Pharmacists prescribing?

[pharm B]

Advertisement - Members don't see this ad

http://community.advanceweb.com/blo...prescribing-rights-what-it-means-for-nps.aspx

I was reading on a different site that UK pharmacists can prescribe medications for minor conditions (cold, etc). I decided to look this up for the States and found an article saying that some groups are pushing for similar rights here.

Is anyone familiar with this? What are your thoughts on being able to prescribe and dispense?

 

[CynicalIntern]

The problem with this is twofold. First off, in the US healthcare system that is mostly ran through capitalism, doctors are not going to want to give up prescribing rights. PAs and NPs and whoever else is one thing, because they still need an authorizing physician to practice under, which mandates some sort of an office visit. There is no such caveat to visiting a pharmacist, unless they're going to charge for a prescription (in which case, who do you think profits here. Does Walgreens need any more money in their pocket this way)

The second problem - diagnosing requires a lot of labwork. It's not a matter of listening to "I have a stuffy nose and my head hurts" and saying you have a cold. What if it's pneumonia. What if it's the flu? It requires testing, and quite frankly I haven't met the pharmacist that has time to do this sort of testing, and that's assuming they'd have access to the necessary equipment.

Maybe in a hospital setting where you're working alongside a doctor, but for your standard retail pharm? That's a lot of extra liability for no noticable gain, sans bragging rights.

 

[Farmercyst]

The problem with this is twofold. First off, in the US healthcare system that is mostly ran through capitalism, doctors are not going to want to give up prescribing rights. PAs and NPs and whoever else is one thing, because they still need an authorizing physician to practice under, which mandates some sort of an office visit. There is no such caveat to visiting a pharmacist, unless they're going to charge for a prescription (in which case, who do you think profits here. Does Walgreens need any more money in their pocket this way)

The second problem - diagnosing requires a lot of labwork. It's not a matter of listening to "I have a stuffy nose and my head hurts" and saying you have a cold. What if it's pneumonia. What if it's the flu? It requires testing, and quite frankly I haven't met the pharmacist that has time to do this sort of testing, and that's assuming they'd have access to the necessary equipment.

Maybe in a hospital setting where you're working alongside a doctor, but for your standard retail pharm? That's a lot of extra liability for no noticable gain, sans bragging rights.

Most of the pharmacists with prescribing rights are working either in the VA or academic medical centers. I know a few that have protocols to prescribe and change therapies in USC run pain management, anti-coag, and HIV clinics. VA ambulatory care pharmacists generally have the same priveleges and perhaps others. The travel clinic on our campus is run by pharmacists and they order and administer immunizations as well as prescribe prophylactic meds for malaria, traveler's diarrhea, etc. It all just depends on how willing the MD is to sign off on your protocol.

 

[apteryx]

yep, in between checking scripts and talking to insurance companies, there's plenty of time to check some hypochondriac for swine flu.

 

[Lily12481]

Colorado was starting to implement prescribing rights to Pharmacists in 2008, but I moved right after the big debate started so I haven't been in tune with what steps have been taken to start or decline it.

 

[Farmercyst]

I forgot to mention, CA also has a protocol where pharmacists can prescribe/dispense Plan B to minors <17 who would otherwise need a Dr. visit to get the medication.

 

[Jetninjin]

http://community.advanceweb.com/blo...prescribing-rights-what-it-means-for-nps.aspx

I was reading on a different site that UK pharmacists can prescribe medications for minor conditions (cold, etc). I decided to look this up for the States and found an article saying that some groups are pushing for similar rights here.

Is anyone familiar with this? What are your thoughts on being able to prescribe and dispense?

The UK also has universal healthcare and a tough time keeping up with demand as is. If they *didn't* give pharmacists this ability, their system would be even more swamped than it is (which is pretty dang swamped). It seems that many countries with universal healthcare perform this type of "diagnostic triage," where MDs/NPs/PAs aren't the only ones to diagnose/prescribe meds for minor ailments.

 

[pharm B]

ruh-roh, someone brought up the NHS.

Time for a discussion on healthcare reform?

 

[Passion4Sci]

I am so going to ignore this thread if that's the case.

Health care needs more than reform.

 

[Monalyce]

I forgot to mention, CA also has a protocol where pharmacists can prescribe/dispense Plan B to minors <17 who would otherwise need a Dr. visit to get the medication.

Illinois does too.

The research institution I shadowed at allows its clinical pharmacists prescribing power, although physicians do sign off on these orders (sometimes a day later). However, nearly all patients are being treated on a protocol which clearly outlines situations in which a pharmacist would be writing orders ("If patient X has Y, treat with Z according to these guidelines by weight, etc").

 

[genesis09]

Illinois does not allow pharmacists to dispense Plan B to minors under 17. Illinois just approved a prescribing by protocol measure. The last time I checked, they still have not written up the rules/regulations of this new provision.

 

[Monalyce]

you're right, I saw a > instead of a <. Hopefully soon!

 

[jmcfa002]

It definitely has pros/cons. IMO I think that pain controls (CII or CIII) shouldn't be an option, there are way to many problems that could come from it. It could be beneficial for things like mentioned earlier, antibiotics or cold medicine, or emergency refills on breathing medications. It would be difficult for a pharmacist though. On the weekends at my store, we only have 1 pharmacist. Adding in consulting/prescribing doesn't seem probable

 

[meteor2]

Edit: Deleted answer since its not accurate.

 

[IrishRxMan]

Passion is right, health care needs way more than reform.

As for pharmacists getting the right to prescribe meds, I think that crosses a line in this country that many people are wary to cross. As as pharmacist one is trained to know what drugs treat which ailment but we aren't trained in school to diagnose the ailment. This would require more schooling. I think the MD's/PA's/NP's should stick to diagnosing and the pharmacists to dispensing and being the drug experts. It's what we all go to school for. 🙂

 

[WVUPharm2007]

Pharmacists prescribing is an idiotic idea. Selecting drug therapy based upon a diagnosis? Ok, maybe...

 

[delano2000]

Pharmacists prescribing is an idiotic idea. Selecting drug therapy based upon a diagnosis? Ok, maybe...

Agreed.