Drug Overdose Death

[owlegrad]

Article: The Consequences of Not Following Your Gut

Pretty interesting article. I have lost track of how many “bad” scripts I have let go because the prescriber wanted it that way and/or I was too busy to properly deal with it.

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[Sine Cura]

This is why you don't call with some mealy-mouthed bull****. Don't be afraid to tell these dinguses they're ****ing wrong. It's your license right?

 

[ValeRx]

This is why you don't call with some mealy-mouthed bull****. Don't be afraid to tell these dinguses they're ****ing wrong. It's your license right?

...and your conscience, knowing you filled something blatantly wrong. That was something I always kept in mind when finding a serious error and calling a doctor's office about it. Filling it "because the doctor told me to" or "the patient was in a hurry" is NOT a valid excuse for filling a script when you know there's something wrong.

 

[lord999]

Well, it's a numbers game. Read about several in the obituaries who ODed before the opioid crisis was a thing, and got their fixes from us among other pharmacies. Didn't exactly mourn them or the physicians involved as the Board of Medicine wouldn't do anything about it despite reports. In fact, I actually have my writeup for refusing to dispense with a particular DM. He's still around in the company, still a jerk.

Pediatric overdoses are a true nightmare from the practice perspective. I knew a couple of pharmacists who did and were culpable though the Board did not discipline them for honest mistakes that were not intensified by them (because AZ ain't Ohio), and they both left practice for a time (one permanently) after the PCH admission. I consider that among the most decent actions I have ever seen taken.

 

[Deja]

i wasnt to know what happened to that Dr. pope

 

[ValeRx]

i wasnt to know what happened to that Dr. pope

Probably nothing.

 

[WVUPharm2007]

I guess we've learned that if you don't follow your gut, you might burn a hole in your patient's.

I am in this situation all the time with codeine for peds patients. There ain't nothing anybody can say to get me to dispense that.

Also, never follow your gut. That's stupid advice. Follow guidelines and the law.

 

[lord999]

I guess we've learned that if you don't follow your gut, you might burn a hole in your patient's.

I am in this situation all the time with codeine for peds patients. There ain't nothing anybody can say to get me to dispense that.

Also, never follow your gut. That's stupid advice. Follow guidelines and the law.

Except you should when you’re in an out of context problem that doesn’t fit. You’re supposed to be the circuit breaker and even in midnight retail, you get info that the prescriber didn’t consider. There’s also “I have a bad feeling about this” that should be trusted if you have good alternatives, the codeine in peds is a feeling backed up with much safer alternatives accomplishing the same mission. The guidelines do tolerate codeine but there’s better.

 

[johnpharm01]

The bully prescriber. They do it because it works and there is little accountability. I scrapped with them, never caved in. Want to report me to the bop, I can defend myself, can you? Complain to my employer? this job sucks I would probably be better off without it.

 

[radio frequency]

Article: The Consequences of Not Following Your Gut

Pretty interesting article. I have lost track of how many “bad” scripts I have let go because the prescriber wanted it that way and/or I was too busy to properly deal with it.

Great article. Should be required reading during pharmacy school. Bully prescribers are a problem. Thankfully they are a minority, but they are a terrible minority.

 

[APN-59 rph]

I rarely if ever know who the prescriber is other than some last name. Actually no clue if they really ARE a valid prescriber . Generally I think that your modern MD would appreciate a heads up when there's a serious question. Some ancient peckerwood poultice walloper wanting to get high and mighty will not fly these days. ALSO......have liability insurance..it's cheap which tells you that they don't get many claims. Know it all medical types are like know it all pilots...they are great until they try and kill you. In fact..in aviation the latest is CRM (cockpit resource management)....no more god like bird men..no more god like doctors..If you see something..say something....of course in aviation you die along with the rest of the crew...CRM has saved me at least once..

 

[itaos]

I'm retail ignorant, so what's the best way to go about getting the stodgy doc the change the rx?

Tell him you can't fill it unless he can provide some type reference to back it up?

 

[owlegrad]

I'm retail ignorant, so what's the best way to go about getting the stodgy doc the change the rx?

Tell him you can't fill it unless he can provide some type reference to back it up?

You can try that but likely the doc will just say fill it anyway. Your only recourse in that situation is flatly refuse to fill it. Which sucks because like was the case in this article patients don’t always understand and it can become a confrontation.

 

[Wickett]

There's a prescriber at a local hospital that discharged all his post surgery patients with norco 10 take 1-2 q 4-6hrs, opioid naive or not. I always called and always got told to eff off when I asked to amend the directions to at least add max 6 tablets daily. I always handed it back and explained why, telling the person if they fill it to please know typical max recommended dose is 6 per day.

Had a wife that got very upset about not filling it for her 80 year old husband who came back a week later to tell me he stopped breathing and had to be treated and resuscitated on her living room floor. Luckily he survived. That prescriber still uses the same old sig, but doesn't argue about amending the max dosage anymore. He got smart with me once, and I mentioned his prior patient almost dying on his living room floor...he doesn't argue with me anymore.

It's easy to get wrapped up in the retail mindset of make the customer happy and avoid prescriber conflict, but at the end of the day, you have to remember your job is also to prevent harm to the patient, customer service be damned.

 

[Sine Cura]

If you feel like reporting such people I wonder how much traction you get.

I reported a PA who kept writing for Percocet 10/325 #360 per 30 days for 8 months but don't know what happened ultimately and I forget the PA's name

 

[VA Hopeful Dr]

If you feel like reporting such people I wonder how much traction you get.

I reported a PA who kept writing for Percocet 10/325 #360 per 30 days for 8 months but don't know what happened ultimately and I forget the PA's name

For most medical boards, its not the amount as much as the process. Is the prescriber getting UDSes, checking the database, that sort of thing.