wrong?



Sent from my iPhone using SDN mobile
Click to expand...
I didn’t say the BOP can send you to jail. i said that you can go to jail for not doing what they tell you because the govt uses them as a defacto govt dept. If you get your license pulled by the BOP and they declare you not a pharmacist anymore and you keep dispensing you go to jail.
 
sb247 said:
I didn’t say the BOP can send you to jail. i said that you can go to jail for not doing what they tell you because the govt uses them as a defacto govt dept. If you get your license pulled by the BOP and they declare you not a pharmacist anymore and you keep dispensing you go to jail.
Click to expand...

Oh so by “do something without their permission” the thing you are talking about doing is practicing pharmacy without a license? Yes in that case you can go to jail for doing something without their permission. You can also go to jail for doing something without the DMV’s permission, if that thing happens to be driving.


Sent from my iPhone using SDN mobile
 
owlegrad said:
Oh so by “do something without their permission” the thing you are talking about doing is practicing pharmacy without a license? Yes in that case you can go to jail for doing something without their permission. You can also go to jail for doing something without the DMV’s permission, if that thing happens to be driving.


Sent from my iPhone using SDN mobile
Click to expand...
which is why I said for the principle I am discussing the BOP or BOM are essentially govt.....
 
Could the Alaskan BoP revoke a pharmacist's license over something like this? It can be so frustrating having disconnects between federal and state regulations.
 
BenJammin said:
Alaska BOP wants their pharmacists to speak with the prescribing physician before refusing, otherwise it's a sign of "incompetent practice"? Easy fix. I will need copies of the patient's chart along with a detailed pain management plan. We'll also need to see your practices policies on diversion. Every prescription will need a valid diagnosis code along with a justification for each use of the code.

That's what I call practicing at the top of your license
Click to expand...
And every prescriber’s personal cell phone number.
 
wagrxm2000 said:
How often are you guys declining to fill a script without talking to the practitioner first?

I understand not filling cocktails without talking to anyone, but I talk to the office first before making decisions.
Click to expand...
Never.

I also choose never to lie about inventory to avoid difficult conversations.

I tell the patient and the MD what my concerns are, and it's up to them to help me paint a complete picture of why I should fill.

Sent from my SAMSUNG-SM-G891A using SDN mobile
 
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