I think you're trying to address 3 different things here:
1) "Standard of care" is completely different from scope of practice and appropriate prescriber-patient relationship. Amphetamines are standard of care for ADHD, whether you're a dermatologist or a GP.
I wasn't talking about medication standard of care or treatment guidelines or whether the drug is appropriate. I was talking about a dermatologist, when writing for an adderall script, is going outside of her standard of care. If you want to call it scope of practice; that's fine.
When you are on trial and the prosecution examines you, they're going to ask you what is the standard of care as a pharmacist: would another pharmacist, in the usual course of his duty, fill this Adderall script written by a dermatologist. The answer would be no.
2) what if that dermatologist subs in for his friend's primary care practice or in a hospital as a hospitalist discharging a patient to continue ADHD therapy? He magically gains the ability to prescribe Adderall then? Gimme a break, there's no logic to that and we've beat that over like a dead horse.
Then it is a judgement that you have to make and defend. As pharmacists, we do this all the time. If you want to fill everything blindly, that is also your choice. You are a highly paid professional who's paid to make decisions; do your job and act like one.
Dermatologist in a dermatology clinic for a dermatology patient being seen for a dermatology issue...then you can say no-go on the script. Dermatologist alone does not tell the whole story.
We're not obligated to look for the whole story. That is not our job. And what could the story be in this scenario? Do enlightment me.
3) wtf does oxy #360 have anything to do with anything? I have oncology patients with chronic pain that meet or exceed this quantity.
I was illustrating that documenting alone does not absolve you of liability. The problem isn't the quantity, but the fact that if you call these pain doctors they will give you a bogus dx code (like Chronic Pain Syndrome). This example was meant for OldTimer and other people who practice in retail. It went completely over your head. It's okay if you didn't get it since you work in a hospital setting.
So three completely different thoughts in your post, which is sortof emblematic of this clusterfracas of a thread.
No, that's just you not understanding my original post. You're just making up things to rant about to sound intelligent. All I've said is that we can use our judgement and make a decision; we're not bound to fill every script blindly.
Side note/thoughts in my head: thank god I don't have to deal with this **** in the hospital...trauma writes for beta blockers and clicking "continue all home meds" in the chart? Sure, have it all, as long as the dose is right! No questioning scope of practice there.
Right, because working in a hospital setting, you already know that and understand what these medications and under what circumstances they are being written for. It's the same judgement that we apply to retail, only with different result because it is a different practice setting....whooshhh