Retail pharmacists in mandatory counseling states- most efficient way to handIe

[crossurfingers]

Just moved to a mandatory counseling state. Some pharmacists just take the chance and leave their counseling badges with the techs at the register who ask the patient, but if an inspector shows up that would be trouble. I've just been going to the registers and counselling every time it is flagged but it's really a big hassle being pulled from the pharmacist station to the out window or drive thru especially when I'm on the phone or in the middle of something. Any suggestions on how to handle it more efficiently while still following the law?

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[txpharmguy]

Just moved to a mandatory counseling state. Some pharmacists just take the chance and leave their counseling badges with the techs at the register who ask the patient, but if an inspector shows up that would be trouble. I've just been going to the registers and counselling every time it is flagged but it's really a big hassle being pulled from the pharmacist station to the out window or drive thru especially when I'm on the phone or in the middle of something. Any suggestions on how to handle it more efficiently while still following the law?

I usually have the techs pull up profile and sort alphabetically. If it's not a new rx, I just ask if they have any questions on the meds they're picking up today. If you just walk over, scan your barcode and walk away, it appears from the customer's standpoint that you don't give a ****.

 

[Digsbe]

I've always worked in a mandatory counselling state for new prescriptions. I've been places where the software system allows techs and pharmacists to put notes in for a prescription. Sometimes they would put a note saying "new rx, patient counselling required" and the pharmacist would then come over. Where I work now the pharmacist will put a "counselling" label in the bag for new prescriptions. When the tech sees that in the bag they are supposed to bring over the pharmacist. We ask first if the patient has used the med before, if they say yes then we ask if they have questions. If not, then no pharmacist is required.

 

[ArcSil]

I've always worked in a mandatory counselling state for new prescriptions. I've been places where the software system allows techs and pharmacists to put notes in for a prescription. Sometimes they would put a note saying "new rx, patient counselling required" and the pharmacist would then come over. Where I work now the pharmacist will put a "counselling" label in the bag for new prescriptions. When the tech sees that in the bag they are supposed to bring over the pharmacist. We ask first if the patient has used the med before, if they say yes then we ask if they have questions. If not, then no pharmacist is required.

But what if there is a real counseling issue? I mean, what if the pharmacist needs to discuss a medication with a patient and the patient comes and picks up the med 6 hours later (or a day or two)? What would you then do? Put a "Counseling required. Really, counseling is required. Alert the RPh now" note?

I don't have anything against mandatory counseling. I actually believe that more states should adopt this approach, as long as you have two pharmacists on duty. Maybe one verifying pharmacist and one counseling pharmacist (who could double as the other, and vice versa as needed).

Let's face it, we are, or at leash should be , health care professionals and not over-glorified McDonalds managers.

 

[Digsbe]

But what if there is a real counseling issue? I mean, what if the pharmacist needs to discuss a medication with a patient and the patient comes and picks up the med 6 hours later (or a day or two)? What would you then do? Put a "Counseling required. Really, counseling is required. Alert the RPh now" note?

I don't have anything against mandatory counseling. I actually believe that more states should adopt this approach, as long as you have two pharmacists on duty. Maybe one verifying pharmacist and one counseling pharmacist (who could double as the other, and vice versa as needed).

Let's face it, we are, or at leash should be , health care professionals and not over-glorified McDonalds managers.

The pharmacist will usually write a more detailed note if there is a specific issue with the medication that requires their counselling. The generic counselling tags are used only for new prescriptions. Where I work now it is usually just a tech (me) and one pharmacist on duty. I always ask the patient if they've used their med before if there is a counselling note. Many people fill somewhere else and have had their medication, but it will show up as new in our system since we've obviously never filled it. In my state I believe it's also a law that the technicians/pharmacists ask if the patient has any questions on any fill and to bring over the pharmacist if they do.

I agree to some degree with you though. Things can get hectic when there is one pharmacist on duty and they are on the phone with a physician or with another patient when a tech has a patient that requires counselling. It would be nice if most places stocked at least 2 pharmacists all the time, but I doubt that will happen. Where I live many places are taking on interns and they just have the interns handle simple counselling things or tell the intern what to say to a patient. It does alleviate the pharmacist to some degree, although this wouldn't help areas where there isn't a pharmacy school nearby. I do hate how retail pharmacy is moving towards a more "McPharmacy" model. A pharmacy is a healthcare facility, you wouldn't run a Big Mac through insurance. Although, maybe patient counselling should be required before eating one

 

[Ackj]

I've worked in stores that had two stamps. An "N" for "new", and a triangle (delta) for "change" which was used if the dosage or frequency changed. That made it easier to counsel, since you could simply tell them "okay, now it's 20mg instead of 10mg, might make you a bit more drowsy" or "don't cut them in half anymore, take the whole tablet now" rather than go through the whole spiel about the drug.

 

[ChicagoPharmD]

But what if there is a real counseling issue? I mean, what if the pharmacist needs to discuss a medication with a patient and the patient comes and picks up the med 6 hours later (or a day or two)? What would you then do? Put a "Counseling required. Really, counseling is required. Alert the RPh now" note?

Some chains (i.e. Walgreens) has a function where the pharmacist can flag the rx where the technician cannot sell it until the pharmacist counsels the patient and clears the exception in the computer. I really like this function for those DUR issues when you can't talk to the patient ahead of time, feel that there is a definite need to talk to the patient, but want to have their rx ready when they arrive. My experience, however, is not in a mandatory counseling situation.