^^^^^ Amen to 5minutes
Sneezing, you make a few valid points but you come across as the most condescending and arrogant jerk to ever post on these forums. Any point you made was negated by your atrociously patronizing tone. I don't care if your a DO resident, an MD resident, an MD/PhD, an attending, or even someone highly prominent in the field. If any physician, nurse, PA, NP ever attempted to unprofessionally belittle me, my colleagues, and my profession to my face, I'd immediately raise my middle finger to their face and tell them to have a nice day.
Why? I don't care who you are or what your credentials are, at the end of the day your a god-da$#@d human. This crap about you being too lazy to look up information so thats the only thing I'm good for? BS. Don't even dare tell me you or any other MD knows a FRACTION what a pharmacist knows about drugs. You may know a sufficient amount of information on a handful of drugs that you commonly prescribe, but the line ends there. Don't ever, EVER have a large enough ego to possibly fathom you know more about a subject area then the person who spent four years of their lives dedicated to the study of Pharmacology, Pharmacokinetics, and Pharmacotherapeutics.
I didn't spend 8 years total of my life to dedicate myself to protect the sorry behind of an incompetent PCP who haphazardly prescribes statins to 25 year old pregnant patients because their LDL was "a little high." What in gods name, this should never happen and yet it has happened multiple times in my short career. I don't give a damn about you, about your ego, or about your license/liability. I care about mine, because I am an independent pharmacy practitioner, not some subservient of a self-created MD demigod.
I spent 8 years dedicated to the study of pharmacotherapy so that I can better the lives of patients by ensuring they receive safe, effective, and ECONOMICAL pharmaceutical care. Economical, something physicians have NO CLUE ABOUT. High blood pressure? How about Bystolic and Diovan (instead of trusty metoprolol and lisinopril)? Forget about the fact the patient has Medicare Part D and that would rip them into the donut hole in 4 months flat combined with their other meds.
I think you sound scared honestly. The monopoly the MD/DO degree has on the health care system is fragmenting as the nation realizes we need a more economical solution. Charging $80-$125 for immunization visits, BP/lipid panel checks and refill renewals is simply not viable long term. Go ahead and make an argument all you want; it simply will not work for this nation collectively. Do I agree with the new health care plan? Not necessarily. That isn't whats important. Whats important is that its here, its reality, and your going to have to adapt your own practice model or drown trying. This includes accepting the expertise of other health care practitioners, and this includes the medication experts.
Take care.
I am not belittling or insulting the profession. I respect pharmacists and want to shake your hand, give you a hug, and simply say, "Thank you for all of your hard work that is often times behind the scenes and unknown to us, nurses and patients." You guys are important.
But when you disrespect what we do on a daily basis and insinuate you can do it better, I don't respect that pharmacist.
Now which is it? Am I afraid, or egotistical to the point of a god complex? I prefer to think neither and realize the importance of what we do should not lightheardedly be usurped at the broad sword of political scope of practice expansions. I will consider the idea of a huge ego when the people who have spent 4 years studying drugs (pharmacists) are asked questions and the first thing they do is go to epocrates or lexicomp or micromedex. You'll realize this once you are actually out on your 4th year rotations. How can one not?
The previous poster above citing the positive and negative trials of expansion I respect that. If there is good evidence that shows you can markedely do so with either economic or financial improvements, go for it, knock yourselves out. Please don't do it by politics, all that does is cause both professions to waste money on politicians. But from what I know of what goes into doing our job, there will likely be very limited issues for you to claim as your own. You do coumadin and vanc dosing at the moment, am I missing any others?
But to draw attention to the $80-120 office visit is a red herring. A patient who is so healthy that lipids or one other issue are their only problem are usually seen once a year anyways, and an anual physical is performed. You also forget the benefit of the longitudinal patient-physician relationship and being able to know your patient, so when they do come in the future, you know when the are sick, and you when something is wrong behaviorally. When you start throwing in other providers that is gone. That is destroyed and patients feel disenfranchised from being punted every where. Now directly addressing the costs, there are such things as fixed overhead. Retail clinics who are targeting that cost you speak so ill of are actually
withdrawing from certain markets. They have found the balance in this market for "low lying fruit" of low acuity patients. If CVS, walgreens, etc feels it is easier to have an NP do it, why do you think you will be able to do it better?
Why would you want to spend your day doing that if not for money? You already have a rich intellectual niche, why add more boring repitious management? If any one is money hungry it is those corporations before it would be a physician...
How is it you spent 8 years learning pharmacology? Pharmacy residencies only extend at most to two years. Pharmacy school is 3-4 years. Now if you are upset that pharmacy kicked off the degree inflation and now wants to mandate a bachelors prerequisite, I would be upset too. That's academic highway robbery. And then to consider you guys are trending towards residencies that mostly use as slave labor rather than truly instruct or offer unique unobtainable knowledge (where just a few years ago a fresh grad performed just fine in), I would again be ticked off too. All the while, bachelors RPH pharmacists know just as much, and so I've heard second hand, actually know how to compound better then new grads.
If you are an independent pharmacy practitioner, as you allude to (even though you show as student), you are my hero. That is the type of pharmacist I would like my patients to go to in the future. You are the person who I would love to get phone calls from because I would know you personally. My patients would also know you. That means what you have to say carries more weight and can even be insightful if patients are having behavioral changes, aren't filling the scripts, etc. CVS and walgreens have destroyed what independents still fight for. Please keep up the good fight if that is your goal or actual practice setting.
