Doctors reject motion to let pharmacists prescribe medication

[CBC News]

Most doctors attending a convention of the Canadian Medical Association have voted against allowing pharmacists to prescribe medication when they're part of a team caring for patients.
Fifty-six per cent of the 268 delegates at the meeting in Vancouver opposed a motion by their national lobby group to let pharmacists have an expanded role within collaborative care teams.
Doctors said they should lead such teams and prescribe medication because they're adequately trained to take a patient's medical history, do a physical exam, order and interpret tests, and come up with a diagnosis.
The Canadian Pharmacists Association says an expanded role for pharmacists is an international trend that includes an effective use of health professionals.
Full story
Do you believe doctors are being too protective?



More...

 

[Kreskin]

Yes I do think doctors need to let go of it. Right now, you get about 3 minutes with a doctor after sitting for 45 minutes in a waiting room. If more of this could be passed to pharmacists then the quality of care should improve.

The other issue is, don't we already wait around long enough at pharmacies? If they take on more what happens there?

 

[Zzarchov]

Go figure, Doctors are not in favour of giving up their tight reigns. THEY think they are the only ones qualified. I'd bet if we asked Pharmacists, they would think they are qualified.

Doctors are obviously not fully qualified, if they new everything about medications, they would be liscenced pharmacists as well.

Pharmacists are better trained with what medication treats what ailment for that patient (As they know more about the medication), doctors are trained to determine what ailment. If they are trained in both, then they don't need to worry about this anyways, they can go get lisences under NAPLEX

 

[karrie]

If I could count the number of times docs had prescribed meds for me that caused serious complications, or could have killed me if the pharmacist hadn't caught it. They're no more qualified than the pharmacists to prescribe.

That being said, the pharmacists also don't know how to do a proper exam, check blood pressure, blood sugar, and all the other things that need to be done for many meds.

I think there needs to be a better system in place, splitting up SOME of the responsibility, but not giving pharmacists free rein either. As it is now, if a doc makes a mistake, a pharmacist catches it. What happens if a pharmacist screws up your scrip?

 

[TenPenny]

I'm all for letting pharmacists prescribe, as long as they aren't allowed to own drugstores.
One of the rules about drugs is that the person who determines what medication is best for you does not profit from the sale of the drugs - doctors are not permitted to own drug stores.

How do you reconcile that idea, or do you just accept the idea that pharmacists may tend to prescribe what is best for their wallets, not necessarily best for your health?

 

[Zzarchov]

A good point tenpenny, One I haven't a good answer for.

@ Karrie:

All of that would be diagnosis, and would be the job of a Doctor, as thats what doctors are trained to do.

But knowing whats wrong and knowing the millions of drugs out there and what each of them do are very different. Doctors have limits to their training and the time they can spend keeping up to date like everyone else, and their time is better spent keeping up to date on their field and their job.

But Pharmacists are trained to know all the drugs and what they do. The doctor says "This exactly is wrong and these are her vital stats, which drug should she have?"

 

[lone wolf]

"...Doctors are not permitted to own drug stores...."

Hmm.... Wonder if that's why my doc "retired" so fast?

In cases where you're just refilling prescriptions, what's the problem? The pharmacist knows - both what you're taking and how long you've been taking it. I have no doctor. None still here are taking patients. To get script, I have to wait in a clinic to see someone who doesn't know me. Health care really HAS improved, eh?

Wolf

 

[karrie]

A good point tenpenny, One I haven't a good answer for.

@ Karrie:

All of that would be diagnosis, and would be the job of a Doctor, as thats what doctors are trained to do.

But knowing whats wrong and knowing the millions of drugs out there and what each of them do are very different. Doctors have limits to their training and the time they can spend keeping up to date like everyone else, and their time is better spent keeping up to date on their field and their job.

But Pharmacists are trained to know all the drugs and what they do. The doctor says "This exactly is wrong and these are her vital stats, which drug should she have?"

I'm fully aware of that. I've had pharmacists look at my scrips, and actually call the doc and suggest they try something else, something better, or something less expensive. Personally, I don't see it as a bad system as it stands (until it comes to the refill issue... that frustrates me). I can't see it working any better.

 

[TenPenny]

"...Doctors are not permitted to own drug stores...."

Hmm.... Wonder if that's why my doc "retired" so fast?

In cases where you're just refilling prescriptions, what's the problem? The pharmacist knows - both what you're taking and how long you've been taking it. I have no doctor. None still here are taking patients. To get script, I have to wait in a clinic to see someone who doesn't know me. Health care really HAS improved, eh?

Wolf

You know how to eliminate the refill issue? Find a way to pay doctors to do it.
There are only two reasons that docs don't do refills over the phone:
- to monitor your condition in case anything changed (which is not always an issue)
- because if you don't come in to see them, THEY DON"T GET PAID, and most people don't like to work for free. I know docs who used to spend an hour a day calling in refills, without getting anything in return, so they stopped doing it.

 

[Curiosity]

I like the role of pharmacists being part of the patient team in that they can offer suggestions as people write here - but ultimately the patient should have a role too.

I don't take my scrips for granted until I check the internet, the pharmacist's input and because I have two doctors - make sure they have my information correct in their computers.

Pharmacists have been relegated a secondary role too long and because so much of medical intervention and practice is by prescription these days - we have to be able to rely on the right decisions made - especially when there are so many choices.

But... I still like the doc initiating the scrip and then seeing what the pharmacist says about it.

I just thought about something: perhaps it isn't an issue so much in Canada but liability sets up rules for doctors and pharmacists to follow to avoid lawsuits.... this may come into play as well about who is responsible for something going wrong.

 

[Unforgiven]

Drugs are bad. M'Kay

 

[Curiosity]

Unforgiven

Agreed drugs are bad. Except when you can't breathe and inhalers make it happen.

 

[Niflmir]

Everyone recalls that the Canadian Medical Association made a big stink when the NDP started to create universal medicare, right? They were harping about how inefficient the new system would be. Now our health care systems is the most successful in North America. Definitely comparable to what you get over here in Europe too.

 

[lone wolf]

A health care system is only efficient if there are enough doctors to see the patients - everywhere. In Ontario, that isn't the case. The province capped class sizes without regard for growing population or doctor retirement. The government capped payments so now you have doctors operating on a deficit basis - inducing more to leave. In Sudbury alone, there are some 30 thousand people who have no family physician. If you can afford private clinics (the ones NOT paid by OHIP) there is a good and efficient health care system.

Wolf

 

[Impetus]

There's an old saying "Don't let the fox guard the chickens".

Last thing I want is someone whose income relies on selling prescription drugs to decide which and how much drugs I need.

Doctors are bad enough with their over-prescribing, and all they get are free golf rounds from the pharmo salesmen...

Like Curiosity, I check every script I get with all sources available (including various forums) before filling them.

My wife's doc tried to put her on Paxil for her asthma attacks! A second opinion and the proper tests by a specialist showed acute asthma when the first opinion was "panic attacks"...

Muz

 

[tracy]

I don't see why a pharmacist couldn't renew prescriptions at the very least. We complain that there is a doctor shortage and then we insist they continue to waste their time with unimportant visits. I've been on the same birth control method for years. A doctor's appointment to renew it is wasteful IMO.

 

[karrie]

I don't see why a pharmacist couldn't renew prescriptions at the very least. We complain that there is a doctor shortage and then we insist they continue to waste their time with unimportant visits. I've been on the same birth control method for years. A doctor's appointment to renew it is wasteful IMO.

Unless you consider the necessity of your yearly exam, which is when you'd usually get a renewal. Keeping a woman on hormones while not doing regular physicals to check for cancers would be a bit irresponsible I think.

 

[tracy]

Unless you consider the necessity of your yearly exam, which is when you'd usually get a renewal. Keeping a woman on hormones while not doing regular physicals to check for cancers would be a bit irresponsible I think.

My well woman care is done by an NP. She doesn't prescribe though. Plus, I am only recommended to have an exam once every two years. Even yearly wouldn't be that annoying, but I have to make the appointment to get the shot every three months. There is nothing about that appointment that requires an MD.

 

[s243a]

Basically doctors want to try to foce people to be as healthy as possible. I got a family doctor recently and it was like, "you will take a physical once a year". I'm sure the'd tell us what to eat if they good. I bet they like the position of power.

 

[karrie]

Basically doctors want to try to foce people to be as healthy as possible. I got a family doctor recently and it was like, "you will take a physical once a year". I'm sure the'd tell us what to eat if they good. I bet they like the position of power.

Well, for most women, and for older men, a yearly physical is the best way to catch cancers before they become fatal, so, you won't hear me complaining about the yearly physicals.