He's not wrong though. Just because a task may be legal to perform doesn't mean one is able to. If tomorrow the practice act allowed me to diagnose I know I'd need additional training. Do you honestly think if a patient came to you with say, nerve pain in the absence of diabetes do you know what tests to run and how to do the differential? I know I don't. Just because it would be legal for me to magically do that doesn't mean I'm able to.
What about the very hot topic pharmacists discuss regarding physicians and others prescribing out of their scope of practice? An MD/DO can prescribe whatever they want under the sun, but do you think say a radiologist should be prescribing a chemo regimen for a cancer patient or medicine do you think they should be cathing cardiac arrest patients or managing their post-cardiac arrest care? I mean legally they can as a physician, but ethically and ability wise I highly highly doubt they are qualified to do that. One duty pharmacists have is to look out for good faith, if I have reason to believe that there isn't a valid physician-patient relationship or they aren't being monitored in my state I'm legally bound to reject that RX or clarify with the prescriber their assessment and rationale. I know most pharmacists wouldn't do this... but ethically we are supposed to and legally if harm befell the patient we'd be held liable as well for grossly and negligently filling something that we had valid red flags about.
I think PharmD's are far overqualified to dispense. I know we are capable of managing (not diagnosing) chronic conditions like diabetes, HTN, COPD, etc. We have successfully practice in more of a "practitioner" role in certain practice settings like the VA. I did 2 VA rotations and my clinical pharmacist preceptors did physicals (to an extent) and routinely prescribed meds via their protocols and monitored disease states and had very open and professional rounds with physicians and others. I did a rotation at a lower-income charity based health clinic where pharmacists/students and NPs/students saw patients. We had legal protocols allowing us to do so. I'd do the routine BP checks, get vitals, listen to the lungs, get a history and interview patients and then bring that info to the NP. In a sense I was able to diagnose a few simple things like a hypertensive patient in hypertensive crisis (BP beyond 180) and I "prescribed" clinidine to bring it down in the office and checked the patient for target organ damage. In essence I did the work and my preceptor/NP agreed with everything I was thinking and authorized my treatment plan. We should be able to practice similarly everywhere. However, I know due to under-appreciation and a need for self validation we develop these over-inflated egos but that needs to stop too. I'm sure you don't like it when you hear the "I'm the doctor, fill it as I say!" line when you refuse to fill a dangerous or questionable script, I doubt others like a "I'm a DOCTOR PharmD and I'm qualified to do your job too!" when we aren't... Yes we deserve and should demand enhanced practice in line with our competencies and training, but we also need to respect our limits.
you're going places.
