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Let’s Cut The Crap!

October 22nd, 2010 by Jim Plagakis

Peon sent me the following article from Pharmacy Times. Before you read it, let’s cut the crap and acknowledge some truths.

Lately, on these pages, pharmacists have been talking about not being in the loop and not being qualified to prescribe because they do not have access to the patients medical records.

Lately, pharmacists have said that they are not privy to the diagnosis.

You are talking about an ideal world if you believe that every prescriber is a competent diagnostician and therapist.

There are plenty of C students who have been working as doctors for two decades and are hopelessly out of the loop when you are talking drugs.

There are plenty of doctors who dont give a crap. They enjoy the golf games at the country club and Thursdays on their sailboat.

There are plenty of doctors who simply guess. My personal experience has soured me. I have the late effects of polio. This is a degenerative neurological condition that every polio patient will get if he/she lives long enough.

I have had only two doctors know as much about it as I do. The first one who diagnosed me in 1987 and the last, the guy who conducted the electromyogram. Every other doctor in between just blew smoke. That is irresponsible. I was dumb enough to take their advice.

So, as you read this article, lets agree that not every doctor is competent. Right at this moment, you can name doctors that you would not allow your loved ones to see for a medical issue. Period.

You know doctors who paint by the numbers. How can it be possible that so many of their patients need the same list of drugs?

I am leading with this because you know and I know that you are under-utilized. Doctors can be wrong and are wrong often. This is not 1975 when the doctor could not make mistakes.

This is not an ideal world, but pharmacists can help.

"Why do I feel so bad, Doctor?" ... "Hmmm, Betty, you have Chronic Fatigue Syndrome".

Patient Letter Sheds Light on Attitudes About Pharmacists

Laura Enderle, Assistant Editor
Published Online: October 20, 2010 – 7:53:13 PM (EDT)

A patients refusal to participate in medication therapy management sessions raises questions about how pharmacists are perceived by patients.

I’ll take drug advice from my MD, thanks, was the title of a letter to the editor published in a recent issue of the Des Moines Register. The letter was a wake-up call for the Iowa Pharmacy Association (IPA), which urged its pharmacists to educate their patients about the benefits of medication therapy management (MTM).

As it turns out, patients may refuse services without fully understanding what MTM is or what they could gain from a thorough review of their medications. To complicate matters, they may think of pharmacists as extensions of their insurance companiesrather than independent, doctoral trained medication experts.

That was Phyllis Andersons first thought when a pharmacist asked whether she wanted to participate in an MTM session. Anderson described the encounter, which took place at the pharmacys drive-through window: [The pharmacist] informed me that my insurance company had recommended me as a candidate to have my prescriptions reviewed. I responded, Since when do I take insurance companies opinions over my physicians?

To Anderson, a counseling session to review her medications suggested the pharmacist was colluding with her insurance company to usurp the physicians role, as she put it. She refused the service.

The offer was extended on behalf of Outcomes Pharmaceutical Healthcare, a group that partners with plan sponsors and pharmacists to provide MTM sessions to eligible beneficiaries. According to IPA, more work is needed to help patients understand these benefits.

Both individual pharmacists and pharmacy associations must assume a larger role in promoting MTM to a broad audience of patients, the organization said. In a letter to the newspaper, IPAs executive vice president and chief executive officer Thomas R. Temple, RPh, MS, defined MTM and addressed consumer concerns that the service undermines physicians prescribing power.

Emphasizing the collaborative aspects of MTM, Temple wrote, Quality health care can be achieved best when physicians, pharmacists, and patients work together to achieve positive outcomes from medication therapy. This message, though familiar to pharmacists, must reach patients if MTM is to become a routine pharmacy service.

Lack of patient understanding or cooperation may simply be evidence of a transitional process, according to IPA. To ease these growing pains, pharmacists should begin or continue participating in Outcomes and other MTM programs to ensure patients receive the most appropriate and cost-effective therapy possible

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