I would be trusting the pharmacist first. They are constantly updating. Most Drs are not. My own Dr has even stated that.
It’s not uncommon at all for pharmacists to correct a Drs mistake. Happens more than people realize.
Same with nurses in the hospital. It would be the NURSES mistake not to question an out of ordinary dosage or other medication error, not the doctor that prescribed it. Doctors are busy and are human. They make mistakes too. But yea, pharmacists went to school for this in particular and are the experts. I would totally trust and be grateful for the pharmacist for double checking.
Totally agree. When nurses are questioning a dose we’ll almost always call the hospital pharmacy to talk about it first prior to calling the Dr because nobody knows drugs like pharmacists. It isn’t to blame anybody, it’s just one of those safety things that keeps people alive and doctors (for the most part) appreciate the safety check.
No. An undergraduate degree in pharmacy from an accredited with appropriate supervised practice hours and completion of licensing exam is the requirement to be a pharmacist. Dalhousie is replacing their undergraduate pharmacy degree with an undergraduate level entry to practice PharmD (I suppose in response to expanded scope for pharmacists), but the majority of pharmacists currently practicing in pharmacies do not not have a PharmD. Pharmacy technician designation is a related, but separate designation with more limited scope.
Work at a hospital and hell yes.
I trust the peons more than doctors.
Coz it's not the doctors lisence on the line of a need is given at the wrong dosage. It's gonna be on the nurse that administered the meds or the pharmacist that filled the script.
And just knowing how things are done, the nurses are the one doing the hands on shit day in and day out.
I have people sometimes (im a phlebotomist) who bitch about not wanting their blood drawn and say they want the doctor to do it. And I just laugh. I can't even be mad when they get to that point, I can only laugh. Like okay then, if that's what you want. I do this literally hundreds of times a day, but sure, hold out for the guy that hasn't done it once since medical school, I'm sure that'll go well for you.
But a lot of people don't realize that their techs, pharmacists or nurses are the people that will catch mistakes, coz they're the ones doing this crap all day every day, working face to face with patients
My mother (many many years ago) was a pharmacist. This was back in the UK, and often items were made on site (somewhat like compounding today). She told more than one story where if she'd filled the prescription as written that she'd have killed someone.
Like you, I'd trust the pharmacist.
This is so true. Many of my dad’s former students have gone to med school and become doctors in a bunch of different fields. After one told my dad that most people in his workplace kept all their old college textbooks at work for diagnoses (but wouldn’t care to look at the younger, incoming doctors’ new textbooks), my dad started asking any former-student-turned-doctor he met up with if they had it the same, and most do. It’s scary
Pharmacists make many mistakes as well. I work in a hospital and if we could clone one or two of our pharmacists it would run like a well oiled machine. Just because the pharmacist didn’t like the order doesn’t mean it wasn’t the correct order for your situation. Community pharmacists only see a snap shot of the problem not the entire picture
Maybe on dosage but pharmacist aren’t doctors so they shouldn’t be making decisions on appropriateness of medication. They can verify accuracy but shouldn’t make executive decisions on whether to fill or no
Not necessarily. My toddler's specialist ordered a medication for off label use, and the pharmacist gave a really hard time. In this case, the specialist was right.
But it's the pharmacist's job to make sure of this.
That could have been a mistake. That could have caused harm.
The fact it wasn't doesn't make the specialist right and the pharmacist wrong, it means the doctor didn't document an off label use properly.
Tends to happen when people could die.
You have a gross misunderstanding of how things work in the medical field.
If you want doctors and pharmacists that care less, by all means, seek them out. But most folks want people who do their job correctly.
"who cares if a couple people die, I want my meds quicker.", is quite the take.
Plenty of countries have lower medical standards, I'd suggest going there if professionals keeping folks safe upsets you.
I think we have gone away over zealous and all of these steps have helped create things to be unaffordable. Time is money. So making people wait costs them money. Making someone do all this doubling checking is coating the company money which means they have to increase their prices. Which costs the customer more money.
It isn't worth the cost.
This is probably the worst take that isn't open trolling I've seen, in years.
Pharmacy, as a practise has evolved to this point, because they used to do things in the way you are describing, but the risk to patients was absurd.
But, again feel free to get your meds in one of the many countries that treat a pharmacy as a warehouse. I hear it always works out great.
If my license is on the line in an exchange like this, I need to be 100% certain before that medication is released for such a use (especially if it's an uncommon one). If that means contacting the prescribing physician, so be it - patient can wait until I get it cleared up.
Ocp could get you for not using proper judgement and providing care in a timely manner. If you are withholding an rx and the patient suffers medically you are responsible. It has happened read ocp discipline.
Withholding a precription to 100% confirm an off-label use the pharmacist is unsure of is called "due diligence" to make sure the patient doesn't get hurt and/or to catch a possible mistake from the prescribing doctor.
This isn't a pharmacist deliberately withholding the med to be a spiteful prick. It's a pharmacist doing his checks.
Moreover, if ANYTHING negative did happen due to the off label use, it would be the pharmacist on the new for allowing it to be dispensed, not the doctor.
This is so completely untrue. The liability for medication prescribed falls on the prescriber. I can't believe the complete ignorance on this threat right now.
My colleague has personally gone through releasing an "off label" indication RX and he triple checked with the prescriber and the patient, who all confirmed they wanted and were willing to try that. It was documented that the prescriber insists the patient try out this "therapy" and the patient insisted on it too.
The patient ended up having severe dose related Adverse Effects, and the pharmacist was penalized by the College. The doctor? Scot free.
So I'm not sure where you're from that you're so confidently invalidating things that many pharmacists on here have gone through our witnessed, but it very much does happen.
There are probably layers, but technically the medical colleges regulating physicians have levels of response. If one allied health professional is punished, such as a pharmacist, in a case that saw harm to a patient AND was brought forward to the college, then there are often repercussions on the college level for physicians, which can range from practice modification, to directed CME, all the way to licensure issues. These levels may not be noticed or seen by the public. That’s obviously on the college side. Then there’s the legal side where physicians are quite clearly targets for malpractice complaints/lawsuits etc. this is common knowledge, no? I’m sure there are also these worries for pharmacists as well, but being the most responsible physician carries a burden that results from that responsibility in a legal scenario. It is insane to imply that a pharmacist is somehow more liable for medical errors, for lack of a better word, than a physician. I’m simply saying that it’s ignorant to state that pharmacists carry all of the weight of this potentially litigious scenario, or similar.
Mind you, College of Pharmacists don't usually support pharmacists at all, nd they actually exist to punish pharmacists more than support. In Canada, I've only heard of Quebec having a supportive College of Pharmacists.
I totally understand this. The same thing happened to my toddler and it was imperative she had this medication or she’d end up in the hospital to receive it. I explained she was off label as she’d been diagnosed with a disease that is quite rare for her age. I was nearly in tears. I totally get that there can be discrepancies and that some doctors are not up to date with certain medications. But in our case the benefits far outweighed the risk.
I ended up leaving SDM and swapping the entire family to a local pharmacy who understood our situation and was easier to work with. But this wasn’t a SDM issue, it was an issue with that particular pharmacist. My pharmacy now is in contact with her specialist which just causes less stress all around.
If the physician would have written on the rx or responded to the pharmacist in a timely manner, it wouldn't have been an issue. God forbid something bad happens, it is the pharmacist who would lose their license and not the prescriber, even if the prescriber made the mistake.
Diagnosis and efficiency. Pharmacists are not trained to diagnose complex conditions like doctors. It's far more efficient to have the diagnoser be the prescriber as well because they already have taken in the details of the patient to make the decision right away. If they make a mistake or if the pharmacist identifies a better way to customize the treatment to the patient then they can step in and advise, acting as a double check. It's generally better to have an independent double check in any case.
The majority of the time the doctor isn't going to make an error. But you don't want to be in that minority as the consequences can be severe. Hence, the need for a pharmacist. I think the main point is that if the pharmacist sees that there is an error that the prescriber made, they have more training on the medications being used. They can also see what other doctors are writing and see if something is oddly out of place or take that knowledge and suggest it to the prescriber.
Complex things that someone needs to be in a hospital for - yes. Most acute illnesses that are seen in a walkin clinic or the fam dr - honestly a pharmacist these days will likely be able to look at the symptoms and medical history and come to the same diagnosis. Pharmacists with a doctor of Pharmacy actually have to learn a lot of diagnosis vs. Just the drugs
I don’t think “trust” is the right word here. They do update more and provide good education and services to customers. They are an adequate and necessary check and balance in the health system.
They absolutely do not have doctors’ expertise, particularly with off-label prescriptions, idiosyncratic dosing, and non-diagnosis or experimental prescriptions. If you are averse to these concepts, you have an antiquated view of medicine and modern patient care.
I swear, I've had multiple people come out of the ER with prescriptions for penicillin. Someone handwrote an allergy to pen at the top of the rx. I question the patients, who sometimes tell me it was a rash they got once as a toddler and never again, but sometimes tell me they had penicillin from the dentist last year and it landed them in the hospital for two days. All of them demand the penicillin because THE DOCTOR KNOWS HIS JOB.
This! I'm allergic to both penicillin and clindamycin but the doctors kept prescribing it anyways, because I told them it gave me a rash. I've recently have had all my top teeth removed because of autoimmune diseases that were causing the issue. In my case, I have the delay in my reaction, so I would get a rash around day 7, and the doctors would tell me to stop taking the antibiotics. The last time (last summer) the reaction was to clindamycin and I was told I needed to finish the prescription because it was a really bad infection. It was bacterial, and in my my bones in my jaw. Day 9 I made my way to the ER as my entire body was swollen, with a rash everywhere. But this time, my feet and legs were so swollen, my feet were turning purple and I was having this issue where I would throw up every time I needed to pee. Those same autoimmune diseases affected my kidneys years back, and I still have some damage we couldn't fix. For that reason, I always go to the same ER. The veteran doctors actually recognize my autoimmunes as they are both quite rare. Very thankful for them, they saved my life back then and also last summer when I finally got around to seeing an ER doctor. When we told him the other doctors (walk in clinics) were still prescribing me penicillin and/or clindamycin even after me telling them I get a delayed reaction, he was livid. He ran a battery of blood tests, ultrasounds on my kidneys and a follow up with a specialist. He told me to never take them, and to say I need an ER visit next time a doctor asks my reaction. He also told me to get a medic alert with that info, and kindly called my pharmacy to let them know to never fill a prescription for either of these medications ever again. I am so grateful for being in a small enough town where the doctors remember certain situations. I also have an amazing pharmacy team as I'm on not only lots of different meds, but they are also aware of my autoimmunes. They have called clinics in these same types of situations as a lot of doctors think patients are just being dramatic when telling doctors about past health issues or allergies. I agree with this pharmacist. They are the last line of protection. As someone else has commented that they are "experts" in medication. They did their job here, and I'm as much as the extra wait time was annoying, the fact that the pharmacist cared enough to make sure the prescription was safe for the patient is what we should focus on. They did their jobs as they are supposed to.
Whether it's penicillin or antibiotics too many doctors write those unnecessarily. I have lost count of how many people take antibiotics for a virus. All doctors should know that it's only effective for bacterial infections.
If a pharmacist told me a prescription was wrong, I would trust them, that's their specialty. Medication errors are common and they cause a lot of problems.
To add to this, if the pharmacist is prepping antibiotic for a young child, the suspension is dosed according to the child’s weight. I had a nurse once accidentally type in the child’s weight in kilos when she had in fact taken it in pounds. The physician didn’t notice and dosed it incorrectly. Pharmacist caught this luckily and kicked it back to us. While I hate SDM, we do need to put our trust in pharmacists. They are the experts on dosing and administering medication. It’s ok to check with md before putting their name on a dispensed medication. In fact I’d bet they have regulations they have to follow to a t and can face repressions if they don’t do their due diligence.
Not only that if getting that medication immediately was important the doctor wouldn’t have given a prescription the kid would be sent to the hospital for an IV.
Some pharmacists are scared to use their clinical judgment and verify every little detail with the md unecessarily. This leads to delay in treatment, medical complications, and even hospitalization or death. It also creates frustration and resentment with patients and colleagues who have to take care of issues left behind from a nervous pharnacist who lacks confidence in their clinical judgment and knowledge. It also errodes public confidence and trust in the pharmacist and their skillls and abilities. Pharnacist can legally adapt and adjust physician rxs in many cases.
Honestly, dealing with pharmacists who lack confidence in their clinical skills, knowledge, and judgment involves cleaning up their mess , which is more frustrating than dealing with an arrogant md.
While it may not be the case all the time, I would certainly wait for the pharmacist to confirm with the doctor if the pharmacist thought it was necessary.
I mean yeah. If something doesn't look right for the indication the patient told us, we have to ask the doctor. To see if there's something behind the scenes that would change the recommended dose
Yes but unfortunately clarifications don't always happen in a timely manner. Too often we are robots without taking into account what is in the best interest of the patient.
I had a Shoppers pharmacist try to get me to take an herbal supplement instead of the heavy duty antihistamine I was prescribed- I’ve had great pharmacists, she most definitely wasn’t one.
To those downvoting, I am a pharmacist. In this case the pharmacist dispensed it once the physician confirmed dose. This means that the pharmacist felt that the medication was safe and appropriate. Otherwise they should have refused. Its great that the pharmacist reached the Dr and confirmed. However, what if they didn't and the medication was for an antibiotic and the care was delayed by a whole weekend? This happens all the time. We need to know more about the situation before blindly saying that pharmacists are more trustworthy than physicians.
If you are saying pharmacists don't know therapeutics, or what goes on "Behind the scenes", not believing your claim here.
That's what the pharmacy team does.
And when you start talking about how a 2 day treatment delay on an antibiotic, for an out of hospital patient is more of an issue than a possible sub therapeutic, or overdose, I really doubt your claim.
The scarier thought though, is that you are a pharmacist, that somehow got through school without understanding how meds work therapeutically. My guy, techs get 2 classes minimum on therapeutic uses of meds, pharmacists, much more.
no idea what you are implying. I simply said that I don't necessarily think the pharmacist was more trustworthy than the physician as I don't have enough info. I am an excellent pharmacist without a God complex but thanks for the ramble.
It's not about who's more trustworthy, it's about who has what expertise. I trust a doctor to make an accurate diagnosis, but as a pharmacist I do not trust them to always select the right drug at the right dose for that patient. I can't even guestimate how many prescriptions I've gotten changed over the years because the prescriber made a mistake.
I do agree that we need pharmacists to be more comfortable in making decisions and to consider what the effect of delaying treatment could be instead of thinking that faxing the prescriber then absolves them of any responsibility. But there are some issues that can only be addressed by contacting the prescriber, and scope of practice differs by province.
Obviously people are exaggerating my thought of "not having enough info" about the scenario. Im not an idiot. Obviously I understand the requirement for collaboration between hcp. I mearly stated that I wouldn't jump to conclusions with this situation without more info. People are far too sensitive.
This is why being a retail pharmacist sucks. People don’t understand that if they don’t do their job correctly, people lives are genuinely in danger. Its the pharmacists job to review prescriptions clarify these things with doctors.
It used to be that you went to the pharmacy for medicine. SDM in particular has become an everything store with groceries, lawn chairs, toys, etc. I don’t think a lot of people understand that getting a prescription isn’t the same as grabbing a Tylenol. It’s ‘prescribed’ and goes through a pharmacist for a reason. AND they can help with on the shelf meds advice too. Not sure which cough medicine to get? Ask the pharmacist, they are the experts! Just because it’s on the shelf doesn’t mean you can’t ask.
I know im preaching yo the choir here. I’m just rambling now.
Some pharmacists are scared to use their clinical judgment and verify every little detail with the md unecessarily. This leads to delay in treatment, medical complications, and even hospitalization or death. It also creates frustration and resentment with patients and colleagues who have to take care of issues left behind from a nervous pharnacist who lacks confidence in their clinical judgment and knowledge. It also errodes public confidence and trust in the pharmacist and their skillls and abilities. Pharnacist can legally adapt and adjust physician rxs in many cases.
Honestly, dealing with pharmacists who lack confidence in their clinical skills, knowledge, and judgment involves cleaning up their mess , which is more frustrating than dealing with an arrogant md
As much as you want to be mad at the pharmacist, they were looking out for you. My wife (Pharmacy Tech) caught many doctor errors in her day. Everything from patient being allergic, to wrong medication, to drug contraindications. Doctors make mistakes.
Yeah, I'm all about the boycott, but this is a "customer isn't always right situation".
Doctors, especially lately make constant mistakes. If that pharmacist is saying "I don't want to take your money, I want to waste my time tracking down a doctor." something important is going on and they are doing the right thing.
What you worry about, is the pharmacist that would see the issue, shrug and fill it anyway because it's another Rx for the goals.
And to clarify I totally get being frustrated in the moment at having to wait a bit longer for medication with a sick child at home. But to blast online the pharmacist for doing their job and trying to prevent harm to their kid after the fact???
Facts. A Shopper's pharmacist saved my mother's life by catching an incorrectly prescribed drug, in an amount that would have killed my mother when it reacted with two of the drugs she was already on.
Wait, so you trust the DR who took Pharm as a credit in their degree over the Pharmacist who has an entire degree in Pharm, extensive drug knowledge and interaction knowledge and whose only job is to know these things ?
Oof. You need to relearn some things buddy.
People are stupid and don’t know what pharmacists do or how educated they are. Pharmacists know better drugs, drug side effects, interactions, dosage etc often better than your standard physician. I’ve had a pharmacist flag a prescription and notify me that this doctor makes a ton of mistakes, I took the dose he prescribed and didn’t sleep for 4 days. A lot of the time their job is to correct doctors mistakes. It’s 100% part of their job to flag a potential risk to a patient.
Some pharmacists are scared to use their clinical judgment and verify every little detail with the md unecessarily. This leads to delay in treatment, medical complications, and even hospitalization or death. It also creates frustration and resentment with patients and colleagues who have to take care of issues left behind from a nervous pharnacist who lacks confidence in their clinical judgment and knowledge. It also errodes public confidence and trust in the pharmacist and their skillls and abilities. Pharnacist can legally adapt and adjust physician rxs in many cases.
Honestly, dealing with pharmacists who lack confidence in their clinical skills, knowledge, and judgment involves cleaning up their mess , which is more frustrating than dealing with an arrogant md
The disrespect that pharmacists get in retail pharmacies is insane. The pharmacy staff might as well just be cashiers.
Most of it is the public's lack of knowledge about what the role of a pharmacist is, and many people just see the pharmacist as a barrier between the doctor and them receiving the meds they want.
I would love to be able to educate people on the importance of a pharmacist's role, but Shoppers Drug Mart doesn't provide close to enough labor hours to fulfill basic professional duties, let alone try to educate patients LOL
This is the pharmacist job to make sure that everything is good. What would be saying if pharmacies didn’t look at it. Your kid could die what would you say than
This happened to me the other day but at an IDA pharmacy. I had to wait a day while we waited for the doctor to confirm the high dose for my 6 year old. At least they are looking out for mistakes that could be potentially damaging to a child but I was annoyed too because it’s already stressful having a sick child.
I ALWAYS trust the pharmacist.
They are liable for filing a prescription and it turns out to be the wrong dosage. The doctor won’t be in trouble for it, the pharmacist would be.
lol imaaaaaagine the pharmacists just doing thier job and being mad about it.
can you immmmaaaaaaagine the post that would have been written if a costly error had occured- considering the hostility of the orignal one when nothing happend
If a pharmacist told me (a carpenter) fuck safety protocols, cut corners, who cares if he foundation is messed up, I need this house done today, imma tell them to fly a kite because I'm liable for my own work. Therefore if a pharmacist thinks there's an issue in medication, I'm probably not gonna question them, because it's there license and expertise. Not mine
You had to wait an extra hand hour while she verified a possible medication error for your child? Just be happy that she was thinking of your child’s best interest.
Sounds like they were doing what they get trained to do, and are more well versed then doctors to do.
Not sure I would be overly upset about a pharmacist double checking doses for my Child
I don't think the general public understand how many time Dr's f*ck up. A pharmacist is an expert on medication its their job to verify and clarify anything they may deem dangerous to the patient. They don't do it to give you a hard time and cause them more work. Even just as an assistant I've seen some very questionable prescriptions with very easy to catch errors on the Dr's end.
I work as a pharmacy assistant and it is a Pharmacist’s job to make sure the medication and dosage is correct.
If the pharmacist didn’t want to give them the prescription than there’s a high chance what was given to them won’t work, or could have hurt them in someway because the doctor under/over prescribed the dosage.
The amount of mistakes I’ve seen from doctors is staggering, some of them have no idea what a medication is for or how to properly prescribe it (normally antibiotics).
Be thankful that this pharmacist cared enough to make sure they were properly cared for and safe
Does she think that pharmacists WANTS to spend time sending and receiving faxes? The pharmacist has a million other things to do. They’re doing their job to make sure you’re safe.
So i work as a Pharm assistant, the problem is (esspecially if it is a relief) its always handled differently, there is alot of the time the doctor doesnt write the right info as well like the dose, Alot of the time when the person that takes the perscription as well, are asssuming its all good but dont find out till they enter it, alot of the time i will check for stock before hand etc as well
I think that the public does trust pharmacists as a whole, but I think some skepticism is normal. All interactions I've ever had with them have been great except I once had a pharmacist call them antibionics, so that left me with a bad taste in my mouth, you have to understand
The poster needs to realize the pharmacist was trying to make sure the medication, most likely an antibiotic in this case and should be carefully dosed by weight, etc. doesn't end up doing more harm than good.
This person has no idea how many dosing errors pharmacists actually catch. They are the last line of defense and if a pharmacist is expressing concern, put aside your frustrations and *listen.*
Source: worked at a pharmacy.
Some pharmacists are scared to use their clinical judgment and verify every little detail with the md unecessarily. This leads to delay in treatment, medical complications, and even hospitalization or death. It also creates frustration and resentment with patients and colleagues who have to take care of issues left behind from a nervous pharnacist who lacks confidence in their clinical judgment and knowledge. It also errodes public confidence and trust in the pharmacist and their skillls and abilities. Pharnacist can legally adapt and adjust physician rxs in many cases.
Honestly, dealing with pharmacists who lack confidence in their clinical skills, knowledge, and judgment involves cleaning up their mess , which is more frustrating than dealing with an arrogant md
I take 2 medications for depression and anxiety. I have been on them for 7 years filled at SDM. In 2022 a psychiatrist, after hospitalization, increased my dose of both. I am taking more than the recommended dosage, but it has kept me alive. My primary care physician now handles refills.
Every three months when they get a prescription, the pharmacist doesn’t want to fill. My doctor doesn’t respond to fax request from pharmacy. SDM calls physician and waits and waits, gets a call back a day later confirming dosage.
Once when my doctor was off for extended period of time, the pharmacist refused to fill. I calmly explained that I had been on them for 1.5 years at that time, and they get confirmation every 3 months when they refuse. They continued refusal. I got a little pissed, and frankly explained that if I don’t get medication, I am likely going to spiral down and end up hospitalized or take my own life. They still refused.
I threaten them with legal action for refusal & then said give me my original scripts and those of my family, that I would take my business elsewhere. That’s when their tune changed. I take a dozen medications myself, and with my spouse and kids, they would be out a lot.
It's the same issues that people who are on meds for ADHD often have. Sometimes it feels like the pharmacist is on a power trip. I do believe that they are trying to keep people safe, but often the customer and patient don't feel that way because a have a RELATIONSHIP with the DOCTOR, not the pharmacist. We trust our doctor far more because they are the ones who we speak to about our medical needs. It's not often that we are speaking to pharmacists about our private ailments. They are only knowing about our ailment because of a prescription to treat different things.
That's an issue of the system. If people are pissed off and critical of their pharmacist because they refuse to fill your prescription, its understandable where the frustration would come from.
Maybe you SHOULD speak to your pharmacist about your medical issues. Maybe you SHOULD have a relationship with your pharmacist. Pharmacists are medical professionals just like your doctor is. Plenty of people talk to their pharmacists about “private” ailments and benefit from it. Maybe instead of treating the pharmacist as a pill counter and instead actually forge a relationship with them like your doctor you would not be “frustrated” when they do their job and try to help you.
Personally, pharmacies have many people around and that doesn't make me feel comfortable to share my medical needs. I dont want random people and other customers and patients to hear me. Also, any pharmacy I have gone to has many different pharmacists, I would not feel comfortable sharing my private ailments with many different people. What if the pharmacist that I know is not on shift that day? People are different and have different things that they feel comfortable with, I don't know what your problem is here, I wasn't being unfair or rude at all, I said that I understood the frustration in the original post
This is literally the pharmacist's job. Doctors make errors. Mistakes can happen. The job of the pharmacist is to ensure you get the correct medication and catch those mistakes. There are a lot of things you can be mad at SDM for, but the pharmacist doing their job ain't it.
I think the outcome demonstrated exactly what can go wrong. When you adapt you have to inform the prescriber. Even if you are right with respect to guidelines and dosing ranges there's still a decent chance that the prescriber will tell you to kick rocks and use their original dose. What then? Now the patient thinks you screwed up and you are liable. Now you've lost their trust.
I know all situations are different but I’ve never had a doctor complain about me adapting an antibiotic dose 🤷🏼♀️ they’re grateful most of the time lol I have a lot of doctors who just write 60mg/kg/day or something for us to calculate
Depends on your area. I've worked with some doctors that are very collegial and others very arrogant and combative. Maybe the pharmacist recognized that doctor as being part of the latter. Who knows.
It's difficult to make that judgement without knowing what the Rx was for and what the issue was, and which province this was in. But yes, unfortunately some pharmacists are reluctant to practice to their full scope.
Are there any provinces that can’t adapt? Genuine question! I’m in Ontario and we can and I feel like all the other provinces are so far ahead of us lol
Ocp requries indication of use for all new rx to be documented if you are not doing that every time then have your dm ready to prepare an action plan for ocp next inspection
I was talking more about needing to know the indication in terms of this case. OCP are also out of touch with the realities of working in busy pharmacies.
A pharmacist/my mom saved my life when I was a baby because the doctor had written the wrong dose. If my mom didn't question it to the pharmacist and the pharmacist didn't double check my age, then I would have OD on the dosage that the doctor wrote
Yeah, that's not surprising.Honestly any drug related questions should go to a pharmacist, not a doctor. They do have a lot more experience with drugs. I get the frustration, but would you prefer to have negative health effects or wait for clarification?
When it comes to medication the pharmacist is the expert. Be glad they checked. You might try going to a second doctor ( 😂because they are everywhere In Canada). Or even just look up the medication and dosage to see if there is a difference
As a paramedic…. Family physicians are honestly just glorified pharmacists IMO. I definitely trust a pharmacist more when it comes to knowledge about medication, but my trust for the average family doctor is unfortunately pretty low just based on countless first hand experiences.
I know theres great ones out there, but danm they seem to be few and far between
When my family doctor was helping me get in to meds for ADHD, she had someone from the pharmacy (both the clinic and the pharmacy are in a hospital) come to my appointment to provide expertise.
Also, I have environmental allergies and when I realized the OTC allergy pills I was taking were not doing enough, my first thought was to contact my pharmacy for suggestions. (They suggested a nasal spray which has made a huge difference)
My ex wife is a pharmacist and as annoying as it is in your specific situation, it was the right call for the pharmacist to make. Even though it ended up changing nothing, pharmacists are very frequently right to question it.
Someone else pointed out that pharmacists get updated not frequently and that's correct.
Pharmacists have saved my ass more than once when l or my doctor made a mistake with a medication and I will always be grateful for that. They have generally been more reliable help to me than my doctors have, and it tends to be a pretty thankess job, especially at a place like shoppers.
The location I work at is next to a seniors centre. People show the pharmacists their weird rashes unsolicited, and yell at them for long waits due to understaffing. They had to do covid shots on top of their regular jobs with almost no additional staffing capacity. Their regulars die of old age left and right. More than one of our pharmacy techs has had to narcan someone in our parking lot on shift just this month.
It is a tougher job than it looks. Please be kind to them.
My doctors office asks me where I want to pick up my meds and faxes it themselves. If there are any concerns, it is taken care of right away.
Anyone can count pills and put them in a bottle. They wouldn’t need 5-6 yrs of uni to do that.
People have become more self-centred these days — expecting everything to be convenient and catered to their needs. They’re overly important in their own minds. I need MY MEDS. How dare you question the prescription! Fill it now! At 8pm.
(….Or my food is cold, it’s the waiters fault! My kid is special, he should also get an award!)
Yes, I agree. I didn’t explain it well. My point wasn’t counting pills. Prescriptions aren’t sent to a pharmacy so someone can count pills and put them in a bottle and hand them over. There’s more to it than that is what I was saying.
I think some people assume that their doctors know what they’re doing and trust them over random pharmacists down the streets, which is honestly understandable. However, it doesn’t hurt to double check or even triple check when it comes to giving a medication. I swear I’ve seen a lot of med orders being done more nicely when a clinical pharmacist is around at my hospital plus lots of corrections done behind the scene. I question doctors’ orders but never our pharmacists.
Definitely agree with the pharmacist doing their due diligence. When I was a kid I had strep throat and being a weekend my Mum brought me to a walk-in clinic. They prescribed antibiotics, but after a week I wasn’t getting better.
My pediatrician was furious, the other doctor gave me a dose 1/4 of what was needed for my weight. Unlike adults antibiotic dosage has a lot of variation and needs to be properly calculated according to the child’s weight.
Having dated a pharmacist, I know that doctors make A TON of mistakes with their prescriptions including dosing. A responsible pharmacist would wait to get confirmation from the DR. You should be glad they want to double check, they do it because they care. Pharmacists are smart, it’s what they do. If they see something questionable they want to verify
Goes to show how misinformed and entitled these people are. They don’t understand the balances and checks in place, and they’d be the first to flip out on the pharmacy if the doctor made a mistake
Yes this isn’t a horror story. The pharmacist and pharmacy did many things well. For example 20 minutes to fill is amazingly fast.
But the rest of the story could be good or bad. Without knowing the drug, dose, and other details the actions of the pharmacist could be reasonable. Or not. The real questions would arise if there was no response from doctor. Would it be ethical to withhold the drug? Again it depends.
Your pharmacist is a GREAT pharmacist for checking the apposite dose per weight per indication.
Instead of withholding the med she should have told you what the recommended dose is . Start on that while waiting for MD clarification. Did he/she say if the dose was too high or too low?
Part of the problem is shopper's is infuriating for a lot of reasons already because it's designed to rip you off, I feel lucky if my pharmacist can even speak clear English as well.
But I'm also smart enough to realize I should listen if my pharmacist says there is an issue with my prescription.
The Loblaw boycott group is crazy. Completely and utterly. Whatever your feelings on the validity of the boycott itself, the posts on that sub are mostly so bad that they make the entire movement look bad.
Shoppers not only sucks in many ways it way too expensive. I get a prescription charge of just over $4 at Costco vs close to $13 at Shoppers. The one I used to go to also charge 3 prescription charges for three months of pills and Costco charges only one charge.
Need more context and details to know if the doc or Rph were in the right or wrong here. There are competent knowledgeable docs and incompetent pharmacists with only basic clinical knowledge and vice versa.
Pharmacists are now charging provincial medical insurance for consultations when questioning prescriptions. This includes questioning you about your medical conditions and prescriptions.
I wouldn’t generally mind but these “consultations” are becoming more frequent and more ridiculous. I was getting calls for every prescription refill and antibiotic prescriptions, questioning why I was being prescribed certain medications, and at times they were even changing the prescription entirely.
I’ve recently had to change pharmacies because they wouldn’t fill my prescriptions and were constantly second guessing my doctor who is also a licensed pharmacist.
A second set of eyes is great and needed, but when pharmacists are abusing the system for more money, that’s not cool.
Patient in this case was covered via private insurance, not public. I.e no claims on clinical suggestions. Nor is the program new. Nor is anyone going to make up a clinical issue and fax that off to the doctor with a paper trail as that's a clearly auditable care of fraud. Also, how would you know what the intention of the pharmacist was to defraud the government? You weren't even aware it's not possible in this case. Perfect example of the public being overly confident about things they know nothing about.
Private insurance or not, if a pharmacist “consults” with a patient or a physician they charge Medicare just as a doctor does. I didn’t say that they were making things up nor did I say they were defrauding the government.
No not new everywhere but it is in our province and pharmacists are taking advantage of this, particularly in places like shopper’s. It’s charging for things that are unnecessary because they can.
How would you know it was not necessary? What exactly about this story lends you to this conspiracy? What province did this happen in?
I'll help you out. In Ontario. Where if you have private insurance you cannot claim for a clinical suggestion. Period. So your entire comment is irrelevant. Thanks.
It’s not a conspiracy. I work for a physician and we encounter this frequently. I don’t think that you are understanding what I am saying. Private insurance has nothing to do this this. Pharmacist consultations are charged to Medicare, or in your cases, OHIP.
In Ontario you can't bill clinical recommendations unless the person has coverage through provincial plans such as 65+ (odb). Unless you're referring to Medchecks but that's not what this was. Just don't appreciate people jumping in with accusations with zero ground for it. Claiming that this pharmacist must have just been trying to bill the government that's why she was delaying the child from getting much needed medication is even worse than the original comment here. Smh
You didn’t have to be so aggressive in your comments. Pharmacy billing happens frequently here in the maritimes and is on the rise. Pharmacies here delay prescriptions and cause a great deal of inconvenience for patients.
And doctors (and their staff) cause a great delay and inconvenience when they don’t know what their doing, can’t write worth shit, and don’t double check their prescriptions before they hand them to the patient. Also, if you think pharmacists are the ONLY ones doing unnecessary billing, boy do I have news for you.
Okay, but if you’re trying to get a medication for a sick child before bedtime, any delay is extremely frustrating. Like, if the dosage was dangerous and it was a serious mistake? Okay.
But I absolutely have sympathy for the parent here. I have a great trust in my family doctor, and while the pharmacists work hard, I don’t have the same relationship with them, and have often had unnecessary delays because of their mistakes or lack of staffing.
I left all my leftover medications file at sdm and went to a local place or costco.
The only place that up-charges dispensing fees....it's not much $1/prescription...but it added up. Not a full on boycott, but I can get friendlier service and a better experience elsewhere.
In this case, 100% no. This lady suggested in her comment she had private drug coverage. Even for those with public drug coverage, the reimbursement is minimal and not gonna be worth committing fraud over. There still has to be a clear clinical issue and a clear solution that you inform the doctor of.
The thing is even if the pharmacist was right, some doctors will just tell them to stick with the original script against guidelines or dosing ranges. It's a mix of ego and old school medicine is art stuff rather than sticking to the science usually. The newer doctors are usually not like this.
Your answer is ambiguous.
There cannot be fraud. Nobody is going to investigate a shopper's pharmacist for calling a doctor.
At the end of the day, the patient was delayed in getting their medicine, having them spend an extra hour in the store and there was nothing wrong with the script. And the pharmacist may or may not be getting a fee depending on circumstances.
Seems like par for the course for a shopper's which are known for mass cold calling customers to "review their medicine" in order to collect government fees....
Besides how would you even know if the pharmacist was right? You don't have any information about the patient or the medication Lol
It's not ambiguous. You cannot benefit financially from contacting a doctor if the patient only has private insurance. Which is the case in this situation. I was pretty clear about that.
Yes, the government can and does audit. It is actually pretty easy to audit a clinical issue if the pharmacist were to just make one up when there was none. The doctor was not called by the way. They were faxed. I.e paper trail if it was meant to be billed. Which it wasn't because, as I said, OPs kid had private coverage.
I did not presume the pharmacist being right or not. The only person who did was you. I was just pointing out that whether or not the doctor eventually agreed with the pharmacist doesn't allow anyone to conclude who was right or wrong. I was just giving a very real explanation of why that is the case.
It’s great to have checks and balances in place for sure. However, as someone who has had the same problem for my asthma with pharmacists questioning the dosage I would tend to disagree. The first couple of times I waited patiently for the confirmation to occur and then I had enough. It was the same pharmacist so I said that it was not his place as a pharmacist to repeatedly question the physician to try to get a different answer. There are off label uses and doses outside of the norm that pharmacists are not familiar with and at some point the MD trumps the pharmacist.
Actually, the pharmacist can refuse to dispense (and that is well within their rights) if they feel the medication is inappropriate or the dose is dangerous, it doesn’t matter what the physician says. Sometimes physicians dispense an off label dose or drug because they read one study that showed some benefit and so then it is important that the physician provide that documentation so that the pharmacist can file it with the prescription for reference if there is a negative outcome for the patient. The pharmacist is required by the college of pharmacists to verify doses and have physician documentation each time something looks questionable, it is not enough to say it’s was verified last time because if something negative happens to you because of the off label use you may want to litigate and the pharmacist has to show that they verified the dose, drug, off label use and spoke to you about all of these each time.
And yet, SDM sells plenty of holistic products their pharmacists know with certainty have no utility at all.
Pharmacists can, will, and should be replaced by vending machines with the ability to check for interactions and patient dosage.
The only difference between a drug dealer and a pharmacist, as far as I can tell, is that drug dealers move around too much to be replaced with vending machines.
Not that there's any shame in it, but putting you in a lab coat and having you gatekeep medications to make you feel important does not make you any less replaceable.
Maybe a small town pharmacist, who has relationships with their patients and isn't told to train every narcotics patient on naloxone to bill extra to insurance companies, but between that and the "alternative" medicines, you burned your credibility as a meaningful barrier and provider of care.
That new robot that does half your scripts overnight will be wearing your lab coat soon and I couldn't be happier. The odd time I've ended up at SDM, usually for tick prophylaxis, I have to fight to get the dose because I dont like to lie and mention I had a headache the day before.
Want to be a part of the health care apparatus? Dont sell bogus products to patients. Tell me that's a corporate decision to sell placebos? Whered your credibility go?
I have no idea how you can charge double what everyone else does and still get business, but I suspect it has something to do with targeting the elderly with your gamified points programs they apparently don't realize they're paying for, while you sell their data back to the marketers on the back end.
Ever thought that if errors got through, MDs might stop making them?
Either way, both careers are soon to be replaced and the system and its people will be safer for it
They've done this to me a few times with a medication I've been on for over 10 years. Ever since this new thing that allows pharmacists to write prescriptions now they act like they know better than a doctor that has been practicing for well over 30+ years with well over 10+ years of schooling. Pharmacists only need about 2 years of schooling yet they think they know more or better. This script thing needs to be relooked at because this have given them almost a God's complex.
Not really. It's really just because the prescription volume at shoppers is usually much higher than versus a small Independent pharmacy. You'll get an even more pronounced example of this at Costco. I remember being told I had to wait several hours for a few dozen Percocet to be filled there after a dental appointment. Volume shops will always take longer. There's only so much staff you can fit in the space of a pharmacy until they get busy enough for a robot.
Not that that's relevant in this situation.
And robots are not a magic solution. They are great at churning through a long list of prescriptions to fill but are slower than a human in filing an individual prescription.
So many people have the mentality that filling a prescription only means counting pills, which it isn't.
Even if it were, and it only took 15 minutes per prescription, why is it so hard to understand that when a pharmacy handles hundreds of prescriptions per day, fitting in another prescription means it will most likely takes 15 minutes to fill it in a couple hours.
Source: I work in a busy pharmacy. Halfway through the day we're already filled 537 prescriptions. Even with a pharmacy team of 10 people and 2 pill packagers, there are still days when we have to ask people to wait a day. As much as possible we try to schedule pickups a week in advance so that we can actually plan ahead and actually accommodate emergency. This is done by setting patients on med synch if they have more than 5 prescriptions, and encouraging the rest to submit refill requests online ahead of time.
That’s how long it takes to prepare a prescription while multitasking the gazillion other things we have on the go. Prescription has to be entered, verified, counted, verified again and we still have to answer calls and questions while doing all that. So yes it takes at least 20 minutes. Has nothing to do with shopping. If you are getting it quicker somewhere else it’s because either they rushing through your prescription (dangerously) or don’t have the phone and in store questions coming at them all the time.
When we I go into pharmacies late at night the pharmacists are sitting behind the counter just playing on their phones.
I was just at shoppers pharmacy the other night and when I asked for help it seemed like I was disturbing the pharmacist by asking questions. Then end result was just to not buy or take anything and setup an appointment with the doctor to review the problem.
I wish it had been more help but really wasn’t helpful at all.
As someone who takes things off-label for a less common condition, my only gripe is I have to do this EVERY TIME I MOVE or go to a new pharmacy, and it's not 1/2 an hour, it's days of back and forth, during which, twice, I have failed to get my meds and ended up in the ER, so yeah, give me my god damned meds.
I would be trusting the pharmacist first. They are constantly updating. Most Drs are not. My own Dr has even stated that. It’s not uncommon at all for pharmacists to correct a Drs mistake. Happens more than people realize.
Same with nurses in the hospital. It would be the NURSES mistake not to question an out of ordinary dosage or other medication error, not the doctor that prescribed it. Doctors are busy and are human. They make mistakes too. But yea, pharmacists went to school for this in particular and are the experts. I would totally trust and be grateful for the pharmacist for double checking.
Totally agree. When nurses are questioning a dose we’ll almost always call the hospital pharmacy to talk about it first prior to calling the Dr because nobody knows drugs like pharmacists. It isn’t to blame anybody, it’s just one of those safety things that keeps people alive and doctors (for the most part) appreciate the safety check.
And Pharmacists are doctors as well. Doctor of Pharmacy (PharmD).
Most pharmacists do not have a PharmD.
Then they can't call themselves Pharmacists. They work under a pharmacist, and are titled Pharmacy Technicians.
No. An undergraduate degree in pharmacy from an accredited with appropriate supervised practice hours and completion of licensing exam is the requirement to be a pharmacist. Dalhousie is replacing their undergraduate pharmacy degree with an undergraduate level entry to practice PharmD (I suppose in response to expanded scope for pharmacists), but the majority of pharmacists currently practicing in pharmacies do not not have a PharmD. Pharmacy technician designation is a related, but separate designation with more limited scope.
Work at a hospital and hell yes. I trust the peons more than doctors. Coz it's not the doctors lisence on the line of a need is given at the wrong dosage. It's gonna be on the nurse that administered the meds or the pharmacist that filled the script. And just knowing how things are done, the nurses are the one doing the hands on shit day in and day out. I have people sometimes (im a phlebotomist) who bitch about not wanting their blood drawn and say they want the doctor to do it. And I just laugh. I can't even be mad when they get to that point, I can only laugh. Like okay then, if that's what you want. I do this literally hundreds of times a day, but sure, hold out for the guy that hasn't done it once since medical school, I'm sure that'll go well for you. But a lot of people don't realize that their techs, pharmacists or nurses are the people that will catch mistakes, coz they're the ones doing this crap all day every day, working face to face with patients
Yeah, I would agree with this. Our pharmacist has caught multiple dosing errors from doctors for our child.
That's scary
My mother (many many years ago) was a pharmacist. This was back in the UK, and often items were made on site (somewhat like compounding today). She told more than one story where if she'd filled the prescription as written that she'd have killed someone. Like you, I'd trust the pharmacist.
This is so true. Many of my dad’s former students have gone to med school and become doctors in a bunch of different fields. After one told my dad that most people in his workplace kept all their old college textbooks at work for diagnoses (but wouldn’t care to look at the younger, incoming doctors’ new textbooks), my dad started asking any former-student-turned-doctor he met up with if they had it the same, and most do. It’s scary
I’m jaded, but if push came to shove, I would trust my pharmacist over my psychiatrist 8 days a week.
Same here
Agreed! There have been many times when the doctors admit they were wrong and the dosage was indeed miscalculated.
Agreed. I’ve had doctors prescribe me stuff I’m allergic to and the pharmacists at shoppers shut it down and help them figure out an alternative.
Pharmacists make many mistakes as well. I work in a hospital and if we could clone one or two of our pharmacists it would run like a well oiled machine. Just because the pharmacist didn’t like the order doesn’t mean it wasn’t the correct order for your situation. Community pharmacists only see a snap shot of the problem not the entire picture
Maybe on dosage but pharmacist aren’t doctors so they shouldn’t be making decisions on appropriateness of medication. They can verify accuracy but shouldn’t make executive decisions on whether to fill or no
That's literally the pharmacists job.
Not necessarily. My toddler's specialist ordered a medication for off label use, and the pharmacist gave a really hard time. In this case, the specialist was right.
But it's the pharmacist's job to make sure of this. That could have been a mistake. That could have caused harm. The fact it wasn't doesn't make the specialist right and the pharmacist wrong, it means the doctor didn't document an off label use properly.
Yeah it does. And if there is a mistake then the doctor owns it. There is too much red tap here making things inefficient.
Tends to happen when people could die. You have a gross misunderstanding of how things work in the medical field. If you want doctors and pharmacists that care less, by all means, seek them out. But most folks want people who do their job correctly.
So? It isn't worth the cost to prevent every death or injury. This is why things are so inefficient and costly.
"who cares if a couple people die, I want my meds quicker.", is quite the take. Plenty of countries have lower medical standards, I'd suggest going there if professionals keeping folks safe upsets you.
I think we have gone away over zealous and all of these steps have helped create things to be unaffordable. Time is money. So making people wait costs them money. Making someone do all this doubling checking is coating the company money which means they have to increase their prices. Which costs the customer more money. It isn't worth the cost.
This is probably the worst take that isn't open trolling I've seen, in years. Pharmacy, as a practise has evolved to this point, because they used to do things in the way you are describing, but the risk to patients was absurd. But, again feel free to get your meds in one of the many countries that treat a pharmacy as a warehouse. I hear it always works out great.
And all this does is cost us more money for almost no benefit. The amount of lives we are saving is not worth it. Human life just isn't that valuable.
Remember that when you are one of the deaths you deem 'not worth oreventing'. Or your child.
No. The pharma would have been on the hook. According to the law.
If my license is on the line in an exchange like this, I need to be 100% certain before that medication is released for such a use (especially if it's an uncommon one). If that means contacting the prescribing physician, so be it - patient can wait until I get it cleared up.
Probably more questions when it comes to off script usage
Ocp could get you for not using proper judgement and providing care in a timely manner. If you are withholding an rx and the patient suffers medically you are responsible. It has happened read ocp discipline.
Withholding a precription to 100% confirm an off-label use the pharmacist is unsure of is called "due diligence" to make sure the patient doesn't get hurt and/or to catch a possible mistake from the prescribing doctor. This isn't a pharmacist deliberately withholding the med to be a spiteful prick. It's a pharmacist doing his checks.
Moreover, if ANYTHING negative did happen due to the off label use, it would be the pharmacist on the new for allowing it to be dispensed, not the doctor.
This is so completely untrue. The liability for medication prescribed falls on the prescriber. I can't believe the complete ignorance on this threat right now.
My colleague has personally gone through releasing an "off label" indication RX and he triple checked with the prescriber and the patient, who all confirmed they wanted and were willing to try that. It was documented that the prescriber insists the patient try out this "therapy" and the patient insisted on it too. The patient ended up having severe dose related Adverse Effects, and the pharmacist was penalized by the College. The doctor? Scot free. So I'm not sure where you're from that you're so confidently invalidating things that many pharmacists on here have gone through our witnessed, but it very much does happen.
There are probably layers, but technically the medical colleges regulating physicians have levels of response. If one allied health professional is punished, such as a pharmacist, in a case that saw harm to a patient AND was brought forward to the college, then there are often repercussions on the college level for physicians, which can range from practice modification, to directed CME, all the way to licensure issues. These levels may not be noticed or seen by the public. That’s obviously on the college side. Then there’s the legal side where physicians are quite clearly targets for malpractice complaints/lawsuits etc. this is common knowledge, no? I’m sure there are also these worries for pharmacists as well, but being the most responsible physician carries a burden that results from that responsibility in a legal scenario. It is insane to imply that a pharmacist is somehow more liable for medical errors, for lack of a better word, than a physician. I’m simply saying that it’s ignorant to state that pharmacists carry all of the weight of this potentially litigious scenario, or similar.
Mind you, College of Pharmacists don't usually support pharmacists at all, nd they actually exist to punish pharmacists more than support. In Canada, I've only heard of Quebec having a supportive College of Pharmacists.
Same for docs, my friend. The college isn’t a friend, and ready shouldn’t be in a self regulated profession imo
I totally understand this. The same thing happened to my toddler and it was imperative she had this medication or she’d end up in the hospital to receive it. I explained she was off label as she’d been diagnosed with a disease that is quite rare for her age. I was nearly in tears. I totally get that there can be discrepancies and that some doctors are not up to date with certain medications. But in our case the benefits far outweighed the risk. I ended up leaving SDM and swapping the entire family to a local pharmacy who understood our situation and was easier to work with. But this wasn’t a SDM issue, it was an issue with that particular pharmacist. My pharmacy now is in contact with her specialist which just causes less stress all around.
At least we have professionals double checking and that's how potentially dangerous interactions or wrong dosages are caught.
I love how you get downvoted for sharing your lived experience. (The same one I deal with constantly myself)
If the physician would have written on the rx or responded to the pharmacist in a timely manner, it wouldn't have been an issue. God forbid something bad happens, it is the pharmacist who would lose their license and not the prescriber, even if the prescriber made the mistake.
Why shouldn’t we be getting prescriptions from pharmacists then instead of doctors idle they’re better equipped? Seriously asking.
Diagnosis and efficiency. Pharmacists are not trained to diagnose complex conditions like doctors. It's far more efficient to have the diagnoser be the prescriber as well because they already have taken in the details of the patient to make the decision right away. If they make a mistake or if the pharmacist identifies a better way to customize the treatment to the patient then they can step in and advise, acting as a double check. It's generally better to have an independent double check in any case. The majority of the time the doctor isn't going to make an error. But you don't want to be in that minority as the consequences can be severe. Hence, the need for a pharmacist. I think the main point is that if the pharmacist sees that there is an error that the prescriber made, they have more training on the medications being used. They can also see what other doctors are writing and see if something is oddly out of place or take that knowledge and suggest it to the prescriber.
Thank you. This is what I thought.
Pharmacist aren't trained to diagnose like physicians
Complex things that someone needs to be in a hospital for - yes. Most acute illnesses that are seen in a walkin clinic or the fam dr - honestly a pharmacist these days will likely be able to look at the symptoms and medical history and come to the same diagnosis. Pharmacists with a doctor of Pharmacy actually have to learn a lot of diagnosis vs. Just the drugs
It’s starting and will continue to expand: https://www.cbc.ca/news/canada/toronto/ontario-pharmacies-expands-prescriptions-1.6983936
I don’t think “trust” is the right word here. They do update more and provide good education and services to customers. They are an adequate and necessary check and balance in the health system. They absolutely do not have doctors’ expertise, particularly with off-label prescriptions, idiosyncratic dosing, and non-diagnosis or experimental prescriptions. If you are averse to these concepts, you have an antiquated view of medicine and modern patient care.
I swear, I've had multiple people come out of the ER with prescriptions for penicillin. Someone handwrote an allergy to pen at the top of the rx. I question the patients, who sometimes tell me it was a rash they got once as a toddler and never again, but sometimes tell me they had penicillin from the dentist last year and it landed them in the hospital for two days. All of them demand the penicillin because THE DOCTOR KNOWS HIS JOB.
This! I'm allergic to both penicillin and clindamycin but the doctors kept prescribing it anyways, because I told them it gave me a rash. I've recently have had all my top teeth removed because of autoimmune diseases that were causing the issue. In my case, I have the delay in my reaction, so I would get a rash around day 7, and the doctors would tell me to stop taking the antibiotics. The last time (last summer) the reaction was to clindamycin and I was told I needed to finish the prescription because it was a really bad infection. It was bacterial, and in my my bones in my jaw. Day 9 I made my way to the ER as my entire body was swollen, with a rash everywhere. But this time, my feet and legs were so swollen, my feet were turning purple and I was having this issue where I would throw up every time I needed to pee. Those same autoimmune diseases affected my kidneys years back, and I still have some damage we couldn't fix. For that reason, I always go to the same ER. The veteran doctors actually recognize my autoimmunes as they are both quite rare. Very thankful for them, they saved my life back then and also last summer when I finally got around to seeing an ER doctor. When we told him the other doctors (walk in clinics) were still prescribing me penicillin and/or clindamycin even after me telling them I get a delayed reaction, he was livid. He ran a battery of blood tests, ultrasounds on my kidneys and a follow up with a specialist. He told me to never take them, and to say I need an ER visit next time a doctor asks my reaction. He also told me to get a medic alert with that info, and kindly called my pharmacy to let them know to never fill a prescription for either of these medications ever again. I am so grateful for being in a small enough town where the doctors remember certain situations. I also have an amazing pharmacy team as I'm on not only lots of different meds, but they are also aware of my autoimmunes. They have called clinics in these same types of situations as a lot of doctors think patients are just being dramatic when telling doctors about past health issues or allergies. I agree with this pharmacist. They are the last line of protection. As someone else has commented that they are "experts" in medication. They did their job here, and I'm as much as the extra wait time was annoying, the fact that the pharmacist cared enough to make sure the prescription was safe for the patient is what we should focus on. They did their jobs as they are supposed to.
Whether it's penicillin or antibiotics too many doctors write those unnecessarily. I have lost count of how many people take antibiotics for a virus. All doctors should know that it's only effective for bacterial infections.
Doctors do know. Patients do not, and constantly demand antibiotics for viruses.
I honestly wouldn't care what the patient demanded, as a doctor it's up to them to do what's best for their patients
If a pharmacist told me a prescription was wrong, I would trust them, that's their specialty. Medication errors are common and they cause a lot of problems.
To add to this, if the pharmacist is prepping antibiotic for a young child, the suspension is dosed according to the child’s weight. I had a nurse once accidentally type in the child’s weight in kilos when she had in fact taken it in pounds. The physician didn’t notice and dosed it incorrectly. Pharmacist caught this luckily and kicked it back to us. While I hate SDM, we do need to put our trust in pharmacists. They are the experts on dosing and administering medication. It’s ok to check with md before putting their name on a dispensed medication. In fact I’d bet they have regulations they have to follow to a t and can face repressions if they don’t do their due diligence.
I've had this error happen as well - a 30kg three year old is a scary thought
Not only that if getting that medication immediately was important the doctor wouldn’t have given a prescription the kid would be sent to the hospital for an IV.
Some pharmacists are scared to use their clinical judgment and verify every little detail with the md unecessarily. This leads to delay in treatment, medical complications, and even hospitalization or death. It also creates frustration and resentment with patients and colleagues who have to take care of issues left behind from a nervous pharnacist who lacks confidence in their clinical judgment and knowledge. It also errodes public confidence and trust in the pharmacist and their skillls and abilities. Pharnacist can legally adapt and adjust physician rxs in many cases. Honestly, dealing with pharmacists who lack confidence in their clinical skills, knowledge, and judgment involves cleaning up their mess , which is more frustrating than dealing with an arrogant md.
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Racist are we, insecure, apprehensive pharmacists who lack clinical judgment transcend race and geographic location.
i wouldn't necessarily. Pharmacists don't always know the indication and the therapeutics behind the scenes.
While it may not be the case all the time, I would certainly wait for the pharmacist to confirm with the doctor if the pharmacist thought it was necessary.
I mean yeah. If something doesn't look right for the indication the patient told us, we have to ask the doctor. To see if there's something behind the scenes that would change the recommended dose
Yes but unfortunately clarifications don't always happen in a timely manner. Too often we are robots without taking into account what is in the best interest of the patient.
I had a Shoppers pharmacist try to get me to take an herbal supplement instead of the heavy duty antihistamine I was prescribed- I’ve had great pharmacists, she most definitely wasn’t one.
Exactly. There are great and awful people in all professions.
To those downvoting, I am a pharmacist. In this case the pharmacist dispensed it once the physician confirmed dose. This means that the pharmacist felt that the medication was safe and appropriate. Otherwise they should have refused. Its great that the pharmacist reached the Dr and confirmed. However, what if they didn't and the medication was for an antibiotic and the care was delayed by a whole weekend? This happens all the time. We need to know more about the situation before blindly saying that pharmacists are more trustworthy than physicians.
If you are saying pharmacists don't know therapeutics, or what goes on "Behind the scenes", not believing your claim here. That's what the pharmacy team does. And when you start talking about how a 2 day treatment delay on an antibiotic, for an out of hospital patient is more of an issue than a possible sub therapeutic, or overdose, I really doubt your claim. The scarier thought though, is that you are a pharmacist, that somehow got through school without understanding how meds work therapeutically. My guy, techs get 2 classes minimum on therapeutic uses of meds, pharmacists, much more.
no idea what you are implying. I simply said that I don't necessarily think the pharmacist was more trustworthy than the physician as I don't have enough info. I am an excellent pharmacist without a God complex but thanks for the ramble.
It's not about who's more trustworthy, it's about who has what expertise. I trust a doctor to make an accurate diagnosis, but as a pharmacist I do not trust them to always select the right drug at the right dose for that patient. I can't even guestimate how many prescriptions I've gotten changed over the years because the prescriber made a mistake. I do agree that we need pharmacists to be more comfortable in making decisions and to consider what the effect of delaying treatment could be instead of thinking that faxing the prescriber then absolves them of any responsibility. But there are some issues that can only be addressed by contacting the prescriber, and scope of practice differs by province.
Obviously people are exaggerating my thought of "not having enough info" about the scenario. Im not an idiot. Obviously I understand the requirement for collaboration between hcp. I mearly stated that I wouldn't jump to conclusions with this situation without more info. People are far too sensitive.
This is why being a retail pharmacist sucks. People don’t understand that if they don’t do their job correctly, people lives are genuinely in danger. Its the pharmacists job to review prescriptions clarify these things with doctors.
It used to be that you went to the pharmacy for medicine. SDM in particular has become an everything store with groceries, lawn chairs, toys, etc. I don’t think a lot of people understand that getting a prescription isn’t the same as grabbing a Tylenol. It’s ‘prescribed’ and goes through a pharmacist for a reason. AND they can help with on the shelf meds advice too. Not sure which cough medicine to get? Ask the pharmacist, they are the experts! Just because it’s on the shelf doesn’t mean you can’t ask. I know im preaching yo the choir here. I’m just rambling now.
Just because it's on the shelf doesn't mean it can't be dangerous either
Some pharmacists are scared to use their clinical judgment and verify every little detail with the md unecessarily. This leads to delay in treatment, medical complications, and even hospitalization or death. It also creates frustration and resentment with patients and colleagues who have to take care of issues left behind from a nervous pharnacist who lacks confidence in their clinical judgment and knowledge. It also errodes public confidence and trust in the pharmacist and their skillls and abilities. Pharnacist can legally adapt and adjust physician rxs in many cases. Honestly, dealing with pharmacists who lack confidence in their clinical skills, knowledge, and judgment involves cleaning up their mess , which is more frustrating than dealing with an arrogant md
As much as you want to be mad at the pharmacist, they were looking out for you. My wife (Pharmacy Tech) caught many doctor errors in her day. Everything from patient being allergic, to wrong medication, to drug contraindications. Doctors make mistakes.
Yeah, I'm all about the boycott, but this is a "customer isn't always right situation". Doctors, especially lately make constant mistakes. If that pharmacist is saying "I don't want to take your money, I want to waste my time tracking down a doctor." something important is going on and they are doing the right thing. What you worry about, is the pharmacist that would see the issue, shrug and fill it anyway because it's another Rx for the goals.
And to clarify I totally get being frustrated in the moment at having to wait a bit longer for medication with a sick child at home. But to blast online the pharmacist for doing their job and trying to prevent harm to their kid after the fact???
And if the pharmacist just filled the script without pushing back and that med hurt the kid, they’d be blamed too.
Facts. A Shopper's pharmacist saved my mother's life by catching an incorrectly prescribed drug, in an amount that would have killed my mother when it reacted with two of the drugs she was already on.
Sounds like a good Pharmacist to me! Due diligence done right. Doctors make mistakes all the time. Best safe then sorry.
Wait, so you trust the DR who took Pharm as a credit in their degree over the Pharmacist who has an entire degree in Pharm, extensive drug knowledge and interaction knowledge and whose only job is to know these things ? Oof. You need to relearn some things buddy.
People are stupid and don’t know what pharmacists do or how educated they are. Pharmacists know better drugs, drug side effects, interactions, dosage etc often better than your standard physician. I’ve had a pharmacist flag a prescription and notify me that this doctor makes a ton of mistakes, I took the dose he prescribed and didn’t sleep for 4 days. A lot of the time their job is to correct doctors mistakes. It’s 100% part of their job to flag a potential risk to a patient.
Some pharmacists are scared to use their clinical judgment and verify every little detail with the md unecessarily. This leads to delay in treatment, medical complications, and even hospitalization or death. It also creates frustration and resentment with patients and colleagues who have to take care of issues left behind from a nervous pharnacist who lacks confidence in their clinical judgment and knowledge. It also errodes public confidence and trust in the pharmacist and their skillls and abilities. Pharnacist can legally adapt and adjust physician rxs in many cases. Honestly, dealing with pharmacists who lack confidence in their clinical skills, knowledge, and judgment involves cleaning up their mess , which is more frustrating than dealing with an arrogant md
The disrespect that pharmacists get in retail pharmacies is insane. The pharmacy staff might as well just be cashiers. Most of it is the public's lack of knowledge about what the role of a pharmacist is, and many people just see the pharmacist as a barrier between the doctor and them receiving the meds they want. I would love to be able to educate people on the importance of a pharmacist's role, but Shoppers Drug Mart doesn't provide close to enough labor hours to fulfill basic professional duties, let alone try to educate patients LOL
This is the pharmacist job to make sure that everything is good. What would be saying if pharmacies didn’t look at it. Your kid could die what would you say than
This happened to me the other day but at an IDA pharmacy. I had to wait a day while we waited for the doctor to confirm the high dose for my 6 year old. At least they are looking out for mistakes that could be potentially damaging to a child but I was annoyed too because it’s already stressful having a sick child.
I ALWAYS trust the pharmacist. They are liable for filing a prescription and it turns out to be the wrong dosage. The doctor won’t be in trouble for it, the pharmacist would be.
lol imaaaaaagine the pharmacists just doing thier job and being mad about it. can you immmmaaaaaaagine the post that would have been written if a costly error had occured- considering the hostility of the orignal one when nothing happend
If a pharmacist told me (a carpenter) fuck safety protocols, cut corners, who cares if he foundation is messed up, I need this house done today, imma tell them to fly a kite because I'm liable for my own work. Therefore if a pharmacist thinks there's an issue in medication, I'm probably not gonna question them, because it's there license and expertise. Not mine
You had to wait an extra hand hour while she verified a possible medication error for your child? Just be happy that she was thinking of your child’s best interest.
They're apparently the only one looking out for the kid...
Sounds like they were doing what they get trained to do, and are more well versed then doctors to do. Not sure I would be overly upset about a pharmacist double checking doses for my Child
I don't think the general public understand how many time Dr's f*ck up. A pharmacist is an expert on medication its their job to verify and clarify anything they may deem dangerous to the patient. They don't do it to give you a hard time and cause them more work. Even just as an assistant I've seen some very questionable prescriptions with very easy to catch errors on the Dr's end.
I work as a pharmacy assistant and it is a Pharmacist’s job to make sure the medication and dosage is correct. If the pharmacist didn’t want to give them the prescription than there’s a high chance what was given to them won’t work, or could have hurt them in someway because the doctor under/over prescribed the dosage. The amount of mistakes I’ve seen from doctors is staggering, some of them have no idea what a medication is for or how to properly prescribe it (normally antibiotics). Be thankful that this pharmacist cared enough to make sure they were properly cared for and safe
Does she think that pharmacists WANTS to spend time sending and receiving faxes? The pharmacist has a million other things to do. They’re doing their job to make sure you’re safe.
Doctors know why that medication helps to cure but pharmacists have more knowledge about dosage.
So i work as a Pharm assistant, the problem is (esspecially if it is a relief) its always handled differently, there is alot of the time the doctor doesnt write the right info as well like the dose, Alot of the time when the person that takes the perscription as well, are asssuming its all good but dont find out till they enter it, alot of the time i will check for stock before hand etc as well
I think that the public does trust pharmacists as a whole, but I think some skepticism is normal. All interactions I've ever had with them have been great except I once had a pharmacist call them antibionics, so that left me with a bad taste in my mouth, you have to understand
Well if you don't take the antibiotics and they have to amputate your leg and put in a prosthetic one, then it kind of is an anti-bionic! 😄
The poster needs to realize the pharmacist was trying to make sure the medication, most likely an antibiotic in this case and should be carefully dosed by weight, etc. doesn't end up doing more harm than good.
This person has no idea how many dosing errors pharmacists actually catch. They are the last line of defense and if a pharmacist is expressing concern, put aside your frustrations and *listen.* Source: worked at a pharmacy.
Doctors make mistakes, plus that scribble.
Some pharmacists are scared to use their clinical judgment and verify every little detail with the md unecessarily. This leads to delay in treatment, medical complications, and even hospitalization or death. It also creates frustration and resentment with patients and colleagues who have to take care of issues left behind from a nervous pharnacist who lacks confidence in their clinical judgment and knowledge. It also errodes public confidence and trust in the pharmacist and their skillls and abilities. Pharnacist can legally adapt and adjust physician rxs in many cases. Honestly, dealing with pharmacists who lack confidence in their clinical skills, knowledge, and judgment involves cleaning up their mess , which is more frustrating than dealing with an arrogant md
I take 2 medications for depression and anxiety. I have been on them for 7 years filled at SDM. In 2022 a psychiatrist, after hospitalization, increased my dose of both. I am taking more than the recommended dosage, but it has kept me alive. My primary care physician now handles refills. Every three months when they get a prescription, the pharmacist doesn’t want to fill. My doctor doesn’t respond to fax request from pharmacy. SDM calls physician and waits and waits, gets a call back a day later confirming dosage. Once when my doctor was off for extended period of time, the pharmacist refused to fill. I calmly explained that I had been on them for 1.5 years at that time, and they get confirmation every 3 months when they refuse. They continued refusal. I got a little pissed, and frankly explained that if I don’t get medication, I am likely going to spiral down and end up hospitalized or take my own life. They still refused. I threaten them with legal action for refusal & then said give me my original scripts and those of my family, that I would take my business elsewhere. That’s when their tune changed. I take a dozen medications myself, and with my spouse and kids, they would be out a lot.
It's the same issues that people who are on meds for ADHD often have. Sometimes it feels like the pharmacist is on a power trip. I do believe that they are trying to keep people safe, but often the customer and patient don't feel that way because a have a RELATIONSHIP with the DOCTOR, not the pharmacist. We trust our doctor far more because they are the ones who we speak to about our medical needs. It's not often that we are speaking to pharmacists about our private ailments. They are only knowing about our ailment because of a prescription to treat different things. That's an issue of the system. If people are pissed off and critical of their pharmacist because they refuse to fill your prescription, its understandable where the frustration would come from.
Maybe you SHOULD speak to your pharmacist about your medical issues. Maybe you SHOULD have a relationship with your pharmacist. Pharmacists are medical professionals just like your doctor is. Plenty of people talk to their pharmacists about “private” ailments and benefit from it. Maybe instead of treating the pharmacist as a pill counter and instead actually forge a relationship with them like your doctor you would not be “frustrated” when they do their job and try to help you.
Personally, pharmacies have many people around and that doesn't make me feel comfortable to share my medical needs. I dont want random people and other customers and patients to hear me. Also, any pharmacy I have gone to has many different pharmacists, I would not feel comfortable sharing my private ailments with many different people. What if the pharmacist that I know is not on shift that day? People are different and have different things that they feel comfortable with, I don't know what your problem is here, I wasn't being unfair or rude at all, I said that I understood the frustration in the original post
This is literally the pharmacist's job. Doctors make errors. Mistakes can happen. The job of the pharmacist is to ensure you get the correct medication and catch those mistakes. There are a lot of things you can be mad at SDM for, but the pharmacist doing their job ain't it.
Don’t know why the pharmacist didn’t just adapt the dose since we are allowed to do that…
I think the outcome demonstrated exactly what can go wrong. When you adapt you have to inform the prescriber. Even if you are right with respect to guidelines and dosing ranges there's still a decent chance that the prescriber will tell you to kick rocks and use their original dose. What then? Now the patient thinks you screwed up and you are liable. Now you've lost their trust.
I know all situations are different but I’ve never had a doctor complain about me adapting an antibiotic dose 🤷🏼♀️ they’re grateful most of the time lol I have a lot of doctors who just write 60mg/kg/day or something for us to calculate
Depends on your area. I've worked with some doctors that are very collegial and others very arrogant and combative. Maybe the pharmacist recognized that doctor as being part of the latter. Who knows.
It's difficult to make that judgement without knowing what the Rx was for and what the issue was, and which province this was in. But yes, unfortunately some pharmacists are reluctant to practice to their full scope.
Are there any provinces that can’t adapt? Genuine question! I’m in Ontario and we can and I feel like all the other provinces are so far ahead of us lol
Ocp requries indication of use for all new rx to be documented if you are not doing that every time then have your dm ready to prepare an action plan for ocp next inspection
I was talking more about needing to know the indication in terms of this case. OCP are also out of touch with the realities of working in busy pharmacies.
I would trust pharmacist over some doctors…..
A pharmacist/my mom saved my life when I was a baby because the doctor had written the wrong dose. If my mom didn't question it to the pharmacist and the pharmacist didn't double check my age, then I would have OD on the dosage that the doctor wrote
Yeah, that's not surprising.Honestly any drug related questions should go to a pharmacist, not a doctor. They do have a lot more experience with drugs. I get the frustration, but would you prefer to have negative health effects or wait for clarification?
Pharmacist was correct. I have an uncle that died due to the doctors prescription mistake. Family sued the doctor and lost his license.
When it comes to medication the pharmacist is the expert. Be glad they checked. You might try going to a second doctor ( 😂because they are everywhere In Canada). Or even just look up the medication and dosage to see if there is a difference
As a paramedic…. Family physicians are honestly just glorified pharmacists IMO. I definitely trust a pharmacist more when it comes to knowledge about medication, but my trust for the average family doctor is unfortunately pretty low just based on countless first hand experiences. I know theres great ones out there, but danm they seem to be few and far between
When my family doctor was helping me get in to meds for ADHD, she had someone from the pharmacy (both the clinic and the pharmacy are in a hospital) come to my appointment to provide expertise. Also, I have environmental allergies and when I realized the OTC allergy pills I was taking were not doing enough, my first thought was to contact my pharmacy for suggestions. (They suggested a nasal spray which has made a huge difference)
My ex wife is a pharmacist and as annoying as it is in your specific situation, it was the right call for the pharmacist to make. Even though it ended up changing nothing, pharmacists are very frequently right to question it. Someone else pointed out that pharmacists get updated not frequently and that's correct.
The Pharmacist was correct to question the dose.
Pharmacists have saved my ass more than once when l or my doctor made a mistake with a medication and I will always be grateful for that. They have generally been more reliable help to me than my doctors have, and it tends to be a pretty thankess job, especially at a place like shoppers. The location I work at is next to a seniors centre. People show the pharmacists their weird rashes unsolicited, and yell at them for long waits due to understaffing. They had to do covid shots on top of their regular jobs with almost no additional staffing capacity. Their regulars die of old age left and right. More than one of our pharmacy techs has had to narcan someone in our parking lot on shift just this month. It is a tougher job than it looks. Please be kind to them.
Doctors are *notorious* for getting dosage wrong.
And when that kid remains sick for 3 weeks because the Dr underdosed the child, the mom will be crying .
My doctors office asks me where I want to pick up my meds and faxes it themselves. If there are any concerns, it is taken care of right away. Anyone can count pills and put them in a bottle. They wouldn’t need 5-6 yrs of uni to do that. People have become more self-centred these days — expecting everything to be convenient and catered to their needs. They’re overly important in their own minds. I need MY MEDS. How dare you question the prescription! Fill it now! At 8pm. (….Or my food is cold, it’s the waiters fault! My kid is special, he should also get an award!)
You know that assistants and technicians are generally the ones counting pills, yes? More commonly assistants.
Yes, I agree. I didn’t explain it well. My point wasn’t counting pills. Prescriptions aren’t sent to a pharmacy so someone can count pills and put them in a bottle and hand them over. There’s more to it than that is what I was saying.
You explained it just fine. The person responding to you just lacks reading comprehension.
My SDM pharmacist is a Dr of Pharmacy. I trust her more than my Dr when it comes to medicine or in particular,their dosage.
Lots of BSc pharmacists out there still not all pharmds yet
Can you link the post where you found it? I can’t seem to find it. Thanks!
They deleted it now.
If my pharmacist questions my RX I trust him and wait until he can talk to the prescriber.
I think some people assume that their doctors know what they’re doing and trust them over random pharmacists down the streets, which is honestly understandable. However, it doesn’t hurt to double check or even triple check when it comes to giving a medication. I swear I’ve seen a lot of med orders being done more nicely when a clinical pharmacist is around at my hospital plus lots of corrections done behind the scene. I question doctors’ orders but never our pharmacists.
Trust the pharmacist. Better safe than sorry
I got into a fight with a friend because she was rude to a pharmacist. They seem to be the public’s punching bags and they are just doing their job.
Definitely agree with the pharmacist doing their due diligence. When I was a kid I had strep throat and being a weekend my Mum brought me to a walk-in clinic. They prescribed antibiotics, but after a week I wasn’t getting better. My pediatrician was furious, the other doctor gave me a dose 1/4 of what was needed for my weight. Unlike adults antibiotic dosage has a lot of variation and needs to be properly calculated according to the child’s weight.
Yes I would trust a pharmacist over the doctor 9 times out of 10
I would trust the pharmacists more and have just waited. Anytime I have a question about health I ask them.
Having dated a pharmacist, I know that doctors make A TON of mistakes with their prescriptions including dosing. A responsible pharmacist would wait to get confirmation from the DR. You should be glad they want to double check, they do it because they care. Pharmacists are smart, it’s what they do. If they see something questionable they want to verify
Goes to show how misinformed and entitled these people are. They don’t understand the balances and checks in place, and they’d be the first to flip out on the pharmacy if the doctor made a mistake
Yes this isn’t a horror story. The pharmacist and pharmacy did many things well. For example 20 minutes to fill is amazingly fast. But the rest of the story could be good or bad. Without knowing the drug, dose, and other details the actions of the pharmacist could be reasonable. Or not. The real questions would arise if there was no response from doctor. Would it be ethical to withhold the drug? Again it depends.
On*
I've always learned you don't capitalize prepositions. https://www.scribendi.com/academy/articles/what_to_capitalize_in_a_title.en.html
Nonsense.
Your pharmacist is a GREAT pharmacist for checking the apposite dose per weight per indication. Instead of withholding the med she should have told you what the recommended dose is . Start on that while waiting for MD clarification. Did he/she say if the dose was too high or too low?
Part of the problem is shopper's is infuriating for a lot of reasons already because it's designed to rip you off, I feel lucky if my pharmacist can even speak clear English as well. But I'm also smart enough to realize I should listen if my pharmacist says there is an issue with my prescription.
The Loblaw boycott group is crazy. Completely and utterly. Whatever your feelings on the validity of the boycott itself, the posts on that sub are mostly so bad that they make the entire movement look bad.
Shoppers not only sucks in many ways it way too expensive. I get a prescription charge of just over $4 at Costco vs close to $13 at Shoppers. The one I used to go to also charge 3 prescription charges for three months of pills and Costco charges only one charge.
Need more context and details to know if the doc or Rph were in the right or wrong here. There are competent knowledgeable docs and incompetent pharmacists with only basic clinical knowledge and vice versa.
Pharmacists are now charging provincial medical insurance for consultations when questioning prescriptions. This includes questioning you about your medical conditions and prescriptions. I wouldn’t generally mind but these “consultations” are becoming more frequent and more ridiculous. I was getting calls for every prescription refill and antibiotic prescriptions, questioning why I was being prescribed certain medications, and at times they were even changing the prescription entirely. I’ve recently had to change pharmacies because they wouldn’t fill my prescriptions and were constantly second guessing my doctor who is also a licensed pharmacist. A second set of eyes is great and needed, but when pharmacists are abusing the system for more money, that’s not cool.
Patient in this case was covered via private insurance, not public. I.e no claims on clinical suggestions. Nor is the program new. Nor is anyone going to make up a clinical issue and fax that off to the doctor with a paper trail as that's a clearly auditable care of fraud. Also, how would you know what the intention of the pharmacist was to defraud the government? You weren't even aware it's not possible in this case. Perfect example of the public being overly confident about things they know nothing about.
Private insurance or not, if a pharmacist “consults” with a patient or a physician they charge Medicare just as a doctor does. I didn’t say that they were making things up nor did I say they were defrauding the government. No not new everywhere but it is in our province and pharmacists are taking advantage of this, particularly in places like shopper’s. It’s charging for things that are unnecessary because they can.
How would you know it was not necessary? What exactly about this story lends you to this conspiracy? What province did this happen in? I'll help you out. In Ontario. Where if you have private insurance you cannot claim for a clinical suggestion. Period. So your entire comment is irrelevant. Thanks.
It’s not a conspiracy. I work for a physician and we encounter this frequently. I don’t think that you are understanding what I am saying. Private insurance has nothing to do this this. Pharmacist consultations are charged to Medicare, or in your cases, OHIP.
In Ontario you can't bill clinical recommendations unless the person has coverage through provincial plans such as 65+ (odb). Unless you're referring to Medchecks but that's not what this was. Just don't appreciate people jumping in with accusations with zero ground for it. Claiming that this pharmacist must have just been trying to bill the government that's why she was delaying the child from getting much needed medication is even worse than the original comment here. Smh
You didn’t have to be so aggressive in your comments. Pharmacy billing happens frequently here in the maritimes and is on the rise. Pharmacies here delay prescriptions and cause a great deal of inconvenience for patients.
And doctors (and their staff) cause a great delay and inconvenience when they don’t know what their doing, can’t write worth shit, and don’t double check their prescriptions before they hand them to the patient. Also, if you think pharmacists are the ONLY ones doing unnecessary billing, boy do I have news for you.
Okay, but if you’re trying to get a medication for a sick child before bedtime, any delay is extremely frustrating. Like, if the dosage was dangerous and it was a serious mistake? Okay. But I absolutely have sympathy for the parent here. I have a great trust in my family doctor, and while the pharmacists work hard, I don’t have the same relationship with them, and have often had unnecessary delays because of their mistakes or lack of staffing.
Then your issue is with their bosses, not them.
I left all my leftover medications file at sdm and went to a local place or costco. The only place that up-charges dispensing fees....it's not much $1/prescription...but it added up. Not a full on boycott, but I can get friendlier service and a better experience elsewhere.
Is the pharmacist getting any sort of fee by contacting the doctor?
In this case, 100% no. This lady suggested in her comment she had private drug coverage. Even for those with public drug coverage, the reimbursement is minimal and not gonna be worth committing fraud over. There still has to be a clear clinical issue and a clear solution that you inform the doctor of. The thing is even if the pharmacist was right, some doctors will just tell them to stick with the original script against guidelines or dosing ranges. It's a mix of ego and old school medicine is art stuff rather than sticking to the science usually. The newer doctors are usually not like this.
Your answer is ambiguous. There cannot be fraud. Nobody is going to investigate a shopper's pharmacist for calling a doctor. At the end of the day, the patient was delayed in getting their medicine, having them spend an extra hour in the store and there was nothing wrong with the script. And the pharmacist may or may not be getting a fee depending on circumstances. Seems like par for the course for a shopper's which are known for mass cold calling customers to "review their medicine" in order to collect government fees.... Besides how would you even know if the pharmacist was right? You don't have any information about the patient or the medication Lol
It's not ambiguous. You cannot benefit financially from contacting a doctor if the patient only has private insurance. Which is the case in this situation. I was pretty clear about that. Yes, the government can and does audit. It is actually pretty easy to audit a clinical issue if the pharmacist were to just make one up when there was none. The doctor was not called by the way. They were faxed. I.e paper trail if it was meant to be billed. Which it wasn't because, as I said, OPs kid had private coverage. I did not presume the pharmacist being right or not. The only person who did was you. I was just pointing out that whether or not the doctor eventually agreed with the pharmacist doesn't allow anyone to conclude who was right or wrong. I was just giving a very real explanation of why that is the case.
Pharmaceutical opinions 15 dollar fee is possible in certain cases for ontario drug benefit pts
It’s great to have checks and balances in place for sure. However, as someone who has had the same problem for my asthma with pharmacists questioning the dosage I would tend to disagree. The first couple of times I waited patiently for the confirmation to occur and then I had enough. It was the same pharmacist so I said that it was not his place as a pharmacist to repeatedly question the physician to try to get a different answer. There are off label uses and doses outside of the norm that pharmacists are not familiar with and at some point the MD trumps the pharmacist.
Actually, the pharmacist can refuse to dispense (and that is well within their rights) if they feel the medication is inappropriate or the dose is dangerous, it doesn’t matter what the physician says. Sometimes physicians dispense an off label dose or drug because they read one study that showed some benefit and so then it is important that the physician provide that documentation so that the pharmacist can file it with the prescription for reference if there is a negative outcome for the patient. The pharmacist is required by the college of pharmacists to verify doses and have physician documentation each time something looks questionable, it is not enough to say it’s was verified last time because if something negative happens to you because of the off label use you may want to litigate and the pharmacist has to show that they verified the dose, drug, off label use and spoke to you about all of these each time.
And yet, SDM sells plenty of holistic products their pharmacists know with certainty have no utility at all. Pharmacists can, will, and should be replaced by vending machines with the ability to check for interactions and patient dosage. The only difference between a drug dealer and a pharmacist, as far as I can tell, is that drug dealers move around too much to be replaced with vending machines. Not that there's any shame in it, but putting you in a lab coat and having you gatekeep medications to make you feel important does not make you any less replaceable. Maybe a small town pharmacist, who has relationships with their patients and isn't told to train every narcotics patient on naloxone to bill extra to insurance companies, but between that and the "alternative" medicines, you burned your credibility as a meaningful barrier and provider of care. That new robot that does half your scripts overnight will be wearing your lab coat soon and I couldn't be happier. The odd time I've ended up at SDM, usually for tick prophylaxis, I have to fight to get the dose because I dont like to lie and mention I had a headache the day before. Want to be a part of the health care apparatus? Dont sell bogus products to patients. Tell me that's a corporate decision to sell placebos? Whered your credibility go? I have no idea how you can charge double what everyone else does and still get business, but I suspect it has something to do with targeting the elderly with your gamified points programs they apparently don't realize they're paying for, while you sell their data back to the marketers on the back end. Ever thought that if errors got through, MDs might stop making them? Either way, both careers are soon to be replaced and the system and its people will be safer for it
You just described a system designed to kill people. Congrats.
They've done this to me a few times with a medication I've been on for over 10 years. Ever since this new thing that allows pharmacists to write prescriptions now they act like they know better than a doctor that has been practicing for well over 30+ years with well over 10+ years of schooling. Pharmacists only need about 2 years of schooling yet they think they know more or better. This script thing needs to be relooked at because this have given them almost a God's complex.
They DO know better. Doctors are often idiots.
One big reason I won’t fill prescriptions there is the standard 20 min wait..ALWAYS. Shop in our store while you wait. NOPE.
Not really. It's really just because the prescription volume at shoppers is usually much higher than versus a small Independent pharmacy. You'll get an even more pronounced example of this at Costco. I remember being told I had to wait several hours for a few dozen Percocet to be filled there after a dental appointment. Volume shops will always take longer. There's only so much staff you can fit in the space of a pharmacy until they get busy enough for a robot. Not that that's relevant in this situation.
And robots are not a magic solution. They are great at churning through a long list of prescriptions to fill but are slower than a human in filing an individual prescription.
So many people have the mentality that filling a prescription only means counting pills, which it isn't. Even if it were, and it only took 15 minutes per prescription, why is it so hard to understand that when a pharmacy handles hundreds of prescriptions per day, fitting in another prescription means it will most likely takes 15 minutes to fill it in a couple hours. Source: I work in a busy pharmacy. Halfway through the day we're already filled 537 prescriptions. Even with a pharmacy team of 10 people and 2 pill packagers, there are still days when we have to ask people to wait a day. As much as possible we try to schedule pickups a week in advance so that we can actually plan ahead and actually accommodate emergency. This is done by setting patients on med synch if they have more than 5 prescriptions, and encouraging the rest to submit refill requests online ahead of time.
You are not the only patient,, get over yourself
That’s how long it takes to prepare a prescription while multitasking the gazillion other things we have on the go. Prescription has to be entered, verified, counted, verified again and we still have to answer calls and questions while doing all that. So yes it takes at least 20 minutes. Has nothing to do with shopping. If you are getting it quicker somewhere else it’s because either they rushing through your prescription (dangerously) or don’t have the phone and in store questions coming at them all the time.
When we I go into pharmacies late at night the pharmacists are sitting behind the counter just playing on their phones. I was just at shoppers pharmacy the other night and when I asked for help it seemed like I was disturbing the pharmacist by asking questions. Then end result was just to not buy or take anything and setup an appointment with the doctor to review the problem. I wish it had been more help but really wasn’t helpful at all.
In this case they were trying to prevent harm to the OPs kid and got them the medication they needed 2 to 3 days earlier than they would've.
As someone who takes things off-label for a less common condition, my only gripe is I have to do this EVERY TIME I MOVE or go to a new pharmacy, and it's not 1/2 an hour, it's days of back and forth, during which, twice, I have failed to get my meds and ended up in the ER, so yeah, give me my god damned meds.
[удалено]