Vort3x

10+ Year Member
Nov 23, 2007
41
2
29
NB, Canada
Status
Pharmacist
This is awesome news, coming this October legislation will be passed so that Pharmacists may prescribe drugs in New Brunswick, Canada (of course there are limitations for narcotics and such, but the fact that it's now possible!). This is the second province in Canada where this is now possible, Pharmacists can already do the same in Alberta.

http://timestranscript.canadaeast.com/news/article/302377
 

firefighter9015

It's not THAT kind of study hour...
10+ Year Member
Mar 10, 2007
312
1
Status
Pharmacy Student
OP
V

Vort3x

10+ Year Member
Nov 23, 2007
41
2
29
NB, Canada
Status
Pharmacist
I forwarded this onto a friend, he's an engineer, he said "Next they`ll want to perform surgeries in the drug store!" made me a little upset. I asked are you opposed to it, and he said " Yes, if you want to be a doctor go to medical school and pay your dues! :)".

I told him, uh... pharmacists know more about drugs than doctors, pharmacists know interactions, what works best, etc... Argh, I know there are people who will be opposed but they're so uninformed about what Pharmacists know and are capable of.

Like the article says, Pharmacists are finally doing what they went to school for.
 

Pharmavixen

foxy pharmacist
10+ Year Member
7+ Year Member
Jan 20, 2008
1,043
14
Canada
Status
Pharmacist
A province in Canada, is exactly the same thing as a state in the US.
Naw, it's way better :p

Murphy specified that pharmacists will be able to prescribe for minor ailments and ongoing chronic disease for which patients have not received a prescription previously.

"If they are of what appears to be a minor condition, or an ongoing chronic condition of an individual, they can prescribe certain medications and drugs. The details on this will come out shortly."
Yeah, I'm up to this. Can't count the # of times I've phoned a dr and told him what to prescribe for a given person (or what not to prescribe).

But I'm glad they're leaving narcotics out of it. It's tough enough being a part-time narc without actually having the power to prescribe Oxycontin, etc. Imagine the pressure we'd come under if we had the narcotics in a cupboard behind us and the power to write scripts for them in front of us.

I imagine they're not including benzos either. In Canada, benzos are, like narcotics, federally-controlled.
 

Pianopooh

10+ Year Member
Jan 23, 2006
132
1
Status
Pharmacist
This is awesome news, coming this October legislation will be passed so that Pharmacists may prescribe drugs in New Brunswick, Canada (of course there are limitations for narcotics and such, but the fact that it's now possible!). This is the second province in Canada where this is now possible, Pharmacists can already do the same in Alberta.

http://timestranscript.canadaeast.com/news/article/302377
Wow, that is awesome news! It is certainly progress. The article states that it's to help alleviate the stress of the New Brunswick healthcare system... but I don't know how that would help maintain doctor visits in NB by patients if the pharmacist prescribes the meds. From a patient's POV, a normal procedure for meds would be: pay for a doctor's visit, and then pay for the meds. Now the patient doesn't have to pay for the doctor's visit, and just get the meds. I hope the legislation also include a limit to the amount of meds a pharmacist can prescribe to a patient, so the patient will visit their doctor to have the proper check up from time to time.
 

amartins02

Senior Member
10+ Year Member
7+ Year Member
Nov 27, 2004
230
0
Status
Pharmacy Student
I predict... I predict....I see it.... malpraction dues are on the rise! I think it's cool personally and I wish they did it here in the states. Lot's of poor people can't even afford a doctor so going to a pharmacist who knows drugs makes sense.
 

CanPharm

10+ Year Member
5+ Year Member
Oct 21, 2007
55
0
Status
Pharmacy Student
If it is anything like Alberta, I wouldn't be excited too quickly. To many community pharmacists, this will just allow them to legalize the act of advancing medications a couple of days to patients who have no more refills (no new rx) This is definitely not going to be a major change such as pharmacists managing the patient's refills and etc. That being said, it is definitely a big step for NB and it is nice that pharmacists are being recognized more.
Will NB have a special register for advanced practicing pharmacists where the pharmacists will be able to initiate a new rx based on their assessments? The pharmacists who do this in Alberta are pharmD's and pharmacists who work in specialty areas, ie HIV clinics.
I've heard that this trend is going to spread throughout the country. Saskatchewan and Manitoba are working out the kinks. These are very exciting times for pharmacists in Canada.
 

marr

Senior Member
10+ Year Member
7+ Year Member
May 3, 2004
264
0
Status
This is coming from a third year medical student who is about to start fourth year. Now as many of you pharm people know alot of patient nowadays are on a ton of drug. It's great that you guys are checking on possible interactions because it's impossible for a doc to run the interaction, review the chart and complete an assesment and plan at the same time. With the bill, I see that alot of you are excited to have power to write prescriptions. I don't understand the reason why one would be excited because if you have taken care of one patient and have complete power to do whatever you would think twice about prescribing any kind of medication. It's cool the first time that you write an order and someone carries it out but are you willing to wake up at 3am to see your patient if the nurse call you that the patient had just passed out. What are you going to do? Are you ready to deal with this headache because if you write the prescription then you are acknowleding to the patient that you are managing the disease and is willing to manage the outcome? I am not here to do a pissing contest between md and pharm. I'm just trying to get you to understand what md have to deal with and if you are ready to accept the responsibility then go on ahead.
 

Brixius

Member
10+ Year Member
5+ Year Member
Feb 9, 2006
125
0
Status
Pharmacist
This is coming from a third year medical student who is about to start fourth year. Now as many of you pharm people know alot of patient nowadays are on a ton of drug. It's great that you guys are checking on possible interactions because it's impossible for a doc to run the interaction, review the chart and complete an assesment and plan at the same time. With the bill, I see that alot of you are excited to have power to write prescriptions. I don't understand the reason why one would be excited because if you have taken care of one patient and have complete power to do whatever you would think twice about prescribing any kind of medication. It's cool the first time that you write an order and someone carries it out but are you willing to wake up at 3am to see your patient if the nurse call you that the patient had just passed out. What are you going to do? Are you ready to deal with this headache because if you write the prescription then you are acknowleding to the patient that you are managing the disease and is willing to manage the outcome? I am not here to do a pissing contest between md and pharm. I'm just trying to get you to understand what md have to deal with and if you are ready to accept the responsibility then go on ahead.
Your job is just so much of a burden us pharmacy peons could never begin to comprehend what you physicians go through. That said, go back to your ivory tower, junior.
 

Priapism321

Bursting with enthusiasm
10+ Year Member
5+ Year Member
Apr 17, 2007
1,424
3
Status
Pharmacist
Alright, this thread is officially heading in the direction most could have predicted. Now, can someone page Macgyver out of the OR so he can weigh in on this at some point today.
 

MountainPharmD

custodiunt illud simplex
10+ Year Member
Aug 15, 2004
4,567
323
Status
Pharmacist
This is awesome news, coming this October legislation will be passed so that Pharmacists may prescribe drugs in New Brunswick, Canada (of course there are limitations for narcotics and such, but the fact that it's now possible!). This is the second province in Canada where this is now possible, Pharmacists can already do the same in Alberta.

http://timestranscript.canadaeast.com/news/article/302377
Explain to me why you think this is a good thing?
 
OP
V

Vort3x

10+ Year Member
Nov 23, 2007
41
2
29
NB, Canada
Status
Pharmacist
Explain to me why you think this is a good thing?
I think this is a good thing because it will be taking stress off of the healthcare system as the article states, for simple things like a refill, it's much easier to go to the Pharmacy instead of the doctor's office.

It's much easier for patients to get access to non-chronic medications, like allergy medicine, acne (not Accutane, but for example, Tretinoin, or Dalacin-T). Assuming the creation of a new Rx will be possible.

It will give Pharmacists a better reputation in the eyes of society. A lot of people view Pharmacists as pill counters. Therefore if they see Pharmacists prescribing, then they must know something? :p

Pharmacists go to school for quite a long time and learn an incredible amount about drugs, more pharmacology than a doctor. Instead of putting this knowledge into practical use, the average retail Pharmacist just fills prescriptions, checks interactions, and consults with patients. Therefore I think prescribing would be an exciting task added to a Pharmacist's abilities and career role.

This is just my opinion, and I'm not a Pharmacist, but do plan to become one, will be applying to Pharmacy next year. This is just how it seems to me, feel free to enlighten me on aspects which you don't agree with.
 

devilpup

10+ Year Member
Jan 22, 2006
324
9
CA
restlessmd.blogspot.com
Status
Attending Physician
It's much easier for patients to get access to non-chronic medications, like allergy medicine, acne (not Accutane, but for example, Tretinoin, or Dalacin-T). Assuming the creation of a new Rx will be possible.

It will give Pharmacists a better reputation in the eyes of society. A lot of people view Pharmacists as pill counters. Therefore if they see Pharmacists prescribing, then they must know something? :p

Pharmacists go to school for quite a long time and learn an incredible amount about drugs, more pharmacology than a doctor. Instead of putting this knowledge into practical use, the average retail Pharmacist just fills prescriptions, checks interactions, and consults with patients. Therefore I think prescribing would be an exciting task added to a Pharmacist's abilities and career role.

Good point. It sounds like a great idea.

I am not a pharmacy student so I’m wondering if the education that current pharm. students receive prepares them well to diagnose the "’minor’ and ‘chronic’ conditions and ailments” the article states. I presume that if such law is passed in the U.S, pharm. schools would have to revamp their curriculums to some extent.

I wonder what the reaction to this legislation would be from current MD’s?
 

Priapism321

Bursting with enthusiasm
10+ Year Member
5+ Year Member
Apr 17, 2007
1,424
3
Status
Pharmacist
Good point. It sounds like a great idea.

I am not a pharmacy student so I'm wondering if the education that current pharm. students receive prepares them well to diagnose the "'minor' and ‘chronic' conditions and ailments" the article states. I presume that if such law is passed in the U.S, pharm. schools would have to revamp their curriculums to some extent.

I wonder what the reaction to this legislation would be from current MD's?
Pharmacist: Sir, did you fast for 12 hours like I asked you to on the phone before you came in today?
Man: Yes.
Pharmacist: Hmmm, your total cholesterol is 273. Well, I am not a Nurse Practioner, a Physician Assistant, a Physician, a Podiatrist, a Dentist, or an Optometrist, but I may go out on a limb here and say you have high cholesterol. Now, I will tell you, they didn't teach me how to diagnose during 4 years of pharmacy school or 2 years of post-graduate residency training, but I do know there are some cool drugs to treat high cholesterol. Can you go see one of these genetically engineered diagnosing people so we can really be sure about this?
Man: I don't have one to see.
Pharmacist: Well, wish I could help you, but they actually surgically remove the "diagnosing ability" region of your brain when you are accepted to Pharmacy School, so there is no possible way I could be qualified to tell you if you have hyperlipidemia.
 

devilpup

10+ Year Member
Jan 22, 2006
324
9
CA
restlessmd.blogspot.com
Status
Attending Physician
Pharmacist: Sir, did you fast for 12 hours like I asked you to on the phone before you came in today?
Man: Yes.
Pharmacist: Hmmm, your total cholesterol is 273. Well, I am not a Nurse Practioner, a Physician Assistant, a Physician, a Podiatrist, a Dentist, or an Optometrist, but I may go out on a limb here and say you have high cholesterol. Now, I will tell you, they didn't teach me how to diagnose during 4 years of pharmacy school or 2 years of post-graduate residency training, but I do know there are some cool drugs to treat high cholesterol. Can you go see one of these genetically engineered diagnosing people so we can really be sure about this?
Man: I don't have one to see.
Pharmacist: Well, wish I could help you, but they actually surgically remove the "diagnosing ability" region of your brain when you are accepted to Pharmacy School, so there is no possible way I could be qualified to tell you if you have hyperlipidemia.
very well put.
 

SpirivaSunrise

Go Gators!
Lifetime Donor
10+ Year Member
Apr 29, 2006
4,314
46
Off the coast of somewhere beautiful
Status
Pharmacist
Pharmacist: Sir, did you fast for 12 hours like I asked you to on the phone before you came in today?
Man: Yes.
Pharmacist: Hmmm, your total cholesterol is 273. Well, I am not a Nurse Practioner, a Physician Assistant, a Physician, a Podiatrist, a Dentist, or an Optometrist, but I may go out on a limb here and say you have high cholesterol. Now, I will tell you, they didn't teach me how to diagnose during 4 years of pharmacy school or 2 years of post-graduate residency training, but I do know there are some cool drugs to treat high cholesterol. Can you go see one of these genetically engineered diagnosing people so we can really be sure about this?
Man: I don't have one to see.
Pharmacist: Well, wish I could help you, but they actually surgically remove the "diagnosing ability" region of your brain when you are accepted to Pharmacy School, so there is no possible way I could be qualified to tell you if you have hyperlipidemia.
I vote for Zetia!!! ;)
 

Priapism321

Bursting with enthusiasm
10+ Year Member
5+ Year Member
Apr 17, 2007
1,424
3
Status
Pharmacist
I vote for Zetia!!! ;)
Would you like to get me started young lady? And by the way, it is referred to as Ezetrol up there, and they use about three times less than we do down here, most likely secondary to our allowance of direct to consumer manipulating, I mean, advertising. You see what you did, this thread could be jacked in no time.....
 

MountainPharmD

custodiunt illud simplex
10+ Year Member
Aug 15, 2004
4,567
323
Status
Pharmacist
I think this is a good thing because it will be taking stress off of the healthcare system as the article states, for simple things like a refill, it's much easier to go to the Pharmacy instead of the doctor's office..
Awsome!!!! Taking stress off the healthcare system by adding more work and responsibility to a pharmacist who is bored most of the time and needs more things to do.

It's much easier for patients to get access to non-chronic medications, like allergy medicine, acne (not Accutane, but for example, Tretinoin, or Dalacin-T). Assuming the creation of a new Rx will be possible...
Yes, we don't want to inconveinence patients with acne and allegies by forcing them to see a doctor. They need those life saving meds RIGHT NOW!!!!!

It will give Pharmacists a better reputation in the eyes of society. A lot of people view Pharmacists as pill counters. Therefore if they see Pharmacists prescribing, then they must know something? :p...
I suppose it depends on which chain you work for. Pharmacists at CVS and Walgreens are pill counters (pill verifiers is more acurate). Those of us who work for someone else do quite a bit more and our patiets know it. I get told all the time "oh I always call you when I have questions you know so much more than my doctor. What they really mean is I call you because I can actually get a hold of you. Patients don't gives a **** who wrtires the prescription.

Pharmacists go to school for quite a long time and learn an incredible amount about drugs, more pharmacology than a doctor. Instead of putting this knowledge into practical use, the average retail Pharmacist just fills prescriptions, checks interactions, and consults with patients....
Well no kidding.....thats our job. I fail to see how I am not putting my knowledge to practical use by filling scripts, counseling patients and checking for drug interactions. You know what? THAT WAS THE ENTIRE PURPOSE OF PHARMACY SCHOOL AND WHAT I WAS TRAINED TO DO!!!!!!


Therefore I think prescribing would be an exciting task added to a Pharmacist's abilities and career role....
Okay....What I don't need is any more exciting tasks or things in my day. I have enough excitment and work thanks.

This is just my opinion, and I'm not a Pharmacist, but do plan to become one, will be applying to Pharmacy next year. This is just how it seems to me, feel free to enlighten me on aspects which you don't agree with.
Exactly. You are not a pharmacist and you do not know what you are talking about.....
 

YapYap6

10+ Year Member
Apr 30, 2008
92
1
Status
Well, from my experience thus far, I'd imagine pharmacists prescribing would be more for convenience than diagnosing. As we all know, many people are f'in lazy and don't take responsibility for their own health. They'll come in when they're out of refills or having an acute asthma attack to "demand" a refill.

Examples
1) A woman came into my pharmacy demanding that we fill her birth control even though she was out of refills. Even after offering to call her doctor, she began screaming at me "It's just birth control! Why can't you just fill it?!?!".

2) Father calls in at 11:30 p.m. because his daughter is having an acute asthma attack. Her profile reveals they hadn't been to the pharmacy in over a year and kept demanding that we give her an inhaler.

It's in situations like these that I feel pharmacists should utilize prescribing powers. I really don't see how MD's could feel threatened by us assuming pharmacists are prescribing under circumstances similar to these. Hell, if they'd rather us wake them up to authorize refills on birth control, then sure. I'm getting paid to work the night shift, you're not getting paid to answer my call!

Besides, I'd rather not pay out of my nose for malpractice if I chose to start diagnosing and prescribing at the community level. If I wanted to do that, I'd have gone to medical school.
 

Brixius

Member
10+ Year Member
5+ Year Member
Feb 9, 2006
125
0
Status
Pharmacist
...to be taken off the market because it doesn't work and cost $300.00?
I'm sure you are referring to the ENHANCE study ... I'm not sure it's that simple. From what I saw, it looked like most of the patients were doomed from the start of the study. Then again, I never thought Zetia was to be used as a first line therapy for most patients.
 

SpirivaSunrise

Go Gators!
Lifetime Donor
10+ Year Member
Apr 29, 2006
4,314
46
Off the coast of somewhere beautiful
Status
Pharmacist
I'm sure you are referring to the ENHANCE study ... I'm not sure it's that simple. From what I saw, it looked like most of the patients were doomed from the start of the study. Then again, I never thought Zetia was to be used as a first line therapy for most patients.
Uh oh. Prepare yourself for the wrath that is Priapism. :smuggrin:
 

Brixius

Member
10+ Year Member
5+ Year Member
Feb 9, 2006
125
0
Status
Pharmacist
Uh oh. Prepare yourself for the wrath that is Priapism. :smuggrin:
Anybody who is going to object that strongly to such a modest statement is more jackass than pharmacist. I think the vast majority of people who read the study think the same as I do ... including Priapism.
 

Priapism321

Bursting with enthusiasm
10+ Year Member
5+ Year Member
Apr 17, 2007
1,424
3
Status
Pharmacist
Anybody who is going to object that strongly to such a modest statement is more jackass than pharmacist. I think the vast majority of people who read the study think the same as I do ... including Priapism.
By "think the same way as I do," if you mean thinking that boycotting (or, relegating ezetimibe to absolute last line therapy when surrogate endpoints aren't "low" enough) the use of an expensive drug when proven generic alternatives are available is reasonable, then you would be right sir.

All this is contingent on one thing, actual data proving the drug reduces the incidence of actual outcomes (MI, DEATH), rather than simply making us feel better because LDL is lowered (but now we know the fatty plaques in their neck look the same as they did before before), while our patients are paying out of their *** for some tricky new combination product.
 

UTPharm

10+ Year Member
Mar 16, 2008
101
0
Ohio
Status
Pharmacy Student
personally, i dont know why all of you are wanting to prescribe so bad. I don't want this to become widespread in the united stats. too much more liability. I chose pharmacy becasue i wanted to be a pharmacist. I am ALL for making recommendations to the MDs but I do not want to be liable for prescribing.
 

Priapism321

Bursting with enthusiasm
10+ Year Member
5+ Year Member
Apr 17, 2007
1,424
3
Status
Pharmacist
personally, i dont know why all of you are wanting to prescribe so bad. I don't want this to become widespread in the united stats. too much more liability. I chose pharmacy becasue i wanted to be a pharmacist. I am ALL for making recommendations to the MDs but I do not want to be liable for prescribing.
That is your personal opinion, and that is fine. Some people will agree, some will not. What does this add to the discussion?
 

bananaface

Pharmacy Supernerd
Moderator Emeritus
Lifetime Donor
10+ Year Member
15+ Year Member
Apr 24, 2004
41,977
160
gone to seed
Status
Pharmacist
That is your personal opinion, and that is fine. Some people will agree, some will not. What does this add to the discussion?
A valid point. :p

If we have to start buying more expensive malpractice insurance b/c of an increased scope of practice, we could possibly see a lower net income.
 

RxWildcat

Julius Randle BEASTMODE!
Moderator Emeritus
10+ Year Member
5+ Year Member
Mar 25, 2008
1,406
2
Status
Pharmacist
I understand everyones point here, but is prescribing really THAT big of a liability? I mean its not like we're going to go cowboy and prescribe random stuff, we'll pretty well follow standard protocols and we all should be competent enough to give safe dosages. I mean would telling a pt to buy diphenhydramine and prescribing the diphenhydramine be all that different legally if the pt had a bad reaction to the medication?
 

firefighter9015

It's not THAT kind of study hour...
10+ Year Member
Mar 10, 2007
312
1
Status
Pharmacy Student
I understand everyones point here, but is prescribing really THAT big of a liability? I mean its not like we're going to go cowboy and prescribe random stuff, we'll pretty well follow standard protocols and we all should be competent enough to give safe dosages. I mean would telling a pt to buy diphenhydramine and prescribing the diphenhydramine be all that different legally if the pt had a bad reaction to the medication?
Very good point.
 

bananaface

Pharmacy Supernerd
Moderator Emeritus
Lifetime Donor
10+ Year Member
15+ Year Member
Apr 24, 2004
41,977
160
gone to seed
Status
Pharmacist
I understand everyones point here, but is prescribing really THAT big of a liability? I mean its not like we're going to go cowboy and prescribe random stuff, we'll pretty well follow standard protocols and we all should be competent enough to give safe dosages. I mean would telling a pt to buy diphenhydramine and prescribing the diphenhydramine be all that different legally if the pt had a bad reaction to the medication?
It's another opportunity to be at fault for harm, so yeah. Physicians who aren't "all cowboy" still have hefty malpractice insurance. In the end, it'll really depend on how often we get sued and how big the lawsuits are. It's all supposition at this point.
 

aphistis

Moderator Emeritus
10+ Year Member
15+ Year Member
Feb 15, 2003
8,392
35
Indianapolis
Status
Attending Physician, Dentist
I understand everyones point here, but is prescribing really THAT big of a liability?
Yes. By diagnosing a problem and prescribing a course of therapy, you accept liability for what happens as a result, and it only takes one fatal MI masquerading as a GERD flare-up (or any of a thousand other examples) to ruin everyone's day. I can understand the appeal of being a provider and being able to directly prescribe treatment (obviously), but it's not something you should leap into casually.