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Old 05-27-2013, 07:46 PM   #151
fortwildernessishome
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Quote:
Originally Posted by kaytieeldr View Post
Spot on? Not necessarily - just not nearly as invasive or blindsiding as the original poster claims.
Uh....yes, "spot on"!!!

I read many, many posts that did indeed say that what the pharmacist did, was "his job", "his responsibility" etc.

I am not going to go back and quote them all, but I did indeed read many posts that did say the pharmacist was basically "spot on"!

I also read posts that didn't find it invasive, but that is NOT the posters that I was referring too in my post.
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Old 05-27-2013, 11:00 PM   #152
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I too, am a "lowly" nurse. Who is switching back and forth in 5 days? Who is prescribing new psych meds every 5 days?

Psych patients are notorious for non-compliance, which is why face-to-face assessment is very important. I can't tell you how many of my patients have sworn they are taking their meds but their behavior clearly says they haven't been.

That being said, unless you are terribly familiar with the patient it is impossible to assess, over the phone, whether they are having issues with their medicine. Also psych patients, whose mental status may not be grand may not even recognize certain side effects.

I have patients, when properly medicated, you would not even know they had an issue (most of my patients I'm sure are far sicker than the OP) and other who no matter what dosages and combination of meds they are given still have negative symptoms, the meds just help them live with those symptoms.

For instance, one woman, no matter what she is given continues to hear voices. She has been in the program years, and has tried every med and combination of meds, but she still hallucinates. On her current regime, though, she is able to live independently. She talks to herself, but she lives in her own apartment and attends the program 5 days a week.

The OP had said somewhere (sorry not going to go back through all zillion pages) that she had been on this med before, then switched to a new one and is now back on the old one. The op also mentioned somewhere near the start of the thread that she does not take her prescriptions as prescribed. There was one prescribed twice a day, she takes it " as needed" and tried to "handle the anxiety" on her own or something to that effect. It was in the first few pages of this thread. It could be one of a million things that set off red flags to the pharmacy. Like a script getting filled at strange intervals or two similar scripts getting filled close together (which happens if a doc changes your med on you) . I am just pointing out some reasons why this call may have happened. And the fact that psych patients don't have a great track record of compliance.
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Old 05-28-2013, 12:55 AM   #153
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Well, I suppose you could refer to a person as "a" patient, but it wouldn't be the pharmacist's patient. Pharmacists do not treat. I have never heard a pharmacist refer to a "patient" being his or hers. Always been the customer.
I know quite a number of PharmDs (Doctor of Pharmacy) and they all refer to their patients. There is way more to their practice than just counting pills. They also spend a lot of time consulting with physicians.
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Old 05-28-2013, 01:08 AM   #154
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Yes exactly this!

Part of my cont ed ceu's have to be in pharmacology. Its ongoing in this field.
And i see people complain all the time about doctors being wined and dined by drug reps, we are not being wined and dined, they are educating us in the medication. Providing very useful information about the drugs , how they work, etc .
Really? The drug reps for the high priced high margin meds are über specialized. Their job is to get physicians as well as non-physician prescribers to write scrips for their particular med regardless of whether it is clinically more effective than another med. They are sales and marketing types, not clinicians and in many cases, have little science education.
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Old 05-28-2013, 05:43 AM   #155
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I did mention in one of my posts that doctors are wined and dined. I have a few friends that are pharmacuitical reps.
Sure the reps get education on the drugs they are trying to get the doctors to use. And you better believe they also get a budget to wine and dine and gift Docs to prescribe these new drugs!
Their salaries and bonuses are based on their sales!

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Old 05-28-2013, 08:57 AM   #156
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Originally Posted by Laura66 View Post
I did mention in one of my posts that doctors are wined and dined. I have a few friends that are pharmacuitical reps.
Sure the reps get education on the drugs they are trying to get the doctors to use. And you better believe they also get a budget to wine and dine and gift Docs to prescribe these new drugs!
Their salaries and bonuses are based on their sales!
The rules about accepting "gifts" (dinners included) have changed dramatically in the past couple of years. We even have mandatory training about it yearly now.
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Old 05-28-2013, 09:12 AM   #157
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A word about pharmacists calling people "customers" or "patients". I think it would go back to what they learned in pharmacy school. (And maybe the pharmacy student here can speak to this.) if they generally refer to the people they serve as patients, it might well carry over to a retail situation if that's where they work. I work with pharmacists daily in a hospital and naturally there they refer to people as patients. I think it would be an expectation of the company they work for how they refer to their clientele. However, when using a newer term, even with the best laid plans, if they were trained using the term "patient", it might slip through from time to time. I wouldn't have an issue with that myself. And I would be grateful to have another set of eyes watching out for me and my family when it comes to our pharmaceutical health. But that's just me.
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Old 05-28-2013, 09:15 AM   #158
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Originally Posted by roseaster View Post
I work in mental health. I will tell you as a provider evaluating and assessment in mental health can be a little more tricky and often relies on having a relationship with the patient. You need to assess a patient for a lot of non-verbal clues which aren't apparent over the phone.

Unlike many traditional meds, I will give penicillin as an example, psych meds often take a period of time to even start working and a protracted period of time to achieve maximum effectiveness. Antidepressants typically take 14-21 days to start working, maximum effectiveness may require months of adjusting dosages.

My example is this. Say penicillin is prescribed for strep throat. The patient usually feels better in 2 days. The fever is gone, the sore throat is decreased or gone. All very easy things to determine on the telephone with a simple, "Do you feel better." Now with a psych med it's a little tricker and really requires a face to face assessment and a past knowledge and relationship with the patient. After 14 days a patient may say that they aren't feeling less depressed, but on assessment you may notice non verbal clues that indicate it is working. Better eye contact, less distractibility, less fidgeting. These things may be subtle and not even recognizable to the patient, and certainly can't be evaluated on a telephone call.

Working in psych, I know a lot of patients who fill prescriptions, or rather their family fills it for them, and they don't take the meds. They throw them away, or flush them to make the family think they are taking them.
So you are a licensed provider? Do you mind sharing in what capacity?
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Old 05-28-2013, 10:07 AM   #159
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Originally Posted by CPT Tripss View Post
I know quite a number of PharmDs (Doctor of Pharmacy) and they all refer to their patients. There is way more to their practice than just counting pills. They also spend a lot of time consulting with physicians.
Never said all they did was count pills. I did say they don't treat.
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Old 05-28-2013, 10:34 AM   #160
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Originally Posted by Pea-n-Me View Post
A word about pharmacists calling people "customers" or "patients". I think it would go back to what they learned in pharmacy school. (And maybe the pharmacy student here can speak to this.) if they generally refer to the people they serve as patients, it might well carry over to a retail situation if that's where they work. I work with pharmacists daily in a hospital and naturally there they refer to people as patients. I think it would be an expectation of the company they work for how they refer to their clientele. However, when using a newer term, even with the best laid plans, if they were trained using the term "patient", it might slip through from time to time. I wouldn't have an issue with that myself. And I would be grateful to have another set of eyes watching out for me and my family when it comes to our pharmaceutical health. But that's just me.

I do not think using the term patient is a slip at all. The retailer may use a term, such as shopper for those who come to the store whie their pharmacy uses the term patients for those customers tht use the pharmacy.

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Never said all they did was count pills. I did say they don't treat.
True, you did not, but tht is a commonly held misperception along with what you actually did say. Pharmacists do diagnose and treat medication induced illnesses as well as other medication related problems. Increasingly pharmacists are an integral part of a patient's treatment team.
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Old 05-28-2013, 11:56 AM   #161
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I found this topic interesting so read through the thread and wanted to weigh in.

First about HIPAA, I completely disagree that the Pharmacist didnt use an identifier and it doesnt matter that the OP's phone number was on file and was asked for by name. I get a call monthly now from a mail order pharmacy to set up my shipment and monthly from a nurse that both ALWAYS asks me what my date of birth and address is. They dont call and say "is your dob ---?"

I just started using this mail order pharmacy for 1 med b/c its the only pharmacy in my area allowed to carry the medication per the drug company. It is beyond annoying that I have to go through a 20 min phone call from a Walgreens rep (not even the pharmacist) about my side effects and other information regarding my Dx. Which they know what it is since there is no other disease this medication is for.

I sat through the full conversation as politely as I could but I really need to figure out a way to say can you just send me my meds and confirm the date and nothing else.

I do know that healthcare is changing, but I dont think the phone call was warranted unless he called to say the medication was a conflict with what she was taking. He's not allowed to call her doc and ask are her meds working why would they call her? Since he was new I wouldn't have stated it was their policy, it could possibly be a new policy that was recently instated but if it was it may have come across better than a nosy pharmacist.
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Old 05-28-2013, 12:01 PM   #162
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I do not think using the term patient is a slip at all. The retailer may use a term, such as shopper for those who come to the store whie their pharmacy uses the term patients for those customers tht use the pharmacy.



True, you did not, but tht is a commonly held misperception along with what you actually did say. Pharmacists do diagnose and treat medication induced illnesses as well as other medication related problems. Increasingly pharmacists are an integral part of a patient's treatment team.
One correct statement does not lend itself to a misconception unless someone makes that leap.

Interesting thread.

Bottom line: A pharmacist does not have the same role as a doctor.
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Old 05-28-2013, 12:42 PM   #163
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Originally Posted by CPT Tripss View Post
Really? The drug reps for the high priced high margin meds are über specialized. Their job is to get physicians as well as non-physician prescribers to write scrips for their particular med regardless of whether it is clinically more effective than another med. They are sales and marketing types, not clinicians and in many cases, have little science education.
Funny thing about some of us providers, we dont write a script for something if it is not clinically appropriate for a patient. I dont care how many croissants the drug rep brings. So no one can coerce me.
I like to learn about new drugs though and i dont know where you are from but the majoritynof the reps imhave encountered do have a science or medical background.
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Old 05-28-2013, 02:15 PM   #164
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Funny thing about some of us providers, we dont write a script for something if it is not clinically appropriate for a patient. I dont care how many croissants the drug rep brings. So no one can coerce me.
I like to learn about new drugs though and i dont know where you are from but the majoritynof the reps imhave encountered do have a science or medical background.
Those croissants and pens and consulting fees do influence physicians' prescribing habits, whether it's acknowledged or not - there are studies proving this. That drug rep is not giving you an unbiased education; they are there to sell you on THEIR drug using educational means that fit into the story that they are trying to tell. Big Pharma wouldn't be spending billions of dollars on these "education" programs if they weren't money makers.

Obviously there needs to be a relationship between doctors and the drug companies - there are just too many drugs out there for physicians to have to wade through the literature themselves. But the current model still has big problems, even after the last phrma overhaul.

http://www.reuters.com/article/2013/...93P16120130426
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Old 05-28-2013, 03:02 PM   #165
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I know quite a number of PharmDs (Doctor of Pharmacy) and they all refer to their patients. There is way more to their practice than just counting pills. They also spend a lot of time consulting with physicians.
Excellent point. PharmDs are an essential part of the health care team, as important as nurses and physicians. Many patients go to multiple care givers. A pharmacist is in a unique position to see all of the prescribed medicine a patient is on. He was doing his job.
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