Interns doing ECP?

[bananaface]

My boss was asking me of I was going for an ECP protocol since I am taking a community based screening and immunizations course that will let me do flu shots and some other odds and ends. In my state (WA), an intern can legally do anything a pharmacist can, provided a preceptor is present. If we can do flu shots through a protocol, certainly we should be able to do ECP. But, I am not aware of anyone who has established ECP as an intern.

I really hate sending away people because nobody else at my store has a protocol.

Does anyone know of any interns establishing a protocol for ECP?

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[emogrrrrl]

My boss was asking me of I was going for an ECP protocol since I am taking a community based screening and immunizations course that will let me do flu shots and some other odds and ends. In my state (WA), an intern can legally do anything a pharmacist can, provided a preceptor is present. If we can do flu shots through a protocol, certainly we should be able to do ECP. But, I am not aware of anyone who has established ECP as an intern.

I really hate sending away people because nobody else at my store has a protocol.

Does anyone know of any interns establishing a protocol for ECP?

ECP?

 

[jdpharmd?]

ECP?

Emergency contraception, I think.

 

[Mags]

My boss was asking me of I was going for an ECP protocol since I am taking a community based screening and immunizations course that will let me do flu shots and some other odds and ends. In my state (WA), an intern can legally do anything a pharmacist can, provided a preceptor is present. If we can do flu shots through a protocol, certainly we should be able to do ECP. But, I am not aware of anyone who has established ECP as an intern.

I really hate sending away people because nobody else at my store has a protocol.

Does anyone know of any interns establishing a protocol for ECP?

I thought you were working at a store that WAS establishing protocol or is that someone else I'm thinking of???

and is it just ecp or is it ocp too?

 

[Fermata]

Emergency contraception, I think.

I personally think that it is dangerous territory and should be left to a physician.

I just can't picture the situation: Some girl walks into a pharmacy....waits until the store is relatively empty...and then tries to flag down the pharmacist to help her with "a little problem".

I'm not saying that pharmacists couldn't do it but because of how delicate the situation is...I think it's best to be left up to a physician.

 

[bananaface]

I thought you were working at a store that WAS establishing protocol or is that someone else I'm thinking of???

and is it just ecp or is it ocp too?

You are thinking of the "Direct Access" pilot project, Mags. Bartell's and Fred Meyer have a few stores each in the Seattle area where pharmacists can dispense birth contol pills, patches, etc. on protocol. I know of 2 of our classmates who work for Bartells. One works at a non-participating store. The other works at a participating store but had no clue about the project when I asked her about it.

I am indeed referring to emergency contraception protocol. Just to clarify, EC does not stand for "extra curricular".

I was just told that a couple of my classmates got the ECP established this spring through the Overview of Contraceptive management class at UW.

I have been asked like 10 times in the last month if my store does EC on protocol. It usually happens on the weekends, since that is when people have "recreational" time. (And, they do not wait for the store to be empty.) Since the efficacy of ECP is highly time dependant, it makes no sense to me to ask women to wait to see a doctor. There is alot more I could say on that end of it. But, I will leave it at that for simplicity's sake. Anyway, without pharmacy access points, EC is just not a viable option for many women.

Can you elaborate on what you mean by delicate, Fermata? I already get women (or their boyfriends) coming in or calling and asking if we dispense EC at the store. To me, turning them away is definitely a delicate manner. I need to come across as totally non-judgemental and help them find someplace they can go for the service they are requesting. By the time they come in, they generally have decided they want EC. It is their decision, not mine. I would just be there as a resource.

 

[Fermata]

Can you elaborate on what you mean by delicate, Fermata? I already get women (or their boyfriends) coming in or calling and asking if we dispense EC at the store. To me, turning them away is definitely a delicate manner. I need to come across as totally non-judgemental and help them find someplace they can go for the service they are requesting. By the time they come in, they generally have decided they want EC. It is their decision, not mine. I would just be there as a resource.

All I really meant was that a physician usually tends to know the person a little better(since people tend to go to the same doctors for many years).

And EC is a delicate thing. Choices that are made around it can haunt some people for years. I know what you are saying by not wanting to turn them away, but at the same time....I just think the whole situation could be better handled by a physician. Of course, the pharmacist would be extremely helpful in providing information. I guess that I think that there should just be more hoops to jump through for EC.

 

[bananaface]

Just some thoughts...

I don't see why EC would haunt someone for years unless they believed it to be an abortifacient, which it isn't. It just suppresses ovulation. The MOA is shared with combination BC pills.

When you know what you want, hoops are not a good thing to be faced with, especially when the consequences are so large.

Alot of people may not want to face a familiar physician for EC.

If you are on your mom's insurance, what do you do when she sees the medical invoice and asks why you had an appointment?

Many women requesting EC have experienced a condom breakage incident. These women are less likely to have a regular physician since they are not getting the yearly exam for BC pills and are generally otherwise healthy. And, without having had an office visit in the past year, nobody will prescribe for them.

The need for an office visit is a huge deterrant. Not that many places give people a same day appointment unless you absolutely insist. And, even then you pretty much have to drop everything, including work, and sit there until you are seen.

Even if a physician is willing to call in a prescription, they are likely to take awhile. So, EC through a pharmacy has higher efficacy, due to the time difference.

I feel that it is a woman's choice whether she wants EC or not. Her physician should not be counseling her whether or not to use it. A woman knows when she goes to a pharmacy that dispenses EC by protocol that she will be supported. She doesn't have that same assurance when going to a physician. You never know what that person's beliefs are, or how they will manifest themselves.

So, those are more reasons that I am in favor of ECP.

 

[off2skl]

All I really meant was that a physician usually tends to know the person a little better(since people tend to go to the same doctors for many years).

And EC is a delicate thing. Choices that are made around it can haunt some people for years. I know what you are saying by not wanting to turn them away, but at the same time....I just think the whole situation could be better handled by a physician. Of course, the pharmacist would be extremely helpful in providing information. I guess that I think that there should just be more hoops to jump through for EC.

Deja Vu. We went round a bit on this one before. I think this may be the thread http://forums.studentdoctor.net/showthread.php?t=132053&highlight=contraception

 

[bananaface]

Although there are some characteristics in common, this thread is not hypothetical and it is narrower in scope. I can indeed dispense EC as an intern if I choose to establish the protocol. Also, we are discussing and not arguing, which is cool. It is nice that we can chat without getting all wrapped up in personalities.

 

[Fermata]

Although there are some characteristics in common, this thread is not hypothetical and it is narrower in scope. I can indeed dispense EC as an intern if I choose to establish the protocol. Also, we are discussing and not arguing, which is cool. It is nice that we can chat without getting all wrapped up in personalities.

Out of curiousity, how are you thinking about setting up the protocol?

 

[bananaface]

I would have to take a course on EC then I would be able to participate in a collaborative practice agreement. The certification course has two parts. The first part of the course can be done online through Washington State Pharmacist's Association (WSPA). The second part is a live practicum. Once enough people have done the online portion, they get us together and do the second part. Usually all the people taking the class enter into a collaborative agreement with the same prescriber. It's not like we have to chase someone down on our own. Here is what the agreement paperwork looks like.

Here is a bit of background on EC in Washington State. We have had it here for 7 years now, so there is decent public awareness for the service.

 

[bananaface]

I took the course offered by Washington State Pharmacist's Association and will be setting up a protocol pretty soon.

 

[Caverject]

I took the course offered by Washington State Pharmacist's Association and will be setting up a protocol pretty soon.

want a cookie?

 

[bananaface]

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Yes, please.