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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 6 to 30 of 30. Go back in thread:
Posted by Phillipa on August 27, 2007, at 21:59:01
In reply to Re: Brief vent about Pharmacist... » Racer, posted by Phillipa on August 27, 2007, at 21:56:36
Racer I didn't mean certain pharmacists meant certain meds the one I've heard of is day after you know which one without me saying. Phillipa
Posted by gardenergirl on August 27, 2007, at 22:08:31
In reply to Re: Brief vent about Pharmacist..., posted by Phillipa on August 27, 2007, at 21:59:01
Posted by Racer on August 27, 2007, at 22:13:14
In reply to Re: Brief vent about Pharmacist... » Racer, posted by Quintal on August 27, 2007, at 20:52:01
> Yeah it's frustrating. I once had a similar experience when I was trying to get Parnate. The pharmacist told me it was unavailable through their supplier "which is one of the biggest in the country", so I checked and yeah, it was available after all - he just couldn't be bothered to order it. I waited till he had his day off on Wednesdays and took it to the very helpful lady that stood in for him, and I got it the same day no problem.
LoL That reminds me of another incident at a different pharmacy. I'd just had pretty extensive dental work done, my mouth was literally bleeding, and my husband took me to the pharmacy to get my pain meds filled. The pharmacist said they couldn't do it, because the scrip was written wrong. Scheduled drug, mind you. It's past nine on a Friday night -- and they're saying, "Maybe you can call the office to get a new scrip written." I'm saying, "hey, check the address -- the office is an hour and a half away, it's Friday night, and I'm in a great deal of pain TONIGHT."
Well, it's scheduled, so I can't just call for a correction, of course, so I go home and check. They're right, of course, he wrote it wrong. He wrote it out for Percodan, 5/325. No such animal. It's actually Percodan, 4.8355/325! I called, told the pharmacist she was a [bad word], told her that the label of the last bottle I'd gotten said Percodan, 4.5/325, which *also* did not exist, and that she really was that [bad word]. She, of course, said that there was nothing she could do, the dentist wrote the scrip wrong.
The next morning, my husband went out bright and early -- and called to tell me the pharmacist's question to him when he presented the scrip: "Do you want to wait for that, or come back later?"
You're right -- it's amazing what a difference an attitude makes...
Posted by Phillipa on August 27, 2007, at 22:21:27
In reply to You can say that out loud. It's not a crime. (nm) » Phillipa, posted by gardenergirl on August 27, 2007, at 22:08:31
GG I'd not feel comfortable. Phillipa
Posted by linkadge on August 28, 2007, at 16:12:57
In reply to Re: You can say that out loud. It's not a crime. » gardenergirl, posted by Phillipa on August 27, 2007, at 22:21:27
I always thought that pharmacists were bitter because they had to deal with meds 24/7, but really had no control over most of them.
Pharmacists have been trying (in Canada) to get some authority to prescribe meds. They were recently denied (which I agree with).
They know all about the meds, yet they can't write prescriptions.
Thats what I think is making them crazy.
(Its either that, or having to stand all day behind that counter.)
Linkadge
Posted by JohnnyBLinux on August 28, 2007, at 22:51:04
In reply to Re: You can say that out loud. It's not a crime., posted by linkadge on August 28, 2007, at 16:12:57
I was turned away from my regular pharmacy a couple of days ago after I presented a script for Ritalin. The pharmacist made me uncomfortable with their condescending and suspicious attitude. The pharmacist refused to fill the prescription because he noticed that my pdoc just switched me to Focalin XR (and provided one backup supply for immediate-release Ritalin). Basically, the pharmacist didn't want me to be in possession of two Schedule II medications for fear that I might take them at the same time. I wasn't expecting the 3rd-degree. On a positive note, I appreciate the pharmacist paying attention to a potential drug interaction.
Posted by seldomseen on August 29, 2007, at 8:44:29
In reply to Re: You can say that out loud. It's not a crime., posted by linkadge on August 28, 2007, at 16:12:57
I think a lot of pharmacists are bitter because they have to deal with insurance all day, and work incredibly long hours.
In the state I live in, we had to pass a law in order for pharmacists to get an hour lunch break.When I was in school, I used to work in a pharmacy and I have never seen people work so hard.
They can, however, refuse to dispense any prescription at any time and I have seen it happen a lot.
Again, the laws differ from state to state in the US, but where I live, the physician can prescribe whatever they want - even if two medications interact. If the pharmacist dispenses the medication, they are culpable for any harm done and not the doc.
Posted by linkadge on August 29, 2007, at 15:01:42
In reply to Re: You can say that out loud. It's not a crime., posted by JohnnyBLinux on August 28, 2007, at 22:51:04
to interject their own person opinions and suspicions into the dispensing of medications.
If there is a discrepicy, they should call the doctor and verify the prescription.
If the doctor verifies the prescription, then it shouldn't be up to the pharmacist (IMHO) to suspect that a person might combine meds or the like.
Somtimes they are trying to play doctor.
Linkadge
Posted by linkadge on August 29, 2007, at 15:05:14
In reply to Re: You can say that out loud. It's not a crime., posted by seldomseen on August 29, 2007, at 8:44:29
>They can, however, refuse to dispense any >prescription at any time and I have seen it >happen a lot.
But there should be more requirement of the pharmacist that something allong the lines of "my personal beliefs prevent me from prescribing Plan B" etc.
The pharmacist should have an obligation to provide the medication unless there is a substantial reason why the prescription should not be filled, in which case they should give the patient a valid reason, not just, "I suspect you of such and such, therfore I will not fill the prescription"
Linkadge
Posted by seldomseen on August 29, 2007, at 16:01:49
In reply to Re: They shouldn't have the right.. » JohnnyBLinux, posted by linkadge on August 29, 2007, at 15:01:42
Ah hah! You have hit on, I think, one of the fundamental questions in medicine today.
Who, ultimately, is responsible for what a patient does with meds, advice etc...?
In terms of meds, if a doc prescribes meds that interact, but has directed the patient to take them correctly and the patient does NOT - who is responsible for the harm to the patient?
In my opinion it should be the patient, but in reality it usually is the providers - and that includes the pharmacists.
So I think they have to be very careful how and when they dispense meds.
Posted by Phillipa on August 29, 2007, at 20:13:43
In reply to Re: You can say that out loud. It's not a crime., posted by seldomseen on August 29, 2007, at 8:44:29
Same with nursing required to know all compatibilities and dose ranges. Phillipa
Posted by Racer on August 29, 2007, at 20:39:55
In reply to Re: You can say that out loud. It's not a crime., posted by linkadge on August 29, 2007, at 15:05:14
> >They can, however, refuse to dispense any >prescription at any time and I have seen it >happen a lot.
>
> But there should be more requirement of the pharmacist that something allong the lines of "my personal beliefs prevent me from prescribing Plan B" etc.
>
> The pharmacist should have an obligation to provide the medication unless there is a substantial reason why the prescription should not be filled, in which case they should give the patient a valid reason, not just, "I suspect you of such and such, therfore I will not fill the prescription"
>
> Linkadge
>It's more often not a question of suspecting the patient of anything, but of the pharmacist's belief system. There was a case in the Midwest some time back about whether or not that was legal -- a few pharmacists were refusing to dispense contraceptive pills -- but I don't know the outcome.
My own personal opinion -- worth nothing beyond letting people know me better -- is that a pharmacist whose personal beliefs prevent him/her from dispensing a legal, properly prescribed substance which is sold by his/her employer, should face some consequences. I don't think that's right. I think, because we do have freedom of religion in this country, and some of these beliefs are quite integral to one's make up, that pharmacy's should be allowed to refuse to carry or dispense items such as birth control or whatever, if they choose -- but I don't think they should be contracted to insurance companies if they do so choose. That way, those who share the beliefs can choose to go there, but others won't be pressured by insurance companies to support them.
But, that's probably impossible for a lot of reasons.
And to state it more succinctly: I don't much care what you believe or what you do, just don't do it in the street and scare the horses.
Posted by seldomseen on August 30, 2007, at 4:44:08
In reply to Re: You can say that out loud. It's not a crime. » linkadge, posted by Racer on August 29, 2007, at 20:39:55
I would agree with you that a pharmacist should not be allowed, based solely on his/her morals, to decide whether or not to dispense a legally written prescription. Personally, I would extend that to physicians as well.
But since responsibility seems to follow liability in this country, I think they should have the right to refuse to fill a prescription that they suspect to be dangerous to a patient.
One issue that I run into a lot where I work is how different pharmacies/pharmacists handle dispensation of pain meds in patients with chronic pain. Often there is an escalation of dosing, leading some pharmacists to suspect abuse.
This issue is much more tricky in my mind.
Posted by Quintal on August 30, 2007, at 9:30:10
In reply to Re: You can say that out loud. It's not a crime. » linkadge, posted by Racer on August 29, 2007, at 20:39:55
There was a case here in the UK of a Muslim pharmacist refusing to dispense the morning-after pill to a young woman, because it contradicted his beliefs. I think it went to court because the young woman fell pregnant as a result, but the pharmacist's right to refuse was upheld.
Q
Posted by gardenergirl on August 30, 2007, at 9:58:53
In reply to Re: You can say that out loud. It's not a crime. » Racer, posted by seldomseen on August 30, 2007, at 4:44:08
I forget which, but a major drug store chain here (maybe Walgreens?) allows its pharmacists to decline to dispense the morning after pill if it goes against their personal beliefs AS LONG AS there is someone else available who can help the customer. I'm unclear as to if this is within the same store or if they could be asked to go to a different branch. But this seems like a good compromise as long as it works as it's laid out and doesn't put undue burden on the customer.
gg
Posted by Cecilia on August 31, 2007, at 3:16:18
In reply to Re: You can say that out loud. It's not a crime., posted by gardenergirl on August 30, 2007, at 9:58:53
Maybe it would be ok if that different person were in the same store and immediately available, but NO WAY if it means going to a different branch. No pharmacist has the right to send a woman on a wild goose chase because of his or her personal religious beliefs. If the pharmacist doesn't believe in the pill, fine she doesn't need to take it but that doesn't give her the right to impose her beliefs on someone else. Cecilia
Posted by Bonnie_CA on August 31, 2007, at 4:16:29
In reply to Re: You can say that out loud. It's not a crime., posted by Cecilia on August 31, 2007, at 3:16:18
Nor my husband. I don't think I would appreciate a pharmacist not dispensing based on his/her own moral beliefs.
Now, things that can be abused, I can understand them being more careful about. But not dispensing birth control? Not dispensing MAOIs because they are spooked by the stories? Perhaps they should be in a different line of work. Doctors are not infallible, but if they prescribed something, then there is probably a good reason for it. People who take MAOIs are generally well informed of the dangers and risks. I can't imagine that a doc says "Ok, here you go, take Parnate for awhile ok? See you in three months." Maybe there are some, but the ones who would like to continue practicing wouldn't.
I don't remember who posted about the UK case... that's horrid. If I were her, I would have dropped the baby off at his house after it was born. I mean, since it was against HIS religion to dispense Plan B, then HE can raise the baby that HIS religion dictated should be conceived. But perhaps she was lucky and it was conceived out of love, and she'll have a happy family. However I somehow doubt that is the case, if she was trying to get Plan B. Although, maybe she needed it because financially and career-wise they couldn't do it yet. Who knows. But that pharmacist and judge were wrong. Who are they to say what she can and can't do with her body? I might be more respectful of my parents or my husband's opinion, but a man (or woman) behind a counter in a white coat isn't going to be the one to tell me what I should do with my body. I am aghast that a supposedly progressive society, Japan, would make BCP illegal! They're complaining about low birth rates... haven't they ever heard of failed BCP? Duuur! Make it legal and there might be more babies! Having them illegal is just curbing sex altogether. Perhaps that was their goal, but apparently there is a backfire to it. (BTW, my BCP hasn't failed, but I hear too many stories from people for whom it has.)
-Bonnie
Posted by karen_kay on August 31, 2007, at 8:25:17
In reply to Re: You can say that out loud. It's not a crime. » linkadge, posted by Racer on August 29, 2007, at 20:39:55
you said... (just so i don't confuse myself...) 'And to state it more succinctly: I don't much care what you believe or what you do, just don't do it in the street and scare the horses.'
ha!
did you end up getting it filled though? i think i got lost somehow. seems silly to me that a pharmacist wouldn't fill something a dr gave you (unless of coure you have 3 different scripts on hold for speed. is there something you're not telling us racer dear? :)
take care,
kk
Posted by Racer on August 31, 2007, at 10:34:22
In reply to i like that... » Racer, posted by karen_kay on August 31, 2007, at 8:25:17
> (unless of coure you have 3 different scripts on hold for speed. is there something you're not telling us racer dear? :)
>
> take care,
>
> kkThe old pharmacy manager wouldn't order my immediate release methylphenidate, which I think was largely a question of dose -- the scrip was for 180 of the 5mg tablets. I think it said three tablets twice a day. My guess is that that looked like an awful lot of scheduled pills to him. There was a bit of a problem at Walgreens, but we got it filled there in the end.
The Walgreens problem was practical: they still consider the scrips to expire in seven days, they can't partially fill a scrip, their policy is not to tell any customer when a scheduled drug will arrive at the store. So, if you get a pharmacist who actually cares about customers, they will call around and see if any other Walgreens can fill the order. On very rare occasions, I've had pharmacists tell me on the telephone whether they can fill it. It's a pain in the patootie, but at least with Walgreens I can see why. (Especially the 24 hour locations.)
So, scheduled drugs. I can see pharmacists being afraid of keeping a bunch on hand. If that information gets out, they can worry that someone will show up with a .38 caliber prescription for them, rather than something on paper. Do I look as though I'm carrying heat? Do I look like a drug addict? (Please, don't answer that one...)
OK, I finally have my Concerta back, but yesterday was a Very Bad Day for me, and I feel pretty sick today, so I think I'm going to go lie down...
Posted by linkadge on August 31, 2007, at 13:20:49
In reply to Re: You can say that out loud. It's not a crime. » linkadge, posted by Racer on August 29, 2007, at 20:39:55
But its one thing to not want to take birth control yourself, and another thing to prevent others from taking it.
There are situations where the refusal to despence a certain medication might mean significant health consequences.
Refusal to prescribe emergency contraception for instance could result in significant consequences.
Linkadge
Posted by linkadge on August 31, 2007, at 13:23:29
In reply to Re: You can say that out loud. It's not a crime. » Racer, posted by Quintal on August 30, 2007, at 9:30:10
>There was a case here in the UK of a Muslim >pharmacist refusing to dispense the morning->after pill to a young woman, because it >contradicted his beliefs. I think it went to >court because the young woman fell pregnant as a >result, but the pharmacist's right to refuse was >upheld.
I don't think thats right. Cause if the pharmacist gets the last say, then it essentially means that the pharmacist has all control.
If a doctor prescribes a medication, then the patient is entited to that medication. They shouldn't be precvented from receiving what a doctor deems medically necessary.
Linkadge
Posted by cactus on August 31, 2007, at 17:20:48
In reply to Brief vent about Pharmacist..., posted by Racer on August 27, 2007, at 19:21:38
WOW, I have nothing to vent about pharmacist's at all. The longest I have waited for a script to be filled is about 10 minutes. (Australia) If they don't have the med in question they can call it in and it will be there in about 3 hours, but if you don't have the time to wait they will ring the opposition straight away or call around to see who has it in stock. And when they dispense it to you they call you over and ask if you have taken this med before and if you haven't they take the time out to throughly explain it to you. Pharmacist's here can't refrain dispensing birth control or any drug due to religious beliefs. The only drug you can't get everywhere is methadone. The pharmacist has to be approved to do that and not all of them want to, but still it's not hard to find one that does. I do live in a big city though. I have had a couple of eye rolls when I've handed in benzo scripts but not a word was ever uttered.
Posted by Racer on August 31, 2007, at 19:26:05
In reply to Re: Brief vent about Pharmacist..., posted by cactus on August 31, 2007, at 17:20:48
> WOW, I have nothing to vent about pharmacist's at all. The longest I have waited for a script to be filled is about 10 minutes. (Australia)
OK, I had my vent, now let me sing a paean to an Australian pharmacist in Port Melbourne. While I was there, I sprung up with a case of shingles, and was seen by a doctor -- funny man told me no, it wasn't shingles, it was actually herpes zoster -- and prescribed whichever anti-viral was used for it then. He had looked it up in his little formulary book, and told me the cost would be [x].The pharmacist I took the scrip to asked me if I knew how much it would cost? I said the doctor had said [x]. This very kind man, who was so concerned about my having to pay for this drug out of pocket, told me that it wasn't actually [x], but about [x + 70] -- but that since the doctor had quoted me the lower price, he'd honor that instead. He was just a lovely man, and I'm very thankful to him.
Yet another of those little things that makes me wish I could move to Oz...
Posted by Phillipa on August 31, 2007, at 19:55:28
In reply to Pharmacists are not my parents., posted by Bonnie_CA on August 31, 2007, at 4:16:29
Oops double check when you take antibiotics as some render them ineffective you just triggered my memory. Phillipa
Posted by jhj on September 1, 2007, at 9:17:00
In reply to Re: You can say that out loud. It's not a crime. » Racer, posted by Quintal on August 30, 2007, at 9:30:10
There was a case here in the UK of a Muslim pharmacist refusing to dispense the morning-after pill to a young woman, because it contradicted his beliefs. I think it went to court because the young woman fell pregnant as a result, but the pharmacist's right to refuse was upheld.
Q
I think the court is perfectly right in giving verdict in favour of pharmacist.It is morally wrong obviously.But,evert court in a sacular democracy whould have given the same verdict.I think it is appreciable that UK has upheld the right of minority to have own belief and act according to it.India would have treated that muslim pharmcist in the same way as UK's court has done.
This is the end of the thread.
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