Okay, but the symptom was runny nose. It wasn't chest pain. I wouldn't be arguing about a person with chest pain being sent to urgent care. I appreciate the clarification on intent though.
He is correct. Just because the law allows someone to do something doesn't mean that they are competent in their abilities to perform said thing. Pharmacist training is not designed to provide a foundation for competent clinical diagnosis and patient management, regardless of what the law allows. I would love to have you any of the dozens of patients that seemed straightforward but had underlying life threatening diagnoses that I have come across this year alone- the patient who comes in for the sniffles but had a carotid artery aneurysm that could easily have proven fatal if not for a thorough physical, the patient with vague fatigue and fever that had extensive vegetations on a heart valve, the patient with a headache that had a brain tumor but had symptoms that were nearly identical to the one with birth control headaches or the other one with new onset sleep apnea- I could go on and on. Medicine isn't easy if it is practiced correctly, and competence is a hard-earned thing that requires thousands of hours of foundational work followed by thousands of hours of clinical practice centered around direct diagnosis and management of patients.you're going places.
There's actually a physical exam that goes along with a runny nose that allows one to determine what testing and treatment are indicated. The intervention depends on the evidence gathered from a complete exam.
Well, there's the 2,000-3,000 hours of actual patient management in the seCond year of their training, and the fact that their first year is half basic sciences but half focused entirely in history, physicals, and pathophysiology. And then there's the fact that they have to practice under a physician that is there for consult in most states that can provide them with knowledge in areas they are lacking.
Yeah, I couldn't imagine actually practicing as a mid level.
To each their own, but that sounds like a huge waste of money for the patient and the healthcare system.
Bad medicine is how India ended up with various XDR bugs, how people go without treatment for strep throat because they figure they're just fine and end up with bad mitral valves, etc etc. You wanna live in a country with bad medicine, that's on you. India is a great example of what happens when anybody can just hand out drugs without medical training.
Antimicrobial resistance in India: A review
Your local ED is inadequate if that's true in your area
But also the opposite in terms of MDR bacteria. Keeping a patient with a cold out of the doctors office would be more helpful for that.
Unless pharmacists can just hang out whatever drugs they want, like in India... That's how they ended up with what they've got.
We definitely agree that OTC antibiotics are not good
It's nonsense- it seems when I was flipping my sig back and forth autocorrect screwed it up, because latinWe definitely agree that OTC antibiotics are not good
p.s. What is Perinsolitum?
oh, per insolitum. I still don't know what it means though
By unaccustomed. All to rarely leads to death. ??? I clearly don't speak/understand latin
Given that this discussion was centered around the idea of pharmacists as providers capable of diagnosing and prescribing, your whole post is kind of meaningless, because my point was that if pharmacists become prescribers, they will do more harm than good. In your current state, you are not providers, and do far more good than harm.
It's more that a pharmacist can't tell a runny nose from a CSF leak, so they shouldn't have any involvement in diagnosis period.
Third time I've said this: a recommendation for escalation of care is a recommendation. It is based on patient assessment; and, depending on the appropriateness of the recommendation, it can have real world consequences for the patient.
I really appreciate your comment. I don't think that anything I've said has suggested a scope of practice expansion for pharmacy. Recommendations for OTC products is well within pharmacy scope of practice.
That wasn't even the main point. Are you that dense?
A big part of your point was based on a premise I've generally found to be untrue in my area. Just pointing out that if it is true in yours, that your city isn't getting a proper standard of care.
This all completely is left of field of the original point of this thread, which is that pharmacists shouldn't be writing notes, because they're completely unqualified to do so. As to whether to escalate care, I believe you can advise patients with their desired course of action just fine, but other than that things are dicey. You are who a patient sees when they elect not to seek care, because you do not provide medical care, but rather advise for the optimal course of action on the course that the patient has already chosen, or facilitate a choice, such as getting a flu vaccine, that they have already made. Sure you can do common sense things, (oh, you have a head injury, see a doctor maybe) but so can literally anyone else.
One, I didn't make the original statement. Two, that was not a big part of his/her point. You can actually even ignore that part and just focus on the first part. Do you disagree with that too?
It seems you don't live in an area with good physicians- the percent of patients presenting with respiratory infections that merit a Z-pak is perhaps one in ten at best. I can count the number of Z-paks we prescribed in six weeks of outpatient IM on my two hands and have a couple fingers to spare, only bad doctors hand them out like crazy.
Bruh. Thanks for this post.
The fact that bad doctors exist doesn't mean pharmacists can practice good medicine.
There's probably an uncommon thing presenting as a common thing at least once a week in primary care when I'm rotating through. 99% of those patients would be misdiagnosed by a pharmacist. A lot of them carry serious diagnoses to boot.
So your evidence that what pharmacists have been doing for decades is causing rampant harm is an anecdote that they might misdiagnose something "probably once a week"?
Ah, I thought he was being sarcastic.
Thanks, my point exactly. It's fine if I advise someone on a cold or allergy medication. Goodness that was a long road for that conclusion
100% of those patients would not be diagnosed by a pharmacist. Pharmacists don't diagnose. Did any of those cases mimic conditions that could be treated using OTC products without a referral?
A physician. He or she wrote about treating patients in a primary care setting. Also, he or she thinks pharmacists can't recommend flu vaccines. If he or she is a pharmacist he or she is definitely punking us.
Literally all of my posts are spewed forth from the eye of terror.
