Is Pharmacy threatened?

[Calibration1]

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With electronic medical records soon it will be mandatory to electronically send the RX to the pharmacy. There are pharmacists and PBMs working on systems that before the rx is sent to the pharmacy to be filled the doctor's office submits the claim, handles DUR rejections and interactions, and also handle prior auths.
By pushing this part of pharmacy up stream aren't we in a way handing over our interlectual property... i.e. drug experts? If doctors are having to deal with drug interactions and PBMS what does that leave us with in a retail setting? If doctors are stuck with this part of our job then our scope in the health profession decreases, leaving us with what counseling? Why not just have the doctors counsel the patient on the med before they leave the office, since they are already handling DUR reviews. Then what about retail pharmacists. Can we become exstinct? Or is this scenario not even a reality?

I am just opening this up for discusion to see what your opinions are...

I have the same concerns. I have seen my dads profession become obsolete and his suffereing as a result of computer automation. Are we as pharmacists
enjoying the last hurrah of a dying field????

 

[Calibration1]

This is a quote from the dept of labor and statistics...



With its empha.sis on cost control, managed care encourages the use of lower cost prescription drug distributors, such as mail-order firms and online pharmacies, for purchases of certain medications. Prescriptions ordered through the mail and via the Internet are filled in a central location and shipped to the patient at a lower cost. Mail-order and online pharmacies typically use automated technology to dispense medication and employ fewer pharmacists. If the utilization of mail-order pharmacies increases rapidly, job growth among pharmacists could be limited.

Employment of pharmacists will not grow as fast in hospitals as in other industries, because hospitals are reducing inpatient stays, downsizing, and consolidating departments. The number of outpatient surgeries is increasing, so more patients are being discharged and purchasing their medications through retail, supermarket, or mail-order pharmacies, rather than through hospitals. An aging population means that more pharmacy services will be required in nursing homes, assisted-living facilities, and home care settings. The most rapid job growth among pharmacists is expected in these 3 settings.

 

[pharmforme]

I have the same concerns. I have seen my dads profession become obsolete and his suffereing as a result of computer automation. Are we as pharmacists
enjoying the last hurrah of a dying field????

Didn't you just start an extremely similar thread???

 

[gimpsd]

I have the same concerns. I have seen my dads profession become obsolete and his suffereing as a result of computer automation. Are we as pharmacists
enjoying the last hurrah of a dying field????

How often are we going to discuss this topic on here. No one really knows what the future holds in store. The best you can do is be flexible. Pharmacy is a good profession but it may or may not pay the big bucks in the future. Will I continue working as a pharmacist even if it isn't lucrative? That is a resounding YES. As far as doctors being able to take over the job of the pharmacist....Are you kidding? Some of them don't even know how to spell the medications, much less counsel patients on them. I can't even count the number of times a patient comes in with incorrect dosage and directions that the pharmacist usually catches. You can sit there needlessly worrying about what the future holds but as for me I'm living in the present and going to pharmacy school. By the way most people on this forum will most likely be pro-pharmacy. Maybe you should post this same question on the medical forum and see what the doctors think about taking on extra work.

 

[gimpsd]

Didn't you just start an extremely similar thread???

Hello phramforme. I enjoy reading your posts. They're always very intellectual. Makes me proud that we are going into the same profession. Hopefully we can take different sides on a topic again sometime. BTW...I'm referring to "lady sues walgreens" thread.....in case you're trying to figure out who I am.

 

[Calibration1]

Didn't you just start an extremely similar thread???

Yeah, I guess I did. Is that a big problem?

 

[patmcd]

Yeah, I guess I did. Is that a big problem?

Why yes, yes it is. There's no need to start two threads on the same topic. You could have easily posted this in the other one.

 

[sarahjth]

All I can see is in the 5 years I have been a tech... the workload has increased. Mostly because of computers. Now we have to fax the Dr. everytime a patient runs out of a prescription. Typically, the doctors tell the patients to call us, fax them, and etc. before a patient can get an extension on refills. It's a lot of running around, if you ask me. Also, with the new Part D medications.. A LOT OF THEM need prior auth. etc, etc. That can take a lot of time, trying to get a hold of someone with the right numbers. I am just saying, pharmacists are still taking a lot on.. (in Illinois, anyway)

I really don't think this goes with your question because I surely hope pharmacy isn't threatened.. but no one will ever know!

 

[pharmforme]

Hello phramforme. I enjoy reading your posts. They're always very intellectual. Makes me proud that we are going into the same profession. Hopefully we can take different sides on a topic again sometime. BTW...I'm referring to "lady sues walgreens" thread.....in case you're trying to figure out who I am.

Hi gimpsd! Thanks, I never would've pegged myself as intellectual, but I'll take the ego-boost where I can get it 🙂 Although hopefully next time we can take the same side on a topic 😉 It is nice having educated, professional, respectful conversations on here though!

 

[pharmforme]

Yeah, I guess I did. Is that a big problem?

Not a big problem, just makes it look a little like you're trolling, so if you are not, be aware of that!

 

[pharmforme]

How often are we going to discuss this topic on here. No one really knows what the future holds in store. The best you can do is be flexible. Pharmacy is a good profession but it may or may not pay the big bucks in the future. Will I continue working as a pharmacist even if it isn't lucrative? That is a resounding YES. As far as doctors being able to take over the job of the pharmacist....Are you kidding? Some of them don't even know how to spell the medications, much less counsel patients on them. I can't even count the number of times a patient comes in with incorrect dosage and directions that the pharmacist usually catches. You can sit there needlessly worrying about what the future holds but as for me I'm living in the present and going to pharmacy school. By the way most people on this forum will most likely be pro-pharmacy. Maybe you should post this same question on the medical forum and see what the doctors think about taking on extra work.

Well said. OP, If you are basing any decision on the answer to this question, then my suggestion would be to look into other professions. If that would deter you, then you aren't very excited about the profession to begin with. Just my 2c.

As far as doctors taking over the role of pharmacist, I can honestly say I would bet my life that that will never ever happen! Are you aware of how many deaths are due to adverse drug reactions each year, from prescription drugs? Of how many drs prescribe drugs to elderly that clash with other drugs another dr has prescribed for them? After watching my grandmother nearly die from a sample of meds that her reputable dr gave her that contained an ingredient that her records clearly state she is highly allergic to, my realization of the importance of pharmacists is even more clear. If you think pharmacists are dispensable, you need to get out in the world a little, spend some time with people who depend on medications, and reassess.

 

[museabuse]

As far as doctors taking over the role of pharmacist, I can honestly say I would bet my life that that will never ever happen! Are you aware of how many deaths are due to adverse drug reactions each year, from prescription drugs? Of how many drs prescribe drugs to elderly that clash with other drugs another dr has prescribed for them? After watching my grandmother nearly die from a sample of meds that her reputable dr gave her that contained an ingredient that her records clearly state she is highly allergic to, my realization of the importance of pharmacists is even more clear. If you think pharmacists are dispensable, you need to get out in the world a little, spend some time with people who depend on medications, and reassess.

Right now... doctors don't know what medications were prescribed by other docs. But like I said... PBMs and PHARMACISTS are working on a system where doctors prescribe a medication, that prescription then gets submitted to the pharmacy plan where doctors can see the DUR review, ie dosing wrong, therapy duplication, drug interactions. They can then change the med right on the spot, or submit prior auths. Once the DUR is done, it is then sent electronically to the retail pharmacy where it is filled. It really does make sense to do this, because it does streamline the process. I personally don't want this system to catch on because I think it DOES threaten the retail pharmacists position in health care. I do hope doctors push back on this, and this system does not become a reality because I want to maintain my position as the medication expert. If this system does become reality, then doctors can say, "You guys aren't medication experts anymore, because we have to handle this DUR crap that you guys were doing."

I just want job security thats all.

 

[Calibration1]

Not a big problem, just makes it look a little like you're trolling, so if you are not, be aware of that!

Well, to tell you the truth, Im a family man with 4 children and Im kinda new to forums so I don't know what trolling means. I dont have time to sit at computers much until lately because Im fascinated here. Im fascinated because I love pharmacy and the idea of becoming a Drug expert, hence my
insistent question. It is not a lack of interest but rather a protective concern for the welfare of the profession that I love and hope to spend the rest of my life perfecting.

So anyway,...WTF is trolling?

 

[patmcd]

So anyway,...WTF is trolling?

Basically trying to cause trouble.

 

[pharmforme]

Right now... doctors don't know what medications were prescribed by other docs. But like I said... PBMs and PHARMACISTS are working on a system where doctors prescribe a medication, that prescription then gets submitted to the pharmacy plan where doctors can see the DUR review, ie dosing wrong, therapy duplication, drug interactions. They can then change the med right on the spot, or submit prior auths. Once the DUR is done, it is then sent electronically to the retail pharmacy where it is filled. It really does make sense to do this, because it does streamline the process. I personally don't want this system to catch on because I think it DOES threaten the retail pharmacists position in health care. I do hope doctors push back on this, and this system does not become a reality because I want to maintain my position as the medication expert. If this system does become reality, then doctors can say, "You guys aren't medication experts anymore, because we have to handle this DUR crap that you guys were doing."

I just want job security thats all.

The system you mentioned seems interesting but I see a few glaring flaws. First, who counsels the patients? Answers the patients ?'s? It won't be the dr, and I find it hard to believe the insurance co's will do it. Also, I worked for a health insurance co. (yes, I admit it, and I'm ashamed of it 😳 ) and I find it very hard to believe that the health insurance cos would pay a dr to review medication interactions etc, when they can pay a pharmacist half the salary. Inevitably, I'm not worried about pharmacists being needed.

 

[Sparklee]

As long as insurance stays as complicated as it is and doctors (or their computers) continue to screw up when writing a script, pharmacists will always have a job.

 

[sdn1977]

I read a great comment last weekend at work about this very concern. The practice is changing dramatically, but pharmacists have been reluctant to change their practice/business models by trying to hold onto a model which is increasingly becoming outdated. However, there are many folks both independent & corporate who are realizing this & are changing how we practice.

As for physicians & direct communication with insurance companies. IMO, thats a good thing, but limited in its function because of its scope. Physicians really don't want our jobs - they respect us for the jobs we do & know what we do is more than just reading what gets alerted to us on a screen.

Finally, think of how complex this system would be to intersect all providers with a patients drug information! My husband's dental practice software is extremely expensive & interfaces with dental insurance payors only - not medical (which includes drug coverage). I can't imagine how much it would cost to upgrade it knowing what it cost originally.

IMO - our job security is in our knowledge & how adaptable & willing we are to disseminate that knowledge.

 

[naus]

Finally, think of how complex this system would be to intersect all providers with a patients drug information! My husband's dental practice software is extremely expensive & interfaces with dental insurance payors only - not medical (which includes drug coverage). I can't imagine how much it would cost to upgrade it knowing what it cost originally.

I think you are underestimating the rapid advancement of information and database technology. It may not be feasible or economically sensible in the next 5 years. But the next decade or two? Definitely possible.

PBMs and PHARMACISTS are working on a system where doctors prescribe a medication, that prescription then gets submitted to the pharmacy plan where doctors can see the DUR review, ie dosing wrong, therapy duplication, drug interactions. They can then change the med right on the spot, or submit prior auths. Once the DUR is done, it is then sent electronically to the retail pharmacy where it is filled. It really does make sense to do this, because it does streamline the process. I personally don't want this system to catch on because I think it DOES threaten the retail pharmacists position in health care. I do hope doctors push back on this, and this system does not become a reality because I want to maintain my position as the medication expert. If this system does become reality, then doctors can say, "You guys aren't medication experts anymore, because we have to handle this DUR crap that you guys were doing."

Right on. A technological advancement like this would have a huge negative impact on retail pharmacy.

Also, I worked for a health insurance co. (yes, I admit it, and I'm ashamed of it ) and I find it very hard to believe that the health insurance cos would pay a dr to review medication interactions etc, when they can pay a pharmacist half the salary.

Insurance companies don't need to pay the doctors to review that, they could just expect them to, like they expect doctors today to handle HMO claims. It's called a productivity increase. Why pay for two people when one can do the job with negligible marginal error?

 

[gsinccom]

hmm?

 

[konkan]

I have the same concerns. I have seen my dads profession become obsolete and his suffereing as a result of computer automation. Are we as pharmacists
enjoying the last hurrah of a dying field????

read this http://www.uspharmacist.com/index.asp?show=article&page=8_1008.htm

and go to sleep.

 

[WVUPharm2007]

Eh, whatver. If it does happen, I'll do something else. I'm creative enough to figure it out.

 

[snooz3]

read this http://www.uspharmacist.com/index.asp?show=article&page=8_1008.htm

and go to sleep.

This article was written years ago..

not saying it isn't true.. but things do change a lot in all those years.

 

[creestoL]

i feel stupid for asking this..

but what exactly is PBM?

 

[genesis09]

i feel stupid for asking this..

but what exactly is PBM?

Pharmacy benefits manager. In simplicity, they decide how much a person with insurance will pay for his/her drug.

 

[mustangrolla]

can someone link me to an article that has more information on this topic? It's very interesting and hope to use it as one of my responses. Please PM me with more 411 or links. Thanks a lot!

 

[ZpackSux]

The process described by the Original Poster is called the "Medication Reconciliation" process mandated by ISMP. This process allows healthcare providers to share patient's medication information throughout the continuum of care. Will this affect job securities of pharmacists? No way...if anything, it will make pharmacists busier.