pharmacy future problems.

[yougogirl]

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what would you do to overcome the many problems the pharmacy profession will face in the near future?

 

[shaq786]

Yes please do help with this one. I couldnt find anything meaningful from those pharmacy news websites.

 

[sdn1977]

So....let me turn this around.....what do you view as being the many problems pharmacy faces in the future?

Give me one to start.....

 

[sle3pyguii]

I was thinking about the career, and I know of more than 20 people who are choosing the career due to the demands and wages.

So...at this rate, won't there be too many pharmacists after a decade or so?

 

[Farmercyst]

I was thinking about the career, and I know of more than 20 people who are choosing the career due to the demands and wages.

So...at this rate, won't there be too many pharmacists after a decade or so?

To this, I would say only time will tell. Right now pharmacists are in moderate demand. Schools are increasing which will increase the number of graduating pharmacists. On the flipside, babyboomers are coming down the road. I was reading today that the first of the "official" babyboomers is eliglble for retirement in 2008, only 1 year from now (2008-1945= 63). So we're going to start seeing increased demand from these retirees, as well as those that eventually sign up for medicare Plan D (provided it lives that long). My guess is increase in demand will outstrip increase in PharmD supply for at least the 6 years representing the "boom" between the end of WWII and Korea, but it will probably last longer than that given the boom did. Right now demand is increasing both on the governments' regulatory side (FDA, medicare, DHHS) as well as consulting for HMO's and of course retail. That's just from reading the business section of the newspaper occasionally. I'm sure demand is steady, if not increasing in hospitals as pharmacy's continue to specialize. I know for instance that Loma Linda has a full time staff pharmacist dedicated to the NICU and they'd like to add another one, there's special niches in Nuclear, Formulary, etc. So I don't see oversupply being a problem for quite some time.

Problems I do see are if the FDA decides to regulate mineral supplements there will probably be even more demand in terms of consultation with the newly regulated "drugs."

It also seems to me that the newer drugs have a greater number of possible side effects, as well as a narrower range between the therapeutic and toxic concentrations. (or at least monitoring is required more and more for newer drugs) This will make double checking dosages and consultation more important, take longer, and therefore require additional manpower.

I'm sure are more pressing problems than this, but it's all I could come up with while sitting at work.

 

[genesis09]

You also have to remember a lot of pharmacists are going to retire in the next 10 years or so. Also, some of the older pharmacists are going part time. In certain areas, there is saturation, but overall, the Department of Labor is predicting a shortage for the next 20 years.

 

[vtdancer731]

I would agree with what has been written, but I am concerned about some other ideas. The physician/pharmacist relationship in hospitals has me a bit worried about how I might be treated in a hospital setting. But, I guess that might be minor compared to what everyone else has said. I think once I'm actually in pharmacy school, I will be able to have a better idea.

 

[tt_vo503]

I've been working in the hospital for awhile now as a medical technologist, and I can definetly tell you that pharmacist are currently at a major shortage even in "saturated areas" At my hospital pharmacist positions are always classified as "critical to fill" positions, because the are just soo hard to find (haha job security). These positions not only give the pharmacist a good sign on bonus, but if a current employee successfully recommends a pharmacist to fill the position, the employee also gets a handsome amount of $$$. Currently thats how high a demand pharmacist are needed right now at hospital.

 

[cuedee]

How could an individual help an industry overcome a problem such as labor shortage?

 

[inquirer89]

It's funny I saw this thread...I was the first person within my circle of friends that thought of becoming a pharmacist. This was in my junior year of high school. Then, all of a sudden, 3 people who were seniors that I knew got into pre-pharm...and since I'm a year younger, they think I'm the one copying them!

I also know of 3 other kids who will be doing pre-pharm.

So yes, I feel that the career could be fulfilled, but that is due to my perspective. That's why I plan on setting myself apart by eventually getting an MBA...I want to be the boss of everyone

 

[kismet]

JCAHO is upping regulations every day. When I started working at my hospital pharmacy about a year and a half ago, staff has just been increased to one pharmacist, two technicians, for every 10 hour day. While we passed our JCAHO review, they set forth some conditions we had to meet in the next months, so now we have added a second pharmacist every day. My boss is now expanding pharmacy hours to 13 hours a day to try to make up some extensive costs of "outsourcing" orders at night while we're closed... unfortunately he's not adding staff hours right now, just spreading us thinner.

JCAHO insisted that we do more concurrent review of orders. They also want to see medication reconcilliation for all patients, which I understand to be a review of all medications the patient is currently taking (usually recorded by a nurse or pharmacist) and then a decision to continue or hold these medications while the patient is in the hospital (made by the physician). My boss tell us that our hospital is one of the only ones in the region already doing some of these things, and JCAHO is asking us to do more. It's a little easier for us because we're so small but I can only imagine that the big hospitals are going to HAVE to hire more staff to keep up with the demands. (I don't think that they're bad demands, it is all a great idea in the name of patient safety, but JCAHO is insisting changes be made now and it's a little hard with the shortage..)

So, no... I don't think the demand for pharmacists is going to run short anytime soon. I think pharmacists are going to continue work in shortage conditions in every setting and are going to be forced to be as efficient and cost effective as possible. How can an individual help? I guess by knowing everything they can, keeping up with new stuff, being efficient yet accurate, but that's all kinda BS'ing. I don't think anyone has figured out how we're gonna fix this one besides more pharmacists.

As new drugs and technologies continue to come out it's going to fall on the pharmacists to keep track of everything and to figure out how the technologies can fit where they are.. no matter how great the technology is there has still always got to be a person behind it saying "that's ok, that's ok" (I have seen a ruling, I think about RiteAid's robot filling machine or similar technologies, warning users that while the law does not explicitly state that they must have a pharmacist checking scripts filled by the robot, it's a darn good idea that they do so because there is still a pharmacist somewhere that will be responsible if there is an error.. can't remember if it came from state board or FDA).

People are living longer so we are seeing new combinations of disease states, not to mention obesity is now an "epidemic" which makes accurate dosing and monitoring of weight-based drugs pretty challenging. Plus, plain and simple "more" drugs are required and reimbursement from third party insurance, federal insurance, or the people without insurance is never going to cover the actual costs, so pharmacies and hospitals are forced to be extremely cost effective.

Pharmacogenomics is still mostly a research-based field but I predict within our lifetime (those in or just out of pharmacy school) it is going to "go live" and we are going to be playing a whole new game..

 

[SCCpharm]

In the future, do you think pharmacists will be able to charge for cognitive services? (I think there's a temporary code for Medicare patients, but it expires soon).

For example, at least a couple times a week someone comes into the pharmacy and asks for medical advice...and they get it for free. Now, if they were to do that to a medical doctor, they would have to book an appointment 2 weeks in the future, wait 2 hours in the waiting room, see a doctor for 15 minutes, and be charged a $100 office visit.

 

[lessotto]

In the future, do you think pharmacists will be able to charge for cognitive services? (I think there's a temporary code for Medicare patients, but it expires soon).

For example, at least a couple times a week someone comes into the pharmacy and asks for medical advice...and they get it for free. Now, if they were to do that to a medical doctor, they would have to book an appointment 2 weeks in the future, wait 2 hours in the waiting room, see a doctor for 15 minutes, and be charged a $100 office visit.

oh, I hope the whole "paying for advice" business is not happening ever. People who are coming to the pharmacy for an advice are usually the ones who can not afford paying/do not have a doctor. And if nothing is seriously wrong with that person and a pharmacist's advice can in fact help, then I do not see a reason why a pharmacist should not dedicate 10 mins to "helping others." and yeah, it should be done for free, i think.


I was asked "future problems" question and I talked about insurance (the whole "your drug is only covered in generic" business and fertility medications (for women) being very expensive).

 

[corbomite]

I'll address the problem of the pharmacy market becoming supersaturated with some numbers. I'll use my state, Alabama, as an example since its really a microcosm of whats going down nationwide.
Alabama has two pharmacy schools, Auburn and Samford. Combined they graduate 270 pharmacists a year.
In the year 2000 there were 7200 practicing active care physicians in Alabama. I'm assuming they haven't changed(the number went up), and am also assuming there is an equilibrium of pharmacists(i.e the same number of grads leave the state to work as those coming in from other states).
Lets say that each physician writes 5 more prescriptions a day this year than he/she did last year. Not to staggering of a number if you consider the aging population and the standard American diet. That means roughly 13 million new prescriptions were added to the number filled last year. Divide that by 270 pharmacists and you'll get roughly 130 new prescriptions a day per new pharmacist.
This doesn't mean each pharmacy will do 130 more per day(duh..), it means that if every single pharmacists works the same the new pharmacists will have an average of 130 prescriptions a day. It doesnt seem that bad until you factor in retiring pharmacists(or 50+ pharmacists who decide to work 20 hours a week b/c they can). Or when you realize most pharmacists are already overworked.
The number of prescriptions written daily in the United States has probably doubled in the last 10 years but I guarantee the number of pharmacists have not.

 

[PumpkinSmasher]

oh, I hope the whole "paying for advice" business is not happening ever. People who are coming to the pharmacy for an advice are usually the ones who can not afford paying/do not have a doctor. And if nothing is seriously wrong with that person and a pharmacist's advice can in fact help, then I do not see a reason why a pharmacist should not dedicate 10 mins to "helping others." and yeah, it should be done for free, i think.


I was asked "future problems" question and I talked about insurance (the whole "your drug is only covered in generic" business and fertility medications (for women) being very expensive).

So because doctors are expensive, pharmacists should not get reimbursed for their services? Might as well let pharmacists take all the ****...

Why should the insurance company pay to help make someone a baby factory?

 

[117296]

Pharmacogenomics is still mostly a research-based field but I predict within our lifetime (those in or just out of pharmacy school) it is going to "go live" and we are going to be playing a whole new game..

Pharmacogenomics is going to be huge...and tied directly to the field of biochemical research. I believe pharmacogenomics is going to be highly individualized. There's going to be a need for reliable testing for genetic diseases and conditions which can be treated with new medicines. There's a need for a reliable computer program which can centralize this information and accurately give a result and accompanying treatment. There's a need for pharmacists who are able to interpret this information, appropriately revise drug treatments, and communicate this information to the patient without confusing them. On that note, I do see pharmacogenomics becoming a board certified specialty and a niche field of pharmacy when it very first comes out.

I do agree that it's a field of pharmacy that has a great chance of shaking up the profession of pharmacy as we know it.

 

[BelowTheMean]

Saturation might be a problem in areas like LA or some populated city. Outside of LA/Orange county or maybe new york...I just can't see it happening. You will soon realize why there's always a demand (hint: no one wants to continue doing this and do it part time or do something non retail related). Yes, if you are talking about hospital pharmacy, there could be saturation problems. Retail pharmacy...just dont see it.

 

[lessotto]

So because doctors are expensive, pharmacists should not get reimbursed for their services? Might as well let pharmacists take all the ****...

Why should the insurance company pay to help make someone a baby factory?

1. he he. I imagine one day an old guy will come into the pharmacy and ask you
"Kid, I have a terrible headache and a flu (and an ear infection and god knows what else). what should I take?".

You: "Sure, i know how to help you, Mr. Smith, but let me check in the computer if your insurance covers medical advices. Because you know, Mr. Smith, I only get $90000/year for checking RXs and want to be reimbursed for any additional services". "Sorry, you are in fact not covered. Check the pharmacy across the street, please!"
2. Well, insurance pays for birth control, so it might as well pay for other hormones... And, hey, Cialis is covered.

 

[medicalCPA]

So is shortage the only problem the pharmacy profession faces in the future? Pharmacogenomics may "shake up the profession," but it does not seem to be a problem.

 

[kismet]

So is shortage the only problem the pharmacy profession faces in the future? Pharmacogenomics may "shake up the profession," but it does not seem to be a problem.

I think it will be part of the problem. We will need pharmacists to be pharmacogenomic pharmacists which will take them out of play for the "regular" stuff (and the "regular" stuff is increasing in responsibility already), just like right now, we need more pharmacists to be teachers so we can have new pharmacists, but we still need pharmacists out in rest of the industry.

Also medication safety is always big, especially as it's affected by the shortage, new technologies, new drugs, etc.

Antibiotic resistance? Maybe not so much retail pharmacy but hospital pharmacists are the ones who have to tell the MDs "no, you can't order that antibiotic without relevant labs".

Cost efficiency (also plays into pharmacist shortage... we want more pharmacists to do more things but we don't have the money to pay them anyway) because of decreased reimbursements from third party insurance or because of hospitals/county/state/federal supporting patients with no insurance (preventative medicine is cheaper than a stay in the ICU.. and hospitals can't turn a patient away from the ER).

The increased demand for concurrent review is probably going to lead to an increased demand of satellite pharmacies, so someone has got to figure out how to do it right and safe (maybe could be lumped with medication/patient safety). Some companies are doing it already but I don't think it's on a large scale yet.

There are lots of areas that us future pharmacists will be able to "make improvements" in. 🙂

 

[Rumplestiltazepam]

cool

 

[medicalCPA]

I think it will be part of the problem. We will need pharmacists to be pharmacogenomic pharmacists which will take them out of play for the "regular" stuff (and the "regular" stuff is increasing in responsibility already), just like right now, we need more pharmacists to be teachers so we can have new pharmacists, but we still need pharmacists out in rest of the industry.

Also medication safety is always big, especially as it's affected by the shortage, new technologies, new drugs, etc.

Antibiotic resistance? Maybe not so much retail pharmacy but hospital pharmacists are the ones who have to tell the MDs "no, you can't order that antibiotic without relevant labs".

Cost efficiency (also plays into pharmacist shortage... we want more pharmacists to do more things but we don't have the money to pay them anyway) because of decreased reimbursements from third party insurance or because of hospitals/county/state/federal supporting patients with no insurance (preventative medicine is cheaper than a stay in the ICU.. and hospitals can't turn a patient away from the ER).

The increased demand for concurrent review is probably going to lead to an increased demand of satellite pharmacies, so someone has got to figure out how to do it right and safe (maybe could be lumped with medication/patient safety). Some companies are doing it already but I don't think it's on a large scale yet.

There are lots of areas that us future pharmacists will be able to "make improvements" in. 🙂

kismet, your post is very insightful. But, as a previous poster said, what can an individual do about problems like an industry shortage, or medication safety, or cost efficiency? I could say "graduate more pharmacists" to deal with shortage, but where would the facilities to train them come from? Besides, that would be saying, not doing.

 

[zilko]

Clearly, one of the biggest challenges facing the industry is that of increasing demands on the pharmacist - greater numbers of prescriptions written/filled, retiring older pharmacists and inadequate supply of graduating PharmDs. At present this is resulting in longer hours with an ever increasing number of prescriptions and variety of drugs.

Is there a crunch time coming? I think so. I don't have any reliable numbers, but I think this article
gives a reasonable view of the situation. Is there change coming? I think so. What form is it going to take? I have some ideas, but your guess is probably as good as mine.

So to break it down

• pharmacist shortage
• increasing Rx count
• increasing drug variety
• work harder, not smarter corporate ethic

May you live in interesting times. I'm up for the challenge to help to shape the future of the industry (just that one niggling little problem of getting accepted at a school🙁)

[for inquire89: think a little deeper about that MBA, are you intending to run your own business, then it will be very helpful, but just so you can be the 'boss,' please, being the boss just means that you have to deal with everyone else's problems as well as your own (just something to think about), I got my MBA back in '91, and while the knowledge gives you great insight, it really hasn't been a big differentiating factor for me.]

 

[corbomite]

1. he he. I imagine one day an old guy will come into the pharmacy and ask you
"Kid, I have a terrible headache and a flu (and an ear infection and god knows what else). what should I take?".

You: "Sure, i know how to help you, Mr. Smith, but let me check in the computer if your insurance covers medical advices. Because you know, Mr. Smith, I only get $90000/year for checking RXs and want to be reimbursed for any additional services". "Sorry, you are in fact not covered. Check the pharmacy across the street, please!"
...

hehe, lets see who would you rather have as your pharmacist? the one willing to help you or the one bitching and moaning because they don't make enough money to give easy advice.

 

[inquirer89]

Zilko:

Yes, I do plan on owning a my own business one day, although it will probably not deal with pharmacy. I also hope to go into administration after working as a clinical pharmacist. But thank you for your input.

 

[Rumplestiltazepam]

Never hurts to get an MBA

 

[Rumplestiltazepam]

If you are going the administration route then having that MBA will probably be valuable.

 

[justyliz]

Good points overall, I agree with most everyone's opinion about the future of pharmacy. If there's one thing that's for certain about the future of pharmacy, it's this - things are going to change and pharmacists will have to be versatile and willing to adapt in any career setting. Even within each particular setting (retail, hospital, industry, academia), pharmacists will have to be adaptable to many changes. E-prescribing and pharmacogenomics are just a few examples that will most likely change the way things are done in retail and research pharmacy respectively. In my opinion, as long as you're willing to accept change and have a positive attitude toward everything, you will be just fine. The future of pharmacy is something beyond your control, so might as well accept things you cannot change and just try to be the most versatile healthcare provider you can be.

 

[kismet]

kismet, your post is very insightful. But, as a previous poster said, what can an individual do about problems like an industry shortage, or medication safety, or cost efficiency? I could say "graduate more pharmacists" to deal with shortage, but where would the facilities to train them come from? Besides, that would be saying, not doing.

I saw the question originally being posed because it's likely a question to come up in interviews, so what would you say? So yeah, a lot is probably just a lot of "saying" not "doing".. but I think (hope) they will be giving us some tools in pharmacy school to address these things too. 🙂

I think I said something in my first post - you can talk about individually being on top of your game, as efficient as possible, etc, but I think it's all kinda BS. Everyone is struggling with the pharmacist shortage. I think all one person can do is keep up with things, stay educated, and do their best, which is what we're all going to be aiming for anyway. Maybe being involved in professional associations - they often can help drive policy change, so as an individual you can get involved with a bigger group that will be working on these issues.

I think there are ALWAYS ways to improve medication safety. ISMP publishes a newsletter all about medication errors, and by seeing what happened in other places you can try to make sure it won't happen at your site. Evaluating errors which do occur at your site and finding a way to prevent it in the future. Being aware of look alike sound alike drugs, where drugs are stored in the pharmacy, where they are stored on the floor. It's a never ending game to make sure your processes are as safe as possible.

Cost efficiency.. are you reusing drugs when possible (you can't do this in retail but in the hospital we can get drugs back which haven't been out of their sterile packaging and patient cassette, credit the original patient and dispense to the next), do you have the right balance of "enough drugs on the shelf" but "not so much that it will outdate before you get to use it", evaluating how your staff orders drugs and what's on your formulary, are your pharmacists busy enough to earn their pay (i.e. multitasking enough)..

 

[mrblah]

I don't see any problems for pharmacists. Even with automation, their will still be jobs for pharmacists, because as the population ages, more will become reliant on medication, and more medication will be introduced, and that means more jobs for us. However, i think retail is going to go to poop, because its to reliant on 3rd party ins., and increasingly reliant on how our economy is doing (because of the demiss of the mom/pop pharmacies).

Only way to save retail, is to make it more clinical, but because of current hippa laws and competitition between pharmacies..that will never happen, until someone buys everyone up, and impliments a umbrella program.

thats my doomsday scenerio....

 

[guppyboy85]

Out of curiosity, what blogs would be recommended reading for an aspiring pharmacist? I love to read blogs but sometimes I'm a little wary of the kinds of things that a quick and dirty google search brings up.

Any help would be great, thanks! 🙂

 

[medicalCPA]

Out of curiosity, what blogs would be recommended reading for an aspiring pharmacist? I love to read blogs but sometimes I'm a little wary of the kinds of things that a quick and dirty google search brings up.

Any help would be great, thanks! 🙂

Try these two:
www.theangrypharmacist.com
www.theangriestpharmacist.com

For more blogs, look on the sites to the pharmacy blogs they link to. Personally, I've read the second, and I'm making my way through the first. And FYI, they use lots of salty language, and are not politically correct.

 

[choylifut]

Try these two:
www.theangrypharmacist.com
www.theangriestpharmacist.com

For more blogs, look on the sites to the pharmacy blogs they link to. Personally, I've read the second, and I'm making my way through the first. And FYI, they use lots of salty language, and are not politically correct.

TheAngriestPharmacist is hella funny!!!! I'd love to work with him.

 

[choylifut]

I don't see any problems for pharmacists. Even with automation, their will still be jobs for pharmacists, because as the population ages, more will become reliant on medication, and more medication will be introduced, and that means more jobs for us. However, i think retail is going to go to poop, because its to reliant on 3rd party ins., and increasingly reliant on how our economy is doing (because of the demiss of the mom/pop pharmacies).

Only way to save retail, is to make it more clinical, but because of current hippa laws and competitition between pharmacies..that will never happen, until someone buys everyone up, and impliments a umbrella program.

thats my doomsday scenerio....

I thought about this and wondered if it was really possible to make retail more clinical? How would you differentiate a clinically retail pharmacy from amcare?

I don't think retail will go to "poop", especially with MTMP.

 

[genesis09]

The majority of pharmacist jobs are in the community setting. The area with the fastest growth, in terms of jobs, is with the PBMs. I can't imagine there will become a time when community is not the number one area of practice.

 

[babietuan323]

pharmacist shortage

 

[phrmboy123]

Here's a link that i find pretty hilarious as a pharm student.

these two p1's (i think) go on a rampage bout their class and work and tell it how it really is! and their URL is funny as heck too!!!

http://irritableinternsyndrome.blogspot.com

 

[Sparda29]

Well, I would say that all pharmacies should be required by law to have a private consultation/examination room.

I really liked Dr. Ron Paul's ideas about allowing pharmacists and nurses to do some of the basic things that physicians are allowed to do.

Pharmacists should be allowed to prescribe medication. Basically, everyone and their moms nowadays are allowed to prescribe except for pharmacists. There should be some limitations like diseases that require testing, but if someone is in severe pain, pharmacists should be allowed to prescribe like a 2-3 day supply of painkillers, or just enough until the patient can see a doctor.

A copy of the patients complete medical records should be at the doctor's office and at the pharmacy so the pharmacist would know what the patient's are allergic to.

And finally, separate billing from dispensing. If a patient comes in with a prescription, they don't pay for it on the same day. They are basically told the cost of the medication if their insurance company doesn't cover it.

The pharmacist would have more time talking about the medication and less about why it costs $50 more than last time.

This would be the procedure:

1. Patient comes in with prescription and takes it to drop off.
2. Drop off person processes it and informs them of the price if the insurance company doesn't cover it.
3. Prescription is produced and verified.
4. Patient picks up the prescription.
5. Billing information is sent to insurance company for handling of the matter.
6. Insurance company sends the bill to the patient.

Patients should be allowed to choose if they want brand name or generic instead of having to call the doctor.

 

[medicalCPA]

Well, I would say that all pharmacies should be required by law to have a private consultation/examination room.

I really liked Dr. Ron Paul's ideas about allowing pharmacists and nurses to do some of the basic things that physicians are allowed to do.

Pharmacists should be allowed to prescribe medication. Basically, everyone and their moms nowadays are allowed to prescribe except for pharmacists. There should be some limitations like diseases that require testing, but if someone is in severe pain, pharmacists should be allowed to prescribe like a 2-3 day supply of painkillers, or just enough until the patient can see a doctor.

A copy of the patients complete medical records should be at the doctor's office and at the pharmacy so the pharmacist would know what the patient's are allergic to.

And finally, separate billing from dispensing. If a patient comes in with a prescription, they don't pay for it on the same day. They are basically told the cost of the medication if their insurance company doesn't cover it.

The pharmacist would have more time talking about the medication and less about why it costs $50 more than last time.

This would be the procedure:

1. Patient comes in with prescription and takes it to drop off.
2. Drop off person processes it and informs them of the price if the insurance company doesn't cover it.
3. Prescription is produced and verified.
4. Patient picks up the prescription.
5. Billing information is sent to insurance company for handling of the matter.
6. Insurance company sends the bill to the patient.

Patients should be allowed to choose if they want brand name or generic instead of having to call the doctor.

I do not agree that pharmacists should prescribe. If I wanted prescribing authority I would have gone to med school. And the proposition that patients not pay the same day for their meds seems like it would leave many prescriptions unpaid for.

 

[PharmDnewb]

My Northeastern interviewer asked me what problems I saw in pharmacy. I told him that patients and sometimes physicians don't believe pharmacists are capable of helping patients find the cheapest and most efficient medicine. People tend to forget that pharmacists are doctors of medicine and not some guy standing behind a counter counting pills. For example, I've seen patients yell at the pharmacist when the generic form of a medication is filled instead of the brand name.

 

[medicalCPA]

My Northeastern interviewer asked me what problems I saw in pharmacy. I told him that patients and sometimes physicians don't believe pharmacists are capable of helping patients find the cheapest and most efficient medicine. People tend to forget that pharmacists are doctors of medicine and not some guy standing behind a counter counting pills. For example, I've seen patients yell at the pharmacist when the generic form of a medication is filled instead of the brand name.

A pharmacist is NOT a doctor of medicine. Doctors of medicine are physicians.

 

[kismet]

I really liked Dr. Ron Paul's ideas about allowing pharmacists and nurses to do some of the basic things that physicians are allowed to do.

Pharmacists are starting to get prescribing responsibilities - Plan B in some states, for example - but the pharmacists I know aren't thrilled about it. They're happy to offer a professional opinion to either patient or physician but they'd like to do their job, make sure the physician's order is ok and filled accurately, instead of dealing with a patient fishing for narcotics. And I can see all sorts of problems with that scenario, pharmacy shopping without billing to insurance.

As for allergies, when I worked retail we asked every.single.patient. whether they'd been there for ten minutes or ten years if they had any allergies when they dropped their prescription off. I wouldn't trust a record if I had it anyway - things get mis-entered or new allergies come up. Although if you'd like to inform the DOCTOR what the patient is allergic to... they're usually the ones who don't know!

Insurance companies and patients alike would NEVER go for the bill-after-receipt procedure. Patients would like to be able to choose - maybe they won't get that cough syrup if they know it costs $30 and they'll just go with Robitussin instead. No harm, except if the patient takes the rx and then has to pay for it later, they'll be pissed. And I don't think insurance companies want to deal with people who won't pay. I can see lots of insurance plans being cancelled because patients can't pay and didn't know it and then the patients will be screwed. 🙁 Not the best way to do things. Making them pay when they pick up is really the most efficient way. My retail chain started printing "cash cost" and "insurance paid" on all reciepts so when the patients complained we could point it out and be like, look, your insurance company paid $500! $20 is not a lot!

A private consultation room would be nice though. 🙂