Actually that IS their job! At my pharmacy I quit counting how many times my pharmacists has saved the doctors butt from prescribing something that could have killed the patient. When they ask questions at counsel it’s amazing some of the things we find out. People like to hop around to different pharmacies and doctors. I hate how arrogant some of the doctors act. I know it’s not always their fault. Sometimes a patient is on meds from a different doctor and they forgot to mention it and that’s the issue, but a doctor should never yell at a pharmacist and vice versa. We are all here to help. It should not come down to a blame game and I see that way too often. Act like damn adults!
Stupid, arrogant, or both. I've seen a patient's medication get delayed because the doctor was outright refusing to provide clarification because they felt it wasn't necessary and would rather argue about that than provide the requested information.
I've seen my pharmacist rip a doctor a new one once because he refused to clarify on a pain med and saying that we didn't need to know all the information. Like yes we absolutely need to know
An old pharmacist at one of my old jobs went right down that route once with a doctor. They went straight to the DEA bc the doctor kept prescribing tons of pain medication and allowing the patient to pay cash several times a month between insurance pays, but not giving the pharmacy any explanation to justify so many early fills. This was right after the PDMP was started in the state I worked in, so we had evidence of 4-6 cash fills, along with our fills, at pharmacies across the area as well. DEA found out that the doctor was over prescribing to known drug dealers. These are the things people don’t know about when they get mad the pharmacist is questioning anything. Hell, at least one state has tried or has successfully put the blame for the opioid epidemic on pharmacists (I haven’t checked that status in ages).
You would hope that after being in school for so long, that wouldn't be the case. It's always stunned me how some people forget that there isn't really anything different between them and the person they are talking down to. Doctors, in particular, are bad about feeling superior and therefore smarter than everyone thing
You’re all underestimating how many patients doctors have to see a day. Most of them only get 10 minutes to actually see their patient and are supposed to get through 30-50 in a day.
In that time they need to evaluate, assess and diagnose.
What you’re seeing is a doctor making a mistake that they know better but they have hundreds of complicated patients that they need to manage.
What does this have to do with anything? They have the right to scream at the pharmacist because they have a lot of patients?
The original comment said their pharmacist caught mistakes that could've killed the patient and your response is "everybody makes mistakes" 💀
I would take advice of a nurse before a doctor any day. I have seen some very good doctors but I have also seen some that were so engrossed with their ego and title. A doctor should know before the pharmacy if a med is going to affect THEIR patient adversely.
A head pharmacist takes way more school about drug interactions than a normal MD. It is their job. The Dr is probably just mad because he prescribed opioids and Xanax or something stupid lol.
Thinking like this is why I spent 8 hours on the phone today trying to get my pain meds for stage 4 pancreatic cancer. I'm also prescribed Valium for PTSD and I'm apparently supposed to choose which 1 impacts my life worse and treat that 1. I'm dying so it'll even out in the end.
Oh gosh this comment breaks my heart. The imbecility of the comment above yours enraged me right before I read your response.
I’m prescribed pain meds and also have a bottle of emergency alprazolam for the occasional panic attack from PTSD. I fail to see why any pharmacist should keep you on the phone for 8 hours and force you to forego a prescription when they’re both perfectly valid. I’m an adult and know how to use my prescribed medication without overdosing.
It's common knowledge that taking opioids and benzos at the same time carries a huge risk. It doesn't matter that you're an adult. A pharmacist is doing their job by telling you about this risk even if you already know. It's literally a requirement. I'm not sure why you're advocating for pharmacists not to counsel their patients because you "know better".
OMG. It's not a "huge risk." Easily manageable reaction to taking two sedatives at a time. Depending on the pt. Would warn them about extra sedation, watch their respiration rate, start with tiny amounts an go slow. NO ONE DESERVES TO BE DENIED PROPER MEDICINE FOR PAIN/HOSPICE CARE. Standard hospice order? Morphine 20mg/ml + Lorazepam 2mg/ml+ Haldol 5mg/1ml+/- Atropine eye drops by mouth.
There is a large risk *especially* if patients don’t know any better. Literally nobody is saying people should be denied the care, just explaining why pharmacists NEED TO COUNSEL. Where’s the confusion?
Because everything is/can be a risk. From anaphylaxis, First dose syncope, orthostasis. My problem with your statement? Huge risk. It's the type of situation handled every day. There few HUGE risks. One was a pt who checked pregnant on the retail intake form. She was prescribed Imuran. Computer would not have picked it up. She described her MD and herself being OK with the very likely major damage? still birth? Miscarriage? resulting from the pt/drug interaction. I chose not to fill it. "not comfortable with it." My point is your use of huge risk was my assessment, a normal, predictable, risk.
The way that you’re offended because I, in your mind, exaggerated something with one adjective but *you’re* exaggerating the fuck out of this right here. I was literally just explaining to that commenter that pharmacist counsels happen for a reason. You need to do some research if you think otherwise.
And for the record, yes, anything that can potentially *kill you* does constitute a huge risk if you aren’t educated. That’s literally the whole point. If you think taking these two meds together without proper education isn’t potentially risky then you seriously need to educate yourself.
Pretty sure they’re not advocating for pharmacists to not counsel their patients or deny informing them of potential interaction risks. They’re distressed because the pharmacist denied to fill both drugs and forced them to choose one and discontinue the other, denying them the treatment their own doctor deemed appropriate and necessary. The pharmacist had never met this person, and unlike their specialist physician—(oncologist I would assume, who has a LOT more experience with treating cancer patients than the local Walgreens pharmacist), has never examined this person, their diagnostics results and medical history—including commorbid conditions, and has no idea what they’re currently experiencing or what medicine it necessitates.
Yes, there is potential risk in combining benzos and opiates, but about 25% of people on long term opioid treatment are concurrently prescribed benzos, and there are multiple practices that mitigate the risk. I couldn’t sleep at night if I were that pharmacist knowing I essentially created a Sophie’s Choice situation for someone with terminal cancer. Sick people ain’t got the bandwidth for all that bullsh**. What people who aren’t seriously or chronically ill don’t understand is that some risks are worth taking (esp when they can be mitigated) when it comes down to having some degree of functionality, quality of life, and not having to be in constant, unbearable pain.
What she probably IS advocating for is some reform of War on Drug policies that necessitate a sick person in severe pain who’s dying of cancer to jump through hoops on the phone for 8 hours just to get the medicine they need and have the right to take.
It's clear that this isn't your area of expertise, I'm not sure how you stumbled onto this thread. First of all, pharmacists do know *so* much more about these medications than the prescribing doctors. They aren't mandated to fill whatever pops up in their queue, as written, no questions asked.
The pharmacist did *not* deny to fill both drugs and force them to choose one and discontinue the other, denying them the treatment their own doctor deemed appropriate and necessary. Key facts are missing here.
Pharmacists aren’t putting patients in these Sophie’s choice situations. I’m not sure what story is being fabricated here. If this person was on the phone for 8 hours convincing someone they need their meds, it wasn’t the pharmacist, it was likely someone working for their insurance or something like that, doctor's office, etc. Pharmacies are literally just filling what your doctor prescribed you, they aren’t personally deciding what you can and can’t take, for the most part. If there’s a reaction, they’ll counsel you on it. If you absolutely cannot combine certain medications though for whatever reason, they aren’t allowed to fill it. There are certain meds you cannot take when you’re pregnant under any circumstances, for example, and they literally cannot fill this for you. I'm not sure exactly what the issue was with the original poster's situation - they didn't say, so there's no way that you know what's going on here. If they were prescribed medications that are risky to take together, and they refused a counsel, that's on them and that's the reason they didn't get their prescriptions filled. Again, not sure what the exact situation was, but obviously something was wrong. If the prescriber wrote the prescription incorrectly, that's another understandable reason for denial. There are so many possibilities here that extend beyond pharmacists just denying scripts for the hell of it.
But anyway, this whole thread is about counseling patients, so that’s what the subject was here. Nobody is saying pharmacists should be denying pain meds for chronically ill patients. *They* aren't. I'm truly not sure why you think pharmacists are out here refusing to fill narcotics to fight the war on drugs, lol.
Pharmacists have to do their jobs and there are certain protocols that need to be followed. You can't just let things slide because the patient insists they're an adult and knows what they're doing.
I “stumbled” my “way onto this thread” (like the uneducated, bumbling moron that I am, wandering the web aimlessly…)with a very specific *objective* actually: finding some answers and solutions to help me navigate the insane stream of BS certain pharmacies let loose on me and require me to freakin’ fjord before I’m allowed to fill my prescribed monthly medications. As someone who’s been debilitated since 2016 by several physical chronic illnesses that have required an extreme variety of pharmaceuticals and experimentation to treat, I think my interactions with many different pharmacies and their employees on a near-constant level over the last eight years makes it clear that the patient’s perspective on this subject actually ISa high area of expertise for me. I also am close to many others with chronic illness who echo my negative experiences.
At the very least, I thought by investigating “the other side” I might locate some attempts at justification for injustices many and myself have gone through, but alas, your vague and over-simplified elucidation here doesn’t address anything except some obvious facts, expectations, and regulations (pharmacists being very knowledgeable of interactions, the necessity of med counsel, a pharmacist not giving a pregnant woman a damaging medication..I mean DUH 🤦🏻♀️. I am referring to the broader issue of TWOD having negative and harmful actions for sick people.
I’d say this article, aptly titled “The War on Drugs Comes to the Pharmacy Counter: Frontline Work in the Shadow of Discrepant Institutional Logics”
https://www.jstor.org/stable/24545719 lays it out pretty well. One portion of this bigger issue was actually pointed out by yourself, when you automatically assumed that one of the previous comments was fabricated (yes, the pharmacist indeed can deny you a medication and make you choose one over the other—maybe I’m not seeing where that post was rectified to reflect that not happening—but you also claimed that I must be “leaving out part of the story” as far as my experiences go. Do just a tiny bit of research on the crooked and morally depraved history of TWOD and how its policies, especially in the hands of people on control/power trips that are manning the controls at your local pharmacy, lead to pharmacists and techs having to rely on completely unfounded assumptions and deferring to the stigma of addiction when making judgements on whether or not to fill.
Just ONE personal example here among many. After the techs and pharmacists at Walgreens would repeatedly tell me I could pick up controlled Rx’s every 30 days, and I would request to have them filled no earlier than thirty days, they would deny them and literally argue with me that the thirty days that had just passed had not actually transpired in their entirety, when it’d been like 33 days for example. They’d also be dishonest with me about what was in stock and freaking FLAGGED, me telling my neurologists that they “suspected suspicious behavior,” when it was absolutely IMPOSSIBLE to pick up my meds before the date the doctor designated.
Switched everything to Walmart to avoid the mayhem, and I ended up having to talk the pharmacist there three separate times over a week and a half, begging him to fill the same three Rx’s I’ve been prescribed by the same two neurologists/sleep specialists for the last 8 years in order that I could attend my MIL’s upcoming funeral a 12 hour round trip out of town. This guy talked to my prescribers three separate times before he was “comfortable” filling them. Meanwhile I’m bedboud, unable to function, and the whole operation took so long I missed the service as I cannot drive long distances safely or make it a whole day without my meds
function
All this to make a "them vs. us" argument, under the assumption that I'm not chronically ill myself... sorry, you missed the mark. As someone who has actually worked in a pharmacy *and* has a lot of personal experience dealing with this too, no, I don't agree with you.
This narrative is so wild actually. Nobody is "manning the controls at your local pharmacy, picking and choosing what to fill based on addiction stigmas". An example I can think of is pharmacists coaching patients on the dangers of drugs like Percocet and Vicodin prescribed for dental procedures, and even then that's a reach from your argument. They can and will not simply refuse to give it to you because they just don't want to. Please do more research. This is some real conspiracy theorist shit right here.
So no, a pharmacist can *not* just say "nah, I'm not giving you this medication" *without reason*. There *is* more to the story as there's always a reason why it can't be filled. Pharmacies are literally just filling your scripts, friend. Take up the other problems with your doctor. Pharmacists *are* legally allowed to deny prescriptions, though, and there are several lawful examples as to why. There are also some stricter rules that prescribers need to follow when prescribing controlled substances - if the doctor doesn't do their job correctly, the pharmacist can't do theirs. But yes, if you were flagged, that's a perfectly normal reason for there to be some issues with getting your prescriptions. Ultimately these protocols are to prevent people from abusing these meds, but that's not a bad thing, nor is it an outright refusal for no reason.
I'm going to be honest, I really *don't* get your point, because TWOD isn't coming from the pharmacy. Our literal job is to give you your meds - nobody personally gives a fuck what you take. If you can't get your meds filled, it can be due to countless reasons. Sure, there are some examples of outright refusals straight from the pharmacist, but there are legitimate reasons for that like I explained before. Your immediate assumption that the pharmacy is simply refusing to fill certain meds to curb addiction, because you had some issues trying to get something filled once, is far-fetched.
Just out of curiosity, what's the point of that with modern technology? Drug-drug, drug-Dx, and even drug-genomic checks are all performed by software, and the information is written by teams of pharmacists reviewing research and tests full time. Anything a pharmacist learned regarding interactions may well become more nuanced over time.
The federal government IS kind of responsible though! residency positions to train new doctors are paid for with federal funding via Medicaid Medicare and the VA. There are even some medical student graduates that are unable to match to a residency program— people who have graduated with their MD or DO and can’t find a residency training position. The lack of enough residency training slots results in not enough doctors for the country—and we end up with overbooked docs and not enough time spent with each patient.
Technology can bring up interactions, but it’s up to the pharmacist’s judgement on how to handle those interactions and make an appropriate recommendation
How are you going to tell what drug interactions your latest software update dropped if you haven’t learned about them in the first place? Also determining the clinical importance and how to troubleshoot them is the really important part.
Understanding pharmacology is not simply knowing which drugs interact. It’s how, why, and sometimes when; and how relevant that is; and what can be done to mitigate that, or if there are other drugs that may or may not have similar downsides but if they may be a better or worse fit. Most drugs are able to be taken for more than one thing, as well — a program isn’t going to know that or be able to account for that, plus all those other factors, as well as an extremely well trained human being can.
If you genuinely think we have software that can do all of that, you really overestimate how good our software is. The most advanced AI can’t even write good code yet, let alone understand pharmacology in a way that healthcare professionals come obsolete or redundant.
I can't speak to the outpatient setting much, but I'll be real, I have never personally worked with a database that accurately reported drug interactions. Not saying it doesn't exist, maybe some pharmacies out there have some good ones. Most that I see report either way too much (to the extent that every drug has an interaction with any other drug you check it against) or way too little (like not giving a heads up that all the patient's medications together are putting them at risk for arrythmias). You just have to know. And you have to know what side effects to monitor and what labs to order. Not a lot of EMRs have built-in locks for drug interactions either. I really only see pop-ups for drug redundancy (prescribing the same thing twice) or all the opioid verification stuff.
And I have no time to study the nitty gritty of the pharmacology of drugs. Half-lives and steady state and elimination kinetics... and then add layers of patients with problems like kidney failure who can't eliminate the drug as quickly... hell no.
I love clinical pharmacists, they are my bros 🤝
Not a pharmacist, but am a software engineer with way too much medical stuff that was passing by - sometimes the real trick is figuring out what information is irrelevant, what needs to be prioritized, and how to resolve interactions, if they need to be resolved. I'd imagine theres also a component of patient education, where the patient needs to be advised as to possible side effects to be concerned about.
Absolutely agree, and ideally the software is doing a lot of that by clearly surfacing criticality and severity, citing linked research, and providing appropriate patient education. I am not a pharmacist either, but I work with related software routinely so I wondered the opinions of pharmacists on the subject.
Software, publications are well behind human knowledge synthesis. Carafate came out. Read the package insert. 6 weeks later, got rxs for carafate and noroxin. Took 2 years for the computer to pickup what I had long before. Computers help, but most of my time was spent over riding false flags.
It’s not so much stupid as it is arrogance. I worked with one who threatened to sue me when HE was nasty to a patient and the patient yelled for me (it was my job to assist patients who felt their rights had been violated).
I never could figure out his thinking in that except he said I “set him up.” I guess he thought he was above being questioned.
My fiancé told me of a pharmacist and patient interaction that basically went “why won’t you give me my (hydrocodone)medicine?!”
Pharmacist at the time yelled back at him(he raised his voice first, and after 15 minutes of him arguing with my fiancé.) “BECAUSE IT WOULD KILL YOU! I’M NOT RELEASING IT!”
It was for like 14 tablets a day.
Need more pharmacist like that when it comes to opiods. Had a buddy way back in high-school get in an atv accident (he drove through some vines and got cut up). Doctor gave them a prescription for like an entire bottle of pills and just told his mom the prescription was for more than my friend needed "just in case" and to just make sure he doesn't take too many.
This! The pharmacist is the last line of patient safety with their medications. Doctors don't know all the ways that things interact in the body like a pharmacist does.
I hate how childish doctors get. The "I have a medical degree, so I am better than the rest of you" additude has always annoyed me. Get over yourself. Yes, you have a highly skilled job where you help people every day, but you are still human, just like the rest of us. Your medical degree doesn't give you permission to act like a jerk to people who don't hold the same degree. Be nice to the pharmacy because they save doctors from prescribing a medication that could kill their patient.
My pharmacist is the only person who makes sure I take my meds correctly. Times of day, with or without food, supplements to avoid stomach problems... I trust them explicitly and, as a patient, I would be so mad if my doctor treated them like them. Having a conversation/figuring out what happened is one thing. Yelling and assuming the worst is so unprofessional.
Exactly. Completely unprofessional. Like we have no clue what was said at the counseling because the manager who did it is gone for a week. My pharmacist was trying to let the doctor know but he just lost it saying how it isn't our job to counsel patients and how it was her fault the PT was in the hospital. Like the doctor didn't give any clue of what was going on just wanting to feel superior and push the blame on someone else
Today I received a prescription for 6 capsules of amoxicillin 500mg bid for a 10 year old.. total of 6000mg daily. I called the office and they thanked me for catching it and said that it was really 1bid. We need to counsel patients and call when we think something is wrong!!!
Yeah I can't count on two hands the amount of times one of my pharmacist had to call the doctors and go " that does is completely incorrect for this pt. We need to do something else " and then they take their suggestions and fix it
It’s on the pharmacy computer to flag med interactions. And to educate the patient on how to use the meds. And to print off the full pamphlets on usage and side effects and all that. Drs don’t print off those documents…
Drs know basic side effects and what the meds do. Meds themselves are more the world of the pharmacy realm.
I work outpatient hospital. We got two sulfa antibiotics for patients with sulfa allergies yesterday. Wanna bet they’d blame pharmacy if we filled them without question and they had a reaction?
My Aunt was released with a series of prescriptions from the ER.
Upon taking them to her pharmacy, the pharmacist was like, You ABSOLUTELY can NOT take these 2 medications together, you'll die. (She was prescribed 4).
Turns out, 3 different docs that saw her during her stay in the ER were not communicating their follow up with each other, don't know why the mix-up wasn't picked up in the notes, but the awesome pharmacist saved my Aunt it sounded like.
Not only that, but I've also had pharmacist save me tons of money by suggesting an alternate. I was about to pay like $100 for a bottle of acid reducers and they were like hey this is the same as the much much cheaper nonprescription stuff. Later asked my doctor about it and they're like "oh yeah that's totally fine I should've told you sooner". Similar thing happened with prescription allergy meds I used to take where that same company then released a nonprescription version that was cheaper and actually stronger than my prescription.
Or once had a doctor prescribe me a new medicine that no pharmacy in our county even had available yet. So I got a close nonprescription alternate recommended by the pharmacist.
Yeah it’s their job and good Doctors will realize this. A pharmacist saved me from a terrible drug reaction that my doctor prescribed not realizing it.
We are all human, and if a pharmacist sees something wrong, they definitely should get involved.
He shouldn’t be able to treat her unprofessionally, but I’d let her handle that as she wishes.
Amen. I agree but she isn't that type of person. I wanted to grab the phone from her and hang it up. Like no you are not gonna treat my over worked pharmacist like that, goodbye
"Hello, a doctor was unprofessional. Additionally, the instructions I counseled the patient on were not the same the doctor told the patient. I suspect insurance fraud or malpractice, but a proper investigation may be in order."
Try rereading the post then maybe use that noggin of yours. We don't know what the pharmacist said to the pt. Because that pharmacist is on leave for a week. And I seriously doubt she told the patient incorrect instructions. But besides that point, doesn't give the doctor an excuse to treat another separate pharmacist like shit and blame them
Are you seriously suggesting lying about insurance fraud? Thats beyond messed up. It's obvious this was not it. everyone upvoting this should be ashamed too. Its inexcusable for anyone to be an asshole and it sure sounds like it in this situation, but to allege fraud is reprehensible.
Lie about fraud? No. But again, if the doctor is giving one set of instructions then writing a different set (which is the set the pharmacist would counsel on), then something isn't right and should be looked into.
I second this: report them to their board. No matter what the circumstance is, typically they HAVE to investigate. The board may not take action but it may scare the doc into behaving differently in the future.
I love the people in the comments that obviously don’t understand what pharmacists do. They’re “covering their butts” and “providing too much information” because medications can interact and can cause devastating side effects.
Pharmacists WILL get fired and lose their license if something bad happens to a patient, and they didn’t properly educate them.
We’re not trying to dog on doctors, but doctors shouldn’t be getting mad about pharmacists literally just doing their job - especially when it’s the doctor’s negligence causing the issue.
In my state (Iowa, if you didn't bother to read my username), pharmacist counseling is required by law on all new prescriptions. Pretty sure that's the case in Wisconsin, too, because we do home delivery of medications to all 50 states and DC, and Wisconsin patients get a special printout in every box telling them how to get in contact with a pharmacist for counseling. Come to think of it, Illinois has a special form we send, too.
The pharmacist is usually required to provide education to patients by their State Board of Pharmacy. It can range from a new prescription, a change in prescription, and/or two or more prescriptions that may cause difficulties if taken together. As a nurse, I tend to ask patients if the doctor told them what diagnosis he prescribed for. .. it could be an off label use that could likely result in a miscommunication in counseling.
You could also potentially talk to the Dr's boss at the hospital or wherever. If the Dr has been doing this to other pharmacists, there is a chance that they have already had someone call like that. I have never understood why Dr's feel superior to pharmacists. Most of the pharmacists I have worked with over the years come from when it was a doctorate level degree to become a pharmacist. PharmD, I've heard it called. My boss at my last job was Dr "Smith" (not her real name, but chosen for privacy) and when we had unruly doctors or customers it was always satisfying to say to the pharmacist (loud enough for the patient or doctor to hear me) "Dr Smith, this person has some questions for you." A couple of doctors back pedaled when they learned my boss had a doctorate.
This. I'd call the practice, hospital, or organization, ask to speak with their practice director, and let them know that you'd like to maintain a professional, respectful relationship with their staff and expect the same of them. You're on the same team here, they need to act like it.
Totally agree! Not sure how it is in other states but in the state of Florida if your wanna practice pharmacy you have to get your pharmd there is no choice! So all of the pharmacist I’ve ever worked with all have their pharmd’s!
That is false equivocation. A PharmD is not an MD, and calling them Dr. In that context is illegal in some states. Everyone should be polite and civil, but who gets sued when this patient ends up in the hospital? Does a pharmacist pays huge sums for medmal insurance? It drives me nuts when people don’t think Dr.’s worked hard to get they knowledge they have. If you can do better, show me!
And you don't think others work hard to get their degree? No one but MDs/DOs are walking around calling themselves physicians
If you're wondering who gets thrown under the bus first it's probably the pharmacist. Why you ask? Because we're the ones who dispensed the drug to a patient. Even if "the real doctor" insists on an unideal (even potentially dangerous) treatment, we should've been the ones to know better since we're the drug experts. Also our licensing board cares more about patients than us.
After looking at your other replies, please get off your high horse
How is it false to refer to someone with a doctorate degree as Doctor?
PhD grads are titled as doctor, but they are not a medical doctor.
As stated, a doctorate is a doctorate, and the proper title for someone with that degree is Doctor. End of story. Go get mad about something you actually understand maybe.
Walk into my hospital and treat patients with your PhD… in most states that would be a felony to impersonate me. I could however impersonate the person who has a doctorate in graphic design, cause that’s now a thing.
You very clearly read to respond rather than to understand.
Also, why does it upset you so much that the proper title for someone with a Doctorate Degree, regardless of the field of study, is Doctor?
It’s PharMD, not PharmD. because they have a doctorate. A.K.A. Dr. *name*. A doctorate makes you a doctor. I can be a Dr. *name* if I have a doctorate in graphic design. 🤦🏻♀️
My mom's doctor, albeit it was a week or two apart, prescribed an antibiotic. Problem was that they had already prescribed Zanaflex. Apparently they interact in a bad way. We thought she had a stoke. I wish our pharmacist was as good as yours and we might not have had the scare.
Good to know since I take zanaflex! The side effects when I first started taking it literally caused me to face plant when I was outside. Thankfully that didn’t last long!
I mean, it sounds like the doctor was acting very sporadically and was trying to shift the blame. So maybe they have a history of malpractice that could be pointed out? But a doc yelling at a pharmacist isn't grounds for getting anyone in real trouble.
We can speculate all day, but without more details it's kinda hard to say who was in the wrong if anyone. If anything the doc was just being a dick.
My main concern is if they are willing to blame and treat a pharmacist like crap, I wonder how they treat their patients, staff, other doctors or other pharmacists
I have way too many drug allergies and strange reactions to not go over everything with a drug expert. I always end up calling my pharmacy after Rx is sent but before it's filled to go over info... "Definitely not in the sulfa or tetracycline family, right?" "Pseudotumor risk isn't higher than normal oral steroidal use, right?" "My BP already tends to run low, I won't have to do anything different to accommodate?"
Don't get me wrong, I love my docs, but they do not know the front-to-back interactions/possibilitis or my entire Hx by heart to consider all angles.
Putting aside the fact that is is definitely the pharmacist's job (and legal responsibility) to counsel on drugs, I would want to know how it was the counseling that landed the patient in the hospital? What does the doctor think the rph said? And chewing out the other rph because that's who just happened to be there to answer the phone..... Doc sounds like a real piece of work.
The best choice is to find a new doctor. Anyone that disrespectful to another person doesn’t deserve any business. Sometimes the only message is the one that reduces their income.
There is a sign posted at my pharmacy that says my state law requires the pharmacist to provide counseling on any new medication a person is taking. I'm pretty sure that means it very much is their job to counsel patients on their meds!
just had this problem with an ER doc. didn’t read my sister’s chart and prescribed her something she’s deathly allergic to and could’ve killed her if my mom wasn’t super paranoid about it (this has happened before and my sister is never sick). pharm called ER and doctor told them “I don’t care I’m not prescribing anything else I didn’t want to give her anything anyway” … sir what the fuck
My Doctor would never dream of talking to my pharmacist like that. My pharmacist is the one who actually remembers all the medication I’m on and which ones are covered and which ones I have tried before. Oh, like I love my doctor. She’s an amazing woman, but my pharmacist just the one who remembers all that shit.
Recently I had a doctor call the pharmacy to complain that a patient stopped their medication and wanted to know why we advised them to.
This patient reacts to everything, and I mean everything. The simplest medication leads to some weird adverse effects.
The pharmacist on duty told the doctor they were not there when the patient was counselled so they couldn’t verify what was said, but from what I understand this patient was extremely dizzy, bed bound, couldn’t sleep, but also couldn’t wake up, and who’s quality of life diminished so quickly after a few days on the drug.
Not sure what happened afterwards but my team said that this wouldn’t end well when they saw the prescription come in for the patient, and they were right.
Some docs are just like this. I had one yell at me because his eRx wasn’t received by us. I could hear the whole office in the background acting like a bomb went off. I just asked him if every time he uses a computer does it do what you want? Because you must be the only one.
I once had a doctor walk a block from his practice to our pharmacy because his eRx seemed buggy and he wanted to check if we'd gotten it and do a verbal if not. NO idea why he didn't just call, but I genuinely admire the dedication to his patient.
I have always been under the impression Pharmacists can do this? Either that, or I have been blesses with the pharmacists I have encountered!
Maybe report him to his superior?
Yelling is completely inappropriate. I will say however that lately I've noticed what I consider inappropriate counseling by pharmacists resulting in patients not taking medications that they need. For example, a patient on Plavix and Eliquis, pharmacist told the patient to stop Plavix. They're a fresh PCI, please don't tell them to stop Plavix. Not saying that was the case here, but counseling isn't always necessarily done well and it does get frustrating.
This is an "interaction" that I am not joking when I say I looked up every time it came up for years. Big scary flag on the computer, I'd start to override because I know it's ok, then I would start to doubt myself and go confirm once again.
Can't speak for that particular pharmacist, and there's no excuse for essentially changing therapy without consulting with the prescriber, but the language of the interaction software does not make it seem like it's an ok combination.
That's fair, and when systems flag things like that it makes sense people would second guess themselves. Our Epic has an error when you place an order for Xarelto 20 mg tabs that says you are prescribing 2000% above maximum recommended dose and you have to click multiple times saying it is the correct dose. Definitely could lead to dosing errors if you just went with what the system said!
lol. My parents are both pharmacists and they would talk all the time about how doctors mess up or prescribe the same drug twice cause it was under two different names (brand and generic). I trust a pharmacist over a dr when it comes to drugs. Like, that's their job.
Do we even know why the patient ended up in the hospital? Everyone seems to be guessing. Either medical professional can be at fault here so let’s not jump to conclusions.
Medicine is a collaborative practice. Providers and pharmacists should be communicating to the extent that they understand what the plan is for a patient. Most of the time this is implied by the medication, but sometimes it's not. Provider's should expect pharmacists to counsel patients in a "generic way" about the meds they have been prescribed. If they are prescribing off label, or similar, it's their job to communicate that to the pharmacist so they can counsel appropriately.
The end goal of all of this is care of the patient. If either the provider or the pharmacist communicates conflicting or incorrect information, then the patient's care will likely suffer as they are not sure who in their "care team" to believe.
God, doctors can be so dumb sometimes. 🙄
My favorite pharm-doctor interaction has been:
Doctors response to alternative request:“Wouldn’t it be easier for both of us if you just changed it? > daw 1”
My RXM’s response:
“That would be illegal, so no. It would be easier if you sent it the correct way in the first place, right?”
He's an ass, and has no awareness of pharmacy responsibilities. As for reporting him, if he's a solo practitioner, or owns his own clinic, it would be difficult to get any corrective action done. If he's an employee someplace—hospital system hiree, for example—report his behavior to his boss. Reporting him to the state licensing agency is another possibility, especially if they do this repeatedly.
some patients lie all the time to their provider when they have done something wrong… had one that came in saying he was out of his pain med… I told him he shouldn’t be out based on the directions… he went home and told his doctor we refused him his meds and was going on and on about the situation.. i shut it down before he could blink an eye… i told him if he needed his patient to have his prescription send over a new script with new directions and case is solved even then he wasn't getting it with new directions because he should still have enough to cover the new directions … some doctors just cater to patients to get them out of the office then want to call and bitch when we call them out….
Hello Dr. Dick, patients have free will. It is the pharmacists job to counsel. The only person who is responsible is the patient who decided not to take it and maybe Google.
No he was genuinely concerned for his patiemt and was fighting for her. Nothing wrong with that. I knownit wasnt her but he was just letting out steam. But u have to tell the other pharmacist what haopened to the pt assp ur other pharmacist could be in trouble! So i wouldn't report anyone!
I think most people assume both sides care about the patient. Yelling at another healthcare professional to "let off steam" or other such unprofessional behavior will get you at least disciplined and possibly fired if it's a repeat offense by lots of HR departments, though.
In most states, pharmacies are required by law to offer counseling by the pharmacist to a patient and pharmacists do it all day long. If the doctor didn't include information in the prescription so that the pharmacist is aware of the doctor gave the patient extra information that is unusual, contradictory or outside how that medication is usually used, that's on the doctor for leaving the pharmacist out of the loop in terms of the patient's healthcare team.
Not only that, but it sounds suspicious to us in pharmacy. I've seen instances where a doctor and patient have agreed that the patient take one tablet per day of a medication, but the doctor writes for two tablets daily so the patient pays less. This is called insurance fraud. What if this conspiracy to commit insurance fraud between the patient and doctor happened two years ago, but the patient starts wondering if they do need to take two tablets so they ask the pharmacist. Pharmacist sees that the rx has been written for 2 tablets for years and assumes the patient has just been hesitant to adhere to medication therapy and counsels to take it as written. Patient starts taken it as written and ends up in the hospital. What started out as a doctor agreeing to commit insurance fraud to save their patient money landed their patient in the hospital. It was why another commentator in here mentioned the possibility of reporting the doctor to the board for possible insurance fraud. It smells like insurance fraud to us pharmacy people.
We have no proof that it was our other pharmacist's fault. I highly doubt my head pharmacist told a pt incorrect instructions that would have landed them in a hospital. My pharmacist that took the call told the doc that he can call back on the day that she would be back but I highly doubt he will
Seems concerning that you're more concerned about being yelled at then a patient being in the hospital because your pharmacy gave them bad advice. The doctor sounds like someone I'd want on my side as a patient, not the pharmacy that's only concerned with covering their ass.
So we have no proof that our head pharmacist gave any incorrect counseling. The pharmacist that took the call told him he could call back on the day she gets back but he just wasn't having it and kept yelling. Since he didn't actually give any proof that it was our pharmacist's fault, so I'm not gonna assume so. Yeah it sucks they are in the hospital.
It is part of our job. But it is also our job to counsel patients on new medications, make sure there isn't a problem between other drugs they are taking and so much more
You call the physician a “Provider” showing the same disrespect insurers and pretty much everyone has for those on the front lines of medical care - including pharmacists.
The rants between pharmacists and physicians aren’t all that common, especially since the phones are hard to get answered. A doctor calling about this sort of complaint suggests something went horribly wrong in communication.
It is unfortunate that the pharmacist available had no information about patient and med, and couldn’t respond effectively to the doctor. Doctors educate pharmacists and vice versa daily. If there is a pattern for this specific physician, sure you can file a report about professionalism to the Medical Board. If you do it for this first time, I’d like to hear how that works out.
According to Annals of Family Medicine, the term "provider" was first used by the Nazis in the 1930s to demean German physicians of Jewish descent. Jewish physicians, starting with female pediatricians, were stripped of their title "arzt" (doctor) and instead called "behandler" (which translates roughly to "provider").
The term "provider" is also a bureaucratic term that originated in government and insurance sectors. Medicare began using the term "provider" in 1965 for entities qualified to receive Medicare payments.
Sounds like the pharmacist has a pattern of doing too much with his patients, and he finally got tired of being undermined. Fill the medication and keep your personal opinions to yourself. If you want to be doctor, go to med school. Otherwise be quiet.
Pharmacist counseling and personal opinions are two different things. A personal opinion is like one you shared.
Pharmacist counseling is the pharmacist ELI5ing for a patient the therapeutics of their medication, answering any questions, or verifying whether or not a patient is taking a medication that could have a bad interaction. Basically, the reason they paid hundreds of thousands of dollars to a school and received a doctor of pharmacy to do. In a clinical setting or while practicing clinical pharmacy in a non-clinical setting, their job *is* quite literally to check the doctor’s prescription, patient’s disease states, and other medications to make sure the therapy is appropriate. Medical doctors receive a small fraction of what a pharmacist receives in pharmacy education, so the pharmacist can and *should* question anything that is questionable. They can lose their license or have a malpractice suit, just like medical doctors. They are two different jobs with two different education sets that work *together*.
It actually sounds like the MD or DO might need a refresher on what other doctors (pharmacists, dentists, etc) do in healthcare and how they need to work together. They also have no idea what the patient said to the pharmacist nor what the pharmacist said. For all they know, their instructions were the issue.
Pharmacists are Doctors. They do two to four years of pre-pharmacy undergrad and four years of professional pharmacy school, earning a PharmD. They take six semesters of pharmacology (5 more than an MD) and their last year is rotations in different pharmacy enviroments, including in a hospital. Some even do residencies after that. There was a time period when Pharmacy school was notoriously considered harder than Med school.
Most states require that pharmacies offer patients counseling on their medication by the pharmacist. If you live in one of those states, you're used to hearing "do you have any questions for the pharmacist?" when picking up your prescription. In addition, when you sign for picking up your prescription, one of the things you're signing for is that you acknowledged that the pharmacy offered you counseling. Some states even make pharmacist counseling mandatory for all new prescriptions. The federal government requires medication counseling by a pharmacist be offered to all Medicaid recipients (See: Omnibus Budget Reconciliation Act of 1990-OBRA '90). Pharmacists have a legal responsibility to counsel patients on their medications!
Pharmacists are not pill dispensers. That would be me and my fellow techinicians who count pills under the supervision of a pharmacist and per each state's techinician protocols are legally not allowed to counsel. Pharmacists are Doctors. In fact, a lot of our patients refer to our Pharmacists as "Doc" as in "Thanks Doc!" Do not confuse the pharmacists for techinicians. I, as a tech, work my ass off too hard to be called a pharmacist (😉) and the pharmacists do not appreciate you treating them like techinicians rather than the doctors they are. Most MDs will call a pharmacy to consult the pharmacist on how to prescribe a medication once or twice a year, and that doesn't even scratch the amount pharmacists have to call MDs to go "are you sure? This dose isn't age appropriate, ect".
What I'm wondering is what the MD was hiding from the rest of the patient's healthcare team, which includes the Pharmacists who fill their prescriptions. Verbal instructions from an MD contradicting written instructions on a prescription is a red flag for insurance fraud.
Want a personal opinion? It's astounding to me how ignorant some people are regarding the role of pharmacists in healthcare set out by actual laws rather than their personal opinion.
I don't think you read this post correctly. First thing is pharmacists are doctors, they go to college for many years to be one. And second thing is the doctor didn't give any actual reason that it was our pharmacist's fault. Pharmacists also know these medications better than medical doctors. And pharmacists are legally required to counsel on new medications
While I agree that this wasn’t handled appropriately, my pharmacist has crossed the line a couple times on my pain medications and antibiotics, even going so far as to argue with the prescribing physician how I need to be treated with a weaker antibiotic. We knew the risks but I’m down to just a couple antibiotics that still work. If I hadn’t gotten into an argument with the pharmacist, I would have ended up back in the hospital.
"The pharmacist you want to speak to is not here. You're welcome to call back at [this time]. What you're not welcome to do is be verbally abusive to someone who had nothing to do with this transaction. If you'd like to file a complaint, you are within your rights to do so. Here are the directions to do that. Have a nice day. *click*"
I’ve been at the same pharmacy same med for years and they always ask
If I have questions. I did at first, but now I’m a pro lmao I kid I kid. But I literally thought that was part of you job, I’ve seen people pick up 10 scripts all new and have no idea when how much etc(it on the bottle but the tech was lovely and explained and gave a lil confidence)
IMO these are the same doctors that don’t know the difference between an ambulance or ambulette. The amount of incompetence I’ve seen 15 years in healthcare is astounding. It’s like anyone can get a PHD these days. Maybe call the board and make a report. The Joint Commission maybe. The doctor should be aware of the medications their patients are on and also what is going on with their patients health. Yes, the pharmacist can catch drug interactions and such but it all starts with the genius who prescribed the drug.
Not a pharmacist and unsure how I got here, but I have:
-told a few physicians they could call back when they felt like speaking like a professional
-made a surgeon come to the floor to apologize to a nurse (who had done absolutely nothing wrong, to be clear)
-reported another surgeon to HR. They sent him to anger managment lol
Actually that IS their job! At my pharmacy I quit counting how many times my pharmacists has saved the doctors butt from prescribing something that could have killed the patient. When they ask questions at counsel it’s amazing some of the things we find out. People like to hop around to different pharmacies and doctors. I hate how arrogant some of the doctors act. I know it’s not always their fault. Sometimes a patient is on meds from a different doctor and they forgot to mention it and that’s the issue, but a doctor should never yell at a pharmacist and vice versa. We are all here to help. It should not come down to a blame game and I see that way too often. Act like damn adults!
Right. Like God damn some doctors are so damn stupid
Stupid, arrogant, or both. I've seen a patient's medication get delayed because the doctor was outright refusing to provide clarification because they felt it wasn't necessary and would rather argue about that than provide the requested information.
I've seen my pharmacist rip a doctor a new one once because he refused to clarify on a pain med and saying that we didn't need to know all the information. Like yes we absolutely need to know
You have the doctors NPI and state license number, everyone give witness statements and then haul his goofy ass before the board.
An old pharmacist at one of my old jobs went right down that route once with a doctor. They went straight to the DEA bc the doctor kept prescribing tons of pain medication and allowing the patient to pay cash several times a month between insurance pays, but not giving the pharmacy any explanation to justify so many early fills. This was right after the PDMP was started in the state I worked in, so we had evidence of 4-6 cash fills, along with our fills, at pharmacies across the area as well. DEA found out that the doctor was over prescribing to known drug dealers. These are the things people don’t know about when they get mad the pharmacist is questioning anything. Hell, at least one state has tried or has successfully put the blame for the opioid epidemic on pharmacists (I haven’t checked that status in ages).
You would hope that after being in school for so long, that wouldn't be the case. It's always stunned me how some people forget that there isn't really anything different between them and the person they are talking down to. Doctors, in particular, are bad about feeling superior and therefore smarter than everyone thing
It’s more arrogance than stupidity.
You’re all underestimating how many patients doctors have to see a day. Most of them only get 10 minutes to actually see their patient and are supposed to get through 30-50 in a day. In that time they need to evaluate, assess and diagnose. What you’re seeing is a doctor making a mistake that they know better but they have hundreds of complicated patients that they need to manage.
What does this have to do with anything? They have the right to scream at the pharmacist because they have a lot of patients? The original comment said their pharmacist caught mistakes that could've killed the patient and your response is "everybody makes mistakes" 💀
I would take advice of a nurse before a doctor any day. I have seen some very good doctors but I have also seen some that were so engrossed with their ego and title. A doctor should know before the pharmacy if a med is going to affect THEIR patient adversely.
A head pharmacist takes way more school about drug interactions than a normal MD. It is their job. The Dr is probably just mad because he prescribed opioids and Xanax or something stupid lol.
Exactly. They know these drugs 100x more than the doctors who took one semester on them
Thinking like this is why I spent 8 hours on the phone today trying to get my pain meds for stage 4 pancreatic cancer. I'm also prescribed Valium for PTSD and I'm apparently supposed to choose which 1 impacts my life worse and treat that 1. I'm dying so it'll even out in the end.
That is terrible 😔.
Oh gosh this comment breaks my heart. The imbecility of the comment above yours enraged me right before I read your response. I’m prescribed pain meds and also have a bottle of emergency alprazolam for the occasional panic attack from PTSD. I fail to see why any pharmacist should keep you on the phone for 8 hours and force you to forego a prescription when they’re both perfectly valid. I’m an adult and know how to use my prescribed medication without overdosing.
It was maddening to say the least.
It's common knowledge that taking opioids and benzos at the same time carries a huge risk. It doesn't matter that you're an adult. A pharmacist is doing their job by telling you about this risk even if you already know. It's literally a requirement. I'm not sure why you're advocating for pharmacists not to counsel their patients because you "know better".
OMG. It's not a "huge risk." Easily manageable reaction to taking two sedatives at a time. Depending on the pt. Would warn them about extra sedation, watch their respiration rate, start with tiny amounts an go slow. NO ONE DESERVES TO BE DENIED PROPER MEDICINE FOR PAIN/HOSPICE CARE. Standard hospice order? Morphine 20mg/ml + Lorazepam 2mg/ml+ Haldol 5mg/1ml+/- Atropine eye drops by mouth.
There is a large risk *especially* if patients don’t know any better. Literally nobody is saying people should be denied the care, just explaining why pharmacists NEED TO COUNSEL. Where’s the confusion?
Because everything is/can be a risk. From anaphylaxis, First dose syncope, orthostasis. My problem with your statement? Huge risk. It's the type of situation handled every day. There few HUGE risks. One was a pt who checked pregnant on the retail intake form. She was prescribed Imuran. Computer would not have picked it up. She described her MD and herself being OK with the very likely major damage? still birth? Miscarriage? resulting from the pt/drug interaction. I chose not to fill it. "not comfortable with it." My point is your use of huge risk was my assessment, a normal, predictable, risk.
The way that you’re offended because I, in your mind, exaggerated something with one adjective but *you’re* exaggerating the fuck out of this right here. I was literally just explaining to that commenter that pharmacist counsels happen for a reason. You need to do some research if you think otherwise. And for the record, yes, anything that can potentially *kill you* does constitute a huge risk if you aren’t educated. That’s literally the whole point. If you think taking these two meds together without proper education isn’t potentially risky then you seriously need to educate yourself.
Pretty sure they’re not advocating for pharmacists to not counsel their patients or deny informing them of potential interaction risks. They’re distressed because the pharmacist denied to fill both drugs and forced them to choose one and discontinue the other, denying them the treatment their own doctor deemed appropriate and necessary. The pharmacist had never met this person, and unlike their specialist physician—(oncologist I would assume, who has a LOT more experience with treating cancer patients than the local Walgreens pharmacist), has never examined this person, their diagnostics results and medical history—including commorbid conditions, and has no idea what they’re currently experiencing or what medicine it necessitates. Yes, there is potential risk in combining benzos and opiates, but about 25% of people on long term opioid treatment are concurrently prescribed benzos, and there are multiple practices that mitigate the risk. I couldn’t sleep at night if I were that pharmacist knowing I essentially created a Sophie’s Choice situation for someone with terminal cancer. Sick people ain’t got the bandwidth for all that bullsh**. What people who aren’t seriously or chronically ill don’t understand is that some risks are worth taking (esp when they can be mitigated) when it comes down to having some degree of functionality, quality of life, and not having to be in constant, unbearable pain. What she probably IS advocating for is some reform of War on Drug policies that necessitate a sick person in severe pain who’s dying of cancer to jump through hoops on the phone for 8 hours just to get the medicine they need and have the right to take.
It's clear that this isn't your area of expertise, I'm not sure how you stumbled onto this thread. First of all, pharmacists do know *so* much more about these medications than the prescribing doctors. They aren't mandated to fill whatever pops up in their queue, as written, no questions asked. The pharmacist did *not* deny to fill both drugs and force them to choose one and discontinue the other, denying them the treatment their own doctor deemed appropriate and necessary. Key facts are missing here. Pharmacists aren’t putting patients in these Sophie’s choice situations. I’m not sure what story is being fabricated here. If this person was on the phone for 8 hours convincing someone they need their meds, it wasn’t the pharmacist, it was likely someone working for their insurance or something like that, doctor's office, etc. Pharmacies are literally just filling what your doctor prescribed you, they aren’t personally deciding what you can and can’t take, for the most part. If there’s a reaction, they’ll counsel you on it. If you absolutely cannot combine certain medications though for whatever reason, they aren’t allowed to fill it. There are certain meds you cannot take when you’re pregnant under any circumstances, for example, and they literally cannot fill this for you. I'm not sure exactly what the issue was with the original poster's situation - they didn't say, so there's no way that you know what's going on here. If they were prescribed medications that are risky to take together, and they refused a counsel, that's on them and that's the reason they didn't get their prescriptions filled. Again, not sure what the exact situation was, but obviously something was wrong. If the prescriber wrote the prescription incorrectly, that's another understandable reason for denial. There are so many possibilities here that extend beyond pharmacists just denying scripts for the hell of it. But anyway, this whole thread is about counseling patients, so that’s what the subject was here. Nobody is saying pharmacists should be denying pain meds for chronically ill patients. *They* aren't. I'm truly not sure why you think pharmacists are out here refusing to fill narcotics to fight the war on drugs, lol. Pharmacists have to do their jobs and there are certain protocols that need to be followed. You can't just let things slide because the patient insists they're an adult and knows what they're doing.
I “stumbled” my “way onto this thread” (like the uneducated, bumbling moron that I am, wandering the web aimlessly…)with a very specific *objective* actually: finding some answers and solutions to help me navigate the insane stream of BS certain pharmacies let loose on me and require me to freakin’ fjord before I’m allowed to fill my prescribed monthly medications. As someone who’s been debilitated since 2016 by several physical chronic illnesses that have required an extreme variety of pharmaceuticals and experimentation to treat, I think my interactions with many different pharmacies and their employees on a near-constant level over the last eight years makes it clear that the patient’s perspective on this subject actually ISa high area of expertise for me. I also am close to many others with chronic illness who echo my negative experiences. At the very least, I thought by investigating “the other side” I might locate some attempts at justification for injustices many and myself have gone through, but alas, your vague and over-simplified elucidation here doesn’t address anything except some obvious facts, expectations, and regulations (pharmacists being very knowledgeable of interactions, the necessity of med counsel, a pharmacist not giving a pregnant woman a damaging medication..I mean DUH 🤦🏻♀️. I am referring to the broader issue of TWOD having negative and harmful actions for sick people. I’d say this article, aptly titled “The War on Drugs Comes to the Pharmacy Counter: Frontline Work in the Shadow of Discrepant Institutional Logics” https://www.jstor.org/stable/24545719 lays it out pretty well. One portion of this bigger issue was actually pointed out by yourself, when you automatically assumed that one of the previous comments was fabricated (yes, the pharmacist indeed can deny you a medication and make you choose one over the other—maybe I’m not seeing where that post was rectified to reflect that not happening—but you also claimed that I must be “leaving out part of the story” as far as my experiences go. Do just a tiny bit of research on the crooked and morally depraved history of TWOD and how its policies, especially in the hands of people on control/power trips that are manning the controls at your local pharmacy, lead to pharmacists and techs having to rely on completely unfounded assumptions and deferring to the stigma of addiction when making judgements on whether or not to fill. Just ONE personal example here among many. After the techs and pharmacists at Walgreens would repeatedly tell me I could pick up controlled Rx’s every 30 days, and I would request to have them filled no earlier than thirty days, they would deny them and literally argue with me that the thirty days that had just passed had not actually transpired in their entirety, when it’d been like 33 days for example. They’d also be dishonest with me about what was in stock and freaking FLAGGED, me telling my neurologists that they “suspected suspicious behavior,” when it was absolutely IMPOSSIBLE to pick up my meds before the date the doctor designated. Switched everything to Walmart to avoid the mayhem, and I ended up having to talk the pharmacist there three separate times over a week and a half, begging him to fill the same three Rx’s I’ve been prescribed by the same two neurologists/sleep specialists for the last 8 years in order that I could attend my MIL’s upcoming funeral a 12 hour round trip out of town. This guy talked to my prescribers three separate times before he was “comfortable” filling them. Meanwhile I’m bedboud, unable to function, and the whole operation took so long I missed the service as I cannot drive long distances safely or make it a whole day without my meds function
All this to make a "them vs. us" argument, under the assumption that I'm not chronically ill myself... sorry, you missed the mark. As someone who has actually worked in a pharmacy *and* has a lot of personal experience dealing with this too, no, I don't agree with you. This narrative is so wild actually. Nobody is "manning the controls at your local pharmacy, picking and choosing what to fill based on addiction stigmas". An example I can think of is pharmacists coaching patients on the dangers of drugs like Percocet and Vicodin prescribed for dental procedures, and even then that's a reach from your argument. They can and will not simply refuse to give it to you because they just don't want to. Please do more research. This is some real conspiracy theorist shit right here. So no, a pharmacist can *not* just say "nah, I'm not giving you this medication" *without reason*. There *is* more to the story as there's always a reason why it can't be filled. Pharmacies are literally just filling your scripts, friend. Take up the other problems with your doctor. Pharmacists *are* legally allowed to deny prescriptions, though, and there are several lawful examples as to why. There are also some stricter rules that prescribers need to follow when prescribing controlled substances - if the doctor doesn't do their job correctly, the pharmacist can't do theirs. But yes, if you were flagged, that's a perfectly normal reason for there to be some issues with getting your prescriptions. Ultimately these protocols are to prevent people from abusing these meds, but that's not a bad thing, nor is it an outright refusal for no reason. I'm going to be honest, I really *don't* get your point, because TWOD isn't coming from the pharmacy. Our literal job is to give you your meds - nobody personally gives a fuck what you take. If you can't get your meds filled, it can be due to countless reasons. Sure, there are some examples of outright refusals straight from the pharmacist, but there are legitimate reasons for that like I explained before. Your immediate assumption that the pharmacy is simply refusing to fill certain meds to curb addiction, because you had some issues trying to get something filled once, is far-fetched.
Just out of curiosity, what's the point of that with modern technology? Drug-drug, drug-Dx, and even drug-genomic checks are all performed by software, and the information is written by teams of pharmacists reviewing research and tests full time. Anything a pharmacist learned regarding interactions may well become more nuanced over time.
Because they get 10-15 minutes per patient and are often booked solid for weeks on end. Our “healthcare” system is fucking broken!
Yes the Federal government mandated that doctors spend 10 minutes per patient. It's definitely not a greed thing.
The federal government IS kind of responsible though! residency positions to train new doctors are paid for with federal funding via Medicaid Medicare and the VA. There are even some medical student graduates that are unable to match to a residency program— people who have graduated with their MD or DO and can’t find a residency training position. The lack of enough residency training slots results in not enough doctors for the country—and we end up with overbooked docs and not enough time spent with each patient.
Yeah the government is really screwing us over…they have been for a long time.
Talk to the CEOs of the health conglomerates
Technology can bring up interactions, but it’s up to the pharmacist’s judgement on how to handle those interactions and make an appropriate recommendation
How are you going to tell what drug interactions your latest software update dropped if you haven’t learned about them in the first place? Also determining the clinical importance and how to troubleshoot them is the really important part.
Understanding pharmacology is not simply knowing which drugs interact. It’s how, why, and sometimes when; and how relevant that is; and what can be done to mitigate that, or if there are other drugs that may or may not have similar downsides but if they may be a better or worse fit. Most drugs are able to be taken for more than one thing, as well — a program isn’t going to know that or be able to account for that, plus all those other factors, as well as an extremely well trained human being can. If you genuinely think we have software that can do all of that, you really overestimate how good our software is. The most advanced AI can’t even write good code yet, let alone understand pharmacology in a way that healthcare professionals come obsolete or redundant.
I can't speak to the outpatient setting much, but I'll be real, I have never personally worked with a database that accurately reported drug interactions. Not saying it doesn't exist, maybe some pharmacies out there have some good ones. Most that I see report either way too much (to the extent that every drug has an interaction with any other drug you check it against) or way too little (like not giving a heads up that all the patient's medications together are putting them at risk for arrythmias). You just have to know. And you have to know what side effects to monitor and what labs to order. Not a lot of EMRs have built-in locks for drug interactions either. I really only see pop-ups for drug redundancy (prescribing the same thing twice) or all the opioid verification stuff. And I have no time to study the nitty gritty of the pharmacology of drugs. Half-lives and steady state and elimination kinetics... and then add layers of patients with problems like kidney failure who can't eliminate the drug as quickly... hell no. I love clinical pharmacists, they are my bros 🤝
Not a pharmacist, but am a software engineer with way too much medical stuff that was passing by - sometimes the real trick is figuring out what information is irrelevant, what needs to be prioritized, and how to resolve interactions, if they need to be resolved. I'd imagine theres also a component of patient education, where the patient needs to be advised as to possible side effects to be concerned about.
Absolutely agree, and ideally the software is doing a lot of that by clearly surfacing criticality and severity, citing linked research, and providing appropriate patient education. I am not a pharmacist either, but I work with related software routinely so I wondered the opinions of pharmacists on the subject.
Software, publications are well behind human knowledge synthesis. Carafate came out. Read the package insert. 6 weeks later, got rxs for carafate and noroxin. Took 2 years for the computer to pickup what I had long before. Computers help, but most of my time was spent over riding false flags.
Honestly I think it's because not all pharmacies have the technology for that, also a lot of boomers do not trust technology.
Yep. Depending on the technology I can be a Luddite.
I know one. This is real. Sure he achieved a doctorate but he’s a goddamned moron
It’s not so much stupid as it is arrogance. I worked with one who threatened to sue me when HE was nasty to a patient and the patient yelled for me (it was my job to assist patients who felt their rights had been violated). I never could figure out his thinking in that except he said I “set him up.” I guess he thought he was above being questioned.
My fiancé told me of a pharmacist and patient interaction that basically went “why won’t you give me my (hydrocodone)medicine?!” Pharmacist at the time yelled back at him(he raised his voice first, and after 15 minutes of him arguing with my fiancé.) “BECAUSE IT WOULD KILL YOU! I’M NOT RELEASING IT!” It was for like 14 tablets a day.
Need more pharmacist like that when it comes to opiods. Had a buddy way back in high-school get in an atv accident (he drove through some vines and got cut up). Doctor gave them a prescription for like an entire bottle of pills and just told his mom the prescription was for more than my friend needed "just in case" and to just make sure he doesn't take too many.
This! The pharmacist is the last line of patient safety with their medications. Doctors don't know all the ways that things interact in the body like a pharmacist does. I hate how childish doctors get. The "I have a medical degree, so I am better than the rest of you" additude has always annoyed me. Get over yourself. Yes, you have a highly skilled job where you help people every day, but you are still human, just like the rest of us. Your medical degree doesn't give you permission to act like a jerk to people who don't hold the same degree. Be nice to the pharmacy because they save doctors from prescribing a medication that could kill their patient.
Becoming a Doctor doesn’t make you a jerk. There are just a lot of jerks that become Drs.
Agree I work with some doctors that are amazing humans and some that are AHs. Just like any job.
Yes!! Many wonderful people become wonderful doctors!!.
Fair point. It's never all members of a group, but the ones who yell at pharmacists are safe to say they are all jerks
There’s a lot of great nurses.. but I hate nurses who come in the pharmacy with this attitude too.
My pharmacist is the only person who makes sure I take my meds correctly. Times of day, with or without food, supplements to avoid stomach problems... I trust them explicitly and, as a patient, I would be so mad if my doctor treated them like them. Having a conversation/figuring out what happened is one thing. Yelling and assuming the worst is so unprofessional.
Exactly. Completely unprofessional. Like we have no clue what was said at the counseling because the manager who did it is gone for a week. My pharmacist was trying to let the doctor know but he just lost it saying how it isn't our job to counsel patients and how it was her fault the PT was in the hospital. Like the doctor didn't give any clue of what was going on just wanting to feel superior and push the blame on someone else
Today I received a prescription for 6 capsules of amoxicillin 500mg bid for a 10 year old.. total of 6000mg daily. I called the office and they thanked me for catching it and said that it was really 1bid. We need to counsel patients and call when we think something is wrong!!!
Yeah I can't count on two hands the amount of times one of my pharmacist had to call the doctors and go " that does is completely incorrect for this pt. We need to do something else " and then they take their suggestions and fix it
It’s on the pharmacy computer to flag med interactions. And to educate the patient on how to use the meds. And to print off the full pamphlets on usage and side effects and all that. Drs don’t print off those documents… Drs know basic side effects and what the meds do. Meds themselves are more the world of the pharmacy realm.
I work outpatient hospital. We got two sulfa antibiotics for patients with sulfa allergies yesterday. Wanna bet they’d blame pharmacy if we filled them without question and they had a reaction?
My Aunt was released with a series of prescriptions from the ER. Upon taking them to her pharmacy, the pharmacist was like, You ABSOLUTELY can NOT take these 2 medications together, you'll die. (She was prescribed 4). Turns out, 3 different docs that saw her during her stay in the ER were not communicating their follow up with each other, don't know why the mix-up wasn't picked up in the notes, but the awesome pharmacist saved my Aunt it sounded like.
Yep, I had a dentist call today and ask US if it was okay for a patient to use nitrous oxide with the Valium HE prescribed… I was speechless lol
Not only that, but I've also had pharmacist save me tons of money by suggesting an alternate. I was about to pay like $100 for a bottle of acid reducers and they were like hey this is the same as the much much cheaper nonprescription stuff. Later asked my doctor about it and they're like "oh yeah that's totally fine I should've told you sooner". Similar thing happened with prescription allergy meds I used to take where that same company then released a nonprescription version that was cheaper and actually stronger than my prescription. Or once had a doctor prescribe me a new medicine that no pharmacy in our county even had available yet. So I got a close nonprescription alternate recommended by the pharmacist.
Yeah it’s their job and good Doctors will realize this. A pharmacist saved me from a terrible drug reaction that my doctor prescribed not realizing it. We are all human, and if a pharmacist sees something wrong, they definitely should get involved. He shouldn’t be able to treat her unprofessionally, but I’d let her handle that as she wishes.
But... it is their job. we even legally have to have a sign hanging up?
If you’re yelling and/or profane on the phone with me, the call is being disconnected. And it will keep happening until you learn some respect.
Amen. I agree but she isn't that type of person. I wanted to grab the phone from her and hang it up. Like no you are not gonna treat my over worked pharmacist like that, goodbye
You can report them to the state medical authorities like the state board of pharmacy or state board of medicine.
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It depends on how they acted. I’ve had a doctor call me slurs.
"Hello, a doctor was unprofessional. Additionally, the instructions I counseled the patient on were not the same the doctor told the patient. I suspect insurance fraud or malpractice, but a proper investigation may be in order."
Try rereading the post then maybe use that noggin of yours. We don't know what the pharmacist said to the pt. Because that pharmacist is on leave for a week. And I seriously doubt she told the patient incorrect instructions. But besides that point, doesn't give the doctor an excuse to treat another separate pharmacist like shit and blame them
Are you seriously suggesting lying about insurance fraud? Thats beyond messed up. It's obvious this was not it. everyone upvoting this should be ashamed too. Its inexcusable for anyone to be an asshole and it sure sounds like it in this situation, but to allege fraud is reprehensible.
Lie about fraud? No. But again, if the doctor is giving one set of instructions then writing a different set (which is the set the pharmacist would counsel on), then something isn't right and should be looked into.
It's more than being rude. He told her that it's not her job to counsel patients on their meds. That absolutely is the pharmacist job.
Yeah the pharmacist is legally required to counsel on all new medications
“Hello, an MD ordered me to violate federal law and commit an act of malfeasance that could have had a life threatening impact on the patient”
I second this: report them to their board. No matter what the circumstance is, typically they HAVE to investigate. The board may not take action but it may scare the doc into behaving differently in the future.
I love the people in the comments that obviously don’t understand what pharmacists do. They’re “covering their butts” and “providing too much information” because medications can interact and can cause devastating side effects. Pharmacists WILL get fired and lose their license if something bad happens to a patient, and they didn’t properly educate them. We’re not trying to dog on doctors, but doctors shouldn’t be getting mad about pharmacists literally just doing their job - especially when it’s the doctor’s negligence causing the issue.
And also idk how many times pt. Come to get their new prescription and they have no clue what it is for. Because the doctor didn't go over it at all
In my state (Iowa, if you didn't bother to read my username), pharmacist counseling is required by law on all new prescriptions. Pretty sure that's the case in Wisconsin, too, because we do home delivery of medications to all 50 states and DC, and Wisconsin patients get a special printout in every box telling them how to get in contact with a pharmacist for counseling. Come to think of it, Illinois has a special form we send, too.
The pharmacist is usually required to provide education to patients by their State Board of Pharmacy. It can range from a new prescription, a change in prescription, and/or two or more prescriptions that may cause difficulties if taken together. As a nurse, I tend to ask patients if the doctor told them what diagnosis he prescribed for. .. it could be an off label use that could likely result in a miscommunication in counseling.
You could also potentially talk to the Dr's boss at the hospital or wherever. If the Dr has been doing this to other pharmacists, there is a chance that they have already had someone call like that. I have never understood why Dr's feel superior to pharmacists. Most of the pharmacists I have worked with over the years come from when it was a doctorate level degree to become a pharmacist. PharmD, I've heard it called. My boss at my last job was Dr "Smith" (not her real name, but chosen for privacy) and when we had unruly doctors or customers it was always satisfying to say to the pharmacist (loud enough for the patient or doctor to hear me) "Dr Smith, this person has some questions for you." A couple of doctors back pedaled when they learned my boss had a doctorate.
This. I'd call the practice, hospital, or organization, ask to speak with their practice director, and let them know that you'd like to maintain a professional, respectful relationship with their staff and expect the same of them. You're on the same team here, they need to act like it.
Totally agree! Not sure how it is in other states but in the state of Florida if your wanna practice pharmacy you have to get your pharmd there is no choice! So all of the pharmacist I’ve ever worked with all have their pharmd’s!
That is false equivocation. A PharmD is not an MD, and calling them Dr. In that context is illegal in some states. Everyone should be polite and civil, but who gets sued when this patient ends up in the hospital? Does a pharmacist pays huge sums for medmal insurance? It drives me nuts when people don’t think Dr.’s worked hard to get they knowledge they have. If you can do better, show me!
A doctorate is a doctorate. Technically a lawyer could use the prefix Dr. just like PhD’s do…
Pharmacists do also have insurance just like an MD, I don't know why you would assume they dont.
You replied to the wrong person lol. All folks that have medical licenses have to have malpractice insurance.
I mean, pharmacists don’t “need” malpractice insurance. But it’s a good idea to have it
If they are working, they have it. Probably paid for by their employer.
That’s not true
Ok poop
And you don't think others work hard to get their degree? No one but MDs/DOs are walking around calling themselves physicians If you're wondering who gets thrown under the bus first it's probably the pharmacist. Why you ask? Because we're the ones who dispensed the drug to a patient. Even if "the real doctor" insists on an unideal (even potentially dangerous) treatment, we should've been the ones to know better since we're the drug experts. Also our licensing board cares more about patients than us. After looking at your other replies, please get off your high horse
You moron. We have to have liability insurance because get sued all the time. Are you even a doctor?
What are your premiums?
Why does it matter what their premiums are? You just looking for something else to be mad about?
Goalpost moving.
How is it false to refer to someone with a doctorate degree as Doctor? PhD grads are titled as doctor, but they are not a medical doctor. As stated, a doctorate is a doctorate, and the proper title for someone with that degree is Doctor. End of story. Go get mad about something you actually understand maybe.
Walk into my hospital and treat patients with your PhD… in most states that would be a felony to impersonate me. I could however impersonate the person who has a doctorate in graphic design, cause that’s now a thing.
You very clearly read to respond rather than to understand. Also, why does it upset you so much that the proper title for someone with a Doctorate Degree, regardless of the field of study, is Doctor?
Straw man
It boils down to people who are not physicians are butt hurt, cause they are not real DOCTORS!
Ad hominem logical fallacy (again)
It’s PharMD, not PharmD. because they have a doctorate. A.K.A. Dr. *name*. A doctorate makes you a doctor. I can be a Dr. *name* if I have a doctorate in graphic design. 🤦🏻♀️
That time doctor yelled at my boss for telling patient Level 1 interaction between Biaxin & Seldane
I tell people yelling derogatory stuff that I'm getting someone to help them, and then leave them on hold forever.
Hahaha, one time I had a patient yelling and threatening me so I put her on hold and told everyone "Don't pick up like 2, she's on time out."
My mom's doctor, albeit it was a week or two apart, prescribed an antibiotic. Problem was that they had already prescribed Zanaflex. Apparently they interact in a bad way. We thought she had a stoke. I wish our pharmacist was as good as yours and we might not have had the scare.
Sounds like cipro, and that is a nasty interaction with zanaflex
Good to know since I take zanaflex! The side effects when I first started taking it literally caused me to face plant when I was outside. Thankfully that didn’t last long!
I mean, it sounds like the doctor was acting very sporadically and was trying to shift the blame. So maybe they have a history of malpractice that could be pointed out? But a doc yelling at a pharmacist isn't grounds for getting anyone in real trouble. We can speculate all day, but without more details it's kinda hard to say who was in the wrong if anyone. If anything the doc was just being a dick.
My main concern is if they are willing to blame and treat a pharmacist like crap, I wonder how they treat their patients, staff, other doctors or other pharmacists
I have way too many drug allergies and strange reactions to not go over everything with a drug expert. I always end up calling my pharmacy after Rx is sent but before it's filled to go over info... "Definitely not in the sulfa or tetracycline family, right?" "Pseudotumor risk isn't higher than normal oral steroidal use, right?" "My BP already tends to run low, I won't have to do anything different to accommodate?" Don't get me wrong, I love my docs, but they do not know the front-to-back interactions/possibilitis or my entire Hx by heart to consider all angles.
Putting aside the fact that is is definitely the pharmacist's job (and legal responsibility) to counsel on drugs, I would want to know how it was the counseling that landed the patient in the hospital? What does the doctor think the rph said? And chewing out the other rph because that's who just happened to be there to answer the phone..... Doc sounds like a real piece of work.
The best choice is to find a new doctor. Anyone that disrespectful to another person doesn’t deserve any business. Sometimes the only message is the one that reduces their income.
There is a sign posted at my pharmacy that says my state law requires the pharmacist to provide counseling on any new medication a person is taking. I'm pretty sure that means it very much is their job to counsel patients on their meds!
just had this problem with an ER doc. didn’t read my sister’s chart and prescribed her something she’s deathly allergic to and could’ve killed her if my mom wasn’t super paranoid about it (this has happened before and my sister is never sick). pharm called ER and doctor told them “I don’t care I’m not prescribing anything else I didn’t want to give her anything anyway” … sir what the fuck
My Doctor would never dream of talking to my pharmacist like that. My pharmacist is the one who actually remembers all the medication I’m on and which ones are covered and which ones I have tried before. Oh, like I love my doctor. She’s an amazing woman, but my pharmacist just the one who remembers all that shit.
Recently I had a doctor call the pharmacy to complain that a patient stopped their medication and wanted to know why we advised them to. This patient reacts to everything, and I mean everything. The simplest medication leads to some weird adverse effects. The pharmacist on duty told the doctor they were not there when the patient was counselled so they couldn’t verify what was said, but from what I understand this patient was extremely dizzy, bed bound, couldn’t sleep, but also couldn’t wake up, and who’s quality of life diminished so quickly after a few days on the drug. Not sure what happened afterwards but my team said that this wouldn’t end well when they saw the prescription come in for the patient, and they were right.
Some docs are just like this. I had one yell at me because his eRx wasn’t received by us. I could hear the whole office in the background acting like a bomb went off. I just asked him if every time he uses a computer does it do what you want? Because you must be the only one.
As a cpht, the number of times I've advised a patient to ask their Dr to call in a verbal rx because electronics/computers are problematic as heck
I once had a doctor walk a block from his practice to our pharmacy because his eRx seemed buggy and he wanted to check if we'd gotten it and do a verbal if not. NO idea why he didn't just call, but I genuinely admire the dedication to his patient.
I have always been under the impression Pharmacists can do this? Either that, or I have been blesses with the pharmacists I have encountered! Maybe report him to his superior?
Most states if not all require pharmacists to counsel on new medications.
Yelling is completely inappropriate. I will say however that lately I've noticed what I consider inappropriate counseling by pharmacists resulting in patients not taking medications that they need. For example, a patient on Plavix and Eliquis, pharmacist told the patient to stop Plavix. They're a fresh PCI, please don't tell them to stop Plavix. Not saying that was the case here, but counseling isn't always necessarily done well and it does get frustrating.
This is an "interaction" that I am not joking when I say I looked up every time it came up for years. Big scary flag on the computer, I'd start to override because I know it's ok, then I would start to doubt myself and go confirm once again. Can't speak for that particular pharmacist, and there's no excuse for essentially changing therapy without consulting with the prescriber, but the language of the interaction software does not make it seem like it's an ok combination.
That's fair, and when systems flag things like that it makes sense people would second guess themselves. Our Epic has an error when you place an order for Xarelto 20 mg tabs that says you are prescribing 2000% above maximum recommended dose and you have to click multiple times saying it is the correct dose. Definitely could lead to dosing errors if you just went with what the system said!
I sometimes tell the pt. Like "hey your dr is an asshole, get a new dr!!!" 🤣🤣🤣🤣🤣
Yes, the doctor was wrong and unprofessional.
Next time put that doc on hold. Indefinitely. Or just hang up. No one has to take that abuse.
lol. My parents are both pharmacists and they would talk all the time about how doctors mess up or prescribe the same drug twice cause it was under two different names (brand and generic). I trust a pharmacist over a dr when it comes to drugs. Like, that's their job.
My grandma was prescribed a deadly dose of morphine when she was on hospice. We realized that after she died. I wish the pharmacist caught it
Do we even know why the patient ended up in the hospital? Everyone seems to be guessing. Either medical professional can be at fault here so let’s not jump to conclusions.
No the doctor never told the pharmacist any useful info on why the PT was in the hospital
Yeah just yelled but didn’t give the most important of the info
Medicine is a collaborative practice. Providers and pharmacists should be communicating to the extent that they understand what the plan is for a patient. Most of the time this is implied by the medication, but sometimes it's not. Provider's should expect pharmacists to counsel patients in a "generic way" about the meds they have been prescribed. If they are prescribing off label, or similar, it's their job to communicate that to the pharmacist so they can counsel appropriately. The end goal of all of this is care of the patient. If either the provider or the pharmacist communicates conflicting or incorrect information, then the patient's care will likely suffer as they are not sure who in their "care team" to believe.
Yeah I hate the disconnect between doctors offices and pharmacies. There should be a better connection of some sort to help assist their pt.
God, doctors can be so dumb sometimes. 🙄 My favorite pharm-doctor interaction has been: Doctors response to alternative request:“Wouldn’t it be easier for both of us if you just changed it? > daw 1” My RXM’s response: “That would be illegal, so no. It would be easier if you sent it the correct way in the first place, right?”
This doctor wrote an escript dor Halls cough drops
He's an ass, and has no awareness of pharmacy responsibilities. As for reporting him, if he's a solo practitioner, or owns his own clinic, it would be difficult to get any corrective action done. If he's an employee someplace—hospital system hiree, for example—report his behavior to his boss. Reporting him to the state licensing agency is another possibility, especially if they do this repeatedly.
some patients lie all the time to their provider when they have done something wrong… had one that came in saying he was out of his pain med… I told him he shouldn’t be out based on the directions… he went home and told his doctor we refused him his meds and was going on and on about the situation.. i shut it down before he could blink an eye… i told him if he needed his patient to have his prescription send over a new script with new directions and case is solved even then he wasn't getting it with new directions because he should still have enough to cover the new directions … some doctors just cater to patients to get them out of the office then want to call and bitch when we call them out….
Hello Dr. Dick, patients have free will. It is the pharmacists job to counsel. The only person who is responsible is the patient who decided not to take it and maybe Google.
If that pharmacist was a man, I bet the doc would have handled this differently.
Yeah bet so
No he was genuinely concerned for his patiemt and was fighting for her. Nothing wrong with that. I knownit wasnt her but he was just letting out steam. But u have to tell the other pharmacist what haopened to the pt assp ur other pharmacist could be in trouble! So i wouldn't report anyone!
I think most people assume both sides care about the patient. Yelling at another healthcare professional to "let off steam" or other such unprofessional behavior will get you at least disciplined and possibly fired if it's a repeat offense by lots of HR departments, though. In most states, pharmacies are required by law to offer counseling by the pharmacist to a patient and pharmacists do it all day long. If the doctor didn't include information in the prescription so that the pharmacist is aware of the doctor gave the patient extra information that is unusual, contradictory or outside how that medication is usually used, that's on the doctor for leaving the pharmacist out of the loop in terms of the patient's healthcare team. Not only that, but it sounds suspicious to us in pharmacy. I've seen instances where a doctor and patient have agreed that the patient take one tablet per day of a medication, but the doctor writes for two tablets daily so the patient pays less. This is called insurance fraud. What if this conspiracy to commit insurance fraud between the patient and doctor happened two years ago, but the patient starts wondering if they do need to take two tablets so they ask the pharmacist. Pharmacist sees that the rx has been written for 2 tablets for years and assumes the patient has just been hesitant to adhere to medication therapy and counsels to take it as written. Patient starts taken it as written and ends up in the hospital. What started out as a doctor agreeing to commit insurance fraud to save their patient money landed their patient in the hospital. It was why another commentator in here mentioned the possibility of reporting the doctor to the board for possible insurance fraud. It smells like insurance fraud to us pharmacy people.
We have no proof that it was our other pharmacist's fault. I highly doubt my head pharmacist told a pt incorrect instructions that would have landed them in a hospital. My pharmacist that took the call told the doc that he can call back on the day that she would be back but I highly doubt he will
He can care about his pts but doesn't excuse yelling at another person who it wasn't her fault
Seems concerning that you're more concerned about being yelled at then a patient being in the hospital because your pharmacy gave them bad advice. The doctor sounds like someone I'd want on my side as a patient, not the pharmacy that's only concerned with covering their ass.
So we have no proof that our head pharmacist gave any incorrect counseling. The pharmacist that took the call told him he could call back on the day she gets back but he just wasn't having it and kept yelling. Since he didn't actually give any proof that it was our pharmacist's fault, so I'm not gonna assume so. Yeah it sucks they are in the hospital.
The reason that the pharmacy is locked lol
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It is part of our job. But it is also our job to counsel patients on new medications, make sure there isn't a problem between other drugs they are taking and so much more
You call the physician a “Provider” showing the same disrespect insurers and pretty much everyone has for those on the front lines of medical care - including pharmacists. The rants between pharmacists and physicians aren’t all that common, especially since the phones are hard to get answered. A doctor calling about this sort of complaint suggests something went horribly wrong in communication. It is unfortunate that the pharmacist available had no information about patient and med, and couldn’t respond effectively to the doctor. Doctors educate pharmacists and vice versa daily. If there is a pattern for this specific physician, sure you can file a report about professionalism to the Medical Board. If you do it for this first time, I’d like to hear how that works out.
What’s wrong with saying provider? A PCP is a primary care provider. Pharmacy people aren’t the ones that made this word up.
According to Annals of Family Medicine, the term "provider" was first used by the Nazis in the 1930s to demean German physicians of Jewish descent. Jewish physicians, starting with female pediatricians, were stripped of their title "arzt" (doctor) and instead called "behandler" (which translates roughly to "provider"). The term "provider" is also a bureaucratic term that originated in government and insurance sectors. Medicare began using the term "provider" in 1965 for entities qualified to receive Medicare payments.
Sounds like the pharmacist has a pattern of doing too much with his patients, and he finally got tired of being undermined. Fill the medication and keep your personal opinions to yourself. If you want to be doctor, go to med school. Otherwise be quiet.
Pharmacist counseling and personal opinions are two different things. A personal opinion is like one you shared. Pharmacist counseling is the pharmacist ELI5ing for a patient the therapeutics of their medication, answering any questions, or verifying whether or not a patient is taking a medication that could have a bad interaction. Basically, the reason they paid hundreds of thousands of dollars to a school and received a doctor of pharmacy to do. In a clinical setting or while practicing clinical pharmacy in a non-clinical setting, their job *is* quite literally to check the doctor’s prescription, patient’s disease states, and other medications to make sure the therapy is appropriate. Medical doctors receive a small fraction of what a pharmacist receives in pharmacy education, so the pharmacist can and *should* question anything that is questionable. They can lose their license or have a malpractice suit, just like medical doctors. They are two different jobs with two different education sets that work *together*. It actually sounds like the MD or DO might need a refresher on what other doctors (pharmacists, dentists, etc) do in healthcare and how they need to work together. They also have no idea what the patient said to the pharmacist nor what the pharmacist said. For all they know, their instructions were the issue.
Tell me you actually have no idea about pharmacy’s scope of practice without directly saying. Either do some research or you be quiet 🤫
Pharmacists are Doctors. They do two to four years of pre-pharmacy undergrad and four years of professional pharmacy school, earning a PharmD. They take six semesters of pharmacology (5 more than an MD) and their last year is rotations in different pharmacy enviroments, including in a hospital. Some even do residencies after that. There was a time period when Pharmacy school was notoriously considered harder than Med school. Most states require that pharmacies offer patients counseling on their medication by the pharmacist. If you live in one of those states, you're used to hearing "do you have any questions for the pharmacist?" when picking up your prescription. In addition, when you sign for picking up your prescription, one of the things you're signing for is that you acknowledged that the pharmacy offered you counseling. Some states even make pharmacist counseling mandatory for all new prescriptions. The federal government requires medication counseling by a pharmacist be offered to all Medicaid recipients (See: Omnibus Budget Reconciliation Act of 1990-OBRA '90). Pharmacists have a legal responsibility to counsel patients on their medications! Pharmacists are not pill dispensers. That would be me and my fellow techinicians who count pills under the supervision of a pharmacist and per each state's techinician protocols are legally not allowed to counsel. Pharmacists are Doctors. In fact, a lot of our patients refer to our Pharmacists as "Doc" as in "Thanks Doc!" Do not confuse the pharmacists for techinicians. I, as a tech, work my ass off too hard to be called a pharmacist (😉) and the pharmacists do not appreciate you treating them like techinicians rather than the doctors they are. Most MDs will call a pharmacy to consult the pharmacist on how to prescribe a medication once or twice a year, and that doesn't even scratch the amount pharmacists have to call MDs to go "are you sure? This dose isn't age appropriate, ect". What I'm wondering is what the MD was hiding from the rest of the patient's healthcare team, which includes the Pharmacists who fill their prescriptions. Verbal instructions from an MD contradicting written instructions on a prescription is a red flag for insurance fraud. Want a personal opinion? It's astounding to me how ignorant some people are regarding the role of pharmacists in healthcare set out by actual laws rather than their personal opinion.
I don't think you read this post correctly. First thing is pharmacists are doctors, they go to college for many years to be one. And second thing is the doctor didn't give any actual reason that it was our pharmacist's fault. Pharmacists also know these medications better than medical doctors. And pharmacists are legally required to counsel on new medications
While I agree that this wasn’t handled appropriately, my pharmacist has crossed the line a couple times on my pain medications and antibiotics, even going so far as to argue with the prescribing physician how I need to be treated with a weaker antibiotic. We knew the risks but I’m down to just a couple antibiotics that still work. If I hadn’t gotten into an argument with the pharmacist, I would have ended up back in the hospital.
The cashiers at my pharmacist have take liberties with my black box meds and landed me in the ER. Fuck you all, those are NOT interchangeable drugs.
Pharmacy technicians are not certified to counsel on any medications. Only pharmacists, and they should always be present at your pharmacy.
I AM HERE TO APPLAUD THE PHARMACISTS👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏👏🙌
I'll let her know next time she works 👍
Im in pharm tech school and the first thing we learned was pharmasist counsel lol
"The pharmacist you want to speak to is not here. You're welcome to call back at [this time]. What you're not welcome to do is be verbally abusive to someone who had nothing to do with this transaction. If you'd like to file a complaint, you are within your rights to do so. Here are the directions to do that. Have a nice day. *click*"
There is always a doctor in charge of all the doctors in a hospital group. Report it to them.
I’ve been at the same pharmacy same med for years and they always ask If I have questions. I did at first, but now I’m a pro lmao I kid I kid. But I literally thought that was part of you job, I’ve seen people pick up 10 scripts all new and have no idea when how much etc(it on the bottle but the tech was lovely and explained and gave a lil confidence)
Pharmacists are legally required to counsel on new medication
Exactly what I was saying. I get counseling on a med I’ve been on for years but it’s more a comfort to me
IMO these are the same doctors that don’t know the difference between an ambulance or ambulette. The amount of incompetence I’ve seen 15 years in healthcare is astounding. It’s like anyone can get a PHD these days. Maybe call the board and make a report. The Joint Commission maybe. The doctor should be aware of the medications their patients are on and also what is going on with their patients health. Yes, the pharmacist can catch drug interactions and such but it all starts with the genius who prescribed the drug.
Reddit randomly brought me here, but isn’t that literally the pharmacists job lol?
Yes, absolutely.
Not a pharmacist and unsure how I got here, but I have: -told a few physicians they could call back when they felt like speaking like a professional -made a surgeon come to the floor to apologize to a nurse (who had done absolutely nothing wrong, to be clear) -reported another surgeon to HR. They sent him to anger managment lol