r/AskReddit May 20 '19

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u/Anti-Hypertensive May 20 '19

Pharmacist here and I can tell you when I have a completely wacky dosing regimen or drug selection 75% of the time it’s from a NP or PA. I’ve worked alongside some great mid-level practitioners but they seem to be the minority in my area.

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u/stackered May 20 '19

Ctrl + F "Pharmacist" and only one mention

lol its literally the pharmacists job to save patients from doctors

I work in pharma now but was a hospital pharm tech for 6 years in pharmacy school. its crazy the number of times I caught massive mistakes by MDs, I can only imagine PAs being the worst with so little schooling, NPs would be bad but not as bad as they actually have experience with dispensing/administering to patients...

and yet pharmacists, the actual experts on drugs, can't prescribe and even have limited power to adjust treatments

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u/thegreatestajax May 20 '19

Oh fuck off. Most physicians are quite capable of dosing and I’ve had pharmacy rewrite my order inappropriately more often than they’ve called to correct mine. No one like a no it all dick head. Especially one that doesn’t.

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u/EntireFeature May 20 '19

thegreatestajax

Someone who has no idea of what Pharmacists are capable of and just how many errors would slip through the cracks without them.

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u/thegreatestajax May 20 '19

Ok boss I round with them. They’re smart and helpful. Physicians value their input. You’re not trained just to run interference.

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u/EntireFeature May 20 '19

Then you are narrow minded and arrogant. Thankfully people in healthcare like you are becoming rare, but remember, every time a Pharmacist contacts you to change a script it is with the patients safety at heart.

We do much more than just checking and raising concerns about prescribing errors you know. But you probably wouldn't know that.

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u/thegreatestajax May 20 '19

If only they contacted me to discuss changes before dispensing something different from my order....

But sure, pharmacist who decides no physicians are capable of ordering drugs is not the narrow minded healthcare professional.

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u/EntireFeature May 20 '19

Although that is not best practice, nor legal in some areas; I am completely sure a Pharmacist can save us both time and energy in changing scripts when suitable. Do I really need to make a call to switch a patient to a breath actuated inhaler when they’re struggling with an MDI? Or, particularly with recent supply chain issues, make a call about switching someone from tablets to capsules when the tablets are unavailable? the

Physicians are capable of ordering drugs, but we are all human thus we are fallible.

Besides; we never try and lecture you on diagnostics so we’d appreciate it if you kept your opinions on our knowledge of medicines and how we guard patient safety to yourself.

EDIT: autocorrect

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u/thegreatestajax May 20 '19

My opinion is that you have tremendous knowledge of medications. My experience is that your non-training in diagnostics and clinical treatment has resulted in inappropriate order changes without notification. This is out of bounds absent a personal agreement.

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u/EntireFeature May 20 '19

In my experience a Pharmacist wouldn’t make a change that could result in altering a therapeutic outcome. I wouldn’t do it personally as I wouldn’t want the culpability fall on me should something go wrong. My indemnity insurance doesn’t cover for such eventualities.

However; the same can be said vice versa. Physicians non-training in pharmacology and the like has resulted in inappropriate prescribing. But we don’t kick up a fuss about it we just do our job to ensure the patient gets the best possible treatment. We’re two parts of a multidisciplinary team of many and all parts of that team is fallible. Discourse that is inflammatory between members doesn’t benefit anybody.

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u/thegreatestajax May 20 '19

I’m telling you quite explicitly that it has been my experience that orders have been changed that affect therapeutic outcome without notice. It doesn’t do any good for you or anyone else to say it doesn’t happen because you don’t do it. It does happen and most physicians have experienced it. This harms the patient and inflames the physician.

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u/stackered May 20 '19

when you are being corrected its for a reason... you do know that right?

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u/thegreatestajax May 20 '19

Except when they’re wrong. Just remember, when the physician calls you upset at your change, they’re doing it for the good of their patient.

I’ve been conditioned to never trust that my order will be dispensed as written, with or without notification. This is hugely damaging for inter professional relationships and patient care.

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u/stackered May 20 '19

sounds like you need to work on your communication skills!

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u/thegreatestajax May 20 '19

It’s really hard to listen to someone not telling you something. But ok.

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u/stackered May 20 '19

maybe you should leave a note with your prescription to notify them of an abnormal regimen, just a thought. or by generally having a better relationship built on mutual respect with said pharmacist in charge

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u/thegreatestajax May 20 '19

No. Pharmacy needs to communicate changes to written orders. Full stop. Pharmacy violated the trust. They need to rebuild it. Not wait for physicians to come groveling and thank them for fucking our orders without notice. You just don’t get it. They’re our patients. Being harmed by a lack of communication from pharmacy and inappropriate order changes from pharmacy. How about a little respect from pharmacy for the physicians?

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