Comments on: Pharmaceutical Case Management

By: InferiorityComplexResident

InferiorityComplexResident — Sun, 10 May 2009 06:00:52 +0000

IOM reports showing medication errors as one of most significant sources of poor patient outcomes (death) must be made up. Let’s all sacrifice the quality of patient care for the sake of our misplaced egos. Everyone knows that in the third semester of medical school student physicians are given the magical spells and enchantments (exclusively available in medical school) making them gods of patient care. I don’t care if you have a PhD in microbiology and wipe your ass with all the pages of your CV that contain entries from publications in JAMA and Nature, there’s no way you can comprehend drug resistance on the level of a freshly minted medical resident. These titans of treatment don’t need to look into the training of other professions with whom they interact with in the clinical setting. They innately know that pharmacy schools are basically a glorified community college preparing students for McJobs. The fact that pharmacy students generally begin training involving direct patient care in the first semester and continue on to rotations for the last 1-2 years of their curriculum is irrelevant. Furthermore, post graduate training in the form of pharmacy residencies, fellowships and board certifications consists of little more than getting coffee for the physician pantheon. What the hell else are these human vending machines going to do with all those years dedicated to the study and practice of pharmcotherapy?

Oh Mark, be a sport and go kill some ALL kids blindly dosing mercaptopurine. I wouldn’t want you to burden your wisdom with the pharmcogenomics developed by pharmacists needed to properly use it.

By: Pharm Student from UK

Pharm Student from UK — Thu, 08 Jan 2009 14:13:07 +0000

As a pharmacy student from the UK I am appalled at the level of disrespect for other healthcare professionals shown by some physicans here. Pharmacists are trained for their role and I agree that by doing anything outside of their competence is puting their neck on the line. However if the physician doesnt respect the training a Pharmacist has had then those potential interactions, or side effects will occur, will not be prevented or explained and the patient will suffer do to the lack of respect shown.

Surely a go away and do as your told attitude is not only unhelpful but it is actually insulting.

By: Steven Khong

Steven Khong — Thu, 18 Dec 2008 21:44:30 +0000

Teresa and Dr. Mark, please step off the invisible pedestal.

By: Jane

Jane — Sat, 29 Nov 2008 18:49:48 +0000

Wow Mark it sounds like your life really sucks, you should have been a pharmacist.

By: Mark

Mark — Tue, 04 Nov 2008 19:21:05 +0000

Dr. Mark- I am appalled at the discussion above, but would like to take this as a lesson. Please tell me: do pharmacists at all interact with the patient?
Is it like the doctor just tells the pharmacist what to do and the two never talk again?
I’m very confused from all of the arguments above.

By: Sarah

Sarah — Fri, 31 Oct 2008 20:34:23 +0000

Dr. Mark – A pharmacy technician cannot “fill out” physician orders while the pharmacist sleeps at home. All hospital orders and prescriptions dispensed in the community must be checked by a licensed pharmacist before they go to the floor or to the patient. In my state (and many others) the pharmacy must close if there is no pharmacist on site.

By: PharmDstudent

PharmDstudent — Thu, 30 Oct 2008 12:26:39 +0000

As long as you’re available… else they won’t get it until it’s been cleared.

By: Dr Mark

Dr Mark — Thu, 30 Oct 2008 01:26:29 +0000

Do you live in the real world? Pharmacists work a 40 hour work week. I work 80+ a week. Do you really think you or any of your 40 hour a weekers associates are going to be available at 3am. I am (or my partner if I’m not on call). I have missed my son’s birthday, opening christmas presents on Christmas morning, fourth of July fireworks and picnics, and many kids school and sporting events. Never once did my patient care suffer because a pharmacist wasn’t up or working. Check out “epocrates” and “up to date”. I don’t need a pharmacist’s “consult” in a pinch and if I really did need a pharmacists “consult” most of the time they would be sleeping comfortably at home while a pharm tech is filling out the MDs orders. You significantly overestimate your value, necessity and availability (and ability)

By: PharmDstudent

PharmDstudent — Wed, 29 Oct 2008 12:05:32 +0000

You had better make yourself available to consultation if you’re going to be writing that, especially for outpatient purposes. Problematic prescriptions have a tendency to show up at the most inopportune times- like 3 o’clock in the morning or in the middle of a Saints game on a
Sunday afternoon. Pharmacists don’t get to leave at 4:30pm every day, and they fill scripts on the weekends too…

By: Dr Mark

Dr Mark — Tue, 28 Oct 2008 01:44:31 +0000

A physician unlike a pharmacist is trained to weigh these risk benefit clinical decisions. The risk of death from MRSA pneumonia being markedly more likely then the zebra serotonin syndrome. The physician needs to be made aware of unseen drug interactions by the pharmacists and then make the tough decisions of risk benefit. No one expects you to “take the risk” you think you will be taking, just advice, document and dispense the medication to the patient as the physician requests and you will spend no time in court as a defendant. Do otherwise and you will be risking your future