Arizona Expanding Scope of Practice for Pharmacists

[rxlea]

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http://www.scribd.com/doc/48530463/...on-Arizona-State-Legislature-via-MyGov365-com

This is a link to the bill introduced that will allow pharmacists to enter into collaborative practice agreements with not only physicians but NPs and any "provider". It also eliminates the restriction on location... so essentially, a pharmacist could prescribe ("practice") anywhere...

Note the changes (in strike outs)!

Discuss!

 

[IrishHammer]

http://www.scribd.com/doc/48530463/...on-Arizona-State-Legislature-via-MyGov365-com

This is a link to the bill introduced that will allow pharmacists to enter into collaborative practice agreements with not only physicians but NPs and any "provider". It also eliminates the restriction on location... so essentially, a pharmacist could prescribe ("practice") anywhere...

Note the changes (in strike outs)!

Discuss!

Also, being Arizona, the bill gives pharmacists the right to bludgeon illegal immigrants, or anyone suspected of being an illegal immigrant.

 

[Pharmacy Kid]

http://www.scribd.com/doc/48530463/...on-Arizona-State-Legislature-via-MyGov365-com

This is a link to the bill introduced that will allow pharmacists to enter into collaborative practice agreements with not only physicians but NPs and any "provider". It also eliminates the restriction on location... so essentially, a pharmacist could prescribe ("practice") anywhere...

Note the changes (in strike outs)!

Discuss!

So you could enter a collaborative agreement in Arizona, but then move to any state and practice?

 

[PharmaTope]

So you could enter a collaborative agreement in Arizona, but then move to any state and practice?

no, what you can do is regulated by each state.

 

[rxlea]

From what I hear, Walgreens is already poised to take advantage of this change at their Take Care Clinics.

 

[Clavulanic]

Interesting. I didn't read it, just what you said, but it sounds like the retail chains will be jumping at this one.
I could see the pharmacist working retail with some limited prescribing power. Patients come in with a minor issue, maybe light pain, cough or something. The pharmacist evaluates them, writes up a script then fills it.

But I think, at least in my state, the pharmacy isn't allowed to be at the physicians office and they can't say "here's your prescription, take it to our pharmacy and get it filled". Sounds like my situation i gave would be similar.
Also I doubt someone could fill their own prescription that they wrote, I would think that would go against the system of checks and balances in place.

Of course their are many other applications... I just gave out the first one that came to my mind, and then shot it down lol. Well played.

 

[nlax30]

Interesting. I didn't read it, just what you said, but it sounds like the retail chains will be jumping at this one.
I could see the pharmacist working retail with some limited prescribing power. Patients come in with a minor issue, maybe light pain, cough or something. The pharmacist evaluates them, writes up a script then fills it.

I don't think they are going for independent prescribing power. It still is in conjunction with a prescribing provider (MD/DO/NP). I don't think what you are proposing is appropriate.

 

[VCU07]

I don't think they are going for independent prescribing power. It still is in conjunction with a prescribing provider (MD/DO/NP). I don't think what you are proposing is appropriate.

I agree. These things almost never work out. I am not sure how retail chains expect this to work. Retail pharmacists are already worked to death. There would have to be a pharmacist specifically there for "prescribing." This increases costs and usually works better in an ambulatory care setting.

 

[p-rog]

I agree. These things almost never work out. I am not sure how retail chains expect this to work. Retail pharmacists are already worked to death. There would have to be a pharmacist specifically there for "prescribing." This increases costs and usually works better in an ambulatory care setting.

I would assume there would be some charge for for the visit, perhaps could even bill insurance. How does it work to be a CPP in North Carolina? How does the Wisconsin Pharmacy Quality Collaborative (WPQC) work? As long as it's reimbursed well, it can work.

 

[Dezixn]

I don't think they are going for independent prescribing power. It still is in conjunction with a prescribing provider (MD/DO/NP). I don't think what you are proposing is appropriate.

Well it states that it can occur in a physically separate location. So they could hire a few MDs and keep em in a cage somewhere with a telephone. Just a though

 

[Praziquantel86]

I agree. These things almost never work out. I am not sure how retail chains expect this to work. Retail pharmacists are already worked to death. There would have to be a pharmacist specifically there for "prescribing." This increases costs and usually works better in an ambulatory care setting.

Honestly, it would be irresponsible for this to occur in retail chains. Without access to current laboratory values, it's like prescribing in the dark. Not to mention the fact that I highly doubt a lot of community pharmacists would actually want this responsibility on top of all their other duties in the day.

I can see this being a huge benefit in some of the more niche sort of practices, such as a pharmacy attached to a medical practice or a specialty pharmacy where speed isn't the main concern.

 

[Taurus]

Doesn't matter if pharms get prescribing rights.

If you don't have diagnostic training, prescribing rights are pretty much worthless unless you want to play around with mixing and matching hypertensive and cholesterol drugs. Furthermore, it is extremely risky professionally to diagnose anyone if you don't any prior medical history, labs, imaging. The lawyers would have field day with this and chains would be exposing themselves to huge damages.

I can just see it now. Patient comes in complaining of chest pain/abdominal pain and pharm diagnoses patient with acid reflux and prescribes a PPI. Next day, patient is dead because he was actually suffering from a ruptured AAA.

True story. I had a cool case the other day when a patient presented to the ED with chest pain and I saw suspicious leaking thoracic aneurysm on his CXR and later confirmed by CT.

 

[Praziquantel86]

Doesn't matter if pharms get prescribing rights.

If you don't have diagnostic training, prescribing rights are pretty much worthless unless you want to play around with mixing and matching hypertensive and cholesterol drugs. Furthermore, it is extremely risky professionally to diagnose anyone if you don't any prior medical history, labs, imaging. The lawyers would have field day with this and chains would be exposing themselves to huge damages.

I can just see it now. Patient comes in complaining of chest pain/abdominal pain and pharm diagnoses patient with acid reflux and prescribes a PPI. Next day, patient is dead because he was actually suffering from a ruptured AAA.

True story. I had a cool case the other day when a patient presented to the ED with chest pain and I saw suspicious leaking thoracic aneurysm on his CXR and later confirmed by CT.

Pharmacists have been doing this for years, safely, without having expanded prescription/diagnostic rights (well, maybe not with PPIs). We are trained in triage and recognizing the indications for OTC medications as well as when they need referral elsewhere.

You mentioned playing around with antihypertensives/antilipemics, and that really is what we're after. We're not looking for primary diagnostic and prescriptive capability, just the management of chronic medications for chronic disease states. If you look at states that have these collaborative practices established, like North Carolina, you'll see that this is in fact what happens.

Pharmacists, unlike the NP lobby, are actually proud of being pharmacists. We don't want to become just another midlevel provider and we certainly don't want to become physicians. We want to be pharmacists and utilize our complementary skillset.

 

[Taurus]

You mentioned playing around with antihypertensives/antilipemics, and that really is what we're after. We're not looking for primary diagnostic and prescriptive capability, just the management of chronic medications for chronic disease states. If you look at states that have these collaborative practices established, like North Carolina, you'll see that this is in fact what happens.

Then this is all a big yawn.

Doesn't address the fundamental problems in pharmacy which is mail-order, oversupply of schools, oversaturation of pharms, retailers not expanding, NP/PA's who not only can modify meds but also have diagnostic training and are cheaper, telepharmacy, and Watson-type pharm programs.

This is why when anyone asks me I tell them two fields I would avoid for sure. Law and pharm. Both have too many problems and are highly risky for the required years and debt.

 

[RxWildcat]

Then this is all a big yawn.

Doesn't address the fundamental problems in pharmacy which is mail-order, oversupply of schools, oversaturation of pharms, retailers not expanding, NP/PA's who not only can modify meds but also have diagnostic training and are cheaper, telepharmacy, and Watson-type pharm programs.

This is why when anyone asks me I tell them two fields I would avoid for sure. Law and pharm. Both have too many problems and are highly risky for the required years and debt.

Oh I see, you like NPs when they can support your argument but hate them any other time. Thanks for clarifying that.

 

[RxWildcat]

Doesn't matter if pharms get prescribing rights.

If you don't have diagnostic training, prescribing rights are pretty much worthless unless you want to play around with mixing and matching hypertensive and cholesterol drugs. Furthermore, it is extremely risky professionally to diagnose anyone if you don't any prior medical history, labs, imaging. The lawyers would have field day with this and chains would be exposing themselves to huge damages.

I can just see it now. Patient comes in complaining of chest pain/abdominal pain and pharm diagnoses patient with acid reflux and prescribes a PPI. Next day, patient is dead because he was actually suffering from a ruptured AAA.

True story. I had a cool case the other day when a patient presented to the ED with chest pain and I saw suspicious leaking thoracic aneurysm on his CXR and later confirmed by CT.

And for the record I pretty much agree with this, I don't think pharmacists should be diagnosing anything new. Modification of chronic meds is what's most likely being targeted, you know that.