Will there be a mid-level pharmacist in the future?

[kwakster928]

We saw huge jump in numbers of PA, NPs. Will there be a mid level phamacy degree in the future in the us?

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[aphistis]

We saw huge jump in numbers of PA, NPs. Will there be a mid level phamacy degree in the future in the us?

Wouldn't pharm techs be your "midlevels"?

 

[kwakster928]

Wouldn't pharm techs be your "midlevels"?

hmmm i guess if i think about it. stupid question nevermind.

how about will we give more authority/responsiblity to techs?

 

[Caverject]

hmmm i guess if i think about it. stupid question nevermind.

Go Temple!!

 

[baggywrinkle]

We saw huge jump in numbers of PA, NPs. Will there be a mid level phamacy degree in the future in the us?

That position is already here - IMHO. It's called a PharmD.

Before you pop your cork let me explain. I base my statement on the snowballing trend to require **PROFESSIONAL** licensure for technicians

In Florida, a very conservative traditional state, the requirements to be
a tech were a pulse and the willingness to work. They are encouraging folks
to go get their CPHT and having it earned them a whopping twentyfive cents more per hour at WAGS in the Daytona district. Now I'm in Washington where the board has two levels of tech license. The first is basically a cashier and the second is a true pharmacy tech as we all know and love them (I married one) I don't believe their continuing education is mandatory.....yet, but mark my word it is coming. Coupled with this is the requirement for (help me out Anna) eight hundred some odd hours of technician internship prior to licensure. I only needed twelve hundred hours as a pharmacist intern back in 1984. The washington state techs are paid very well compared to Florida (five to nine dollars an hour more depending). All that is missing is an increasing level of education to qualify sitting for the board exam. An A.A.degree perhaps. If memory serves that degree already exisits in one of the Carolinas. It is a spreading trend. Texas just began requiring licensure of techs last summer.

So, what is the advanced level? Specialties, man, specialties. I worked with one in Colorado. With his basic RPH under his belt this guy went on and got a masters degree in nutrition and wrangled his way into a posh position as head of the nutrition/hyalimentation program. What did he do? Not much other than walk around and drink coffee. He was a true journal reader like you all aspire to be. I assure you there will never be very many of those positions available. Personally speaking, I would not care to be in his shoes when it came time to cut the budget and trim FTE hours....

 

[bananaface]

Technicians aren't generally considered healthcare professionals in the sense that breaking into their job role does not require advanced training. They are certainly healthcare team members, but not in a discretionary capacity.

There are specialty certifications within pharmacy, like nuclear pharmacy, diabetes specialist, etc. Pharmacist "levels" are more analogous to specialites that physicians go into than levels of nursing professions.

 

[baggywrinkle]

Technicians aren't generally considered healthcare professionals in the sense that breaking into their job role does not require advanced training. They are certainly healthcare team members, but not in a discretionary capacity.

.

Not at the moment, this is true. That will change over the course of your
career. Indeed it is already being experimented with and it will be driven by
economics. As their education increases so will their scope of practice and
professional responsibility.

IMHO the turning point for technicians as professionals will be when they assume personal responsibility for their actions in the eyes of the board and under tort liabilty. In both Texas and Colorado hospitals under 100 beds do not require a pharmacist on the premises when the pharmacy is open and a technician is on duty. All the technicians work is checked by the nursing superviser. When the technician can be sued as a licensed professional and they are educated for basic dispensing functions that need to be checked may go away. The tiny hospital in Walsenburg Colorado has a full time technician and a part time pharmacist. The pharmacist shows up 2-3 times per week to sign off on paperwork.

 

[kwakster928]

Not at the moment, this is true. That will change over the course of your
career. Indeed it is already being experimented with and it will be driven by
economics. As their education increases so will their scope of practice and
professional responsibility.

IMHO the turning point for technicians as professionals will be when they assume personal responsibility for their actions in the eyes of the board and under tort liabilty. In both Texas and Colorado hospitals under 100 beds do not require a pharmacist on the premises when the pharmacy is open and a technician is on duty. All the technicians work is checked by the nursing superviser. When the technician can be sued as a licensed professional and they are educated for basic dispensing functions that need to be checked may go away. The tiny hospital in Walsenburg Colorado has a full time technician and a part time pharmacist. The pharmacist shows up 2-3 times per week to sign off on paperwork.

some scary stuff.

 

[baggywrinkle]

some scary stuff.

Relax, I don't see it as threatening at all because I don't see the
"mid level" pharmacist becoming obsolete.

It's a numbers game. Walk into any thriving pharmacy in the country and
that pharmacy is getting beaten black and blue with business. We
are overwhelmed by the raw volume of work out here.

There are only 160,000 some odd pharmacists in the U.S. compared to how
many physicians, P.A.'s, and CRNPs?

There is room for all while the baby boomers are still moving air. Give the
"professional pharmacy technician" some breathing room and you the PharmD
might have time to do what you were trained to do; review profiles and
consult with patients as well as practitioners

 

[bananaface]

Baggy, what new (discretionary) tasks do you see being allotted to techs? They are already allowed to do almost all of the non-discretionary tasks as far as I can see. I agree that techs play and will play a huge role in pharmacy. But I don't know that I see the potential for expansion in their job duties that you do. Perhaps you have some examples/ideas?

 

[baggywrinkle]

Baggy, what new (discretionary) tasks do you see being allotted to techs? They are already allowed to do almost all of the non-discretionary tasks as far as I can see. I agree that techs play and will play a huge role in pharmacy. But I don't know that I see the potential for expansion in their job duties that you do. Perhaps you have some examples/ideas?

In Washington State, compounding.

The verification screen of the Rite Aid Nextgen program has two phase checks; clinical and quality assurance. There is no reason that a two year
tech could not do the quality assurance check leaving the pharmacist to do the clinical verification at the register during counseling.

Elsewhere it was mentioned that somone's pharmacist spent his day shmoozing with the customers rather than hiding behind the counter. The Australians have a label for that style of pharmacy but it slips my mind. The dispensing function is performed by professional technicians and the pharmacist basically spends his day in an office with a computer screen talking. A spatula never touches his hand. The finished product is tossed through a window to the pharmacist so that screening and counseling can occur. This was also the **intent** of OBRA '90 where they mandated a
"private counseling area" but it was bastardized by the chains.

 

[bananaface]

In Washington State, compounding.

Techs already compound here under the supervision of pharmacists. How would this be an expansion of their job role? Do you propose that they be allowed to compound independently? I can't see that being accepted the pharmacist community, since individualized compounding is the only role really reserved to pharmacists at this time by statute. The pharmacist lobby would oppose that change, kicking and screaming.

 

[baggywrinkle]

Techs already compound here under the supervision of pharmacists. How would this be an expansion of their job role? Do you propose that they be allowed to compound independently? I can't see that being accepted the pharmacist community, since individualized compounding is the only role really reserved to pharmacists at this time by statute. The pharmacist lobby would oppose that change, kicking and screaming.

Yes, if they can be sued or sanctioned they may compound independently.
With the current statutes technicians are hands and feet of the pharmacist.
The tech may make the error but the pharmacist takes the fall for it. It is an entirely different kettle of fish when the tech may be sued PERSONALLY.

Kicking and screaming is to be expected, carmudgeonly hyperconservative lot that we are. Just as physicians had a problem with P.A.'s and CRNP's in the beginning. Some still do. But once again, with the VOLUME of work that we face today - and it will only increase - such changes may be a welcome breath of fresh air on a strained delivery system. I have talked about running
pissy customers off at my store. No worries about loss of volume. We take in
new faces every day. Plenty to do and no time to do it!

Don't think it can't be done. There is precedent. See the thread concerning
DRUGGISTS defined. During World War II many of the pharmacists were drafted leaving a grave shortage in Colorado. The legislature took emergency
action allowing existing technicians of the day to fill the void. They did such
an outstanding job that there was special legislation enacted allowing that group to become registered pharmacists without having the benefit of graduating from a pharmacy school. I met one when I worked in Pueblo.

 

[bananaface]

Aside from the fact that techs make less money, there is nothing preventing them from being named in a civil suit at this time, so long as their role in an error can be established. Lawsuits are just more viable when those with the money are being sued.

I have no problem with individuals being allowed greater responsibilities as long as those changes are done without leading to decreased patient care or asking people to work beyond their level of training. One acceptable change that I have observed is electronic drug selection allowing pharmacy assistant (B-techs) to pull, count, and pour.

If there is a new group of practitioners within pharmacy, there is going to be a new standard of education and training. Techs need more than current training programs provide to be able to provide safe care on their own.

What lobby group do you see as a potential proponent of a change in technician responsibilities? Chains are all I can think of. Techs don't really have a lobby at this time.

 

[baggywrinkle]

a new standard of education and training for techs. They need more than current training programs provide to be able to provide safe care on their own.

What lobby group do you see as a potential proponent of a change in technician responsibilities? Chains are all I can think of.

The technicians themselves will find their voice and begin to lobby as professionals. In my web wanderings I have seen a pharmacy technician newsletter/journal and I seem to recall (foggy through my alzheimers) a national association of pharmacy technicians. I think you will find these groups working closely with state pharmacy associations - indeed working from the same office. This will occur because there will be a group of pharmacists who will champion their cause.

Pressure for these changes will increase as the boomers retire and demand for services skyrockets over the next twenty years.

Once again, I do not view this as a threatening trend.

I did a bit of research and found...

This style of retail pharmacy is known in Australia as Forward Dispensing
and was created by John Morgan of Melborne It involves a seated pharmacist face to face with the customer while the assistant does the
lick stick and pour. Both forward dispensing and traditional bench pharmacy
are practiced down under. The former being more appropriate for slower
independent operations.

http://www.swin.edu.au/agse/publications/hindle/HindleCuttingANZAM.pdf

Training requirements for Pharmacy Assistants in Australia

http://www.guild.org.au/public/ntcpa.asp

From the Auspharmlist on forward dispensing;

"I have been forward dispensing for over 5 years now, & I certainly wouldn't
return to the old way of being closeted behind the counter & unable to talk
to people. The stress levels used to be max as I would pound away at the
keyboard not daring to look up at the sea of faces behind the counter all
waiting for their scripts. I'm now in a small pharmacy where we talk to
people, sometimes at length, about anything from their health, family, what
they should wear at the upcoming wedding, you name it, we talk about it. We
offer people tea/coffee, lifts home, mind stray dogs etc etc. There's just
me & my assistant, & we do everything ourselves. The downside of this
seemingly relaxed atmosphere is we're obviously not bringing in the dollars
that your 300Rx a day phcy is. Swings & roundabouts.
I've found by talking to people about their medications has saved many
errors, & I think the pharmacist should definitely be inputting the Rxs."

Cathy Beckhouse
Lyons Pharmacy
ACT

 

[ultracet]

in VA i believe techs must now be certified and they have CE as well...

 

[npp71681]

Hi!

I think now all the US states should required some kind of education or training prior to obtain a license as a Pharmacy Technician, because there are so many people who work in the pharmacy and do not have any training. Because of these kind of people who don't even know a word about pharmacy, so those who are majoring in pharmacy do not get any oppourtunity to work and to get pharmacy experience.

There are people on SDN(pre-pharms) and all around the US who are looking for job as a Pharm Tech, but can't get one because those who are not majoring in pharmacy get all the jobs.

 

[2badr]

Hi!

I think now all the US states should required some kind of education or training prior to obtain a license as a Pharmacy Technician, because there are so many people who work in the pharmacy and do not have any training. Because of these kind of people who don't even know a word about pharmacy, so those who are majoring in pharmacy do not get any oppourtunity to work and to get pharmacy experience.

There are people on SDN(pre-pharms) and all around the US who are looking for job as a Pharm Tech, but can't get one because those who are not majoring in pharmacy get all the jobs.

While I believe the trend right now is to be certified, it is also becoming the standard that one must be registered as well (where I reside anyway). Altho most places will not tell you, it is increasingly difficult to get a job without certification and registration. I'm certified, but not registered. I am in tne middle of fulfilling my CE units to remain certified.

I have no problems with the requirements. I think it is a good idea and is very much needed to keep patients/public safe.

I've had 2 unfortunate circumstances with the "wrong" medications in my family. One was near-fatal. The other was fatal. I am glad for the certification satndards and applaud the powers that be for trying to keep the public safe with qualified, knowledgeable techs.

 

[Glycerin]

The technicians themselves will find their voice and begin to lobby as professionals. In my web wanderings I have seen a pharmacy technician newsletter/journal and I seem to recall (foggy through my alzheimers) a national association of pharmacy technicians.

There are several technician associations out there. I'm a member of the National Pharmacy Technician Association, and their members seem to be very involved. I receive a monthly magazine/newsletter from them that includes issues, concerns, updates, and even a free CE. They even have a 3-day yearly trip specifically for CE's (last year was Vegas, this past summer was San Antonio, I believe...). For anyone interested, here's a link to the NPTA organization:

www.pharmacytechnician.org

Also, this is the link to American Association of Pharmacy Technicians (AAPT): www.pharmacytechnician.com

Membership is also a nice ornament to pharmacy school applications, though being a member of such organizations may not carry much weight.