"Pro-life" Pharmacists

[DHG]

Employers should be able to fire people for not dispensing IF the employee has agreed to and then broken specific terms of the contract. If there is no aghreement in the contract, I feel that employees shoudl retain the right to use their discretion. Basically, people need to decide their boundaries at hiring.

You do have a point about laws giving the right to refuse dispensing. If I were an employer I woulde able to hire employees who would follow my wishes.

Absolutely.


As long as "using discretion" means medical discretion, not moral discretion.

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[bananaface]

Medical ethics involves both. They can't be seperated adequately.

 

[ultracet]

ok here's a big one.......


i have been asked by pharmacists to say when i get a lortab rx that "all we have is generic, is that okay?"

that is lying and yes we do have brand name in stock

is that the same thing?

 

[DHG]

ok here's a big one.......


i have been asked by pharmacists to say when i get a lortab rx that "all we have is generic, is that okay?"

that is lying and yes we do have brand name in stock

is that the same thing?

Same thing as what? Unethical? Yes, I'd say so. Just my opinion. Cuts the patient completely out of any decision-making about their own healthcare, on the whim of the Pharmacist.

Is this a joke I'm not getting?

 

[Leah27]

Maybe... because if you consider contraception wrong you may lie and say you dont have it in stock..... and if you consider drug abuse wrong you might say you don't have name brand lortab/vicodin in stock.

Is it equally wrong? I dont' think so. Because their is a reasonable valid reason to want birthcontrol, but no reasonable valid reason for name brand vicodin.

Plus in NYS it is generic unless DAW is written.... I like generics also

 

[DHG]

Maybe... because if you consider contraception wrong you may lie and say you dont have it in stock..... and if you consider drug abuse wrong you might say you don't have name brand lortab/vicodin in stock.

Is it equally wrong? I dont' think so. Because their is a reasonable valid reason to want birthcontrol, but no reasonable valid reason for name brand vicodin.

Plus in NYS it is generic unless DAW is written.... I like generics also

Who decides that wanting brand name is not reasonable? That should be the patient's decision. If they request brand name, they should get brand name. If someone's been on a particular thing a long time, even switching to generic, while technically the same active substance, can effect people. If they consent the switch, fine.... But seriously... you guys think its OK to lie to them and let them make a decision based on that? Wha....?


Wow.

Not that you can't reason with them and suggest generic.... Nothing says you can't be a persuasive salesperson, but to lie and essentially cut them off from participating in a decision as a result?? So fill me in here... does the store get more profit for filling generics over name brands?

Just wow.

And a pharmacist isn't law enforocement, either. I'm sure there are specific procedures to follow if abuse is suspected, but if it's a legit script, fill it. Do whatever your employer policy is on reporting suspected abuse, and go on with your lives, but going around the rules because you "feel" one way or another about something is not a good way for any profession to operate.

 

[ultracet]

DHG: are you a pharmacist yet? in pharmacy school? work in a pharmacy?

i'm just curious about your experiences with the profession because of your perspective with your posts

 

[DHG]

DHG: are you a pharmacist yet? in pharmacy school? work in a pharmacy?

i'm just curious about your experiences with the profession because of your perspective with your posts

No, I am pre pharm. I'm sure I have a lot to learn. Am I being ******ed?
Regardless, I don't think its right to flat out lie to people.

That's why I was curious what the deal was with forcing generics on people. I personally wouldn't mind a generic, would actually prefer, (for cost) but I just think it's kinda strange that people would say "out of stock" and give generic instead, if the script is for name brand specifically. I guess I never knew how that worked. Care to enlighten? I wasn't being sarchastic earlier, I really did want to know!

Also, my husband's grandmother died of a stroke a few years back.... She was on BP meds... I don't know the particular one but she'd been on the same one for a long long time. Anyhow, they switched her to generic for some reason (or maybe they switched her from generic to name brand.... I'm not sure-- it was one way or the other) Anyhow she died of a stroke the next day. Was it the switch in medication that triggered it? I don't know. But it makes me wonder. I'm not saying the quality of the generic is any different, but the fillers, preservatives, etc can be. Does that make any difference? probably not 99.99999% of the time. But I still am curious.

 

[Sosumi]

No, I am pre pharm. I'm sure I have a lot to learn. Am I being ******ed?
Regardless, I don't think its right to flat out lie to people.

That's why I was curious what the deal was with forcing generics on people. I personally wouldn't mind a generic, would actually prefer, (for cost) but I just think it's kinda strange that people would say "out of stock" and give generic instead, if the script is for name brand specifically. I guess I never knew how that worked. Care to enlighten? I wasn't being sarchastic earlier, I really did want to know!

Also, my husband's grandmother died of a stroke a few years back.... She was on BP meds... I don't know the particular one but she'd been on the same one for a long long time. Anyhow, they switched her to generic for some reason (or maybe they switched her from generic to name brand.... I'm not sure-- it was one way or the other) Anyhow she died of a stroke the next day. Was it the switch in medication that triggered it? I don't know. But it makes me wonder. I'm not saying the quality of the generic is any different, but the fillers, preservatives, etc can be. Does that make any difference? probably not 99.99999% of the time. But I still am curious.

I think you are being a little naive, DHG. I was in the same boat as you before I began working as an intern. I absolutely hate lying. I did not understand for the life of me why my pharmacist kept lying saying we don't have clonidine, klonopin, xanax, etc. in stock. You'll find it's a lot easier that way than having to deal with their screaming and yelling when it's so obvious they're addicts or dealers. The pharmacist is also trying to protect his/her license because professionally and ethically, they shouldn't be dispensing medications that they suspect the customer is abusing.

I think asking if generic Lortab is okay is because a lot of drug seekers prefer to see that name when they're dealing, since many don't understand or can't pronounce the generic name. I once had a customer come in asking for brand name only Percocet carrying a horribly faked prescription (the stickered label had black marker scratching out the name, the "Not for controlled substances" was scratched out in pen with some initials, there was no DEA number, the doctor's signature while I've seen it before with that horrible single big S from that healthcare site, was still illegible without his printed name). When we said we don't carry it (no Rite-Aid that I know of carries brand Percocet regularly) and explained that we could not fill it because the prescription had so many problems, he had a fit saying he had it filled the clinic and that they changed it because they had given him Oxycontin before which he was "allergic" to Then wtf was he getting percocet??

Anyway, generics generally give the pharmacy more profit and cost the customers much less out of pocket. Most insurance companies will not pay for brand if AB rated generics are available. Most hospitals will only carry generic on their formulary if they're available. Generics have to pass FDA bioequivalence and drug dissolution tests. Often, generics are made by the brand's same manufacturer (Greenstone = Pfizer).

My pharmacist however usually checks to see what they were on before asking if they'd like to switch to the generic. We still run into the occasional problem like last weekend where this woman who only gets brand but we accidentally gave her generic glipizide. She realized it because she usually pays $50 for it but was only charged $11 this time. Looking back at the Rx, it was because the doctor wrote for glucotrol 5mg rather than the Glucotrol XL and is why neither of us caught it.

 

[Leah27]

Who decides that wanting brand name is not reasonable? That should be the patient's decision. If they request brand name, they should get brand name. If someone's been on a particular thing a long time, even switching to generic, while technically the same active substance, can effect people. If they consent the switch, fine.... But seriously... you guys think its OK to lie to them and let them make a decision based on that? Wha....?


Wow.

Not that you can't reason with them and suggest generic.... Nothing says you can't be a persuasive salesperson, but to lie and essentially cut them off from participating in a decision as a result?? So fill me in here... does the store get more profit for filling generics over name brands?

Just wow.

And a pharmacist isn't law enforocement, either. I'm sure there are specific procedures to follow if abuse is suspected, but if it's a legit script, fill it. Do whatever your employer policy is on reporting suspected abuse, and go on with your lives, but going around the rules because you "feel" one way or another about something is not a good way for any profession to operate.

OK.... I mentioned it is law in NYS to dispense generic unless otherwise specified by the doctor. It is not up to the patient to decide what they want. It is up to them to decide what OTCs they want, or what they want for lunch from McDonalds, not to interpret for themselves what the doctor perscribed. If anyone can get whatever they want (which seems to be the case anyway with doc-in-the-box's and tons of pharmacies to jump around too) why not do away with doctors and pharmacists and we can just have big oxycontin and percocet vending machines?

 

[DHG]

OK.... I mentioned it is law in NYS to dispense generic unless otherwise specified by the doctor. It is not up to the patient to decide what they want. It is up to them to decide what OTCs they want, or what they want for lunch from McDonalds, not to interpret for themselves what the doctor perscribed. If anyone can get whatever they want (which seems to be the case anyway with doc-in-the-box's and tons of pharmacies to jump around too) why not do away with doctors and pharmacists and we can just have big oxycontin and percocet vending machines?

Of course they can't just get whatever they want, but patients have a role in deciding on their healthcare, they do this with their doc. Of course the doc has the final say, but there is a relationship there... otherwise docs would be like veterinarians, who's patients can't talk (I'll bet some of them wish that from time to time ). From personal experience with docs, some are better at this than others. If they come in with a LEGIT script for a name brand, specifically name brand (that's what I was talking about), then they should get name brand.

I know the drug abuse problem is huge. (I work in a law enfocement support capacity right now) Obvious forgeries aside, though, what are most employers policies regarding suspected abuse, if the script is legal, i.e. a real prescription fom a real doctor?

And as general standard operating procedure, is it really any company's policy to LIE and say, "out of stock?" so they are more likely to get generic and this more profit for the store? Seriosuly, is that official policiy? If so, Wow. Does the APA endorse that? Or allow it? Just seems really unethical to me.
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Oh BTW thatnks, Sosumi for the rundown.

*sigh* Maybe I'll feel diferently about it once I learn more and have some experience.

 

[ultracet]

The reason we say is generic lortab okay
is because brand name have little blue speckles and little green speckles (look similar to a robin's egg)
the generics don't
they work absolutely the same and should not make a difference for ligitamite pain

however...
if you want to buy lortab or sell them on the street the only way to know if they are real is if they have the blue dots.

that is the reason for that pharmacist's policy

some pharmacies choose not to stock heavy duty pain killers if they are in an area that is notorious for substance abuse.

There are different buttons in some computer systems that allow for a patient dispense as written preference and yes there are certain drugs that SHOULD NOT be substituted or should be watched very carefully

there are some out there that you wouldn't think it would make a difference but they do.. i.e. my mom is on zestril and switching from brand to generic sent her for a loop even though it shouldn't have. she could be adjusted with a different strength or take the brand name


i believe you will realize somethings when you get to school and work a little...

it is typically fairly obvious when someone wants to abuse a drug and honestly i dont want to make it easy for those people to do that at all.

if you're curious about how brand and generics rate against each other etc.. just google FDA orange book

it will give ratings for each drug and its generics and whether they can be substitued

 

[ChemAngel]

Pharmacists have no right or power to interpret the law. We do not only have the moral and legal obligation but also professional obligation to follow the law like everyone else! If a pharmacist wants to intrepret the law then he/she should become a judge and work for the court, not for Sav-On!

correct me if I'm wrong but don't we have a law that states that pharmacist are given " the right to refuse to dispense a medication"?

At least, when I work with my pharmacist at walgreens, he is allowed to refuse to dispense a CII drug under the pretext that he thinks that they will abuse the drug.

Not that I am saying that not dispensing BC is good or bad. I'm just saying it is the right of the pharmacist to be able to refuse prescriptions.

Being catholic, I really don't appreciate the jokes coming out at the expense of a recently deceased pope...a figure that our religion value highly.

This topic isn't necessarily about religion. It is a discussion as to whether the beliefs of a pharmacist should interfere with their ability to dispense prescriptions.

Would you give a narcotic to a person who smells like alcohol? Some pharmacist have problems dispensing ADD medications like Adderall because they feel that the child is being damaged or that some of the parents (especially some on medicaid) use that as a form to keep quiet their children.

Do any of those issues deal with religon? no. It is only the belief of the pharmacist that makes it difficult for them to dispense a medication they feel might be more harmful than good.


I apologize if I have insulted anyone...but I was personally insulted with the constant badmouthing of my religion. We as professionals should learn to respect people's beliefs...and mocking them isn't a good way to resolve anything.

 

[atlanta_pharm]

http://www.foxnews.com/story/0,2933,153515,00.html


Cha ching

If you own your own pharmacy do what you like, but I bet the big retailers will fire those pharmacists who refuse to fill BC. I see many many lawsuits in the horizon

 

[BMBiology]

correct me if I'm wrong but don't we have a law that states that pharmacist are given " the right to refuse to dispense a medication"?

We absolutely have the legal right to refuse to dispense medications that we feel may harm our patients. That is our professional duty. However, this issue has nothing to do with professional objections but rather moral objections. We have no right to impose our moral objections on someone's choice which has not only been fully discussed with a physician but also is fully supported by our laws.