future of pharmacy

[Lisochka]

One pharmacist told me that lobbysts are trying to make a new law that would let to a retail pharmacy to operate without a pharmacist. In other words, pharm techs will do all the work.
Of course, it will jeopardize the whole job security-salary situation on the market Why would a store manager hire a pharmacist and pay 80K, if there is a pharm tech who will work for 20K...
So what do you guys think?
Will it ever happen?

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[AwesomeSauce]

Gah, I have no connection at all to pharmacy, but I hope that dosen't happen. Where is the oversight? that sounds dangerous.

 

[jmkraus]

it will never happen. pharmacists get paid so much because people's lives are in their hands. you cant pay someone with that kind of responsibility 20k a year. unless it's a teacher.

 

[sdn1977]

Nope- not even a possibility. Not on my radar at all, but for some people, the sky may always fall....

 

[Da Alchemist]

it will never happen. pharmacists get paid so much because people's lives are in their hands. you cant pay someone with that kind of responsibility 20k a year. unless it's a teacher.

Im curious.. in retail, people's lives are in the pharmacist hands? I thought most of the medical errors are found only in hospital setting. The medications that the patients are takng are the prescriber's order so if anything happens it's the prescribers fault right? under the prescriber's hands? and the retails main job is to dispense that order right? (for 20k the tech cant learn how to dispense drugs?) if the patient ask "can i take coumadin with aspirin?" why cant the tech look it up on a computer. are there any hard questions about drugs that the computer cant answer? or are there any patients out there that ask hard questions? in retail most of the patients just come and go right? If the rx order for example is coumadin, why can't the computer print out all the possible drug/food interactions so that patients wont have to ask? for example, avoid alcohol, avoid dairy, avoid aspirin etc. These are just curious questions that i have, since im not in pharm school yet. Can anyone school me? Sdn?

 

[gaba101]

Im curious.. in retail, people's lives are in the pharmacist hands? I thought most of the medical errors are found only in hospital setting. The medications that the patients are takng are the prescriber's order so if anything happens it's the prescribers fault right? under the prescriber's hands? and the retails main job is to dispense that order right? (for 20k the tech cant learn how to dispense drugs?) if the patient ask "can i take coumadin with aspirin?" why cant the tech look it up on a computer. are there any hard questions about drugs that the computer cant answer? or are there any patients out there that ask hard questions? in retail most of the patients just come and go right? If the rx order for example is coumadin, why can't the computer print out all the possible drug/food interactions so that patients wont have to ask? for example, avoid alcohol, avoid dairy, avoid aspirin etc. These are just curious questions that i have, since im not in pharm school yet. Can anyone school me? Sdn?

b/c nobody reads the stupid leaflet let in their little pharmacy baggie even though they should. Why do we include it then if nobody reads it, you ask? LIABILITY LIABILITY LIABILITY. "Thank God" for most people not bothering to read those leaflets w/ side effects and all--that provides job security for us because that's where you, the pharmacist, verbally tell them what's on that paper (not everything, just important things) and combine it w/ your professional judgment.

 

[Jbuprepharm]

Im curious.. in retail, people's lives are in the pharmacist hands? I thought most of the medical errors are found only in hospital setting. The medications that the patients are takng are the prescriber's order so if anything happens it's the prescribers fault right? under the prescriber's hands? and the retails main job is to dispense that order right? (for 20k the tech cant learn how to dispense drugs?)

yes the prescriber would be at fault, but the pharmacist is at equal fault in some cases for filling something they know is wrong (at least without making sure by the doctor). a tech doesn't have extensive (or any in some cases) drug knowledge and would likely miss a lot of otherwise obvious errors.

I think too many people assume that patients only go to one doctor and to one pharmacy. If a patient has 2-3 different doctors they see, chances are that the different doctors have no idea what the others are prescribing.

 

[Da Alchemist]

b/c nobody reads the stupid leaflet let in their little pharmacy baggie even though they should. Why do we include it then if nobody reads it, you ask? LIABILITY LIABILITY LIABILITY. "Thank God" for most people not bothering to read those leaflets w/ side effects and all--that provides job security for us because that's where you, the pharmacist, verbally tell them what's on that paper (not everything, just important things) and combine it w/ your professional judgment.

it doesnt really answer my main questions. why is it that peoples lives are in their hands? (retail pharmacist) because they dispensed the prescribers order or because they counsel the patients about side effects? let the licensed tech with compounding skills dispense it. patients with drug info questions? let the tech look it up in the computer pharm database.

 

[Da Alchemist]

yes the prescriber would be at fault, but the pharmacist is at equal fault in some cases for filling something they know is wrong (at least without making sure by the doctor). a tech doesn't have extensive (or any in some cases) drug knowledge and would likely miss a lot of otherwise obvious errors.

why cant the MD confirm with the Hospital Pharm.D first before prescribing it? So that the tech wont fill something wrong since its pharm.d confirmed?

 

[Da Alchemist]

I think too many people assume that patients only go to one doctor and to one pharmacy. If a patient has 2-3 different doctors they see, chances are that the different doctors have no idea what the others are prescribing.

I think that is impossible? I might be wrong since im not in school yet. but usually if you see other doctors everything is faxed. all the med history, prescription order will be faxed to the next MD right? So how can they have no idea what others are prescribing?

 

[Farmercyst]

it doesnt really answer my main questions. why is it that peoples lives are in their hands? (retail pharmacist) because they dispensed the prescribers order or because they counsel the patients about side effects? let the licensed tech with compounding skills dispense it. patients with drug info questions? let the tech look it up in the computer pharm database.

This is where the news expose' from last month (or was it two months ago now) comes in. The one thing they did show is how a medication error can affect the lives of the general public. You think that a PharmD with 4 years training behind him makes an error every now and again. Wait til you have techs earning 1/4 the pay with 0-1 years worth of training (and none of it beyond basic categorization, side effect alerts, and inventory, plus basic HIPAA) and you'd be in a world of hurt. Let an 18 year old with no college degree, no science background, no training in pharmacology make a judgement call based on what some stupid corporate database tells him? Not a freakin chance.

 

[piyi]

I think that is impossible? I might be wrong since im not in school yet. but usually if you see other doctors everything is faxed. all the med history, prescription order will be faxed to the next MD right? So how can they have no idea what others are prescribing?

That would be nice. Unfortunately, I do not believe that is the case all the time. Don't forget, some people have their primary care physician, and then they have go to the ER. And then there are patients who don't have a PCP and just go from doctor to doctor. Or they have a specialist for this, that, and the other. I'm still a tech, but I will imagine I will learn a lot more about this once I'm a pharmacist. This is just what I'm picking up from working as a tech for 3 years.

 

[Da Alchemist]

This is where the news expose' from last month (or was it two months ago now) comes in. The one thing they did show is how a medication error can affect the lives of the general public. You think that a PharmD with 4 years training behind him makes an error every now and again. Wait til you have techs earning 1/4 the pay with 0-1 years worth of training (and none of it beyond basic categorization, side effect alerts, and inventory, plus basic HIPAA) and you'd be in a world of hurt. Let an 18 year old with no college degree, no science background, no training in pharmacology make a judgement call based on what some stupid corporate database tells him? Not a freakin chance.

yea i saw the news, the none licensed no skills tech typed 10mg on the computer instead of 1.0 mg and only 13y/o (ok maybe 16)? the RX order clearly says 1.0 mg, They didtn double check it which can be easily done. But let's get to the op topic, if there were no pharm.d in retail then hire a licensed tech with compounding skills. after all retails main job is to dispense the order of the prescriber?

ALso, about the tech making a judgement call based on database? i dont think the patient will ask how drugs work in human body or any other questions none related to drug info should not be asked by a pharm.d anyway? the most logical question they tend to ask are side effects? drug/food interactions? drug comparisons? The MD after consulting with Hospital Pharm.D shouldve told the patient the side effects and other issues about the medication he/she is taking anyway so that the patient doesnt ask unecessary questions at the pharmacy?

And why most Retail Pharmacist complain that they are forgetting some of the knowledge they learned in pharmschool? maybe because everything they do everyday is what technicians do. the main big difference is techs cant counsel? but counsel what? Didnt the MD already counsel the patient.

 

[Jbuprepharm]

I think that is impossible? I might be wrong since im not in school yet. but usually if you see other doctors everything is faxed. all the med history, prescription order will be faxed to the next MD right? So how can they have no idea what others are prescribing?

because probably 9 times out of 10 that doesn't happen. It MAY happen if someone were to move and the old PCP faxes the new PCP. But the people who doctor hop, or go to the ER, or a specialist, etc etc aren't going to carry their med history with them, and the likelyhood of it being faxed to the next provider is nil. It's like pulling teeth just to get a refill request faxed back to the pharmacy.

 

[Da Alchemist]

wow that sounds so unreal. I just learned something new right now if what you are saying is true? so the next doctor can peform something without knowing what your other doc has prescribed or even med history? this will definitly kill the patient lol

 

[Jbuprepharm]

wow that sounds so unreal. I just learned something new right now if what you are saying is true? so the next doctor can peform something without knowing what your other doc has prescribed or even med history? this will definitly kill the patient lol

it happens all the time (not the killing part so much though). Because even when the new doc asks the patient what they're on, they may forget to mention one or more drugs, or may choose to withold the info. In real like there are way too many variables to count on a machine for error elimination. The best case is machine augmenting what people can do.

what's unreal is expecting the various docs to all collaborate so cooperatively.

it'd be great if they did, and better for all, but it doesn't happen near as often as it should.

 

[Farmercyst]

yea i saw the news, the none licensed no skills tech typed 10mg on the computer instead of 1.0 mg and only 13y/o (ok maybe 16)? the RX order clearly says 1.0 mg, They didtn double check it which can be easily done. But let's get to the op topic, if there were no pharm.d in retail then hire a licensed tech with compounding skills. after all retails main job is to dispense the order of the prescriber?

ALso, about the tech making a judgement call based on database? i dont think the patient will ask how drugs work in human body or any other questions none related to drug info should not be asked by a pharm.d anyway? the most logical question they tend to ask are side effects? drug/food interactions? drug comparisons? The MD after consulting with Hospital Pharm.D shouldve told the patient the side effects and other issues about the medication he/she is taking anyway so that the patient doesnt ask unecessary questions at the pharmacy?

And why most Retail Pharmacist complain that they are forgetting some of the knowledge they learned in pharmschool? maybe because everything they do everyday is what technicians do. the main big difference is techs cant counsel? but counsel what? Didnt the MD already counsel the patient.

I guess the big thing is what they do versus what they'd be capable of doing if staffed properly. You're probably right, most times retail pharmacies (based on posts I've read in this forum, so take it with a grain of salt) are understaffed and overworked and the RPh is stuck doing what techs should be hired to do. I think that's part of the problem. It's not that the pharmacists don't have anything else they could be doing, it's that they don't have anytime to do anything else. Check a lot of the posts from retail techs/Pharmacists. A lot of them seem to be run ragged and can't use the clinical skills taught in pharmacy, much to the disservice of the general public. (I apologize if I sound like SDN here) They should be consulting patients, helping them understand what their meds are for, common side effects, problems that should be reported to physicians, etc. In a perfect world where the doctor isn't 2 hours behind when the clinic opens, sure they should be doing consults with their patients on their drugs, as well as any unprescribed self-medicating. They should cover side effects and so on. How many times does it happen? Based on what I've learned in pharm tech classes, through the grave vine, and on SDN this is a rare occurence. Most of the time the doctor writes the script and the pt goes on their way with little or no explanation, and generally if an explanation is given, 1/2 the time it's not understood. I'd say SDN and other more seasoned professionals could give you real life examples where I currently am resorting to rhetoric. Again, this may be my naivete, and I may get smacked in the face when the real world comes around, but it's currently how I see it.

 

[Farmercyst]

wow that sounds so unreal. I just learned something new right now if what you are saying is true? so the next doctor can peform something without knowing what your other doc has prescribed or even med history? this will definitly kill the patient lol

Somewhere around here I posted a link to a story in Pharmacy Times where a guy goes to PCP gets wellbutrin, another Doc prescribes same guy bupropion and he gets another script for Zyban. Guy's inexplicably tossing cookies everywhere and noone knows why til someone points out the guy's triple dosing on the med due to 3 scripts for the same med by different names. Three doctors, all should have advised their patient about drug facts, either they didn't or it didn't stick. Based on your premise they all should have had faxes indicating what scripts had been written. And 2 scripts would never have made it to the patient. Your right, the reason it was printed in the Pharmacy times is because it was a "this shouldn't happen" article, but it's also why we're out there, to make sure it doesn't.

 

[tussionex]

wow that sounds so unreal. I just learned something new right now if what you are saying is true? so the next doctor can peform something without knowing what your other doc has prescribed or even med history? this will definitly kill the patient lol

seriously? unreal? i agree with other posters; what's unreal is thinking that patients will remember/even think to mention to their multiple docs that they are on other medications and the MDs have both the time and inclination to collaborate....sometimes patients see docs in differents counties, states, etc...no oppportunity to collaborate there..

that's the whole point of having a pharmacist

ps - i know "retail" pharmacists who are top-notch and pharmd's that i wouldn't let pour me a glass of water...it's not just the degree that matters!

 

[Da Alchemist]

seriously? unreal? i agree with other posters; what's unreal is thinking that patients will remember/even think to mention to their multiple docs that they are on other medications and the MDs have both the time and inclination to collaborate....sometimes patients see docs in differents counties, states, etc...no oppportunity to collaborate there..

that's the whole point of having a pharmacist

the whole point of having a pharmacist where? hospital? or retail?

 

[sdn1977]

Im curious.. in retail, people's lives are in the pharmacist hands? I thought most of the medical errors are found only in hospital setting. The medications that the patients are takng are the prescriber's order so if anything happens it's the prescribers fault right? under the prescriber's hands? and the retails main job is to dispense that order right? (for 20k the tech cant learn how to dispense drugs?) if the patient ask "can i take coumadin with aspirin?" why cant the tech look it up on a computer. are there any hard questions about drugs that the computer cant answer? or are there any patients out there that ask hard questions? in retail most of the patients just come and go right? If the rx order for example is coumadin, why can't the computer print out all the possible drug/food interactions so that patients wont have to ask? for example, avoid alcohol, avoid dairy, avoid aspirin etc. These are just curious questions that i have, since im not in pharm school yet. Can anyone school me? Sdn?

Yeah - I can tell you, but like most things in pharmacy...its a bit complicated if you really want to understand. I could just tell you its the law - but that wouldn't satisfy you (good for you!!!!). But, sadly, I'm off to work.

So...if you can give me a few hours, I'll give you a complete & thoughtful answer which will help you understand the laws which govern who can & cannot give out information & the liability each one carries.

Hope thats ok - thats the best I can do for now, but I'll be back .

 

[patmcd]

Im curious.. in retail, people's lives are in the pharmacist hands? I thought most of the medical errors are found only in hospital setting. The medications that the patients are takng are the prescriber's order so if anything happens it's the prescribers fault right? under the prescriber's hands? and the retails main job is to dispense that order right? (for 20k the tech cant learn how to dispense drugs?) if the patient ask "can i take coumadin with aspirin?" why cant the tech look it up on a computer. are there any hard questions about drugs that the computer cant answer? or are there any patients out there that ask hard questions? in retail most of the patients just come and go right? If the rx order for example is coumadin, why can't the computer print out all the possible drug/food interactions so that patients wont have to ask? for example, avoid alcohol, avoid dairy, avoid aspirin etc. These are just curious questions that i have, since im not in pharm school yet. Can anyone school me? Sdn?

Your forgetting the other very important thing that pharmacists do in retail stores.....OTC products and medical referrals. A tech would have a very hard time answering many of the questions about what OTC product to use, and when someone needs to see a doctor without the training that pharmacists get. A computer database only gets you so far. What if someone asks a question thats not in the database?

 

[Da Alchemist]

Your forgetting the other very important thing that pharmacists do in retail stores.....OTC products and medical referrals. A tech would have a very hard time answering many of the questions about what OTC product to use, and when someone needs to see a doctor without the training that pharmacists get. A computer database only gets you so far. What if someone asks a question thats not in the database?

arent otc pretty much self explanatory? (im not sure) it tells you which is for allergy/sore throat/ fever/ vitamins, etc.. right?

What if someone ask a question that's not in the database? If u look on my above post I asked what can be the hardest question that a patient might ask? There are computer robots these days that can solve a rubik cube in less than 40 seconds no matter how much you re arrange it. Now, can't they program something similar for pharmacy? For example, if the patient ask "I'm taking coumadin, can i take this with aspirin?" with the computer programed for pharmacy, let the tech plug in "coumadin w/ aspirin" let it analyze and tell the patient the result? I think any drug info can be programmed and any med advice questions should be reffered to physician because a pharm.d are not allowed to give med advice anyway right?

 

[Pharmguy07]

We should eliminate physicians too. Just input your symptoms into a computer and it spits out a diagnosis, along with a prescription you can actually read.

 

[Da Alchemist]

We should eliminate physicians too. Just input your symptoms into a computer and it spits out a diagnosis, along with a prescription you can actually read.

lol symptoms are a little complicated i think? just watch Dr. House..

btw the whole computer substiting pharm.d idea is for retail only not hospital.

 

[rxlynn]

yea i saw the news, the none licensed no skills tech typed 10mg on the computer instead of 1.0 mg and only 13y/o (ok maybe 16)? the RX order clearly says 1.0 mg, They didtn double check it which can be easily done. But let's get to the op topic, if there were no pharm.d in retail then hire a licensed tech with compounding skills. after all retails main job is to dispense the order of the prescriber?

ALso, about the tech making a judgement call based on database? i dont think the patient will ask how drugs work in human body or any other questions none related to drug info should not be asked by a pharm.d anyway? the most logical question they tend to ask are side effects? drug/food interactions? drug comparisons? The MD after consulting with Hospital Pharm.D shouldve told the patient the side effects and other issues about the medication he/she is taking anyway so that the patient doesnt ask unecessary questions at the pharmacy?

And why most Retail Pharmacist complain that they are forgetting some of the knowledge they learned in pharmschool? maybe because everything they do everyday is what technicians do. the main big difference is techs cant counsel? but counsel what? Didnt the MD already counsel the patient.

In today's insurance managed care world, doctors don't have time to sit around and talk to patients with a lot of specifics about their medications. Also, MDs typically only take a course or two in pharmacology, so their knowledge of drugs is certainly less than a pharmacist. I'm not sure why you wrote that the MD would be consulting with a hospital pharmacist - I can see that happening if it was an in-patient in the hospital, but who is the MD supposed to consult with for the majority of their patients who aren't in the hospital??

Finally, I'll simply point out that sometime patients don't even know the question they need to ask, so a well-trained pharmacist can help in that scenario as well. The more I work retail, the more I am reminded that the average patient is really really stupid when it comes to medication/prescription insurance/etc. , so I can't imagine how they could simply query a computer.
thanks for asking - this is an interesting thread.

 

[ButlerPharm.D.]

All I have to say is, once you start pharmacy school all of these questions will be answered for you and you will be learning more about these topics than you ever cared to know.

For example, we have an ENTIRE 1 year course called "Self-Care and Health Promotion", in which we learn about common medical conditions that can be treated with OTC products. As a result we learn about the condition and all of the meds that can possibly be used to treat this condition, their interactions, their directions for use, exclusions for self-care etc. In addition to these topics we also learn about ways we can help our patients manage their disease states such as how we can provide patient education to our patients regarding diabetes, cardiovascular disease and other disease states.

In response to some of your statements about letting techs do the work of a pharmacist. First of all, not all states license their techs hence anyone wishing to work in a pharmacy can. with a simple background check, get a job as a pharmacy technician which leads to the question-what kind of knowledge do these people have and secondly how can they be held both legally or professionally responsible for their recommendations if something were to go wrong??

In response to your comment about computers replacing pharmacists: would you feel comfortable going to a pharmacy run by technicians that have no previous experience who, if you asked them a question, had to go to a computer and type in your question??? I guess then, based on this logic, that we can replace medical doctors-hospitals can be run by patient care technicians that have computers, all they need to do is type in your systems and the computer should spit out a diagnosis and treatment!!

Medicine is very complex and always evolving-simply KNOWING that someone has this condition and takes this medication is not enough, one must be aware of how these conditions and medications effect the patient and how this may impact your decisions about how to treat this patient.

I guess you can't truly appreciate or be aware of the complexity of medicine until you start school and you start learning about these things.

 

[ButlerPharm.D.]

You can find an interesting article on health literacy by clicking on the following link. http://www.medicinenet.com/script/main/art.asp?articlekey=31951In short it states that, "Nearly half of all American adults - 90 million people - have difficulty understanding and using health information, and there is a higher rate of hospitalization and use of emergency services among patients with limited health literacy, says a new report from the Institute of Medicine of the National Academies. Limited health literacy may lead to billions of dollars in avoidable health care costs."
Source: Press release, the Institute of Medicine of the National Academy of Science, April 8, 2004.

Or this, article titled, "The Importance of Knowing What the Doctor is Talking About" http://www.nytimes.com/2007/01/30/health/30brody.html?ei=5088&en=b63051c1ba1f7083&ex=1327813200&adxnnl=1&partner=rssnyt&emc=rss&adxnnlx=1177734205-Tw0qWeL4AxzJjvFc3uJ7CQ which found, "Among the many problems resulting from limited health literacy are misinterpretations of warning labels on prescription drugs. For example, among 251 adults attending a primary care clinic in Shreveport, La., those with low literacy were three times more likely to misunderstand warnings than the more literate.

When the warning label read "Do Not Chew or Crush, Swallow Whole," misinterpretations included "Chew it up, so it will dissolve" and "Don't swallow whole or you might choke."

When the warning read "Medication Should Be Taken With Plenty of Water," the mistakes included "Don't take when wet" and "Don't drink hot water."

When the warning was "For External Use Only," the mistakes included "Medicine will make you feel dizzy" and "Use extreme caution in how you take it."

....A main obstacle has been the decreased time patients can spend with their doctors, dictated largely by managed care and other medical reimbursement plans.

A second hurdle is the embarrassment that patients with limited health literacy experience when they do not understand what the doctor has said. And, of course, asking for clarification is seriously impeded by the imbalance in power between the white-coated physician and the paper-wrapped patient. Even when conversations are conducted in the doctor's office with a fully clothed patient, patients are often reluctant to ask questions.

 

[Da Alchemist]

In today's insurance managed care world, doctors don't have time to sit around and talk to patients with a lot of specifics about their medications. Also, MDs typically only take a course or two in pharmacology, so their knowledge of drugs is certainly less than a pharmacist. I'm not sure why you wrote that the MD would be consulting with a hospital pharmacist - I can see that happening if it was an in-patient in the hospital, but who is the MD supposed to consult with for the majority of their patients who aren't in the hospital??

If the MD doesnt have time to sit and talk to the patients, then it would be great if HOSPITAL Pharm.D can do that job mandatory to all the patients. It would make the pharm.d proffesion even more important. About the MD consulting with Pharm.D before prescribing an order. Why not? in patient or not, with the hospital pharm.d''s aproval of the right medicine then the MD/RETAIL Pharm.D wont have to worry about speaking over the phone since it's already been confirmed in hospital? why does the retail pharm have to call the physician and warn him about medication the patient is taking when the hospital pharm can confirm it with the physician before prescribing? it saves everyone time.

 

[Da Alchemist]

In response to your comment about computers replacing pharmacists: would you feel comfortable going to a pharmacy run by technicians that have no previous experience who, if you asked them a question, had to go to a computer and type in your question??? I guess then, based on this logic, that we can replace medical doctors-hospitals can be run by patient care technicians that have computers, all they need to do is type in your systems and the computer should spit out a diagnosis and treatment!!

with the technicians today who arent licensed and only 14 y/o, No i wouldnt feel comfortable but assuming that there are no retail pharm.d and the tech are licensed skills trained and assuming that they double check what the order was before realeasing it. Yes I would feel comfortable picking up the order the physician prescribed? The Mcdonalds worker doesnt know understand the fats and calories of the food but they know how to prepare it and serve. Im sure a proper trained tech can prepare the physician order as well. or no? maybe wrong analogy

How can you replace MDs with computers? if the symptom is Seizure, migraine, etc it doesnt neccasarily mean the patient have tumor? Because if you plug that in on the comp the comp will spit out "u have brain tumor" MDs job requires more problem solving/thinking. A good example is watching Dr. House on channel FOX lol. Just think why Pharm.D forget what they learned in pharmschool? Because their main role is only to prepare the physicans order.

 

[ButlerPharm.D.]

In the perfect world all physicians would speak with a pharmacist before they prescribe however, as we are all aware, this world aint perfect. I think you'd agree with me that if your health were on the line you'd want the maximum number of checks and balanaces bulit into a system that has the potential to cause you harm.

 

[Priapism321]

Alchemist,

After reading all of your posts on this thread, I cannot believe so many people are entertaining the broken and/or run-on sentences you are putting through as supposed thoughts/ideas. I don't think you have the slightest clue about what you are talking about, and if you do, please give me some credentials that give you the right to even have an opinion. Prepharmacy/premed/pre-anything disqualifies you from being involved in this topic in my book. As far as I see it, you can barely type in the English language; I am not sure I would trust you to double check my chik-fil-a sandwich to make sure the pickles have been removed, let alone double check that a prescription medication is appropriate for me to walk out of the store onto the streets with.

 

[ButlerPharm.D.]

Let's get one thing clear, there are not 14 year olds working as pharmacy technicians, at least as far as I am aware. If you are aware of any 14 year old pharmacy technicians I would avoid that pharmacy like the plague. There are however 16 year olds working as technicians, such as in the state of Illinois, however they are licensed and held liable to the state.

I don't know how to say this without the possibility of offending someone but I will say it anyway; technicians do not have the experience nor do they possess the knowledge necessary to partake in the degree of professional decision making capacity necessary of a pharmacist. When you make the statement that you would feel comfortable if, "the tech are licensed skills trained and assuming that they double check what the order was before releasing it" you are assuming that the technicians have the professional capacity and decision making capacity of a pharmacist. The checks you are speaking of come naturally to a pharmacist because of the years of education they receive regarding pharmacology, drug interactions, and adverse drug effects; these are topics for which many technicians do not receive proper education. Pharmacists operate in a professional capacity as a result of their education and technicians operate in a technical capacity as a result of their education.

As for your last comment, if you feel comfortable comparing the potential for death related to a medication error to preparing McDonalds hamburgers go ahead-that is not an analogy I going to debate because to me, the comparison is a little to far fetched.

Lastly, are you aware how involved the diagnosis of any of the diseases you listed are? For instance, the following is diagnostic criteria for migraine without aura: Diagnosis

International Headache Society of America (IHSA) Diagnostic Criteria for Migraine Without Aura

At least 5 attacks fulfilling the following criteria

• Headache attacks lasting 4-72 hours (untreated or unsuccessfully treated)

• At least 2 of the following:
Unilateral location
Pulsating quality
Moderate or severe pain intensity
Aggravation by or causing avoidance of routine physical activity

• During headache at least one of the following:
Nausea and/or vomiting
Photophobia and phonophobia

• Not attributable to another disorder"

Although you can make the argument that patients maybe able to self diagnose based upon the above criteria, this is simply not the case do to the potential that the patient may be experiencing these symptoms due to some other condition for which you must possess the knowledge to differentiate between the two-would a computer possess this capability? I think not.

Lastly, if all you think pharmacist do are "prepare the physicians order" you will be sorely mistaken when you begin pharmacy school. Pharmacists are capable of offering MTM to their patients, they are capable of providing patient education to patients regarding their medications and disease states, and pharmacists are capable of making recommendations for self-treatment for certain medical conditions-these are all things you will learn about in school. If however you enter the profession with the mind set that all you have to do is prepare the physician order, you might find pharmacy a little less enjoyable than you thought it would be.

with the technicians today who arent licensed and only 14 y/o, No i wouldnt feel comfortable but assuming that there are no retail pharm.d and the tech are licensed skills trained and assuming that they double check what the order was before realeasing it. Yes I would feel comfortable picking up the order the physician prescribed? The Mcdonalds worker doesnt know understand the fats and calories of the food but they know how to prepare it and serve. Im sure a proper trained tech can prepare the physician order as well. or no? maybe wrong analogy

How can you replace MDs with computers? if the symptom is Seizure, migraine, etc it doesnt neccasarily mean the patient have tumor? Because if you plug that in on the comp the comp will spit out "u have brain tumor" MDs job requires more problem solving/thinking. A good example is watching Dr. House on channel FOX lol. Just think why Pharm.D forget what they learned in pharmschool? Because their main role is only to prepare the physicans order.

 

[ButlerPharm.D.]

deleted

 

[Da Alchemist]

Alchemist,

After reading all of your posts on this thread, I cannot believe so many people are entertaining the broken and/or run-on sentences you are putting through as supposed thoughts/ideas. I don't think you have the slightest clue about what you are talking about, and if you do, please give me some credentials that give you the right to even have an opinion. Prepharmacy/premed/pre-anything disqualifies you from being involved in this topic in my book. As far as I see it, you can barely type in the English language; I am not sure I would trust you to double check my chik-fil-a sandwich to make sure the pickles have been removed, let alone double check that a prescription medication is appropriate for me to walk out of the store onto the streets with.

"I dont have a clue?" Well first of all my posts above are mostly "questions" because obviously I do not know more about it. Duh!!!! lol Do you know how to read? "2nd" this is not an essay contest. So why do I need to type all proper to bring my message out? Oh english is not my primary language by the way I dont know why you're making fun of my english. Let me remind you that some of the best doctors out here in america doesnt speak english that well. You talk as if you perfected the english language but you can't even read.

 

[Da Alchemist]

Let's get one thing clear, there are not 14 year olds working as pharmacy technicians, at least as far as I am aware. If you are aware of any 14 year old pharmacy technicians I would avoid that pharmacy like the plague. There are however 16 year olds working as technicians, such as in the state of Illinois, however they are licensed and held liable to the state.

I don't know how to say this without the possibility of offending someone but I will say it anyway; technicians do not have the experience nor do they possess the knowledge necessary to partake in the degree of professional decision making capacity necessary of a pharmacist. When you make the statement that you would feel comfortable if, "the tech are licensed skills trained and assuming that they double check what the order was before releasing it" you are assuming that the technicians have the professional capacity and decision making capacity of a pharmacist. The checks you are speaking of come naturally to a pharmacist because of the years of education they receive regarding pharmacology, drug interactions, and adverse drug effects; these are topics for which many technicians do not receive proper education. Pharmacists operate in a professional capacity as a result of their education and technicians operate in a technical capacity as a result of their education.

Im sure you know that I was being sarcastic about the 14 yr old techs. Im not saying that technicians have the proffesional decision making capacity of a pharmacist but im saying the proper trained technicians can dispense the correct medicine that the physician prescribed. Patients picking up the physicians order in retail store is the major point of retail pharmacy anyway right?

 

[Dustbunny]

Pharmacies without pharmacists CAN and DO EXIST.

My doctor's office has one with no one but (essentially) pharmacy technicians preparing the scripts. There are no controlled substances, and everything is e-prescribed by him and his partners in-house.

http://www.allcaremedical.org/about_us/services.html

I have mixed feelings on the subject.

 

[Priapism321]

"I dont have a clue?" Well first of all my posts above are mostly "questions" because obviously I do not know more about it. Duh!!!! lol Do you know how to read? "2nd" this is not an essay contest. So why do I need to type all proper to bring my message out? Oh english is not my primary language by the way I dont know why you're making fun of my english. Let me remind you that some of the best doctors out here in america doesnt speak english that well. You talk as if you perfected the english language but you can't even read.

Your "questions" have been loaded and asinine throughout the thread, almost as if you did actually know something. If you are simply just asking "questions," just take the responses from people who may be in a slightly better place than you to understand these things and shut the hell up. And thank you for the reminder on doctors in this country, how many of these individuals have you worked with again? Once again, I call bull**** on your assertions, and even though your statement about the physicians in this country may be true, I don't think you have any basis for knowing this information.

 

[OrganicPharmer1]

Take it easy, you guys. Let's be civil here and get back to the "future of pharmacy". I'm not a moderator. Cheers.

 

[konkan]

One pharmacist told me that lobbysts are trying to make a new law that would let to a retail pharmacy to operate without a pharmacist. In other words, pharm techs will do all the work.
Of course, it will jeopardize the whole job security-salary situation on the market Why would a store manager hire a pharmacist and pay 80K, if there is a pharm tech who will work for 20K...
So what do you guys think?
Will it ever happen?

One girl in the gym told me that they are trying to pass laws which would enable physician assistants to do physician jobs and nursing assistants - nurse jobs.

 

[Priapism321]

Pharmacies without pharmacists CAN and DO EXIST.

My doctor's office has one with no one but (essentially) pharmacy technicians preparing the scripts. There are no controlled substances, and everything is e-prescribed by him and his partners in-house.

http://www.allcaremedical.org/about_us/services.html

I have mixed feelings on the subject.

Well, I would say that you are in the position to have feelings on this, and your post actually interests me. This is contrary to "Da Alchemist's" thoughts, because I don't think he understands medicine, pharmacy, or how either of the professions really operate.

 

[Priapism321]

Take it easy, you guys. Let's be civil here and get back to the "future of pharmacy". I'm not a moderator. Cheers.

I apologize, I have been reading too much of www.theangrypharmacist.com lately.

 

[Jbuprepharm]

arent otc pretty much self explanatory? (im not sure) it tells you which is for allergy/sore throat/ fever/ vitamins, etc.. right?

It's obvious that you haven't worked in a pharmacy ever, because 95% of the people that come in to where I work (at my old job during undergrad and now here in Amarillo) have no idea how to read the drug facts on a box, or what they mean. Most people, if left to their own devices would probably end up with a lot of therapy duplication, improper product selection, the list goes on.

If you read the Afrin box, it says not to use it for more than 3-5 days at a time, and we've had several people come in with bad congestion, who have been using their Afrin for 2-3 weeks straight and can't figure out what's wrong, afterall, their Afrin "usually works just fine".

I think you must have grown up in a utopia where most people don't lost cognitive function when they walk into a pharmacy, because, for some reason, that is what happens to the average person when they're trying to figure out how to take medication.


Edit: I'm not attacking, just pointing out that nothing you've said so far applies to the real world. You seem to have VERY idealized conceptions of how things work in the world of pharmacy.

 

[Jbuprepharm]

I apologize, I have been reading too much of www.theangrypharmacist.com lately.

that site is

 

[Dustbunny]

I apologize, I have been reading too much of www.theangrypharmacist.com lately.

TAP rules! (Even though I don't always agree with him.)

 

[Da Alchemist]

Your "questions" have been loaded and asinine throughout the thread, almost as if you did actually know something. If you are simply just asking "questions," just take the responses from people who may be in a slightly better place than you to understand these things and shut the hell up. And thank you for the reminder on doctors in this country, how many of these individuals have you worked with again? Once again, I call bull**** on your assertions, and even though your statement about the physicians in this country may be true, I don't think you have any basis for knowing this information.

Oh you are brilliant because you learned english before me and you grew up on the english language. yay. What is your point though? Because I was curious how things might work in pharmacy withouth Retail Pharm.D?

btw, This is just a forum why are you cursing and yelling. Did you ever consider anger management classes? Are you a pharmacist? This proffesion doesn't look like it's for you. You curse alot and you make fun of people's english. lol take some anti highblood pressure, you might get a stroke.

 

[Priapism321]

Oh you are brilliant because you learned english before me and you grew up on the english language. yay. What is your point though? Because I was curious how things might work in pharmacy withouth Retail Pharm.D?

btw, This is just a forum why are you cursing and yelling. Did you ever consider anger management classes? Are you a pharmacist? This proffesion doesn't look like it's for you. You curse alot and you make fun of people's english. lol take some anti highblood pressure, you might get a stroke.

I will refrain, this is going nowhere, which in turn, essentially proves my point.

 

[OrganicPharmer1]

Oh you are brilliant because you learned english before me and you grew up on the english language. yay. What is your point though? Because I was curious how things might work in pharmacy withouth Retail Pharm.D?

Take it easy, Da Alchemist. I think the retail pharmacy would be a mess without a Pharm.D.. There would probably be a lot of angry customers if there's no pharmacist checking up on the techs. If I'm not mistaken, all you need to be a tech is a high school degree. I wouldn't want to get counseling from techs. I wouldn't want techs choosing an OTC drug for me. Etc.

 

[Da Alchemist]

It's obvious that you haven't worked in a pharmacy ever, because 95% of the people that come in to where I work (at my old job during undergrad and now here in Amarillo) have no idea how to read the drug facts on a box, or what they mean. Most people, if left to their own devices would probably end up with a lot of therapy duplication, improper product selection, the list goes on.

If you read the Afrin box, it says not to use it for more than 3-5 days at a time, and we've had several people come in with bad congestion, who have been using their Afrin for 2-3 weeks straight and can't figure out what's wrong, afterall, their Afrin "usually works just fine".

I think you must have grown up in a utopia where most people don't lost cognitive function when they walk into a pharmacy, because, for some reason, that is what happens to the average person when they're trying to figure out how to take medication.


Edit: I'm not attacking, just pointing out that nothing you've said so far applies to the real world. You seem to have VERY idealized conceptions of how things work in the world of pharmacy.

Yea I said "aren't otc meds self explanatory(not sure)" meaning i do not know? why not train the technician to explain to the customer what 3-5 days at a time mean? without giving med decision advice. Oh and I do agree that pharmacist should stay in retail. If u look at my first post i said i was just curious.

 

[ButlerPharm.D.]

Your post is quite interesting. I'm surprised that for such a small practice that they are able to offer all of those services, namely the onsite lab and medication dispensary. Are their any limitations on what they can dispense besides the obvious; controlled substances?

Pharmacies without pharmacists CAN and DO EXIST.

My doctor's office has one with no one but (essentially) pharmacy technicians preparing the scripts. There are no controlled substances, and everything is e-prescribed by him and his partners in-house.

http://www.allcaremedical.org/about_us/services.html

I have mixed feelings on the subject.