NP/PAs will replace hospital pharmacists?

Started by konkan
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konkan

coup de grace
15+ Year Member
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Recently had a conversation with my manager about where hospital pharmacy is going. She wasn't too optimistic. In her opinion, eventually pharmacists will be phased out because their dispensing/distributing role will be greatly diminished my technology (which is not new), and whatever clinical we do in hospitals now, can be done by mid-levels. They can do it by law. We unfortunately cannot do what np/pas do (prescribing, diagnosing et.) by law. And in fact, I remembered we have an ortho group, which, for whatever reason, does not want us to dose warfarin for their patients. And guess who does warfarin dosing for them? An np that works for that group.
My manager also mentioned that a while ago (maybe 50, 60 or whatever years ago) pharmacists had 2 paths to choose from: to stay enterpreneurs or to become a part of healthcare team. They chose the first path, and now it's too late to make any drastic changes. Any thoughts?
 
konkan said:
Recently had a conversation with my manager about where hospital pharmacy is going. She wasn't too optimistic. In her opinion, eventually pharmacists will be phased out because their dispensing/distributing role will be greatly diminished my technology (which is not new), and whatever clinical we do in hospitals now, can be done by mid-levels. They can do it by law. We unfortunately cannot do what np/pas do (prescribing, diagnosing et.) by law. And in fact, I remembered we have an ortho group, which, for whatever reason, does not want us to dose warfarin for their patients. And guess who does warfarin dosing for them? An np that works for that group.
My manager also mentioned that a while ago (maybe 50, 60 or whatever years ago) pharmacists had 2 paths to choose from: to stay enterpreneurs or to become a part of healthcare team. They chose the first path, and now it's too late to make any drastic changes. Any thoughts?
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I guess anyone who wants to do "CLINICAL PHARMACY" in the hospital setting will have to go back to NP or PA school... Or abandon hospital pharmacy altogether...
 
This does not concern me one bit. There is NO WAY NPs and PAs could replace pharmacists. I find that laughable.
 
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Your manager has no clue. I have NPs/PAs calling me all the time for help. The roles are very different and complimentary. Any hospital I have worked at is moving toward a multidisciplinary approach to include a variety of physicians and mid-levels.
 
If anything, I am optimistic that it will grow. With the new ACGME hours and NPs/PAs stepping in more instead of residents, I think our services are needed more than ever. Not only that, but from my experience PAs are way less pretentious and have no qualms about asking for help regarding things outside their scope.
 
Uggh.. what? NP/PA's always ask for pharmacist's advice at every single rotation I completed. The roles are too different for NP/PA's to replace pharmacists. There is just no commonality at all, NP/PA's have limited drug knowledge and it's not their scope.
 
You can always tell it is NP/PA is writing a rx for a child's antibiotic. Honestly, they are the only ones who won't round. They will write for 4.91 ml of amoxicillin 400/5 bid.
 
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ZZZZOMG!!!!! I should quit school with 2 rotations left, give up my residency and go on medicaid so I can get a sweet Lexus SUV, food stamps and a brick of coke!
 
cycloketocaine said:
ZZZZOMG!!!!! I should quit school with 2 rotations left, give up my residency and go on medicaid so I can get a sweet Lexus SUV, food stamps and a brick of coke!
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It took you long enough to see the light. Welcome to the dark side. :ninja:

You're only doing that residency b/c you couldn't get any other kind of job. See the "Atlanta" thread for full explanation. :meanie:
 
this will not happen. as you know many people are at the hospital as "insurance". pharmacists will NOT be replaced by PA's or NP. their roles are 100% different. You may possibly see a decline in the number of pharmacists at the same time, but you will not see pharmacists be replaced by NP or PA.
 
NP/PA is more likely to replace MDs than PharmDs. We are already seeing this in the primary care/family practice sector. creep...creep..creep, then BAM! hand is in the cookie jar.
 
Lol they're not going to replace MDs either. Maybe take more business away but there's plenty of business to go around and who wants to do routine don't-use-your-brain stuff anyway?
 
If Coumadin monitoring is your only example, that won't matter too much once Coumadin is replaced over the coming years. Pharmacy will have to move their consults into other areas: bedside med reconciliation, TPNs, core measures, etc..
 
I heard that with all the money the US will be raking in by banning medicaid and babies, all community clinics and hospital will be able to get their very own robotic PAs/NPs uploaded with the curriculum from online diploma mills. They can perform all essential functions of a pharmacist without needing a lunch break or a bathroom break... Diaper sales are likely to go down so make sure you sell your stock and invest elsewhere.

There will be an upgrade feature that allows the robots to snif out baggies of cocaine and adderall.
 
ethyl said:
If Coumadin monitoring is your only example, that won't matter too much once Coumadin is replaced over the coming years. Pharmacy will have to move their consults into other areas: bedside med reconciliation, TPNs, core measures, etc..
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Am I the only one who thinks Coumadin isn't going away very soon? The VA has decided, at least at this point, that it's cheaper to monitor warfarin than it is to put people on Pradaxa.
 
The studies of pradaxa were well controlled... We will see how many bleeding events we will get now that it is on the market. With clotting factors and FFP as the only options, I am willing to bet coumadin is going to stick around, too.
 
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Since Pradaxa has been released, I have had only one rx for it which went through. I can't count how many warfarin rxs have come through. Warfarin is still cheaper than Pradaxa; even when you include INR testing. Warfarin is a very well known drug, and I doubt it will go away any time soon.
 
genesis09 said:
Since Pradaxa has been released, I have had only one rx for it which went through. I can't count how many warfarin rxs have come through. Warfarin is still cheaper than Pradaxa; even when you include INR testing. Warfarin is a very well known drug, and I doubt it will go away any time soon.
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At my last rotation (IM/Cards) the docs (community hospital) wanted to start EVERYONE on Pradaxa at discharge. We had more than a few bounceback admits who told us they had never filled it because it cost too much. 🙁
 
My sister-in-law is a PA, a very good one, but she openly admits how inept she feels when it comes to medications. I don't think any good PA or NP would feel comfortable doing what pharmacists do. The only ones that would are those who have egos that are over-inflated and think they are God's gift to the earth.
 
NP/PA replacing Pharm.D in any setting is just laughable...

2 semester of pharmcology vs what 2 year+1-1.5year of therapeutics...
 
rxlea said:
I heard that with all the money the US will be raking in by banning medicaid and babies, all community clinics and hospital will be able to get their very own robotic PAs/NPs uploaded with the curriculum from online diploma mills. They can perform all essential functions of a pharmacist without needing a lunch break or a bathroom break... Diaper sales are likely to go down so make sure you sell your stock and invest elsewhere.

There will be an upgrade feature that allows the robots to snif out baggies of cocaine and adderall.
Click to expand...

:meanie: :laugh: 🤣😆:roflcopter::boom:
 
As a physician I find this laughable. If I'm rounding in the ICU or working in the ER and I have a question about a medication I'm giving, why would I go and ask someone (a PA or NP) who has much less training in pharmacology than I do? I'll go to a pharmacist because you have more training in that area.

One possible exception to this would be a coumadin clinic in which a NP or PA is running the dosing of that one specific drug and can also watch for some minor complications. Otherwise, I'll talk to a pharmacist for advice or I'll just do it myself.
 
unit clerks and candy stripers will be replacing physicians and nurses soon, you heard that here first:meanie:
 
KYTNOH said:
As a physician I find this laughable. If I'm rounding in the ICU or working in the ER and I have a question about a medication I'm giving, why would I go and ask someone (a PA or NP) who has much less training in pharmacology than I do? I'll go to a pharmacist because you have more training in that area.

One possible exception to this would be a coumadin clinic in which a NP or PA is running the dosing of that one specific drug and can also watch for some minor complications. Otherwise, I'll talk to a pharmacist for advice or I'll just do it myself.
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THis is exactly what happens in oncology and we have NP's. None of the oncologists would ask an NP a drug question. I can't believe im responding to this. ummph.....
 
KYTNOH said:
As a physician I find this laughable. If I'm rounding in the ICU or working in the ER and I have a question about a medication I'm giving, why would I go and ask someone (a PA or NP) who has much less training in pharmacology than I do? I'll go to a pharmacist because you have more training in that area.

One possible exception to this would be a coumadin clinic in which a NP or PA is running the dosing of that one specific drug and can also watch for some minor complications. Otherwise, I'll talk to a pharmacist for advice or I'll just do it myself.
Click to expand...

You all keep fixated on drug information. Yeah, sure pharmacists are more knowledgeable about drugs, but if that's the only function pharmacists would be doing in the hospital, how many of them would they need? one maybe two. I work inpatient pharmacy, and it's not like we are getting bombarded about drug info all the time.
We all know that pretty soon we'll see drastic cuts in health-care, and if somebody can do a job 30% cheaper ( I think NPs make about that much less), it will be done. I think that's what my manager had in mind. Not that I fully agree with her opinion...
 
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konkan said:
You all keep fixated on drug information. Yeah, sure pharmacists are more knowledgeable about drugs, but if that's the only function pharmacists would be doing in the hospital, how many of them would they need? one maybe two. I work inpatient pharmacy, and it's not like we are getting bombarded about drug info all the time.
We all know that pretty soon we'll see drastic cuts in health-care, and if somebody can do a job 30% cheaper ( I think NPs make about that much less), it will be done. I think that's what my manager had in mind. Not that I fully agree with her opinion...
Click to expand...
You have not "marketed" your department well enough in your hospital if you're not bombarded with DI requests, pharmacy-to-dose, interaction consults, d/c recommendations, patient counseling, ID consults, etc. As healthcare gets more complicated (CMS requirements, core measures, etc) there simply is too much for any one person to do. If your manager is not stepping up to fill those voids, you're missing out.

Think about how you can make your services indispensable to your facility. It saddens me to hear this.
 
spacecowgirl said:
You have not "marketed" your department well enough in your hospital if you're not bombarded with DI requests, pharmacy-to-dose, interaction consults, d/c recommendations, patient counseling, ID consults, etc. As healthcare gets more complicated (CMS requirements, core measures, etc) there simply is too much for any one person to do. If your manager is not stepping up to fill those voids, you're missing out.

Think about how you can make your services indispensable to your facility. It saddens me to hear this.
Click to expand...

I see push back at different institutions that I'm rotating at when more "traditionally clinical" responsibilities are loaded in. Kind of like a "well, we've never had to do this before...what the hell?" thing, or "isn't this why we hired those clinical pharms who did those residencies?"

I don't like to stereotype, and there are exceptions, but it's typically an age/# of years removed from school kind of thing. Definitely institution/pharmacy dept. personality specific. Any thoughts on this?
 
confettiflyer said:
I see push back at different institutions that I'm rotating at when more "traditionally clinical" responsibilities are loaded in. Kind of like a "well, we've never had to do this before...what the hell?" thing, or "isn't this why we hired those clinical pharms who did those residencies?"

I don't like to stereotype, and there are exceptions, but it's typically an age/# of years removed from school kind of thing. Definitely institution/pharmacy dept. personality specific. Any thoughts on this?
Click to expand...

I see that too. A lot of people are resistant to change of any sort, and that's doubly true when that change causes more work for them. Even if it's for the good of the patient/department/hospital/etc.
 
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so does this mean we're going back to the days when docs (or NPs and PAs too) functioned as both the prescriber and dispenser ?

my dad was saying that in korea the pharmacists are gaining more power because doctors can no longer dispense medicine like they used to (my uncle is a doctor in korea). the docs are not happy about losing their munnay.

they're moving forward while we're going ass-backward. 😡
 
Nurses ran the outpatient Coumadin clinic at one of my rotations. But pharmacists did inpatient Coumadin and vanco dosing.
 
It will never happen. PAs learn pharmacology only to the application of a provider role and THATS IT. They couldn't dispense Rx's like a pharmacist and to think so would make no sense. You simply cannot compare 2 semesters of pharmacology in PA school Vs. a 4 year degree that specializes in pharmacy and any PA would agree to that.

Now PAs learn alot of stuff that pharmacists don't learn as well, so basically PAs and Pharmacists have quite distinct roles and are in no way gonna replace each other.
 
NEU2014 said:
It will never happen. PAs learn pharmacology only to the application of a provider role and THATS IT. They couldn't dispense Rx's like a pharmacist and to think so would make no sense. You simply cannot compare 2 semesters of pharmacology in PA school Vs. a 4 year degree that specializes in pharmacy and any PA would agree to that.

Now PAs learn alot of stuff that pharmacists don't learn as well, so basically PAs and Pharmacists have quite distinct roles and are in no way gonna replace each other.
Click to expand...

Totally agree with most of what you said above. However, PAs, in reality , have a lot of more autonomy and they get respect far more than pharmacists. How many times have we seen RN "accidentally" call and address PA as "doctor", and treat pharmacists as "where's my medication" guys? A lot. Surprisingly, I have a doctorate degree and no nurses ever call or address me as "Dr", whereas a PA (who might just have BA/BS only in Physician Assistant" get that title all the time. Not that I want to compare, but reality does tell us that people respect PAs far more than pharmacists...
 
robertobaggio said:
Totally agree with most of what you said above. However, PAs, in reality , have a lot of more autonomy and they get respect far more than pharmacists. How many times have we seen RN "accidentally" call and address PA as "doctor", and treat pharmacists as "where's my medication" guys? A lot. Surprisingly, I have a doctorate degree and no nurses ever call or address me as "Dr", whereas a PA (who might just have BA/BS only in Physician Assistant" get that title all the time. Not that I want to compare, but reality does tell us that people respect PAs far more than pharmacists...
Click to expand...

I currently work as a scribe for a PA and I've seen that too but almost everytime I've noticed the PA would correct a patient or nurse that calls him "dr". I don't think pharmacists get respected less, or more, than PAs. I've noticed that PAs and pharmacists are respected equally and generally paid the same as well (esp. in a hospital setting). I've had the honor of working for well respected, experienced PAs and doctors and I think they all respect the pharmacists as much as the other providers in the hospital.

Unfortunately there are still some people out there who look at pharmacists as pill pushers but I think they are becoming more and more of a minority now a days.
 
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