Pharmacist's Opinions Now Out Weigh Doctor's Orders

Lately, pharmacists have gotten just a little too big for their britches. Now I'm not belittling pharmacy as a profession. In every state, it takes a college degree and specialized training to become a licensed pharmacist. They work long hours, sometimes 14 hour shifts, and have to be on their toes at all times. One mistake could kill. They are a wealth of drug-interaction knowledge and have caught several potentially harmful interactions in my medications.

Their jobs have been made much harder by recent laws that require signatures for pseudo-ephedrine products. My life's been complicated by that, too. Instead of the extra two minutes it should take to get my antihistamine, it now takes 15 while the man in front of me rants about government intrusion into his personal affairs. Mister, let's get some serious perspective. The governments not really interested in your runny nose. If you're worried about your fourth amendment rights, switch to vapor rub. Besides, if your state is like mine, those signatures don't go anywhere useful. The paper gets locked in a box at the pharmacy. Nothing is entered into a central database; nothing is every cross-referenced between pharmacies. The method of executing that law has no direct impact on meth production. This isn't about those complex laws. This is about the expectation that when I visit a pharmacy chain, I simply want my meds. I want consistency in my life and lately pharmacists have been the bane of my sanity.

What I'm talking about is simple, straight-forward prescriptions. In this situation, the transaction becomes a simple exercise in computerized insurance filing and counting. It's not the pharmacist's job at these times to question why my doctor has prescribed the medications. Other than checking for interactions, which the software does, their job is to count the pills and fill my order. Not a very complex exercise; one that any high-school graduate can execute. This is a job, in fact, which I once did as a moonlight lark. After one month as a clerk, I was tagged to help in the pharmacy. Within two days, I was self-trained to file insurance and dispense medication. The only rule was the pharmacist had to double check everything and only they had the keys to the schedule-2 cabinet. The point here? It's not brain surgery. It's counting.

If you have moral or ethical objections to the particular drug called for by the physician, keep them to yourself. Your views on birth control pills and abortion, don't change the fact that it is dangerous and downright deadly for some women to get pregnant. A few states passed laws giving pharmacists a loophole on that, but if you can't do your job, isn't it just easier to find a new line of work than change the laws to fit your prima-Dona attitude? Now we have some pharmacists that don't believe you hurt quite that badly. The fact that they have never experienced enough physical pain in their life to empathize with someone in extreme chronic pain, doesn't give them the right to deny a patient the dosage that their doctor has deemed adequate to control their pain.

The public just wants some standards so their expectations of proper service are met. Getting a script filled has become a game of "who's-on-duty-today?" roulette. When visiting our local merchant, the expectation is that the various employees will follow the same policies, whether it concerns sales, returns, store credits or prescriptions. When those policies become subject to the pharmacist's personal opinions, every order becomes a matter of personal debate.

Here is a vivid example of the situation. Each month my wife needs several medications. This requires a written prescription since doctors can not call in schedule-2 drugs. Some of the pills are very tightly controlled and the doctor can not prescribe more than exactly a one-month supply. If you haven't done the math, this means that when she runs out, she has about 8 to 12 hours to get the script filled since it is her next dose. To facilitate this, her doctor post-dates the prescription, so I can take it the pharmacy early on the prescription date. Sounds easy and it worked beautifully for several months until I encountered a new pharmacist one morning. He refused to fill it based on his opinion that the date on the prescription wasn't valid until the doctor's office opened. Everywhere on the planet Earth, the day starts at midnight (technically 12:01), but in this 24-hour pharmacy, the day starts when the pharmacist decides. Combine this with the fact that he would be going off duty and would hand this off to the next shift simply meant that he refused to fill the prescription. I wasn't about to let this get lost in the shift-change shuffle. My wife needed her medicine very soon and I need to get to work very, very soon. Thankfully, I found another pharmacy, with a sane pharmacist that took care of the situation. My wife even took the time to call the district office and compliment the pharmacy team where I ended up. I didn't bother calling the other chain and complaining because there is basically nothing they can do. The pharmacist is king of his backroom domain. Sadly, I know that the exchange I had with that man did nothing to change his outlook. He firmly believes he was in the right. But that's ok, my wallet is firmly in my pocket and won't be removed anywhere near that chain again. I suppose this is why this particular man is a pharmacist and not a doctor, complete lack of compassion, bed-side manner, and common sense.

Not to oversimplify the analogy, but the pharmacist is a waiter and the doctor is the chef. All I expect of the waiter is to serve the meal that the chef prepared based on my tastes. I don't need the waiter to inject their personal opinion about vegan diets or the dangers of red beef or mercury levels in the fish. Can you imagine how long a waiter would last if they refused to carry certain meals to the tables? If you don't want to serve what I've ordered, find another job. Likewise, Mr. Pharmacist, if you have objections to dispensing legal medications, find another profession. As for the chain pharmacies policies, pick one and stick with it. At least that way, the public can choose where to spend their money based on something more consistent than the pharmacist's personal convictions, religious beliefs, and private theories of time and space.