Doctors are so scared of our profession

[southpharmindy]

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Indeed. I described something similar to medical school. My point being that if clinical pharmacists want to expand their role and prescribe you would have to have some changes with the way they are trained. Also with those minor modifications I think you would have a darn good provider.

I'm just thinking out loud here.

Myself I am content with my role. I love independent, corner drugstores in small communities.

 

[Yazdi990]

Now please correct me if i'm wrong (and i know you guys will) but the idea behind this law isn't that a pharmacist now has the functionality of a physician in terms of writing prescriptions. I see this law as more of a convenience thing for both professions.

if a patient has been on a statin for months and now needs a refill, the pharmacist can write a script for the refill instead of waiting to hear back from a doctor.

or if a patient is on a birth control but has some adverse reaction to it, the pharmacist can write a script for a new birth control.

i don't want to tell a patient that they need warfarin. but if a doctor has already done so, i think a pharmacist should be able to adjust the strength.

 

[eagles22]

if a patient has been on a statin for months and now needs a refill, the pharmacist can write a script for the refill instead of waiting to hear back from a doctor.

or if a patient is on a birth control but has some adverse reaction to it, the pharmacist can write a script for a new birth control.

i don't want to tell a patient that they need warfarin. but if a doctor has already done so, i think a pharmacist should be able to adjust the strength.

You need labs to know if the statins are working. And, in cases for the other conditions, you need to figure out why the problem is occurring. A simple substitution isn't going to be sufficient, and most pharmacists don't have the time or resources to figure out whats going wrong.

However, things like (and this has been said before) nasonex to fluticasone, aciphex to omeprazole, caps to tabs, etc should be totally within a pharmacis's scope. It would make everyone's life easier.

 

[All4MyDaughter]

People must be dropping like flies in the UK, where certain statins are OTC?

 

[owlegrad]

People must be dropping like flies in the UK, where certain statins are OTC?

I always knew you were a socialist.

 

[Yazdi990]

You need labs to know if the statins are working. And, in cases for the other conditions, you need to figure out why the problem is occurring. A simple substitution isn't going to be sufficient, and most pharmacists don't have the time or resources to figure out whats going wrong.

However, things like (and this has been said before) nasonex to fluticasone, aciphex to omeprazole, caps to tabs, etc should be totally within a pharmacis's scope. It would make everyone's life easier.

a pharmacist writing a refill for a statin doesn't have to mean that the patient stops seeing their doctor. it could just bridge the gap between the time that the patient runs out of medication and whenever they see their doctor. it would be a short-term solution.

checking a person's profile to see that they have been on the same meds for 6 months and then writing script to get them through the next few weeks until they can see a doctor doesn't take that much time or require that many resources.

one would hope that if the problem were more complex, then a pharmacist would know their limitations and ask for a physician.

the great thing about modern medicine is that we don't work in a vacuum. anyone worth the title of pharmd should know what they personally are capable of and know when they need to reach out to other professionals.

 

[All4MyDaughter]

a pharmacist writing a refill for a statin doesn't have to mean that the patient stops seeing their doctor. it could just bridge the gap between the time that the patient runs out of medication and whenever they see their doctor. it would be a short-term solution.

checking a person's profile to see that they have been on the same meds for 6 months and then writing script to get them through the next few weeks until they can see a doctor doesn't take that much time or require that many resources.

one would hope that if the problem were more complex, then a pharmacist would know their limitations and ask for a physician.

the great thing about modern medicine is that we don't work in a vacuum. anyone worth the title of pharmd should know what they personally are capable of and know when they need to reach out to other professionals.

I agree. Other cases that come to mind... patient is going on vacation and needs a new albuterol inhaler. Or patient switches physicians and needs a refill to get them through the wait for 1st appointment with the new provider, etc.

Actually, in my state, the pharmacy practice act allows pharmacists to do ALL of that and more in declared disasters. We've had a few of those recently, and as far as I know, the world hasn't ended from pharmacists exceeding their limitations.

 

[southpharmindy]

Absolutely. Ive been in situations where the patient has been on 10 medications or so for years. Suddenly their provider is out of the country/dies/change doctors. In those situations I believe the pharmacist should be able to give the patient a 1 month supply even for controlled medications.

I also believe we should be free to substitute between Proair/Ventolin without calling.

 

[All4MyDaughter]

Absolutely. Ive been in situations where the patient has been on 10 medications or so for years. Suddenly their provider is out of the country/dies/change doctors. In those situations I believe the pharmacist should be able to give the patient a 1 month supply even for controlled medications.

I also believe we should be free to substitute between Proair/Ventolin without calling.

Here we can refill non-controlled RXs from deceased providers for "a reasonable time" (undefined). No controls, which I understand is a federal thing. The DEA license dies with the doctor, so to speak.

We also have a "formulary compliance" provision in our law, which allows us to substitute within a therapeutic class if insurance formularies require is. So switching statins, rapid acting insulins, etc. There are procedures that must be followed for notifying the prescriber when a switch is made. But the prescriber has to write "formulary compliance permitted" on the RX and that rarely happens.

 

[SHC1984]

As for SHC1984, July interns are interesting bunch. I still can't figure out what rotation that intern is on that will have him work directly with pharmacy and have him take pharmacy patients (since he took patients from you). Also, it's July - he is new to the hospital, new to the computer system, and new to whatever policies the hospital have. He should have a senior resident (who should be watching him like a hawk) and an attending physician who is supervising him. He shouldn't be having to run to you for questions (and why is pharmacy calling a pharmacy student for clarification instead of your preceptor if the errors on the orders was made by the PGY1? it's not like you can correct it). But there are some interns who just plain SUCK. But I've seen a lot who fumble early on, and really pick up their game to become strong residents and very good physicians. Residency is a big (and rapid) learning curve. Also, depending on his background, this may be his first exposure to US healthcare (although I've seen some US MDs also suck as July interns)

long rant, some of it on a soap box, thanks for letting me rant

This resident graduated from the University of Baghdad. He is from Iraq.

My rotation is Nutritional Support. I write TPN orders everyday for ICU patients. My preceptor gets pharmd and md residents as well...I am on my P4 rotations.

I was on my fourth week when this MD resident started here.

I was suppose to split my patients with him...we both do pre rounds and write TPN orders for patients and then my preceptor do rounds with us to check us off.

The resident is only with us for 2 weeks and then he goes to his internal medicine rotation.

I guess it's important for doctors to learn about TPN orders too. I just know my preceptor gets MD residents as well as PharmD.

There was nothing wrong with this guy. I never say he wasn't qualified to be a doctor or that he wasn't smart.

I was just annoyed that he wanted all the patients and yet expected that I helped him the entire time too...either we split the patients or you get them all like you want to to learn more which is fine but don't ask me to spoon feed you!

His ego is also overly inflated!!! I would tell him to come to pick up his list of patients since he wanted them all and he told me one time "I just love taking orders from you. Coming sir!" WTF. I am just telling you that you have patients....you can do whatever you want to I don't give a damn.

Lastly he can't follow directions very well and he doesn't like to do any required readings.

The pharmacy called me asking for orders b/c he didn't make copies of them to send to the pharmacy and he forgot to label the orders with names!!!

I am sure he is smart..but I guess I wish he would follow directions more AND kind of do things on his own and not expect me to do it for him.

I HATE teaching that's why I am not a teacher!

 

[SHC1984]

Just because it's rampant, doesn't mean it's right. I don't sling these negative phrases around. But what do I know, I don't belong here.

My apologizes if my first post sounded like I was insulting MDs. I have nothing against MDs I know they are smart and that med school is very diffcult and that doctors are important in healthcare...etc.

I think what is most annoying about MDs are the overly inflated egos. It's not their intelligence or anything like that. I never once said I thought they were not smart.

I can relate to the overly inflated egos so I am NOT judging at all. I can totally understand where it comes from! haha....I have always had the highest grades in college and high school and got the best test scores etc.. I went into dentistry before and got into tons of good schools and even interview at Ivy League schools like Harvard, Columbia and UPenn. I was a student at Columbia before I started pharmacy school. I am telling you this b/c I am saying I understand WHY people that do very well in school will almost always have INFLATED egos and think they are superior.

Hell, I had a super inflated ego when I got my interveiw at Harvard. And then I became a student at Columbia which inflated my ego too. So I can totally understand why a MD from a very good medical college would have an overly exaggerated ego too. I got it and I know where it came from.

I use to think I was superior and good stuff just b/c of my grades, college degree, where I went to school, etc. etc. I know how it is....

But now looking back I think it is quite annoying to other people!!! I am 100% sure I was annoying as hell back then when my ego was off the charts!

The same with some MDs...their egos are just as inflated and it just comes off as annoying to other people. It's hard to explain it...but I totally understand where it comes from and how annoying it is to deal with it from another person's perspective.

I am just saying speaking from experience MDs can be a pain in the butt to work with due to their egos. I was at Columbia Medical school (dental and med students take the same class for the first 2 years) and I can not tell you how inflated all the egos are from all the med and dental students at Columbia. We all think we are God's gift to mankind.

I know b/c I had that ego and know exactly where it comes from and I know for a fact that I was just as much of a pain to deal with before too. LOL...

I hope it clears up why some people can't stand some MDs attitudes.

I am NOT here insulting MDs and their potentials. In fact I know it's HIGH...but the huge egos are a pain for the people that have to deal with it. I know from experience.

 

[gsRx]

My apologizes if my first post sounded like I was insulting MDs. I have nothing against MDs I know they are smart and that med school is very diffcult and that doctors are important in healthcare...etc.

I think what is most annoying about MDs are the overly inflated egos. It's not their intelligence or anything like that. I never once said I thought they were not smart.

I can relate to the overly inflated egos so I am NOT judging at all. I can totally understand where it comes from! haha....I have always had the highest grades in college and high school and got the best test scores etc.. I went into dentistry before and got into tons of good schools and even interview at Ivy League schools like Harvard, Columbia and UPenn. I was a student at Columbia before I started pharmacy school. I am telling you this b/c I am saying I understand WHY people that do very well in school will almost always have INFLATED egos and think they are superior.

Hell, I had a super inflated ego when I got my interveiw at Harvard. And then I became a student at Columbia which inflated my ego too. So I can totally understand why a MD from a very good medical college would have an overly exaggerated ego too. I got it and I know where it came from.

I use to think I was superior and good stuff just b/c of my grades, college degree, where I went to school, etc. etc. I know how it is....

But now looking back I think it is quite annoying to other people!!! I am 100% sure I was annoying as hell back then when my ego was off the charts!

The same with some MDs...their egos are just as inflated and it just comes off as annoying to other people. It's hard to explain it...but I totally understand where it comes from and how annoying it is to deal with it from another person's perspective.

I am just saying speaking from experience MDs can be a pain in the butt to work with due to their egos. I was at Columbia Medical school (dental and med students take the same class for the first 2 years) and I can not tell you how inflated all the egos are from all the med and dental students at Columbia. We all think we are God's gift to mankind.

I know b/c I had that ego and know exactly where it comes from and I know for a fact that I was just as much of a pain to deal with before too. LOL...

I hope it clears up why some people can't stand some MDs attitudes.

I am NOT here insulting MDs and their potentials. In fact I know it's HIGH...but the huge egos are a pain for the people that have to deal with it. I know from experience.

I see that the whole ego thing is very hard to control, it appears as if you (or your ego) unknowingly had typed the exact same response, only re-worded in several different ways, just so us laymen could understand. Your ego is most generous, because I didn't quite understand until the third or fourth time you mentioned how intelligent you were

When did you bail on Columbia?

 

[notafraid87]

My apologizes if my first post sounded like I was insulting MDs. I have nothing against MDs I know they are smart and that med school is very diffcult and that doctors are important in healthcare...etc.

I think what is most annoying about MDs are the overly inflated egos. It's not their intelligence or anything like that. I never once said I thought they were not smart.

I can relate to the overly inflated egos so I am NOT judging at all. I can totally understand where it comes from! haha....I have always had the highest grades in college and high school and got the best test scores etc.. I went into dentistry before and got into tons of good schools and even interview at Ivy League schools like Harvard, Columbia and UPenn. I was a student at Columbia before I started pharmacy school. I am telling you this b/c I am saying I understand WHY people that do very well in school will almost always have INFLATED egos and think they are superior.

Hell, I had a super inflated ego when I got my interveiw at Harvard. And then I became a student at Columbia which inflated my ego too. So I can totally understand why a MD from a very good medical college would have an overly exaggerated ego too. I got it and I know where it came from.

I use to think I was superior and good stuff just b/c of my grades, college degree, where I went to school, etc. etc. I know how it is....

But now looking back I think it is quite annoying to other people!!! I am 100% sure I was annoying as hell back then when my ego was off the charts!

The same with some MDs...their egos are just as inflated and it just comes off as annoying to other people. It's hard to explain it...but I totally understand where it comes from and how annoying it is to deal with it from another person's perspective.

I am just saying speaking from experience MDs can be a pain in the butt to work with due to their egos. I was at Columbia Medical school (dental and med students take the same class for the first 2 years) and I can not tell you how inflated all the egos are from all the med and dental students at Columbia. We all think we are God's gift to mankind.

I know b/c I had that ego and know exactly where it comes from and I know for a fact that I was just as much of a pain to deal with before too. LOL...

I hope it clears up why some people can't stand some MDs attitudes.

I am NOT here insulting MDs and their potentials. In fact I know it's HIGH...but the huge egos are a pain for the people that have to deal with it. I know from experience.

I never would've guessed that SHC was that smart. All of a sudden, I don't see you as this promiscuous, attention-seeking girl anymore. I now think of you as a...scholar 😱

I volunteered as a research assistant at a Columbia facility and met several med/dent students, but they were pretty down-to-earth. I guess I don't know the entire story.

 

[VA Hopeful Dr]

Here we can refill non-controlled RXs from deceased providers for "a reasonable time" (undefined). No controls, which I understand is a federal thing. The DEA license dies with the doctor, so to speak.

We also have a "formulary compliance" provision in our law, which allows us to substitute within a therapeutic class if insurance formularies require is. So switching statins, rapid acting insulins, etc. There are procedures that must be followed for notifying the prescriber when a switch is made. But the prescriber has to write "formulary compliance permitted" on the RX and that rarely happens.

I would love not having to deal with that exact situation, as it seems to happen several times daily.

 

[Old]

If your goal is patient care and prescribing go to med school. Simple , I think. Why try to play doctor without the required credentials and training. I am sure the MD's are protecting their turf and their patient but I don't think they are afraid of the pharmacy profession. I haven't seen many new grads that I would want prescribing for me or my family.

 

[meister]

We also have a "formulary compliance" provision in our law, which allows us to substitute within a therapeutic class if insurance formularies require is. So switching statins, rapid acting insulins, etc. There are procedures that must be followed for notifying the prescriber when a switch is made. But the prescriber has to write "formulary compliance permitted" on the RX and that rarely happens.

That sounds awesome

 

[SHC1984]

I never would've guessed that SHC was that smart. All of a sudden, I don't see you as this promiscuous, attention-seeking girl anymore. I now think of you as a...scholar 😱

I volunteered as a research assistant at a Columbia facility and met several med/dent students, but they were pretty down-to-earth. I guess I don't know the entire story.

Well I was in class with med students for a year....and whenever us dental students ask a question in class sometimes I see med students rolling their eyes at us.

During orientation some made smart remarks at dental students.

It's not all but I seen a few medical students look down on us for being in dentistry instead.

I am not really that smart. I just grew up with very crazy Asian parents.

I see that the whole ego thing is very hard to control, it appears as if you (or your ego) unknowingly had typed the exact same response, only re-worded in several different ways, just so us laymen could understand. Your ego is most generous, because I didn't quite understand until the third or fourth time you mentioned how intelligent you were

When did you bail on Columbia?

2009. I worked very hard for my grades. Most people aren't super intelligent we just work hard for what we got.

My ego has decrease quite a lot over the years....when I get old (and uglier) I am sure none will be left. 🙁

 

[eagles22]

a pharmacist writing a refill for a statin doesn't have to mean that the patient stops seeing their doctor. it could just bridge the gap between the time that the patient runs out of medication and whenever they see their doctor. it would be a short-term solution.

checking a person's profile to see that they have been on the same meds for 6 months and then writing script to get them through the next few weeks until they can see a doctor doesn't take that much time or require that many resources.

At what point would you refuse to fill because the patient just relies on you to refill? How do you know that the medicine is working? Would you eventually let the patient go without medicine? If you denied the patient, what would prevent him from transferring to another pharmacy willing to refill or just waiting for another pharmacist to come on duty? Patients will abuse the system and these are legitimate questions that need to be answered if pharmacists are ever to prescribe.

I'm not going to argue that a pharmacist's ability to give that emergency albuterol for vacation is a bad thing or a 1 time refill on some HTN meds while patients find new docs is bad, but this just opens up a whole gray area that I don't think pharmacists or doctors want to deal with. I don't get who this would be good for other CVS and Wags.

 

[notafraid87]

At what point would you refuse to fill because the patient just relies on you to refill? How do you know that the medicine is working? Would you eventually let the patient go without medicine? If you denied the patient, what would prevent him from transferring to another pharmacy willing to refill or just waiting for another pharmacist to come on duty? Patients will abuse the system and these are legitimate questions that need to be answered if pharmacists are ever to prescribe.

I'm not going to argue that a pharmacist's ability to give that emergency albuterol for vacation is a bad thing or a 1 time refill on some HTN meds while patients find new docs is bad, but this just opens up a whole gray area that I don't think pharmacists or doctors want to deal with. I don't get who this would be good for other CVS and Wags.

-Pharmacists are professionals, remember that. We don't give away medicine that easily, even when patients would be on their knees and beg (which makes them look even more suspicious).

-And how do doctors know whether the medicine works or not? Who knows, despite all the schooling you guys received, your recommendation might not be accurate 100%.

-We're not isolating our profession away from physicians or any other health care professionals, for that matter. I honestly don't understand why pharmacists assisting patients during emergency would be considered as a "gray area". It's common sense to me.

Well I was in class with med students for a year....and whenever us dental students ask a question in class sometimes I see med students rolling their eyes at us.

During orientation some made smart remarks at dental students.

It's not all but I seen a few medical students look down on us for being in dentistry instead.

I am not really that smart. I just grew up with very crazy Asian parents.




2009. I worked very hard for my grades. Most people aren't super intelligent we just work hard for what we got.

My ego has decrease quite a lot over the years....when I get old (and uglier) I am sure none will be left. 🙁

Dental student will have the last laugh, though. Chance to earn more than docs, practice after graduation, residency (although I'm aware that it's extremely competitive), great lifestyle. No wonder med students hate dental students

 

[Yazdi990]

At what point would you refuse to fill because the patient just relies on you to refill? How do you know that the medicine is working? Would you eventually let the patient go without medicine? If you denied the patient, what would prevent him from transferring to another pharmacy willing to refill or just waiting for another pharmacist to come on duty? Patients will abuse the system and these are legitimate questions that need to be answered if pharmacists are ever to prescribe.

I'm not going to argue that a pharmacist's ability to give that emergency albuterol for vacation is a bad thing or a 1 time refill on some HTN meds while patients find new docs is bad, but this just opens up a whole gray area that I don't think pharmacists or doctors want to deal with. I don't get who this would be good for other CVS and Wags.

pharmacists are just as capable of using good judgement as a physician in these situations.

i'm not going to keep blindly write an rx just because the pt asks for one. if a pt needs a new script, maybe because they're in between physicians, then you give them a two week supply. this gives them two weeks to find a physician and then they can continue their therapy with this physician. if not, then that's on the patient, just as with any other issue of non-adherence.

as for a patient going to multiple pharmacies, physicians face this issue all the time with a pt going to multiple doctors. how do you guys deal with the issue?

pharmacists are habitually working in a gray area and are just as well equipped as physicians in using good judgement.

 

[Yazdi990]

-Pharmacists are professionals, remember that. We don't give away medicine that easily, even when patients would be on their knees and beg (which makes them look even more suspicious).

-And how do doctors know whether the medicine works or not? Who knows, despite all the schooling you guys received, your recommendation might not be accurate 100%.

-We're not isolating our profession away from physicians or any other health care professionals, for that matter. I honestly don't understand why pharmacists assisting patients during emergency would be considered as a "gray area". It's common sense to me.

this

 

[ImmunoPharmD]

I think all of you (doctors/pharmacists/dentists..etc) are full of it. Your job is to make people feel better. So shut up and do your jobs. Please 🙂

 

[eagles22]

as for a patient going to multiple pharmacies, physicians face this issue all the time with a pt going to multiple doctors. how do you guys deal with the issue?

pharmacists are habitually working in a gray area and are just as well equipped as physicians in using good judgement.

We can examine them. So if they are seeing multiple docs, at least they are being evaluated as to how the medications may be working. That's the difference. Physicians are trained in how to gather the data of the efficacy of a treatment of an individual patient. Pharmacists are not which will just limit the effectiveness of their possible prescriptive abilities.

 

[Yazdi990]

We can examine them. So if they are seeing multiple docs, at least they are being evaluated as to how the medications may be working. That's the difference. Physicians are trained in how to gather the data of the efficacy of a treatment of an individual patient. Pharmacists are not which will just limit the effectiveness of their possible prescriptive abilities.

this goes back to my original point: you are overestimating how much power this law would give pharmacists.

me writing a prescription doesn't mean that all of a sudden, the patient isn't seeing the doctor to be evaulated. i'm not looking at a patient and saying "you look like the kind of person that takes metformin 1000" and writes an order.

i'm extending their supply of what ever the YOU, as the PHYSICIAN has already ordered for another week or so. once i write this order, i notify the physician that is overseeing this patient's care to update them. if the patient goes to another pharmacy, then the doctor can tell that they're moving around when they hear from multiple pharmacies.

 

[njac]

I'm ok with not having prescribing rights. As a clinical pharmacist in the ED, my physicians seek me out and ask my opinion, and 95% of the time write for what I recommend. All the glory without the liability. (I'M KIDDING)

But really, I call in Rx's when I do culture f/u under aphysician name, I change antibiotic dosing per protocols, as an inpatient pharmacist I don't need prescriptive authority.

 

[UES Girl]

Spoken like a true pharmacy student. I know many and they are the dumbest group I have encountered thus far.

Nevertheless, they are very well suited for Walgreens and Walmart.

.

Where the hell are the MODS ? 😱 I reported this post - I've seen plenty of **** talking from premeds, but this is pure ridiculous. How you weren't banned AT THIS STAGE is beyond me. GTFO out of our forum, you stupid biatch and go join the vast number of 8/10 proud as peacock premeds that never make it to med school.

t is not a complicated issue. Why don't you practice what you are trained to do? Sounds simple enough to me .

Before you open that **** of a mouth, go educate yourself on what our scope of practice actually is so you don't look like a complete idiot that speaks out in front of a large group of people while vastly unfamiliar with an issue and looks like a total *****.

Oh and thanks for the priceless stupidity - it gave me a pretty good material - I'm presenting a big presentation on this topic for my team on this clinical rotation I am doing at a joined medical/clinic pharmacy setting and I'm going to use you as an example of a typical ignorant hick - zing! Our top notch educated physicians and pharmacists will get a good laugh at your expense:

 

[UES Girl]

Well, here in case anyone interested to read a preliminary report - here it is - topic in question on page 18:

http://www.ama-assn.org/assets/meeting/2012a/a12-refcomm-b-report.pdf

 

[Kwiz]

I don't blame them...for being scared. Recommend adoptions of blah in lieu of BS. FDA is gonna do what they want, it's not like pharmDs are going to lose anything by any of this. Not like pharmDs are scared. Shieettt, maybe pharmDs might start questioning more scripts as potential forges. Call it the FUQMDS initiative. Forged, Undetermined, or Questionable Medical Dispensing Stoppage initiative. Maybe pharmDs recommend other physicians for them to speed up the process next time they come in? Maybe one day all pharmDs in the country wont come into work that day? Like someone already said, clinical pharmacists often have the scope without the liability attached, especially in certain specialties.

 

[FarMD2012]

Ok honestly, I do not blame the AMA for going against the proposal as it is for their self interest. Just like how the AphA, NCPA promoting the proposal for the pharmacist's self interest. It comes down to money eventually to a certain degree.

But I think there are definitely things can be changed to make a pharmacist's job easier and better patient outcomes (especially retail).
(1)Adding refills to chronic medications without having to call/fax every time,
(2)Change certain dosage forms,
(3)Switch between certain drugs in the same class to avoid having to call insurance/physician for changes.

But AMA does make a point about the training of the physicians vs pharmacists. Pharmacists do not get the same training, but of course pharmacists will not be diagnosing. But working strictly under a physician's protocol like in some VA hospitals or the above mentioned authorities added to a pharmacist's scope of practice probably will do more good than bad. But I do not think the FDA will approve a proposal that might lead the patients to think a pharmacist will take over the management of their doctors. So they are probably still outlining the specific medications allowed, protocol etc.

Overall, I think its a good thing.

 

[hereticmnk]

(1)Adding refills to chronic medications without having to call/fax every time,
(2)Change certain dosage forms,
(3)Switch between certain drugs in the same class to avoid having to call insurance/physician for changes.

My original propositions closely match to what you suggested 🙂
Some basic prescribing rights is all I need to make things run smoother. And it's not like you guys will concede an inch , and we will ask for a mile. These small changes would make most pharmacists happy.

#1- Change capsules to tablets etc. (after checking for proper bioavaility and what not). This is seriously a no brainer.
#2- Change some basic generic drugs within the same class.. Prilosec vs. Nexium etc.
#3- Change dosing of drugs based on various parameters.

 

[confettiflyer]

My original propositions closely match to what you suggested 🙂
Some basic prescribing rights is all I need to make things run smoother. And it's not like you guys will concede an inch , and we will ask for a mile. These small changes would make most pharmacists happy.

I'm sure physicians would enjoy the reduced overhead, i mean who really wants to be tie up resources for that crap?

 

[hereticmnk]

I'm sure physicians would enjoy the reduced overhead, i mean who really wants to be tie up resources for that crap?

I agree, I think some physicians see this as a power-grab move vs. what's best for the patients.

 

[Socrates25]

The problem I have with it is that the pharmacists, NPs, PAs, psychologists, social workers, RNs and everybody else trying to expand scope are blatant hypocrites.

The AMA should come out with a statement that says:

"The AMA will support prescription privileges for pharmacists when the APhA supports pharmacy techs dispensing medicine independently of a pharmacist"

Crickets from the pro-pharmacist crowd on that one.

 

[Digsbe]

The problem I have with it is that the pharmacists, NPs, PAs, psychologists, social workers, RNs and everybody else trying to expand scope are blatant hypocrites.

The AMA should come out with a statement that says:

"The AMA will support prescription privileges for pharmacists when the APhA supports pharmacy techs dispensing medicine independently of a pharmacist"

Crickets from the pro-pharmacist crowd on that one.

Why? The two are not comparable at all.

 

[UMterps]

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[Rockinacoustic]

Why? The two are not comparable at all.

Why not? One frees up the physician for more pressing matters, the other frees up the pharmacist for more pressing matters.

 

[Rx MPLS]

The problem I have with it...

It = changing basic things on a prescription (tablets to capsules, etc) or writing a one-week refill on psych meds to hold a patient over until their MD visit in one week (when, judging by dating, they have been taking the medication appropriately), etc?

You don't mind getting badgered about mindless details from pharmacists?

 

[UES Girl]

Why not? One frees up the physician for more pressing matters, the other frees up the pharmacist for more pressing matters.

Because trying to draw a comparable analogy between equivalency of a tech - with a HS diploma and a pharmacist - a doctorate degree holder vs. physician and pharmacist - both doctorate degree holders is absurd.

 

[Rockinacoustic]

Because trying to draw a comparable analogy between equivalency of a tech - with a HS diploma and a pharmacist - a doctorate degree holder vs. physician and pharmacist - both doctorate degree holders is absurd.

It doesn't take four years of school to make sure the pill in the bottle matches the pill on the screen (I'm imagining a scenario where a pharmacist verifies data entry and handles DUR/intrxns before a tech even sees the order).

Likewise it doesn't take MD/DO training to monitor the proper continuity of medication therapy for patients with certain disease states, or at least that's what we're arguing in here.

I'm not saying the tech dispensing analogy is without flaws, just playing devils advocate here....

 

[hereticmnk]

The problem I have with it is that the pharmacists, NPs, PAs, psychologists, social workers, RNs and everybody else trying to expand scope are blatant hypocrites.

The AMA should come out with a statement that says:

"The AMA will support prescription privileges for pharmacists when the APhA supports pharmacy techs dispensing medicine independently of a pharmacist"

Crickets from the pro-pharmacist crowd on that one.

So, you are saying the discrepancy in the educational status between a MD and a pharmacist is comparable to a pharmacist and a pharmacy tech.. brilliant. breakthrough.

Also most pharmacists will be happy with only some prescribing rights as described a couple of posts above yours.

Why not? One frees up the physician for more pressing matters, the other frees up the pharmacist for more pressing matters.

It doesn't take four years of school to make sure the pill in the bottle matches the pill on the screen (I'm imagining a scenario where a pharmacist verifies data entry and handles DUR/intrxns before a tech even sees the order).

Likewise it doesn't take MD/DO training to monitor the proper continuity of medication therapy for patients with certain disease states, or at least that's what we're arguing in here.

I'm not saying the tech dispensing analogy is without flaws, just playing devils advocate here....

Valid points, I have no qualms in techs dispensing as long as I have checked the prescription and the patient has denied consultation. As long as its their ass on the line and not mine if they mess up, I have no reason to be concerned.

 

[Digsbe]

It doesn't take four years of school to make sure the pill in the bottle matches the pill on the screen (I'm imagining a scenario where a pharmacist verifies data entry and handles DUR/intrxns before a tech even sees the order).

Likewise it doesn't take MD/DO training to monitor the proper continuity of medication therapy for patients with certain disease states, or at least that's what we're arguing in here.

I'm not saying the tech dispensing analogy is without flaws, just playing devils advocate here....

When I hear the proposition that techs should be able to dispense without a pharmacist I think of them doing the clinical review on a prescription and also providing patient counselling, something that a tech is not qualified to do. I think a tech that is certified in laws and has experience may be qualified to review a prescription for legal compliance/correct directions, but not for any kind of clinical evaluation, contacting a healthcare professional on an issue or patient counselling.

Personally, I think with additional training through a residency or program a pharmacist should be able to prescribe under a physician like an NP or PA can in most states. Currently, I think all pharmacists are qualified to substitute medications within class or swap out tabs/caps and other mundane things. Although I do think it's important to play the Devil's advocate in any kind of critical thinking scenario/policy evaluation like this (as you said you were doing).

Because trying to draw a comparable analogy between equivalency of a tech - with a HS diploma and a pharmacist - a doctorate degree holder vs. physician and pharmacist - both doctorate degree holders is absurd.

I agree with this and this is primarily the reason why I don't think they are equivalent. In regards to Socrates25's analogy, I think a closer similarity would be a medical assistant doing a full diagnosis and prescribing for a patient, not a pharmacist that holds a doctorate.

 

[STLclinical16]

so if...Im a patient...

my physician knows ALOT about my condition, diagnosis, prognosis and is an expert in the physiology behind it.

my pharmacist knows ALOT about every drug to treat my condition, it's side effects, efficacy,safety, pharmacodynamics, etc.


maybe if they worked together instead of trying to constantly prove themselves/outdo/put down eachother, I would feel like i had a pretty good healthcare combo.

 

[MountainPharmD]

The problem I have with it is that the pharmacists, NPs, PAs, psychologists, social workers, RNs and everybody else trying to expand scope are blatant hypocrites.

The AMA should come out with a statement that says:

"The AMA will support prescription privileges for pharmacists when the APhA supports pharmacy techs dispensing medicine independently of a pharmacist"

Crickets from the pro-pharmacist crowd on that one.

Crickets because of your lame attempt at a comparison.

If you want to use pharmacy techs as an example then you need to compare apples to apples. Doctor to pharmacist is not the same as a pharmacist to pharmacy technician. Your medical assistant independantly writing prescriptions is analogous to a pharmacy technician independantly dispensing medication.