Is it a pharmacists responsibility to check dosage?

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I've been lurking for a while, but this post finally prompted me to register and speak my mind.

I've tried retail pharmacy, I've tried hospital/clinical pharmacy, and I've tried smaller community pharmacy. Here are my thoughts:

As much as I loved the problem-solving that came with working in a hospital, I'm the type of person who gets very attached to my patients. I like getting to know them and their families. When I've spent time in hospitals, I've wound up bringing my patients home with me. I've lost sleep over difficult cases, cried when patients have passed, and have really struggled with the suffering that I've seen. Yes, hospital pharmacists have a different "type" of practice, but (for me) it's just too depressing. I love retail, not because of the money, but because I feel like I'm actively participating in the lives of my patients. I can say that I've saved lives just like any hospital pharmacist has. I make recommendations every day that improve the lives of patients and help them with their medical needs. I love retail pharmacy, and I'm not ashamed of it. I agree that corporations are frustrating, but not all corporate policies are bad ones. I don't think that $4 generics are negatively affecting pharmacy practice. Most of them are NOT "loss-leaders"...I've seen our invoices. Our cost is much lower than you might think. If selling generics for $4 helps ensure that a patient gets their medication, I see no shame in that. How is it any different than forgiving hospital debt for patients who have an inability to pay??? Do you honestly believe that your hospital gets compensated for every patient who spends a month in the hospital?

Small community pharmacies are great, but I'd argue that I know just as many of my patients as your average community pharmacist does. We have a higher volume of patients,so I don't know every Tom, dick, and Harry that comes in for their cough medicine, but when it comes to regular patients - I know them. I pride myself in remembering names and faces. Just because I work for a company who matches my 401K and holds company policies doesn't mean that I care any less for my patients than you do. I'm sure there are pharmacists who feel that way, and that's unfortunate...but you'll find that in any setting.
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Vitamin K said:
I've been lurking for a while, but this post finally prompted me to register and speak my mind.

I've tried retail pharmacy, I've tried hospital/clinical pharmacy, and I've tried smaller community pharmacy. Here are my thoughts:

As much as I loved the problem-solving that came with working in a hospital, I'm the type of person who gets very attached to my patients. I like getting to know them and their families. When I've spent time in hospitals, I've wound up bringing my patients home with me. I've lost sleep over difficult cases, cried when patients have passed, and have really struggled with the suffering that I've seen. Yes, hospital pharmacists have a different "type" of practice, but (for me) it's just too depressing. I love retail, not because of the money, but because I feel like I'm actively participating in the lives of my patients. I can say that I've saved lives just like any hospital pharmacist has. I make recommendations every day that improve the lives of patients and help them with their medical needs. I love retail pharmacy, and I'm not ashamed of it. I agree that corporations are frustrating, but not all corporate policies are bad ones. I don't think that $4 generics are negatively affecting pharmacy practice. Most of them are NOT "loss-leaders"...I've seen our invoices. Our cost is much lower than you might think. If selling generics for $4 helps ensure that a patient gets their medication, I see no shame in that. How is it any different than forgiving hospital debt for patients who have an inability to pay??? Do you honestly believe that your hospital gets compensated for every patient who spends a month in the hospital?

Small community pharmacies are great, but I'd argue that I know just as many of my patients as your average community pharmacist does. We have a higher volume of patients,so I don't know every Tom, dick, and Harry that comes in for their cough medicine, but when it comes to regular patients - I know them. I pride myself in remembering names and faces. Just because I work for a company who matches my 401K and holds company policies doesn't mean that I care any less for my patients than you do. I'm sure there are pharmacists who feel that way, and that's unfortunate...but you'll find that in any setting.
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Well said......
 
Not sure it added much to this 150-something post thread though...
 
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Vitamin K said:
If selling generics for $4 helps ensure that a patient gets their medication, I see no shame in that. How is it any different than forgiving hospital debt for patients who have an inability to pay???
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Are you serious? You can't see the difference between selling $4 script vs. Hospital write offs? Hospitals write off bills for patients who are indigent or uninsured and therefore by no means collection is a possibility.

$4 script doesn't discriminate. It's another dagger in the heart of independent pharmacy who can no longer compete now because the gross margin that was sustaining the pharmacy business is no longer there. And patients rich or poor take advantage of $4 scripts..not just the indigents.

And do you think hospital write offs are good things? Do you know of a mass merchandiser pharmacy who provide free drugs? What happenes when hospital goes out of business?
 
Wow someone's actually using hospital write-offs as a defense of $4 generics? Hospital write-offs is one of the many factors currently contributing to our terrible, terrible healthcare system. Using it to justify anything is utterly without merit and laughable.

I mean honestly, can you just edit that out of your post? It's embarassing.
 
meister said:
Wow someone's actually using hospital write-offs as a defense of $4 generics? Hospital write-offs is one of the many factors currently contributing to our terrible, terrible healthcare system. Using it to justify anything is utterly without merit and laughable.

I mean honestly, can you just edit that out of your post? It's embarassing.
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Nope, I won't edit it. I wasn't defending it and I don't believe it needs to be defended. Are you forgetting that hospitals are businesses too? I was using write-offs as an example of how hospitals also lose money in some transactions. I know some of you are on your high-horses about hospital pharmacy, and if your ego needs that, so be it...but retail saves lives too, and I'd rather not have my patients end up with complications/ hospitalizations because they're not being adherent due to cost. I was skeptical of the whole $4 generic idea when Walmart first started it, but after seeing people pick up prescriptions that they otherwise couldn't afford, I've changed my stance on this. I don't believe that $4 generics will be the "end-all" of community pharmacy. People have always gone to the independents for their customer service and dependability, and that hasn't changed. Last I checked, independents still order their drugs from the same distributors that the big chains do. I'm not saying that they should also do the $4 generics, but if cheap generic drugs make medications accessible, I'm all for it. That's their business model. I care more that my patients are taking their meds than I do about the mom and pop store on the corner. Business isn't "fair". This is the real world. I agree that it's sad, but it's a fact that has always existed and always will. Are we forgetting the whole reason that we went into this profession? Our patients. ...and we can care for them no matter where we work. Some of the people on this forum are so negative. We're professionals. As a professional, I respect other people in my profession regardless of their job choice. I'm not sure where this whole holier-than-though idea got started, but I'm certainly as competent as any of my hospital counterparts. Please...let it go.
 
No more words.

Time to die...

:beat:
 
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Wow.... this is all over the place. For the sake of fun, let's break this down and see if we can make some sense out of it.

Vitamin K said:
Nope, I won't edit it. I wasn't defending it and I don't believe it needs to be defended. Are you forgetting that hospitals are businesses too? I was using write-offs as an example of how hospitals also lose money in some transactions.
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Here is why your example is not a good example. $4 script is by design and choice to draw customers. Hospital write offs isn't by choice but because hospitals are left with no choice but to write off bad debt. This actually is detrimental to already fragile hospital fiscal health. $4 script and hospitals are different like night and day.



I know some of you are on your high-horses about hospital pharmacy, and if your ego needs that, so be it...but retail saves lives too, and I'd rather not have my patients end up with complications/ hospitalizations because they're not being adherent due to cost.
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I'm not sure if this is directed to me but I never denounced the value of retail pharmacy. I usually just say retail sux because I think retails sux and I don't want to work retail. I would never take offense to someone saying hospital pharmacy sux. That's ok...cuz sometimes hospital pharmacy jobs suck.



I don't believe that $4 generics will be the "end-all" of community pharmacy. People have always gone to the independents for their customer service and dependability, and that hasn't changed.
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Well, guess what...those independents who customers relied on for customer service and dependability are now shutting down because they can't compete with mass merchandiser's $4 scripts. Of course..you're not worried about those mavericks who are holding on to the last thread of hope for the profession we will now only remember in our nostalgia.


Last I checked, independents still order their drugs from the same distributors that the big chains do.
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What's this got to do with anything??? Yet, independents don't have the front end like Wags and Walmarts and backing of mega giant corporate finance. So what is your point on bringing this up?



This is the real world.
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:smuggrin: Is there a fake world??


I agree that it's sad, but it's a fact that has always existed and always will. Are we forgetting the whole reason that we went into this profession? Our patients. ...and we can care for them no matter where we work.
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mmm... I doubt that's why people go into pharmacy. But guess what...I've been a part of 3 hospital closures in 2008... you can compare your $4 generics to hospital write offs all day long...but you have no idea how devastating it is to close a hospital..let alone 3... with all the layoffs and the disservice it causes to the community.

Some of the people on this forum are so negative.
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Who??

We're professionals. As a professional, I respect other people in my profession regardless of their job choice. I'm not sure where this whole holier-than-though idea got started, but I'm certainly as competent as any of my hospital counterparts.
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If you respect your hospital counterparts, don't pretend to be as competent as someone who do it daily. And I won't pretend to be as competent as you as a retail pharmacist.





Please...let it go.
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Let what go??
 
Nobody seems to realize that not once has anyone said that the concept of community pharmacy is a bad one. It's just that the execution of such, led by the retail giants, has been detrimental. And because of this, it's become a sad excuse of a profession. That's all we're saying. And nobody can really deny it. For every gift card and loss leader script that goes out the door, our profession is devalued.
 
"I care for my patients so much that I'm willing to buy their medication for them so they will take it."

Noble intent but terrible execution. While personally I feel that we should have single-payer healthcare and that all this profit-driven crap is a terrible exercise, that does not mean I'm going to throw my profession under the bus for the sake of the patient. We all have to work within the system we have, barring major reform, and unfortunately our current system is based almost entirely on profit, at least retail pharmacy. As such, you cannot throw profit out of the window and expect to keep your profession at the same level of respect, people will just start taking it for granted and taking advantage of you. All you have to do is look at the state of retail pharmacy currently and you'll realize this.

I empathize with your intentions but this is the worst way to go about effecting meaningful reform in our current healthcare model.
 
ItsOverZyvox said:
Wow.... this is all over the place. For the sake of fun (you mean for the sake of looking clever?), let's break this down and see if we can make some sense out of it.
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I wasn't directing my opinions toward you. I was speaking my mind as people on an open forum should be allowed. I'm tired of people pissing and moaning about how corporations are ruining their practice. I think it's bullcrap. YOU are your own dictator of how you practice. If you don't like the corporate system, stay out of it. I'll never understand why people feel the need to cry about how horrible things are. I get frustrated with "Big Brother" as much as anybody (and definitely more than my patients), but that's what I have to work with and I manage it well.

I don't know what it's like where you live, but we have a lot of local community pharmacies here that have been around a long time and seem to be doing quite well (two of them have just expanded to other locations). I haven't seen their books though...have you? If community pharmacy is so terribly important to you, get in there and work for one. Do something about it.


And what does a closing hospital have to do with anything?

Ok, I'm done. Clearly it was a mistake to join this board if people can't voice an opinion without being personally insulted. Very professional.
 
Vitamin K said:
Ok, I'm done. Clearly it was a mistake to join this board if people can't voice an opinion without being personally insulted. Very professional.
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clearly you have some extremely thin skin...perhaps pharmacy is not the profession you should be in.
 
Oh, jeez...read Z-pack's post again. If in doubt, re-read WVU's post #165.

As you have correctly stated, it's an open forum. People have a tendency to respond to other people's posts and they don't necessarily agree with one another...
 
67echo said:
clearly you have some extremely thin skin...perhaps pharmacy is not the profession you should be in.
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HEY! Don't be jumping in ahead of me, ya judgemental jerk!:D
 
MountainPharmD said:
I guessing by this person comments they are not involved in pharmacy. Probably pre-pharm or a P-1.
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I hope you meant echo, and not about me. I'm 2 rotations away from graduation, with 5 years of working experience. Definitely not pre-pharm...

I think I have a good grasp on the pharmacy world, and no, my skin is not thin. It just rubs me the wrong way to see pharmacy students/ pharmacists berate their fellow professionals' job decisions.
 
Vitamin K said:
It just rubs me the wrong way to see pharmacy students/ pharmacists berate their fellow professionals' job decisions.
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I think most members of this forum are not berating other pharmacists but I don't think you can defend the corporations and their destructive business practices.
 
Let me tell you about Canada.. what little I know.

I've travel to the end of the world as I know... (remote parts of Vermont..Maine...) It's really remote and seems like the civilization ends.

Then you go further up North...there is a whole another country up there..called Canada. Dang.. Don't y'all get cold??
 
ItsOverZyvox said:
Let me tell you about Canada.. what little I know.

I've travel to the end of the world as I know... (remote parts of Vermont..Maine...) It's really remote and seems like the civilization ends.

Then you go further up North...there is a whole another country up there..called Canada. Dang.. Don't y'all get cold??
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If Vancouver, BC were in the States, I'd totally move there. :love:
 
Glycerin said:
If Vancouver, BC were in the States, I'd totally move there. :love:
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Yup...if Vancouver, Toronto, Montreal, and Quebec were all in Texas, I would move there too.. but we have to kick out those French speaking people back to where they came from.
 
I've heard really nice things about Ottawa as well.

I just don't do cold. So that leaves Vancouver as the only real option.
 
If I moved again... it would be somewhere around San Antone or little north of Houston. I need some farm land.
 
ItsOverZyvox said:
Aren't you from the East Coast now living in NM?
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yes. and I spent 10 years in Arizona as well, too.

Maryland was the furthest north I applied. I. don't. do. cold.
 
I applied to the University of Maryland Medical Center but haven't heard anything.

My family is over in Harford and Cecil counties. I got lost on my way to my great grandmothers house and ended up driving all over northern Baltimore and Carroll counties (picked up 83 instead of 795 on my way to Westminster - oops!) - it was gorgeous out there.

I used to ride (horses) very, very seriously and that is a big motivation to get back to the Mid-Atlantic.
 
Open land is disappearing in Harford/Cecil counties...damned developers!

In a way, I'm glad the current economic crisis has slowed development down a little...of course, there's BRAC to contend with (population increase).
 
loo said:
Open land is disappearing in Harford/Cecil counties...damned developers!

In a way, I'm glad the current economic crisis has slowed development down a little...of course, there's BRAC to contend with (population increase).
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yeah it's crazy - my dad/stepmom live in the BOONIES of northern Harford County and there's development starting up there.

Frankly, once you're close to 95 the commute isn't that bad. I commuted from Perryville to Baltimore a couple summers ago and it was right about an hour for 48 miles.

When I got lost I was up in hunt country. I imagine it's $$$$$$$$ to live up there, and I'd really rather not live in thecountry, but to board up there would be lovely.
 
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