SDN Pharmacy Forum Makes the Blogosphere Thanks to Anti-Pharmacist Rhetoric

Discussion in 'Pharmacy' started by Caverject, Nov 19, 2004.

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  1. Caverject

    Caverject Try Some Schnitzel! 10+ Year Member

    Aug 19, 2003
    49°43′N 11°54′E
    Hey guys!

    I was going through some old posts today?s and decided to click on a fellow SDN members signature that was linked to his personal blog site. I have to admit, I was appalled with what I saw. We are compared to "Nazi's" in the way that we practice pharmacy. The funny part is that I had a profound respect for this person's posts cause I've always have found them interesting; good, bad, or indifferent.

    For some reason, from what I get from this person's post is that pharmacist's want to take complete control over prescribing. This is just utterly wrong. The pharmacy profession is trying to create a better healthcare team by having pharmacists participate more in the selection of therapeutic agents. In no way, shape, or form are we trained to diagnosis a patient. It was noted in another post that this person has seen a patient that had shingles, get treated for poison ivy with hydrocortisone cream by a pharmacist. Well, a pharmacist is the most open health professional there is in the health care industry. You are right in the fact we do not have years of dermatology experience. Most pharmacists will not physically handle a patient either; more like just eyeball the problem for this instance. If it itches, go ahead and recommend an anti-itch cream. If it doesn't go away in a few days, go see a doctor. What, may I ask, is the problem with that? Keep in mind; it usually takes a few days in order to see a physician. What does the patient do in the mean time?

    In the last part of this person's initial rant, he compares pharmacists to untrained non-medical professionals. I just find this statement being said by this person hard to believe. How can you honestly say that about a *Pharmacist*?? Part of patient health care is to work well with a team. In the hierarchy of things, the attending physician is always first. There is no doubt about it. Then comes everyone else from nurses to pharmacists. I am sorry if this person feels that the physician's main duty is to boss everyone around and let everyone else on the team play "Stooge".

    Normally, stupid BS like this person's post wouldn't bother me cause usually people that talk this way, don't really have a clue. It bothers me when a person that usually writes very good, well thought out posts goes and pisses on our profession. Oh well, C'est la Vie
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  3. GravyRPH

    GravyRPH Senior Member 7+ Year Member

    Jun 12, 2003
    Did you just find this? I've been checking it since he started ranting in here about how uneducated we all are. There's been a pharmacist who has been defending our position at that blog site since he got suspended. Unfortunately, Matt has been deleting all comments that don't support his opinion. There was at least one other med student who said Matt's post was a load of crap and didn't agree with one iota of it. Guess what? Deleted. Another poster said how they were sad that this educated professional takes such a narrow minded point of view. Yep. Deleted. Apparently, only his point of view counts. Even though one of his earlier blog posts talks about how he created this site to open up all different points of view and that he welcomed everyone to participate. Just not the "nazi pharmacists". Heh.

    I try not to wast too much time on people like this.

    I think we all know how much respect and help he will get from the pharmacy community in his home town.
  4. baggywrinkle

    baggywrinkle cranky old fart 7+ Year Member

    Aug 14, 2003
    Tacoma, Washington
    Comeon now Matt was misquoted

    What he really said was

    ? H ? Matt Messas Blogs :: Matthew M :: email link
    2004 坎城影展最佳導演


    時間:11月28日 11:00 地點:台中德安華納威秀 1廳
    時間:11月29日 18:00 地點:台中德安華納威秀 1廳

    時間:12月2日 14:20 地點:台北信義華納威秀 12 & 13廳〔售完〕
    時間:12月3日 15:00 地點:台北信義華納威秀 17 廳
    時間:12月5日 12:15 地點:台北信義華納威秀 12 & 13廳〔售完〕








    posted 20 November 2004, Saturday

    ...a clear case of spatula envy
  5. GravyRPH

    GravyRPH Senior Member 7+ Year Member

    Jun 12, 2003
    He writes in other languages too? Impressive.

    Hmm. I thought you just screwed up the cut and past at first, but it looks like someone hacked the blog and screwed it up. I hope that wasn't any of us. He should have the right to say what he wants, even if it is misguided and hateful.
  6. ultracet

    ultracet 1K Member 10+ Year Member

    Mar 4, 2004
    I went to the main website and got this...

    Blog-city is down for maintenance. A hacker has effected a number of blogs and we are in recovery mode. Please accept our apologies for the delay we shall be back shortly.
  7. ultracet

    ultracet 1K Member 10+ Year Member

    Mar 4, 2004
    On another note.... Things like this just really make me mad... I'm so glad there are "real" doctors out there who do not feel this way....
    It has been my experience that when an MD has had a positive experience with a pharmacist they will call and as the pharmacist EVERYTHING...
    ironically some of the older MDs are the ones who seem to be coming around the fastest in my hospital. the younger ones just expect to write things like....
    APAP- pharmacy to dose..... and they don't even take the time to call and ask.

    Thank goodness for MDs with some since and respect for other professionals involved in patient care.
  8. Oneday_9

    Oneday_9 Senior Member 7+ Year Member

    Nov 9, 2003
    San Francisco, CA
    Wow, these anti-pharmacist points of view are nauseating.

    I can't believe what I was reading, and it seems some agree.

    Glad he was banned...unprofessional all around, how old is this brat?
  9. GravyRPH

    GravyRPH Senior Member 7+ Year Member

    Jun 12, 2003
    I can't believe I'm actually going to do this, but I'm going to defend the guy a bit. I have met a few doctors like this in my travels through many pharmacies, and the one thing I noticed is their underlying motive is actually based in concern. Concern for the patient. They truly don't want to see their patients harmed and only want what they feel is best for them. Sure, it could have been said in a better way; done without degrading an entire profession, but to be honest, you can see that his motive perhaps is a noble one.
  10. bananaface

    bananaface Pharmacy Supernerd Moderator Emeritus Lifetime Donor 10+ Year Member

    Apr 24, 2004
    gone to seed
    He was not banned but placed on temporary post-hold, which has now been lifted. If he chose to, he could take part in this conversation. To his credit, he has not replied to any of the remarks made about him in this thread or in other areas of the forum.

    Something to think about: If we turn our back on other professionals that treat us poorly or speak of us poorly, will we ever win them over? And, if we give up, isn't it partly our fault that the problem remains unfixed?
  11. kwakster928

    kwakster928 A Legal Drug Dealer 10+ Year Member

    Jun 10, 2004
    Please note, I do not really know what exactly what pharmacists are lobbying for. I wrote this with assumption that pharmacist are trying to get the generalized prescribing rights. I apologize for lack of specifc knowledge in this matter.

    Here is my thought on this issue of prescribing rights. I have to say i have to defend PACtoDOC on his position of not giving pharmacist general prescribing rights. I have to say however, way how PACtoDOC gone about making his point was not professional.

    I believe that we are concentrating on the wrong issue here. Many of us might feel that since our degree has gone some changes BsPharm to PharmD, we feel that we are more capable of being in the clinical role. That is true but it is not completely to the point that we have the right knowledge and experience to have prescribing rights. in order to prescribe, you need to make a diagnosis, reviewing pt's symptoms and vital signs. we as pharmacist not only lack sufficient skills to do so, nor know all the disease states as well as physicians do in their regular day of practice. it is physicians job to find out what disease the pt has, and what ways he/she wants to go about treating that pt. our job is to interpret his/her choice of drug treatment and make sure it is safe to the pt also drug treatment that was assigned to pt gives maximum therapeutic effect.

    I think the general conflicts arise when one?s profession?s territory is not respected. Perhaps we as pharmacists had too many incidences where our recommendations were shut down in front of physician, or putting our job on the line to defend our interventions or recommendations. I believe that these conflicts could be minimized if physicians and pharmacist understand that our goal here is to maximum positive outcome for the pt. Two of us happen to have different knowledge specialty, let us all listen to what we have to say, lets us and pt both decide where we can go about treating this pt. After all, we all serve under our king the pt.

    Instead of putting so much our effort on getting prescribing rights, let us the pharmacist worry about where we can be more beneficial to healthcare team and strengthen our territory. Everyone knows here everything ultimately depends on economics. What saves money on what. So we say ourselves we are more clinically oriented than ever before thanks to our new curriculum in the pharmacy school. What have we done to prove such a claim? I want to share with you guys with a except from an article that I have read in October issue of the ?Pharmacy Practice News? written by Al Heller, it reads ?if you re spending $1 million on that drug class, hire an FTE (full time clinical pharmacist) at $100,000 to make him save $300,000 a year? It is sad to see that only way to show our progress is to integrate our performance with a dollar value, but it drives the point home. We as pharmacist must show the public and other healthcare profession or the organization that we stand here for reason. Unfortunately putting the dollar value not only makes everyone understand, but that is the only way it seems like. Let us argue our position in respect to pt?s outcome and economics. If we can strengthen that, I think we will have less time dealing with getting prescribing rights. Overall, don?t we have enough to do on our side of territory already?
  12. Oneday_9

    Oneday_9 Senior Member 7+ Year Member

    Nov 9, 2003
    San Francisco, CA
    I am not necessarily defending that we as pharmacists should have prescribing rights, if I wanted that responsibility I would have gone to medical school. As far as I know, the opporunity for such things arise in specialty clinics. We have a HIV clinic, where the pharmacist works closely with the physicians, so much so that the doctor often times simply allows her to prescribe what is necessary to alleviate ADE's and interactions, when reviewing how to improve a particular drug regimine with the patient.

    I am sure everyone's problem is the utter contempt and disrespect that was shown behind a valid point. It is hysterical in voice and degrades the other profession. I might add, addreessing a callous remark, tt is not our job to correct medical errors. I know at my former employer, a mail order facility, too much time was spent by pharmacists tracking errors by techs mixed with errors from medical doctors, and honestly, given the intense environments of the modern pharmacy, handling many insurance issues, the last thing the pharmacist should have to do is worry about a PCP prescribing the wrong dose or medication. That was a problem I had with what was said.

    Finally, I am unaware of a huge population of pharmacists ravenously campaigning fior prescription rights. I think the place where it is necessary, again, is in specialty clinics, or when the physician feels comfortable allowing the pharmacist to select a specific drug regimine. PERIOD.

    So if this individual is reading this, I am glad he was not banned indefinitely, I simply wish him to realize many of us respect the physician, as I have many friends who are physicians. We don't want to step on toes, only help in alleviate many problems that surround patient's health in today's medical world.

    We don't need this type of division because this is why the patient is suffering in every facet today, and, right now, this is not our healthcare system anymore, it is the insurance companies. To get through such times, we must all work together.

    Simply put, sir, respect us, we'll respect you, and try to maintain a professional demeanor at all times, even in anonymity.
  13. jdpharmd?

    jdpharmd? Turning lead into gold 7+ Year Member

    Mar 3, 2003
    AND then...
    Speaking of concern for patient, I'd like to share a recent (attempted)intervention on behalf of the patient.

    PT comes in for Alprazolam (Xanax) 2mg, 2QHS prn insomnia (total 4mg), and another script for Provigil 200mg 1qam. Set off anyone's mind as to a possible reason? Yeah, the poor guy is taking so much benzo at night to sleep, that he can't get going again in the morning because he's still drugged!

    When the patient came to pick them up (provigil copay was $150+), we asked him if he thought that it was possible that he was drowsy in the am from so much xanax. He agreed that it was very likely, and we offered to call his doctor for him. Our idea was to change his Alprazolam 2mg to Ambien 5mg or 10mg qhs, and eliminate the provigil all together. We left a message at the office and waited for a return call. When Dr. XXXXX called back, he spoke to a pharmacist who wasn't familair with the situation, and left this message. "I'm not changing anything. The patient is not taking provigil becuase of the sleeping pills, he's taking it because he is 'low on energy'!! And for your information alprazolam is a short acting benzo! Goodbye"

    Fast forward to the patient calling us back. We relayed mr friendly doc's message to the patient and the patient replied with something like "I'll call him! He's taken enough of my money, he can at least help me!"

    And now a little kinetics for you: Alprazolam has a 6.3-26.9 hour half life. Anywhere from 1/2 to 4/5ths of the original dose is STILL active in this guy's body when he wakes up 7 hours later in the am! How would you do after a 2 or 3mg dose of Xanax daily before breakfast?

    Ambien has a half life of about 2.5 hours. Therefore, about 1/8th of the original dose will still be active in the patient when he wakes up, and even that will be gone in just a few hours!

    It's clear to me that this doctor doesn't want to work outside his limited scope of knowledge. "Can't sleep?"=Xanax until you can. "Can't get up?"=Provigil until you can.. Outside suggestions will not be accepted, as they might actually reveal how little this guy knows...
  14. Oneday_9

    Oneday_9 Senior Member 7+ Year Member

    Nov 9, 2003
    San Francisco, CA
    Great example!!

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