Bill Maher to Pharmacists: You're Fake Doctors

[El Duderino]

There aren't any stats out there (which is probably because only a handful of pharmacists out of the 100,000s of RPh's have made this an issue).

Well, check out www.pfli.org (Pharmacists for Life International), which claims 1600+ pharmacist members. That site is popup hell, by the way.

I couldn't find any Medline studies documenting the issue, but several states apparently have conscience clauses that allow pharmacists to refuse filling prescriptions conflicting with their personal religious beliefs. Interesting. By the same rationale, could a nurse/doctor who belongs to Jehovas Witnesses refuse to give blood transfusions? (I know they couldn't, but if pharmacists have a right to refuse, why not doctors and nurses?)

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[Bob_Barker27]

Coulter.....SMART?


BWAHAHAHA!!! She insisted on Canadian television that Canada sent troops to Vietnam. (They didn't) What a *****. Seriously, she's ignorant. I think you've mistaken "attitude," which she has in spades, for "intelligence."

There is a difference between being mistaken about something and being ignorant in general. I dug up the following on the internet at http://moorewatch.com/index.php/weblog/2005/02/06/:

"The Government of Canada did not send troops to Vietnam under the flag of Canada. If that’s what Coulter was referring to, well, she is clearly wrong. However, she may be thinking of the same thing I did, because many Canadians did go fight in Vietnam, with the blessing of Canada under the flag of the US. When I say many, I am talking in excess of 30,000 troops. In fact, Canada was in the process of downsizing her military at the time from the all time high numbers they held during WWII. Many of their soldiers were allowed to join the US military as Canadian citizens and were allowed to return after their tour was over. Throughout our shared histories, Canadians and Americans have fought shoulder to shoulder in so many battles, at least 24 Canadians have been awarded the United States Medal of Honor, including Sgt. Peter C. Lemon for his heroic actions in Vietnam. Additionally, six Canadians are still listed as MIA’s from the Vietnam conflict, although it is speculated that they have died as or still remain POW’s."

Personally, I would have never thought Canada sent troops to Vietnam - I can't even see Canada protecting itself if attacked.

 

[yatzek]

i dont think BM is far off the way I feel. im going to be a pharmacist and i hate when people refuse to aknowledge us as "doctors" that really pisses me off, but it equally pisses me off when pharmacists deny rx based on morals... if you want to be a virgin till you are married, fine, but leave the "hot chicks" alone, hehehe

 

[Samoa]

Unfortunately, many people actually believe that, and the current controversy will spark many of those same people (in influential governement positions)...to keep us in our place, and as they see it, to force us to..."shut up and bag my pills and dorritos".

Had a gentleman come up to me at a CVS in Vegas, wondering why I was a pharmacy student. He said I should take up nursing because, in his view, they made more money and there was more demand. I told him how much pharmacists make. He said "Oh...", wished me a good day and walked away. He probably thought that since pharmacists are dressed in the same white coats as the lady behind the photo lab counter, we aren't professionals. Not a single iota of knowledge as it pertains to the qualifications of a pharmacist. I did not have to do an internship behind the photo lab counter to become a registered pharmacist...sorry Mr. Maher.

Bad PR...we had it to begin with, now we are getting it in spades.

Yeah, someone did a study not too long ago where they found that the average American believes that becoming licensed as a pharmacist requires only an Associate Degree. That's two years of education beyond HIGH SCHOOL, folks!

IMHO, pharmacy as a profession needs to spend some $$$ educating the public, not about drugs, but about itself. Otherwise you're completely at the mercy of ignorant demagogues like Maher.

 

[Bob_Barker27]

Well, check out www.pfli.org (Pharmacists for Life International), which claims 1600+ pharmacist members. That site is popup hell, by the way.

I couldn't find any Medline studies documenting the issue, but several states apparently have conscience clauses that allow pharmacists to refuse filling prescriptions conflicting with their personal religious beliefs. Interesting. By the same rationale, could a nurse/doctor who belongs to Jehovas Witnesses refuse to give blood transfusions? (I know they couldn't, but if pharmacists have a right to refuse, why not doctors and nurses?)

They don't force medical school students to do a residency in abortion, and I believe state medical schools are not denied funding if they chose not to offer such a residency. This policy seems to be allowing medical school students to opt out of something based on their personal moral beliefs since abortions are legal. Do you think medical students should be forced to do residency in abortions? They aren't getting a full education if they don't, right?

Is there some kind of law that gives a customer the right to buy a product from another person at a given time even if the other person does not wish to engage in the business transaction? You and others in here seem to support shotgun enterprise, not free enterprise.

 

[njac]

Yeah, someone did a study not too long ago where they found that the average American believes that becoming licensed as a pharmacist requires only an Associate Degree. That's two years of education beyond HIGH SCHOOL, folks!

IMHO, pharmacy as a profession needs to spend some $$$ educating the public, not about drugs, but about itself. Otherwise you're completely at the mercy of ignorant demagogues like Maher.

oh man so true - I was talking to a friend yesterday telling her how my interview went - when another woman asked what it was for - when I told her pharmacy school she said "oh at *enter name of local community college*" I was like "ummno, I want to be a pharmacist, it was at the University"
scary stuff.

 

[jdpharmd?]

IMHO, pharmacy as a profession needs to spend some $$$ educating the public, not about drugs, but about itself. Otherwise you're completely at the mercy of ignorant demagogues like Maher.

Actually, I am going to try to work this into one of my rotations as a large project. "This is where your pharmacist came from" type of thing.. I would love to see it in the ads for CVS...

-High school
-4-year degree, including high-level chem, bio, calc, stats, business, anatomy, physics, etc.
-4-year professional degree from one of only 89 pharmacy schools in the country (5 apps for every seat, Doctorate degree upon graduation)
-(Optional Residency or Fellowship 1-3 years)
-Board exams, law exams, CE, licensure
-Post grad training in Diabetes (CDE), Cholesterol Screening services, Immunizations, etc...

 

[imperial frog]

By the same rationale, could a nurse/doctor who belongs to Jehovas Witnesses refuse to give blood transfusions? (I know they couldn't, but if pharmacists have a right to refuse, why not doctors and nurses?)

A JW going by what the "official" beliefs are wouldn't refuse to give a blood transfusion. They wouldn't take one themselves, but unless the teachings have changed in the years since I was liberated (old enough that my parents couldn't make me go anymore) they wouldn't impose their no-blood policy on anyone else who didn't believe in it.

 

[ultracet]

A JW going by what the "official" beliefs are wouldn't refuse to give a blood transfusion. They wouldn't take one themselves, but unless the teachings have changed in the years since I was liberated (old enough that my parents couldn't make me go anymore) they wouldn't impose their no-blood policy on anyone else who didn't believe in it.

Whatever religion it is that will not hang blood is allowed to refuse to hang it..

I have seen it happen. I believe they will not start it but they will monitor it.

So yes... nurses are allowed to impose their beliefs on others

And hate to break it to you El Duderino... doctors can refuse any patients as long as its not in the ED
Did you miss the group of MDs who started to refuse to treat lawyers and their families a while back??


So the question is.. if MDs and nurses can, why not pharmacists??

 

[daelroy]

Not to be rude, but are you pharmacy students really this suprised by Marr's comments? He was only saying what most of the public think of pharmacists. Sure, Bill Marr was making a joke and thus hyperbolizing your situation. I can understand how you would feel offended by his joke and it was in poor taste. But did you really think the public would view you in the same regard as physicians, dentists and PhD researchers. I'm sorry but the fact that you guys work at retail centers like Walgreens, Wal-Mart, and a variety of grocery stores not to mention the fact that many of these places have drive-thru services will not ever convince the public that you are on the same level as these other professionals. I agree that this type of thinking is ignorant but it is the reality. And I worked as a tech in pharmacy for 4 years in college so I have some first hand knowledge of what pharmacists do. 95% of the time, they simply filled prescriptions and never gave advice that wasn't on the sticker we printed out for each medication. I respect the knowledge pharmacists have but it's sad that knowledge is rarely used in the retail setting and most pharmacists work in this setting. I would really hope you didn't enter the field of pharmacy and expect to earn the same level of prestige from the public; that will never be there. I think being a pharmacist is an excellent career and it offers a lot of perks. You guys can finish school in 3 or 4 years depending on the school. And you can start at 90-100K. Your hours are fixed and you will never have to take call. But yes, reputation is definitely not a perk of your job and it's something I think you should accept before becoming a pharmacist.

I agree that pharmacists should be referred to as doctors. If chiropractors and podiatrists are called doctors, why can't pharmacists? The only problem I have is when other professions want to be referred to as physicians. However, I don't think pharmacists should be making decisions about refusing to fill prescriptions. I don't think a pharmacist has any right to impose his or her moral beliefs on their job duty. Yes, I know most OB/GYN do not engage in abortions but that is an extreme example. What about the thousands of Catholic and Mormon physicians who prescribe birth control pills to their patients? They don't believe in birth control yet they prescribe them daily. If these physicians can prescribe birth control then I don't see why a conservative pharmacist can't simply fill them. Abortions are on a different level altogether.

 

[Samoa]

However, I don't think pharmacists should be making decisions about refusing to fill prescriptions. I don't think a pharmacist has any right to impose his or her moral beliefs on their job duty. Yes, I know most OB/GYN do not engage in abortions but that is an extreme example. What about the thousands of Catholic and Mormon physicians who prescribe birth control pills to their patients? They don't believe in birth control yet they prescribe them daily. If these physicians can prescribe birth control then I don't see why a conservative pharmacist can't simply fill them.

The point here is that a physician has the right not to engage in any practice he or she considers a violation of his or her religious beliefs. Whether they exercise that right is up to them, but they have it. All professionals have the right to choose what services they will offer to the public, within the scope of their professional license. Pharmacists, as professionals, should have that right as well.

The only exception to this is the emergency room, which is required to treat everyone who needs treatment. If emergency contraception is truly an emergency, it should come from the emergency room. But the fact is that it's not. It has a 72 hour window. I can drive from Louisiana all the way to California in 72 hours, and I'm quite certain there are hundreds of pharmacies between here and there that will fill a prescription for "emergency" contraception. My doctor can also call my prescription to a pharmacy anywhere in the US and I can have it delivered to my doorstep by 10am tomorrow morning. So the whole argument that EMTALA-type rules should apply is specious.

 

[nomorelaw]

I agree that pharmacists should be referred to as doctors. If chiropractors and podiatrists are called doctors, why can't pharmacists?

Last time I checked, podiatrists can do amputations and perform surgery. I think having the ability to perform theses tasks qualifies the use of "doctor." Why did you compare chiros. and podiatrists? There is nothing similiar in their training, education, etc. Pods. are no different then dentists i.e. specialists.

 

[El Duderino]

They don't force medical school students to do a residency in abortion, and I believe state medical schools are not denied funding if they chose not to offer such a residency. This policy seems to be allowing medical school students to opt out of something based on their personal moral beliefs since abortions are legal. Do you think medical students should be forced to do residency in abortions? They aren't getting a full education if they don't, right?

Doctors that don't want to perform abortion can easily choose not to have that kind of training, because just being a doctor does not require you to be able to perform abortions (it does require you to order blood transfusions when appropriate). Abortions, like most other surgical procedures, are a highly specialized procedure, ordering blood transfusions/administering antibiotics are not.

On the other hand, filling prescriptions are a pretty integral part of what pharmacists do. If, on a personal level, you feel strongly opposed to the use of certain medications, then maybe you shouldn't be in a profession where people depend on you know full well that people will be depending on your making it available to them.

Is there some kind of law that gives a customer the right to buy a product from another person at a given time even if the other person does not wish to engage in the business transaction?

Wait a second here. Suddenly, you are no longer a noble healthcare professional, just a salesperson? No no no. If you want more respect for your profession (which I think is very reasonable), you can't play the "I'm just a salesperson" card when you're faced with a moral conflict. You are a health professional. A life saver. Moral and ethical conflicts come with the territory.

 

[ultracet]

ok one of the main problems i have with pharmacists not being able to step in if they feel it is necessary (what i think it is coming to not just on moral grounds) is the fact that i have gone to school to learn about drugs... and i have spent 4 years learning about drugs.

no one else has done that..

and it appears that if i want to help a patient and help them to get the best medication possible then i need to become a drug rep.

 

[El Duderino]

ok one of the main problems i have with pharmacists not being able to step in if they feel it is necessary (what i think it is coming to not just on moral grounds) is the fact that i have gone to school to learn about drugs... and i have spent 4 years learning about drugs.

I don't think anyone here argues against pharmacists stepping in for MEDICAL reasons. I have no problem with that, on the contrary, that is what you should be doing.

Refusing to give patients medication for PERSONAL reasons is another matter altogether. Just imagine what would happen if a strict jain were persuaded to become a pharmacist and then invoke the conscience clause... No antifungals, no antibacterials etc. Yikes.

 

[BTB]

Bill Maher? Honestly. "Consider the source," as my grandmom used to say.

 

[PharmD2002]

The only doctors Bill likes are the ones who do his plastic surgery and the ones who check his prostate (repeatly). Hes had more work done than Barbie and still looks like warmed over ****. Who cares what he thinks. I'm still proud to be a pharmacist and still making over 80000 a year sitting on my ass in a hospital. What we dispense is our choice, if you dont feel comfortable, send the patient down the road. As far as APhA, **** em, its cool when your in school getting everything basically free but I'm not going to send them $140 just so I can get more junk mail in the mailbox. Ive applied for 6 pharmacy jobs and been offered all 6 jobs, full-time and part-time, and there was never any APhA mentioned at any of the interviews. And I am just a Pharm.D who did NOT do a residency and graduated on the low end of the class GPA. What a liberal douche says on TV does not mean **** in the real world.

 

[ultracet]

I don't think anyone here argues against pharmacists stepping in for MEDICAL reasons. I have no problem with that, on the contrary, that is what you should be doing.

Refusing to give patients medication for PERSONAL reasons is another matter altogether. Just imagine what would happen if a strict jain were persuaded to become a pharmacist and then invoke the conscience clause... No antifungals, no antibacterials etc. Yikes.

I completely agree that most think we should have professional judgement.

The main problem I have is the fact that legislation needs to be written extremely carefully and it needs to be consistent with the rest of the health care profession.

If the legislation says we have to fill a legal script then everyone should be concerned because no one is perfect (MDs included)

 

[PharmD2002]

I am a pharmacist. You are giving us your opinion but you have not said what your profession is or will be. I would like to know to determine how I should process your opinion.

 

[jdpharmd?]

But yes, reputation is definitely not a perk of your job and it's something I think you should accept before becoming a pharmacist.

Pharmacists are consistantly ranked among the top 2 or 3 professions overall in the Gallup poll. I think that we finished 3rd this year... behind nurses and soldiers if I remember correctly. Reputation? Perhaps the poll results could be interpreted as a "good reputation" for pharmacists.

 

[El Duderino]

What we dispense is our choice, if you dont feel comfortable, send the patient down the road.

If you see yourself as no more than a salesperson, that sentiment is understandable.

If you see yourself as an important cog in the healthcare wheel, you would have a hard time defending your (assumed) refusal to dispense medically indicated pharmaceuticals.

 

[Caverject]

If you see yourself as no more than a salesperson, that sentiment is understandable.

If you see yourself as an important cog in the healthcare wheel, you would have a hard time defending your (assumed) refusal to dispense medically indicated pharmaceuticals.

heh...pharmaceuticals

 

[BMBiology]

As long as pharmacists are being paid for pushing a product and not for drug counseling, the public will always have this perception about us. Perception, regardless of it is true or not, is reality.

Research has repeatedly shown that drug counseling not only improves and saves lives, but also saves money. Pharmacists need to be paid for our services! That is the key. Unfortunately, the chain retails don't see it this way. The only thing they care about is the bottom line and the bottom line is to make money by pushing a product.

However, the retail is not own only concern. There are many burned out pharmacists who are there just for the paychecks. They don't care about our profession or its directions. Changes have to be made...internally as well as externally.

 

[Ivorymist]

Back to the original comment about BM, I've heard it all myself too. My family always asks me why don't I go "all the way" since they think Rphs need to go to school for just 2 more years to become a doctor. Some of them even refer me as someone who's "almost a doctor". It's no secret that pharmacists are many times misunderstood amongst the public, and of course it doesn't make us feel good as future pharmacists to hear people degrading us.

But maybe it's time to look within ourselves and what we do as pharmacy professionals for sources of happiness instead of relying on other's opinions. We all have no doubt that we do provide a valuable service to the public, right? Try to be at peace with that, acknowledging that sometimes the most helpful things you do often will go thankless.

I am not there to take the doctor's (or anybody else's) job - I'm the PHARMACIST and
I am there to optimize any medication-related outcomes, whether it be from a therapeutic, economical, or practicality standpoint. We as pharmacists have our own niche and provide a service that NO ONE else can provide. Just today at the hospital, the pharmacist and I...

- D/C'ed some antibiotics that should already have been d/c'ed
- Prevented a nurse from hanging two beta-blocker drips simultaneously (big one)
- Managed many patients' insulin drips, stress ulcer prophylaxis regimens, and anticoagulant therapies to minimize mortality/morbidity
- Saved some kidneys (dosed AGs/Vanc, ordered levels, adjusted doses for nephrotoxic drugs, etc.)
- Made recommendation after recommendation to many different healthcare professionals
- and much more...

All I know is, You can call me a doctor-wannabe or a clerk or a donkey or what-have-you, but it won't stop me from sleeping more peacefully at night knowing that I played a huge part in giving patients their best chance to regain their health, go home to their families and continue living their lives. I know it's tough sometimes hearing these hurtful things from other people, but it doesn't change what I've done and who I've helped as a professional. If the job's thankless, then so be it. The results of my work as a pharmacist remain the same regardless.

 

[Caverject]

B.M. is on Leno tonight...I'm curious to see what he has to say

 

[rxgal8]

B.M. is on Leno tonight...I'm curious to see what he has to say

I'm glad he only talked about non-pharmacy related stuff.

 

[Bob_Barker27]

Doctors that don't want to perform abortion can easily choose not to have that kind of training, because just being a doctor does not require you to be able to perform abortions (it does require you to order blood transfusions when appropriate). Abortions, like most other surgical procedures, are a highly specialized procedure, ordering blood transfusions/administering antibiotics are not.

The same principle is involved - med school students are opting out of the residency in abortion based on their moral beliefs. They are required to do residencies in other specialized fields even if they won't be practicing in those fields. Your contention seems to be that health professionals shouldn't be allowed to opt out of doing something based on their personal moral beliefs. If physicians were all generalists like most pharmacists are, and all physicians were trained in abortion procedures, would you be against a physician refusing to do abortions on moral grounds? It seems you would have to be, if you are consistent.

On the other hand, filling prescriptions are a pretty integral part of what pharmacists do. If, on a personal level, you feel strongly opposed to the use of certain medications, then maybe you shouldn't be in a profession where people depend on you know full well that people will be depending on your making it available to them.

This point would make sense if there was only 1 or 2 pharmacists in the entire world. There are plenty of other pharmacies and pharmacists out there where the customer can go if one pharmacist prefers not to dispense a certain medication based on their personal moral beliefs.

Wait a second here. Suddenly, you are no longer a noble healthcare professional, just a salesperson? No no no. If you want more respect for your profession (which I think is very reasonable), you can't play the "I'm just a salesperson" card when you're faced with a moral conflict. You are a health professional. A life saver. Moral and ethical conflicts come with the territory.

It seems to me that you view the pharmacist as just a slave of the physician or customer. A pharmacist is a salesperson, just as a physician is, just as an architect is. They all have a service and/or product to sell, and I would think they have the right to refuse to offer their service to a potential customer in a free country like America.

 

[El Duderino]

Your contention seems to be that health professionals shouldn't be allowed to opt out of doing something based on their personal moral beliefs. If physicians were all generalists like most pharmacists are, and all physicians were trained in abortion procedures, would you be against a physician refusing to do abortions on moral grounds? It seems you would have to be, if you are consistent.

If treatment is medically indicated and the patient does not object, it's unethical for the healthcare professional not to provide it. That is my contention, and it applies for pharmacists, physicians and nurses alike.

This point would make sense if there was only 1 or 2 pharmacists in the entire world. There are plenty of other pharmacies and pharmacists out there

That doesn't matter. Failure to do your job is not excusable just because you think someone else will do it for you. What would happen if everyone said the same thing?

It seems to me that you view the pharmacist as just a slave of the physician or customer.

No, but if I had to choose, I would say the latter.

A pharmacist is a salesperson, just as a physician is, just as an architect is.

This is where we disagree. The role of the healthcare professional is much more complex than the role of the salesperson, for the reasons we discussed.

They all have a service and/or product to sell, and I would think they have the right to refuse to offer their service to a potential customer in a free country like America.

Let's say I'm a pharmacist and for personal reasons, I happen to dislike insulin (or aspirin, or HCTZ or whatever). Would I be justified in refusing to dispense it? To reiterate: If you see yourself as a salesperson, you would be, but you wouldn't be right to complain about not being enjoying the social status of other healthcare professionals. If you see yourself as a healthcare professional, you do what is best for the patient and put your personal opinions aside. I have objections to putting my finger up peoples bottoms, but if it is medically indicated I will put my convictions aside and do it.

From what I've read, John Kerry suggested that pharmacists should be able to refuse filling prescriptions, but only if there was another pharmacist on service who could fill it instead. To me, that sounded like a pretty reasonable compromise.