Why We NEED Pharmacists

Our job as pharmacists is to dispense the right medication to the right patient and make sure it is correct and appropriate. It's also our job to protect the patient, sometimes from the prescriber or doctor who wrote the prescription.

Above is an example. A careless pharmacist would just type this up as:

Dissolve one and one-half tablet under tongue twice daily as needed for pain.

But a good pharmacist would see the conflicting notes and if he or she didn't know the patient and history, he or she would call the doctor. This careless doctor actually wants the patient to take one tablet in the morning and one-half tablet in the pm.

What would happen if this patient was given incorrect instructions? Probably not much. But with a different drug this could be catastrophic.

Think about that the next time you're pressuring your pharmacist to hurry with your prescription.

Feeling Uncomfortable about Filling Prescriptions

"Dr. RxMan, my name is Detective Daniels. I'm with the Snootyville Police Department. We'd like to ask you some questions."

"Certainly, how may I be of assistance?"

"On November 22, did you fill a prescription for the generic Norco 5/325 to a Mrs. White?"

"Yes, I did."

"Are you aware that the quantity you filled was for 180 tablets?"

"Yes, I know."

"Didn't that seem like a high amount of tablets?"

"Yes, of course. I verified the quantity with the prescriber."

"Are you aware that you filled this prescription 20 days AFTER you filled the same quantity for the same patient?"

"Yes, of course. Mrs. White indicated that she was going on vacation 'somewhere in the middle of Nevada' where 'there are no pharmacies.' When I called the doctor, he approved filling the medication early."

"Were you not concerned for the health and welfare of Mrs. White? Did it not occur to you that so many tablets of Norco might endanger her if taken incorrectly?"

"I'm always concerned about all the medications we dispense. We counsel every patient about the dangers of these medications."

"Are you aware that Mrs. White was found dead in a motel room here in Snootyville? She left a suicide note indicating her intentions. The forensic team is still working on the case, but it appears Mrs. White died from an overdose of Norco."

"Oh my gosh! That's horrible!"

"Our concern is that you ignored a clear and present danger to Mrs. White and YOU are partly responsible for her death. We will be taking evidence to the grand jury for an indictment. Please do not leave the state, Mr. RxMan..."

NO, this didn't really happen...

but could it?

Recently I've seen blog posts ranting and raving about chronic pain sufferers being "mistreated" by pharmacists and pharmacies all over the country. Some encourage the patient to hire a lawyer if they feel like the pharmacist has somehow mistreated them by "keeping them" from their pain meds. They also encourage patients to invoke a clause in the American Disabilities Act to pressure pharmacies to fill without questioning quantities or timing.

Another comment talks about how pharmacists should never say they're "not comfortable" with filling a prescription... the author suggests that no matter what the situation, simply presenting a prescription to a pharmacist FORCES them to fill it without question. 

Mind you, we're only hearing the disgruntled rants of the "mistreated patients," but lets consider the point of the blog: You should never turn down filling a prescription because you feel uncomfortable about it. Is that the correct thing to do? No, it's not. Let me tell you why:

If you're a pharmacist, YOU have EVERY RIGHT to question ANY PRESCRIPTION presented to you, and YOU have EVERY RIGHT to NOT FILL IT for WHATEVER REASON if it makes YOU feel UNCOMFORTABLE. 

If it doesn't feel right, then don't fill it. Are there some people that will feel "mistreated" because you don't fill it? Maybe. Are there some people who are chronic pain sufferers who might slip through the cracks? Possibly. Should we just give out medication to anyone that asks for it and take the risk upon ourselves that people might do what Mrs. White did? Hell no.

No pharmacist anywhere wants people to suffer! But we will NOT be extorted into filling anything and everything because some people, including retired pharmacists, feel like its not our business to assess situations and deny filling. It is our job, and we will do our job.

And in case you don't think scenarios like the one I suggest above with Mrs. White isn't possible... think again. I personally had a very similar situation actually happen to me. It DOES happen. I did not fill a prescription for a large quantity of generic Ambien because I did not feel comfortable doing so, despite having prescriber approval. As it turns out, the man (and his wife) who wanted the large quantity of Ambien were planning on using it to commit suicide! Read that story here. 

I was NOT comfortable filling the prescription as stated in that blog story... and as it turned out, it was for a good reason. If I had ignored my "uncomfortable feelings," I would have had to explain to the police and the victims' families why I filled the medication. And who knows? Maybe I would have been implicated and/or sued by the surviving family? And/or lost my license? Above all else, I would have known forever that I played a part in their suicide. What would that do for your "comfort" zone, pharmacist?

So if you're a pharmacist that feels uncomfortable filling a medication, you go right on feeling uncomfortable and don't fill it. There's a reason why you're feeling that way. Don't feel bullied or pressured into filling anything that you're not comfortable with filling! Period.