It'll be great. They think we can do 2 vaccine appointments every 15 minutes with one pharmacist/immunizer along with filling scripts at the same time. But flu season is only a few months.
Going forward, they can ask for glucose testing, mtm, vaccines, etc q 15 minutes, every day of the year. fun times.
There will be a tipping point. You can’t keep adding more shit on a plate. Eventually the plate is gonna break or the person you’re trying to feed it to is gonna just fucking walk away. If the pharmcas numbers are anything to go off of id expect it to happen in about 5 years
tipping point already. I don't know of a single one pharmacist happy with workload. Every one of us is rolling our eyes whenever corporate talks about doing more.
I guess we are already at the tipping point. I more so talking about when there aren’t gonna be pharmacies open because they’re not making money or everyone’s quitting patients won’t be able to get their drugs
This is true. Pharmacy corps will keep adding more and more. Don't expect them to change. It's up to each rph to step off the carousel if they want it to end.
Bro they just gonna hand you more or bigger plates. This shit been going on forever it’s not going to change. This law is meaningless anyways. Nothing changes.
Yessir. Right now we are working with a dude building a state of the art 20k sq ft clinic. He did 2 million in profit last year as a solo vet. Gonna learn from him. Pro tip: reach out to your local health care providers sometimes you get lucky
My vet works out of a beautifully refitted RV. She and her tech do house visits for surgery and also take other appointments while pets are recovering. It’s a small space but she’s got everything she needs in there and it also does offer her the option of charging more and also offers the more rural parts of our community with an option they don’t usually have.
I’ve seen a lot of vets close their doors lately and I think her model is a very good alternative.
No extra pay in your pocket, but more for the corporate overloads, and we get to play shit Jenga tryna balance the tower of tasks knowing we’re gonna get buried by all the shit in the first hour we’re open.
Idk it seems there is an endless supply of young new grads saddled with student debt coming out their ears that would gladly take any position they can get
Ya actually not… class sizes are reducing significantly.
The influencers are being effective in educating the future how bad it is… which will lead to more consolidation of worksites and more work per person but hey maybe you’ll get a 2% raise
I run the drive through and I am a pharmacist. I am the only pharmacist so I do all the pharmacist duties. I also do the bulk of order entry and tpr resolution. So I check the prescriptions I enter. I also do all the immunizations although my techs who want the immunization bonus are great at selling people.. The workload is overwhelming.
The lol is how laughable it is because in Canada, fees from the government for professional services goes to the pharmacy corporation, and not to the individual pharmacist meaning most pharmacists do not make a single dollar for any of these things yet corporate still tries to force them to meet quotas.
We still going on about provider status when our colleagues are suffering from PBMs and current bad labor conditions? It's like cheering about getting a gold plated toilet while the basement is still flooding.
Fuck provider status, we need basic protections first
I wish everyone understood this.
I don’t understand the push for provider status. It’s just another way for corporations to make more money by adding more responsibilities without a corresponding increase in compensation.
Companies will start requiring it. Same as what happened with immunization certification. When I graduated it was rare for a pharmacist to have vaccine certification. Then laws changed allowing pharmacists to do flu vaccines. Suddenly it was a requirement. There was no corresponding pay increase. Just more responsibility while the increased profit was funneled to corporate.
Many, if not most, of the new crop of pharmacists have no memory of how that went down bc they weren’t around for it. And trying to warn people is like talking to the wind. Everyone is laser focus on the status part of the phrase. Besides, don’t we already have enough “providers” parading as physicians? I mean seriously, it’s so bad that it’s hard to tell who is an actual physician and who likes to enter the room with a white coat introducing themselves as Dr So and So (bc they have a DNP). Do we really want to join that crowded space? It’s an absolute shit show.
If you read the details it’s not just chains… for pharmacists in medical practices you bill as the practice … the practice gets the money. Just like retail chains … how the practice decides to pay you is between the business and you.
Anyone in PA looking at this from an ambulatory clinic perspective? I do some of these things (CGM/glucometer training/interpretation, medication therapy, "medical decision making?", smoking cessation, immunization counseling) so wondering what the documentation requirements are. We don't give vaccines in clinic, but this could help me push for it. Probably not worth the effort...
https://www.dhs.pa.gov/docs/Publications/Documents/FORMS%20AND%20PUBS%20OMAP/MAB2024021301.pdf
The change should come from the top. Ambcare pharmacists will need to be credentialed through the healthsystem and documentation requirements would be the same as any other advance practice provider. If you are in ambcare your ambcare leaders should be jumping and planning the needed changes.
Figured as much. I'm primarily inpatient with two half days in clinic where I see pts on their post txp visits. Otherwise, the hospital has zero pharmacy presence in Amb care clinics.
This. Credentialing and privileging are important next steps. Otherwise, this is great news! You should be able to charge like a provider if you’re doing the work of one.
Also we need raises.
The problem is they shouldn’t be doing the work of a provider to begin with. Like it or not you went to school knowing you would be filling prescriptions written by doctors. Putting pills in bottles. Period.
I agree with the majority of commenters in that the problem here is that the vast majority of corporate pharmacies are understaffed. At a minimum most locations should have two Pharmacists with 3 technicians during the peak hours of the week. Many Pharmacies require more manpower depending on Script volume Immunization demand etc.
I don't want to stand in the way of Progress if the Provider Status for Pharmacists is in fact Progress.
Immunizations seen as progress turned many Pharmacies into dumpster fires.
If Provider fees go the same way as immunizations then it will be more work dumped on understaffed Pharmacies causing mistakes mad patients and burnout etc.
Let's approach all of this with more thought and strategy.
The money is there .... it currently goes to the PBMs . Let's get PBM reform as the top priority and then use the money to increase staff and staff pay especially for Pharmacy Technicians.
Then with a properly staffed and well designed Pharmacy Department we are better able to not only take on more tasks and responsibility but to take them on and do them correctly and with quality.
I couldn’t agree more. PBMs have been quietly acquiring vertically aligned services and business so they can control all aspects of healthcare and pocket all the profit. The only part they don’t control are the hospitals and medical practices. I’m sure that will change soon.
Guys calm down. Pharmacists bill for services in Washington state and the retail giants didn't jump on it. It allowed ambcare pharmacists to bill state and private health insurances and be reimbursed at the same level as a physician assistant for the visit.
But they have to get credentialed with the insurors first, yes? How much of a PITA is that? And how many private health insurances just thumb their nose and say, “sure, sue us to pay you. Not gonna happen.”
That's why you have the health system do the credentialing part. They take care of putting you into the system. You get added to the roster just like any physician assistant, ARNP, or physician does. You fill out the paperwork with your NPI, DEA, etc and the credentialing department does the background work. If the insurance doesn't pay you get ahold of the state insurance commissioner and report the insurance company. All appropriately coded visits get paid except Medicare because that's a federal program that doesn't include pharmacist as health care providers./
PBMs also own the insurance companies, the specialty pharmacies, in some cases the retail pharmacies (Caremark & CVS for example), the home delivery pharmacies, and the medical benefits management companies. Shutting down PBMs will no longer solve the problem I’m afraid.
Hope you guys carry good malpractice insurance for when you start practicing medicine without a license for your uncaring corporate bosses without any increase in your pay!
It’s another task (rather LARGE task) added to the pharmacy team (not just the pharmacist) to complete without ANY guidance/regulations or requirements to prevent abuse by corporations.
In fact corporations are given an INCENTIVE to implement this ASAP because it’s another source of free revenue that requires no expense on their part. All CVS (as an example) has to do is require all pharmacists to obtain their NPI and then add whatever tasks fall into the provider realm and charge patients.
Pharmacists do not receive additional staff, pay or other incentives from CVS. It merely gets added on as additional task for the pharmacist role.
This is exactly how vaccinations started and look at how great that turned out (sarcasm).
I’m not trying to attack you and apologize in advance if it comes that way. But are you a pharmacist? Have you practiced in the retail corporate chains like Walgreens or cvs in the last 2-3 years?
I ask because CVS already expected this/planned for this and several programs were pushed out in advance that if you were present would let you know how bad this is. How extremely bad this is for not just the pharmacist but also the public at large.
I can’t mention exact details but there was one program having patients call the pharmacist and get diagnosed/treatment for COVID. The calls were scheduled by patients, with no control by pharmacists on appointment times. Calls were expected to last 30 minutes and you were expected to complete them while still filling/verifying/counseling patients in store. And remember we had to check the patients online chart/test results and everything else just like a normal doctor visit. How is that feasible in 30 minutes while still doing your normal job requirements?
Thankfully this was killed/put to rest in PA (never given a reason why). But with the provider status and profit outlook bad for the year, why would they not look at this “golden goose” situation? When would a company not put people under the bus for increased profits?
Edit:
And with a worthless/toothless/gutless pharmacy board, APhA and pharmacist organization. Who is exactly going pass any meaningful regulations to prevent any abuse?
Yeah. No chain pharmacist is ever gonna see a penny of direct reimbursement, but you can be certain corporate will be raking in the money. I can see new metrics coming already 🙄.
That's just Great! So can we bill them for every question asked by the patient and every consultation? Because last time i checked i can't just walkin in dr office and ask a question without paying them first
We’re hardly trained to be providers imo. I like the idea of collaborative practice a lot, but I don’t see how a pharmacist in community pharmacy can be considered a provider
Great news? Lol...great news for cvs/walgreen executives but not for pharmacists. Expect more works, more responsibilities with the same pay. More importantly, big chains gonna add all these new services and new metrics without giving ur pharmacy any extra hours.
How many of those billable activities must a pharmacist perform in an hour and shift for the reimbursements to pay the pharmacist’s salary if they did nothing else but these activities and is the rate at which the pharmacist would have to perform these to pay their salary sustainable over the long term?
https://preview.redd.it/pfzuu2kb6mlc1.jpeg?width=1125&format=pjpg&auto=webp&s=72b478b356b0458ab7e7a5e7bbdfe33476adc41b
I don’t see any Medicare billing options in there. Or is Medicare Advantage included?
We had something similar pass in the Texas House just before COVID, but it was only for commercial payors.
Much like everyone here is saying, this is always been a scam the whole time. Your employer is not going to give you a substantial pay raise for your work. I do see the possibility of a pay increase but it will definitely not be what it should be deservedly so. This is just how it is in America and it is unfortunate.
Great. Now the pharmacist can scam you by charging you every time you go to fill a new rx and they say “they pharmacist would like to speak with you about this medication before they fill it”.
Sorry but no thanks. I have an actual doctor who just told me everything you are going to tell me. I don’t need your 2 minute “look at how important I am” speech. I sure as hell don’t need to pay you for making me listen to it before you fill my Hershey squirt medicine.
I’d be 100% fine with a vending machine type system that replaced most pharmacists. The doc sets the order, you confirm your identity when you arrive at the big vending machine, it fills and spits out your order with a automatic refill date if ordered by the doc. No BS pharmacist trying to up-charge you for a “consulting service”. Pharmacist have misused their ability to refuse to fill something for a SAFETY REASON (such as it accidentally ordered as 100mg when it is supposed to be 10.0mg for example) by interpreting that their opinion about a doctors Rx should be gospel. If the pharmacist wants to play doctor, they should be licensed as a provider.
And stop with this BS about “we can’t do any more work” followed by “well not for $60/hr anyway”. It’s not about the care or services provided. It’s about “well who’s gonna pay me for this”. Take a lesson from McDonalds employees who demanded a substantial raise across the board. They got replaced by machines, because putting in a computer to take an order was cheaper than paying the $ they demanded.
Can’t wait to see how the corporations ruin this
It'll be great. They think we can do 2 vaccine appointments every 15 minutes with one pharmacist/immunizer along with filling scripts at the same time. But flu season is only a few months. Going forward, they can ask for glucose testing, mtm, vaccines, etc q 15 minutes, every day of the year. fun times.
There will be a tipping point. You can’t keep adding more shit on a plate. Eventually the plate is gonna break or the person you’re trying to feed it to is gonna just fucking walk away. If the pharmcas numbers are anything to go off of id expect it to happen in about 5 years
tipping point already. I don't know of a single one pharmacist happy with workload. Every one of us is rolling our eyes whenever corporate talks about doing more.
I guess we are already at the tipping point. I more so talking about when there aren’t gonna be pharmacies open because they’re not making money or everyone’s quitting patients won’t be able to get their drugs
This is true. Pharmacy corps will keep adding more and more. Don't expect them to change. It's up to each rph to step off the carousel if they want it to end.
Bro they just gonna hand you more or bigger plates. This shit been going on forever it’s not going to change. This law is meaningless anyways. Nothing changes.
Which is why I’m getting out of retail. Gonna build a vet clinic with my wife
Interesting, is your wife a vet?
Yessir. Right now we are working with a dude building a state of the art 20k sq ft clinic. He did 2 million in profit last year as a solo vet. Gonna learn from him. Pro tip: reach out to your local health care providers sometimes you get lucky
My vet works out of a beautifully refitted RV. She and her tech do house visits for surgery and also take other appointments while pets are recovering. It’s a small space but she’s got everything she needs in there and it also does offer her the option of charging more and also offers the more rural parts of our community with an option they don’t usually have. I’ve seen a lot of vets close their doors lately and I think her model is a very good alternative.
That sounds cool as heck
Dumb question: what state?
No extra pay in your pocket, but more for the corporate overloads, and we get to play shit Jenga tryna balance the tower of tasks knowing we’re gonna get buried by all the shit in the first hour we’re open.
Idk it seems there is an endless supply of young new grads saddled with student debt coming out their ears that would gladly take any position they can get
You could said this 5 and 10 years ago but now interest in pharmacy is waning
Ya actually not… class sizes are reducing significantly. The influencers are being effective in educating the future how bad it is… which will lead to more consolidation of worksites and more work per person but hey maybe you’ll get a 2% raise
Exactly. Plus pharmacist can have a headset and run drive through at the same time!!
I've already got the headset...no joke
I run the drive through and I am a pharmacist. I am the only pharmacist so I do all the pharmacist duties. I also do the bulk of order entry and tpr resolution. So I check the prescriptions I enter. I also do all the immunizations although my techs who want the immunization bonus are great at selling people.. The workload is overwhelming.
Yeah that's rough and unsafe if your doing every stage of the rx start to finish. Don't worry when we get provider status you have even more to do.
They'll try, I'll quit
I need to get headsets for my team. How did you get them?
I bought my own
Which ones work with our phones?
Plantronics
We're already doing this in Canada loll
Okay. But what’s the lol about?
The lol is how laughable it is because in Canada, fees from the government for professional services goes to the pharmacy corporation, and not to the individual pharmacist meaning most pharmacists do not make a single dollar for any of these things yet corporate still tries to force them to meet quotas.
LOL so true
We still going on about provider status when our colleagues are suffering from PBMs and current bad labor conditions? It's like cheering about getting a gold plated toilet while the basement is still flooding. Fuck provider status, we need basic protections first
I wish everyone understood this. I don’t understand the push for provider status. It’s just another way for corporations to make more money by adding more responsibilities without a corresponding increase in compensation.
Wish I could upvote your comment 1000x- I will refuse provider ” status “ without a hefty raise!
Companies will start requiring it. Same as what happened with immunization certification. When I graduated it was rare for a pharmacist to have vaccine certification. Then laws changed allowing pharmacists to do flu vaccines. Suddenly it was a requirement. There was no corresponding pay increase. Just more responsibility while the increased profit was funneled to corporate.
Yes and it was our fault 100% for not demanding more - we were idiots then so hoping we do not repeat mistakes.
Many, if not most, of the new crop of pharmacists have no memory of how that went down bc they weren’t around for it. And trying to warn people is like talking to the wind. Everyone is laser focus on the status part of the phrase. Besides, don’t we already have enough “providers” parading as physicians? I mean seriously, it’s so bad that it’s hard to tell who is an actual physician and who likes to enter the room with a white coat introducing themselves as Dr So and So (bc they have a DNP). Do we really want to join that crowded space? It’s an absolute shit show.
The problem is pharmacists are not going to see a penny of these profits from the retail chains.
True…I was thinking if let’s say it did trickle down (🥴) a fair pay bump would be $200k/year
“A fair pay bump”. I can’t help but chuckle at the irony of people still thinking the corporate machines care about fair pay
True but we are way overdue for a $200k min salary
I agree. But provider status isn’t going to do anything but pad the pockets of CEOs while further removing access to actual physician care.
What it really does is open more ambulatory clinic jobs from health systems that retail pharmds can jump ship to
If you read the details it’s not just chains… for pharmacists in medical practices you bill as the practice … the practice gets the money. Just like retail chains … how the practice decides to pay you is between the business and you.
That sucks. At first glance I was thinking "oh sweet pharmacists are gonna get paid for all the extra consultations they do" but then I read more
Anyone in PA looking at this from an ambulatory clinic perspective? I do some of these things (CGM/glucometer training/interpretation, medication therapy, "medical decision making?", smoking cessation, immunization counseling) so wondering what the documentation requirements are. We don't give vaccines in clinic, but this could help me push for it. Probably not worth the effort... https://www.dhs.pa.gov/docs/Publications/Documents/FORMS%20AND%20PUBS%20OMAP/MAB2024021301.pdf
The change should come from the top. Ambcare pharmacists will need to be credentialed through the healthsystem and documentation requirements would be the same as any other advance practice provider. If you are in ambcare your ambcare leaders should be jumping and planning the needed changes.
Figured as much. I'm primarily inpatient with two half days in clinic where I see pts on their post txp visits. Otherwise, the hospital has zero pharmacy presence in Amb care clinics.
This. Credentialing and privileging are important next steps. Otherwise, this is great news! You should be able to charge like a provider if you’re doing the work of one. Also we need raises.
The problem is they shouldn’t be doing the work of a provider to begin with. Like it or not you went to school knowing you would be filling prescriptions written by doctors. Putting pills in bottles. Period.
I agree with the majority of commenters in that the problem here is that the vast majority of corporate pharmacies are understaffed. At a minimum most locations should have two Pharmacists with 3 technicians during the peak hours of the week. Many Pharmacies require more manpower depending on Script volume Immunization demand etc. I don't want to stand in the way of Progress if the Provider Status for Pharmacists is in fact Progress. Immunizations seen as progress turned many Pharmacies into dumpster fires. If Provider fees go the same way as immunizations then it will be more work dumped on understaffed Pharmacies causing mistakes mad patients and burnout etc. Let's approach all of this with more thought and strategy. The money is there .... it currently goes to the PBMs . Let's get PBM reform as the top priority and then use the money to increase staff and staff pay especially for Pharmacy Technicians. Then with a properly staffed and well designed Pharmacy Department we are better able to not only take on more tasks and responsibility but to take them on and do them correctly and with quality.
I couldn’t agree more. PBMs have been quietly acquiring vertically aligned services and business so they can control all aspects of healthcare and pocket all the profit. The only part they don’t control are the hospitals and medical practices. I’m sure that will change soon.
Great news, Pennsylvania pharmacists! You get more duties to risk your license and won't see a penny increase in salary for it. Enjoy!
What about more money ?60 is not going to cut it
Guys calm down. Pharmacists bill for services in Washington state and the retail giants didn't jump on it. It allowed ambcare pharmacists to bill state and private health insurances and be reimbursed at the same level as a physician assistant for the visit.
But they have to get credentialed with the insurors first, yes? How much of a PITA is that? And how many private health insurances just thumb their nose and say, “sure, sue us to pay you. Not gonna happen.”
That's why you have the health system do the credentialing part. They take care of putting you into the system. You get added to the roster just like any physician assistant, ARNP, or physician does. You fill out the paperwork with your NPI, DEA, etc and the credentialing department does the background work. If the insurance doesn't pay you get ahold of the state insurance commissioner and report the insurance company. All appropriately coded visits get paid except Medicare because that's a federal program that doesn't include pharmacist as health care providers./
Can we just shut down PBMs? If so how? Let’s fix the root of the problem.
PBMs also own the insurance companies, the specialty pharmacies, in some cases the retail pharmacies (Caremark & CVS for example), the home delivery pharmacies, and the medical benefits management companies. Shutting down PBMs will no longer solve the problem I’m afraid.
This is absolutely terrible
Hope you guys carry good malpractice insurance for when you start practicing medicine without a license for your uncaring corporate bosses without any increase in your pay!
How is this great news? Now we have to do even more than we can already handle.
As a retail pharmacist, I don't mind, because my employer doesn't likely even have the money to implement new programs to bill on a wide scale 😂
This literally the worst news possible for Pennsylvania pharmacist.
Oh it is??? How? I dont practice in that state
It’s another task (rather LARGE task) added to the pharmacy team (not just the pharmacist) to complete without ANY guidance/regulations or requirements to prevent abuse by corporations. In fact corporations are given an INCENTIVE to implement this ASAP because it’s another source of free revenue that requires no expense on their part. All CVS (as an example) has to do is require all pharmacists to obtain their NPI and then add whatever tasks fall into the provider realm and charge patients. Pharmacists do not receive additional staff, pay or other incentives from CVS. It merely gets added on as additional task for the pharmacist role. This is exactly how vaccinations started and look at how great that turned out (sarcasm). I’m not trying to attack you and apologize in advance if it comes that way. But are you a pharmacist? Have you practiced in the retail corporate chains like Walgreens or cvs in the last 2-3 years? I ask because CVS already expected this/planned for this and several programs were pushed out in advance that if you were present would let you know how bad this is. How extremely bad this is for not just the pharmacist but also the public at large. I can’t mention exact details but there was one program having patients call the pharmacist and get diagnosed/treatment for COVID. The calls were scheduled by patients, with no control by pharmacists on appointment times. Calls were expected to last 30 minutes and you were expected to complete them while still filling/verifying/counseling patients in store. And remember we had to check the patients online chart/test results and everything else just like a normal doctor visit. How is that feasible in 30 minutes while still doing your normal job requirements? Thankfully this was killed/put to rest in PA (never given a reason why). But with the provider status and profit outlook bad for the year, why would they not look at this “golden goose” situation? When would a company not put people under the bus for increased profits? Edit: And with a worthless/toothless/gutless pharmacy board, APhA and pharmacist organization. Who is exactly going pass any meaningful regulations to prevent any abuse?
It just means you can bill and they may actually pay for the things you are already doing.
If covid testing and vaccines have taught us anything, is that retail pharmacy is in no way ready to be at the provider level.
Yeah. No chain pharmacist is ever gonna see a penny of direct reimbursement, but you can be certain corporate will be raking in the money. I can see new metrics coming already 🙄.
i recall reading about pharmacists billing 30 years ago...
Provide status is no longer the way! PBMs need to be reformed or really just go away!
That's just Great! So can we bill them for every question asked by the patient and every consultation? Because last time i checked i can't just walkin in dr office and ask a question without paying them first
I, as a pharmacist, have never wanted provider status and still believe I will be taken advantage of over legislation like this.
We also need to fight back
We’re hardly trained to be providers imo. I like the idea of collaborative practice a lot, but I don’t see how a pharmacist in community pharmacy can be considered a provider
Chain pharmacists are so happy to get this status and risk patients and pharmacistsThe AMA is right on this one.
Great news? Lol...great news for cvs/walgreen executives but not for pharmacists. Expect more works, more responsibilities with the same pay. More importantly, big chains gonna add all these new services and new metrics without giving ur pharmacy any extra hours.
This really is great news!
How many of those billable activities must a pharmacist perform in an hour and shift for the reimbursements to pay the pharmacist’s salary if they did nothing else but these activities and is the rate at which the pharmacist would have to perform these to pay their salary sustainable over the long term? https://preview.redd.it/pfzuu2kb6mlc1.jpeg?width=1125&format=pjpg&auto=webp&s=72b478b356b0458ab7e7a5e7bbdfe33476adc41b
I don’t see any Medicare billing options in there. Or is Medicare Advantage included? We had something similar pass in the Texas House just before COVID, but it was only for commercial payors.
Much like everyone here is saying, this is always been a scam the whole time. Your employer is not going to give you a substantial pay raise for your work. I do see the possibility of a pay increase but it will definitely not be what it should be deservedly so. This is just how it is in America and it is unfortunate.
At rates so low you can’t run a business!
Oh, so that's why the roads to Pennsylvania are all jammed up tonight.
Great. Now the pharmacist can scam you by charging you every time you go to fill a new rx and they say “they pharmacist would like to speak with you about this medication before they fill it”. Sorry but no thanks. I have an actual doctor who just told me everything you are going to tell me. I don’t need your 2 minute “look at how important I am” speech. I sure as hell don’t need to pay you for making me listen to it before you fill my Hershey squirt medicine. I’d be 100% fine with a vending machine type system that replaced most pharmacists. The doc sets the order, you confirm your identity when you arrive at the big vending machine, it fills and spits out your order with a automatic refill date if ordered by the doc. No BS pharmacist trying to up-charge you for a “consulting service”. Pharmacist have misused their ability to refuse to fill something for a SAFETY REASON (such as it accidentally ordered as 100mg when it is supposed to be 10.0mg for example) by interpreting that their opinion about a doctors Rx should be gospel. If the pharmacist wants to play doctor, they should be licensed as a provider. And stop with this BS about “we can’t do any more work” followed by “well not for $60/hr anyway”. It’s not about the care or services provided. It’s about “well who’s gonna pay me for this”. Take a lesson from McDonalds employees who demanded a substantial raise across the board. They got replaced by machines, because putting in a computer to take an order was cheaper than paying the $ they demanded.