I laugh at that one just because I've
had physicians ask me that.
They call us the police people of medicines,
and it's not true.
The first thing we do before we ever look at costs,
and I'm speaking even from a-- We call it P&T Committee,
but pharmacy and therapeutics committee.
We always look at the clinical utility of the drug first,
always.
In the hospital setting,
the doctor will write an order in
and you receive it on your end and you're just
like nope, that's not on the formulary.
You'll get this phone call, who are you?
I wrote this prescription, you need to release this.
And there might be some expletives in there as well.
A lot of times we're the messenger.
So we're like, well the P&T Committee met and then still--
Well, I think this should be on there,
and they're making the case to you.
And that is challenging,
and I think
that's where kind of this idea of us being
the policemen of meds comes from,
because we're kind of in a position
where we have to enforce the formulary because we
have all the meds there.
And I think what's important here,
is for us to all just kind of realize that it's not
about the egos and it's not about turf wars,
it's about the patient who is in the hospital bed, who
is waiting for that medicine.
So there is a misconception that prescriptions
can be written and unwritten without any consequences.
When a physician writes a prescription,
a pharmacist is obligated to prepare that medication.
And if they did not pay attention
to what dose were they writing, or how many of those tablets
they were writing for, it can't just be taken back.
So I've had a situation where the physician told the patient,
I'm going to prescribe you this antibiotic-- let's
say A antibiotic.
And they come to the pharmacy expecting
to pick up prescription A.
And we actually received an order
for a completely different antibiotic.
And they're a bit taken back.
Oh, the physician told me they're prescribing me
something completely different.
This doesn't sound right.
I don't want to take this medication.
If physicians have questions about a medication order
they're placing,
they should certainly contact a pharmacist
to help in assisting in inputting that order
Because once they sign that order,
there is a potential for that patient to get that medication.
There's always a misconception that pharmacists only
count pills.
But there's a lot that goes behind the scenes
when a pharmacist dispenses medications.
So like, first of all, the prescription
has to be written correctly.
It has to be the right dose.
It needs to be the right drug.
It needs to be the right route.
And a lot of times, it's not just
pouring from a large bottle into a small bottle.
On the outpatient environment it takes a little bit longer.
So let's say a patient comes in-- let's say
for a pediatric patient, but the dose
seems a little higher than normal
for a pediatric antibiotic.
Essentially, you just have to-- you
don't tell the patient that oh, we expect
this drug is wrong dosedly.
You just, essentially, say oh, there's some clarifications
we have to ask the physician to make sure
that we're giving the right medication in the right dose.
That takes a lot of time for you to call the outpatient
provider, expect them to call back,
and then before to dispense the drug.
So it's usually difficult on the patient's end, but most of them
do understand it is important that you have to check
the doses of the drugs.
Additionally, if it's something that, you know, it's unique--
and it's a little bit off label or nonstandard,
just maybe, you could give the pharmacist
a heads up, so then they are aware,
and then just knowing that this is intentional
versus just an unintentional, like, tenfold dose increase,
or something like that.
There's a misconception that pharmacists cannot write
prescriptions, and that's false.
It couldn't be further from the truth.
I think that comes from the fact that about 15, 20 years ago,
we could not.
When I say we could not, we could not in many states,
and there was a push in the pharmacy profession
to shift that.
So I think a good example is, a patient who
I'll call Ms. Garcia.
And Ms. Garcia will come in and she'll see us
and she'll need refills on several of her medicines.
We'll call up the pharmacy, the pharmacy
doesn't have any refills on record
and she needs the medicine.
is I'll call up the doc, and say,
hey I'm seeing your patient, this was the assessment,
she needs x,y, and z.
And the cute interaction is, there's usually a sigh,
because when we call the physician's office,
the physician is already seeing 30 other patients that day.
OK, do I need to call it in.
I'm like no, I can do it for you
and then usually the response is, really?
You can call in a prescription?
And I say, yeah actually we can.
And they're like, wow yes, yes do that,
call in the prescription.
In fact, call in the refills.
Do you need my DEA number?
No, I have my own DEA number.
Oh well, that's great, good to know.
Pharmacists can definitely specialize.
And there's actually a wide variety of specialties
and multiple practice settings.
So in general, there is outpatient pharmacy
and inpatient pharmacy.
Oftentimes when we get new practitioners,
or we get a new attending on the medicine service,
I come in the morning, and I introduce myself.
Hi, I'm Sammy.
I'm the pharmacist.
And they're like, oh, wow, you round with us, OK.
So they're always a little taken back
that we're actually participating.
They may not have known when I introduced myself
what my role was.
But by the end of rounds, they understand
that I'm a clinical pharmacist.
I round with our internal medicine teams.
And I'm a specialist within that area.
And I help them with an array of questions,
from drug information, to drug dosing,
to ensuring an appropriate therapy is selected
for each patient.
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