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| Sleeping Giants: Rants and Musings of a Retail Pharmacist |
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by The Redheaded Pharmacist - August 15, 2011
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Provided by The Redheaded Pharmacist
Pop quiz everyone: what is the most under utilized profession in the healthcare world? What healthcare professional could be doing so much more for patient care and at the same time saving the healthcare system money? The answer in my mind is the pharmacist.
Think about all the training that pharmacists must endure before becoming licensed. The Doctor of Pharmacy degree includes a lot of clinical training and patient evaluation skills. Pharmacy students also have the option of continuing their clinical training through a residency after school. There is even some consideration now to make at least a one-year residency either standard or required by all pharmacy students on top of the Doctor of Pharmacy degree training they already receive now.
But that focus on patient care and medication therapy management seems to be shelved once a pharmacist graduates and starts practicing in the real world. After we enjoy the distinction of becoming an actual RPh we are often relegated to tasks like simple dispensing and distribution. Sure hospital pharmacists regularly participate in rounds with clinical teams now and contribute so much more to patient care than say twenty or thirty years ago but have we really tapped into all of our potential as a profession? It just seems to me that we are sleeping giants just waiting to wake up and show the world our capabilities.
Couldn’t we do widespread clinical functions in the retail setting like cholesterol screenings, medication therapy management functions like medication reviews, or even prescribing under a protocol of a supervising physician? Couldn’t hospital pharmacists do more for patients to ensure they know about all of the new prescriptions that are being prescribed for them during their hospital stay? These aren’t new concepts and in fact they are all already implemented in some form or another by pharmacists all across the country but it does seems like we are doing these functions on such a limited basis at best.
And think about the government for a moment. Shouldn’t they be open to all suggestions for making the healthcare system more efficient and cost effective? Pharmacists can provide services to patients that have been proven to save money and reduce the drain on the system by patients with chronic diseases who don’t manage their conditions properly. Yet we are rarely given the tools or opportunities to do these functions despite a widespread desire and the training to back it up.
What would happen say if we could help push for a behind the counter class of medications as an example? Aren’t we the drug experts of the healthcare world? Couldn’t we safely and effectively manage the distribution of certain medications that traditionally were prescription only under a supervised care model? Why is an idea like this considered so radical? Wouldn’t a third class of medications increase accessibility of needed medications to patients that need care? I think so.
Instead we find that many pharmacists in both the community and hospital settings are relegated to traditional dispensing functions as the main aspect of their jobs. Although there are opportunities and times when our duties and responsibilities extend well beyond those functions for the most part we are still under utilized. We could be managing patient care in a whole new variety of ways if the healthcare system would simply realize our capabilities and embrace some changes. And part of that needed change is legislative improvements giving us the legal backing to do these expanded functions.
We can’t survive as a profession if we are simply relegated to dispensing and distribution functions. Our value to patients and the healthcare system as a whole is measured by the knowledge base we bring and not simply our ability to safety distribute dangerous drug entities to the general public. The sooner the profession realizes this fact and moves forward to make the necessary changes the better.
And in the case of retail or community pharmacy the clinical capabilities of pharmacists is at direct odds to the corporate focus on metrics and volume and profits. Not only does it seem impossible to have a widespread implementation of a clinical service for patients but any function that does make it to community pharmacies like vaccine administration isn’t accompanied by proper facilities and support staff to properly do the job.
Years ago when I lived on the other side of the country I worked for a grocery store company that allowed me as a pharmacist to do cholesterol screenings for patients. I had a device that could measure their cholesterol in minutes after a simple finger stick. I scheduled patients to come in before the opening of the pharmacy because it was a fasting test and they didn’t want to go without eating all morning. And the results came back in minutes for them. It was simple and effective. And I haven’t done one in years for a patient! Why?
You don’t see cholesterol screenings offered in most community pharmacies. While it is true that other functions like vaccine administration for the seasonal flu is so commonplace it is the norm now that is about the extent of most pharmacists clinical involvement with patients even though our potential is so much more. We could be assisting patients and managing their care in ways that would improve outcomes and save money at the same time.
But as I go to work after writing this post I won’t be involved in a dozen wonderful clinical functions to serve patients. I will be caught up in the madness that engulfs much of the profession of pharmacy now: extremely high prescription volumes, third party processing, and administrative requirements that leaves little time to even counsel patients who are picking up their prescriptions. I am a walking prescription filling machine because that is what makes the money for my employer.
This untapped clinical side of the profession of pharmacy seems to be a sleeping giant that needs to be awakened. But the efforts involved in waking up the beast and really tapping our full potential seems unlikely and difficult at best. Pharmacists must resist the urge to cling onto traditional distribution functions like a life preserver and find ways to expand the horizons of the profession. That is the only way we can have a bright future as a profession. That may be our only chance at any kind of future!
So what’s it going to be everyone? Are we going to watch as the dispensing functions we cling to decline further and bring down the profession of pharmacy with it or will we push to change what it means to be a pharmacist and show we are capable of so much more than handing pills to patients? That question might hold the key to the future of pharmacy. And our response to that question might hold the key to our own futures.
The Redheaded Pharmacist
The Redheaded Pharmacist has been working full time in retail pharmacy for more than a decade. He is in his mid 30s, and, yes, he has red hair.
Disclaimer: This blog represents the opinions of the author and the author alone. It does not represent any pharmacy group or organization. I also will leave out or change the names of patients/customers to protect their privacy and comply with government regulations regarding patient privacy rights and personal information.
The viewpoint expressed in this article is the opinion of the author and is not necessarily the viewpoint of the owners or employees at Healthcare Staffing Innovations, LLC.
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| RWBAmerican |
on 18 Aug 2011 at 3:50 pm |
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I have been a health care provider for nearly 34 years and I am still amazed how people are deliberately deceived and brain washed by the medical profession. Why in the world would anyone ask a physician about drugs or other medicinal therapeutic agents, whether it is allopathic, homeopathic, herbal or whatever? Physicians and other so-called medical providers know next to nothing (and I mean that literally) about these agents because their understanding and education amounts to less than one semester of pharmacology. If you don't believe me, go online and pull the medical curriculum for any medical school and compare it to the Pharm.D's curriculum. The reason medical providers pretend like they have the education and training in drugs is because of political chicanery. If the public knew the real truth about their training patients would not trust them to prescribe, which they shouldn't. Physician's expertise is in diagnostics, PERIOD. They have absolutely NO in depth knowledge pharmacotherapeutics. Their understanding of pharmacokinetcs and pharmacodynamics is restricted to what they read in one of their clinical journals and what they receive from pharmaceutical representatives. If you don't believe me, ask one of them to explain pharmacokinetics or pharmacodynamics to you. They will quickly spew some double talk gibberish and quickly change the subject. If you are serious and want the truth concering theraeutic agents, speak to a trained and educated expert in this area. Make an appointment with your Clinical Pharmacist Specialist. They will tell you the truth.
Regarding the issue of efficacy and safety, there are Hundreds of drugs the FDA has declared to be safe and effective that have caused morbidity and mortality. A good example is Acetaminophen (APAP). It has been hailed for decades as one of the safest and effective drugs available for mild to moderate analgesia and pyrexia. Yea, if you don't care about your liver.
Each year in America alone, Acetaminophen is responsible for in excess of 100,000 calls made to Poison Control and 56,000 emergency room visits, 26,000 hospital admissions and 450 deaths due to liver failure. OH YEA! THEY ARE TRULY SAFE! Give me a break. Because the drug is OTC, consumers believe (because they have been lied to) from Big Pharma and their medical practitioner cronies that Acetaminophen is safe as long as it is taken as directed on the label (that is a maximum of 1Gram per dose and a maximum of 4 Grams daily). That is a lie. Even a very low dose of APAP can cause severe liver damage, the emergency need of a liver transplant and yes, death has occurred from only one low dose. Guess what? You will never know that from reading the warning label on the product. You know why? Because it is not there. So much for the safely theory put forth by the medical profession and big pharma. Again, if you want to know the truth about drugs, talk to those trained and educated professionals in the field you need advice on. Trust your Pharmacist. I am sure this comment will not published, because medical providers do not want the truth to be exposed concerning their fraud and deception. To allow medical providers to prescribe drugs is analogous to allowing an aircraft mechanic to give flying lessons and would result much in the same way as medical providers prescribing. Morbidity and mortality. How ridiculous! The flight mechanic has their expertise, but flying the airplane is not one of them. |
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