republished and reported in youarewithinthenorms.com
ARTICLE BY STEVE ARIENS
In listening to the attached video, remember … that one of the basics of the practice of medicine is starting, changing, or stopping a patient’s therapy. Pay attention to what the pharmacist is saying, telling the prescriber!
This is a video of a recent discussion between prescribers and pharmacists regarding a patient who lost her regular prescriber because of retirement. I know the prescriber on the phone but do not know who the Pharmacist is. I suspect he works for a CHAIN because of a few things stated by the Pharmacist.
https://www.facebook.com/1094599019/videos/687636116626942/
Notice that the Pharmacist did not look at the patient’s PDMP history… all he is focused on is either the MME and/or Narxcare score, ignoring the patient’s long-term history of being on these medications for years.
He seems to be fixated on some arbitrary number and a “line drawn in the sand.” I suspect that this pharmacist works for one of the three chain pharmacies that agreed with 50 state AGs & others. In which they agreed to reduce the opioids and/or controls that they dispense.
“The Give Me’s in the life for each of us are pain and suffering. Not since the fables of Hans Christian Andersen has someone so aptly written such heart-touching stories. Doctor Bison shows us how important the doctor-patient relationship is to healing.”
Mark Victor Hansen, #1 NYT Chicken Soup For The Soul®
https://www.facebook.com/1094599019/videos/687636116626942/
This Pharmacist seems to be VERY RELUCTANT to explain what and where the criteria behind the “RED FLAG” that he is quoting came from and “hell-bent” on refusing to dispense any medications above this seemingly arbitrary MME/day.
Since the Controlled Substance Act was signed into law in 1970, Pharmacists have not been allowed to change a C-II Rx for any reason – including verbal order from the prescriber. Maybe part of the lawsuit settlement to reduce the amount of controls those three chains dispensed. Gave them a special dispensation on that part of the CSA as long as they reduce the number of opioids they dispense.
I find it quite appalling that this Pharmacist had no interest in knowing if this pt was a confirmed ultra fast metabolizer by pharmacogenomics – which would be justification for the pt to have a higher dose and/or he had no concern .. he was happy to enter into his pharmacy computer system a “corresponding responsibility rejection,” which would void the pt’s C-II Rx and would most likely intentionally the pt into cold turkey withdrawal.
Last week, 12 Kansas City area CVS locations closed as pharmacists walked out over working conditions. I wonder if these Pharmacists walked out because CVS dictated how they were to practice pharmacy, what meds they could fill, what meds they couldn’t fill, and they were to limit how many controlled med doses they could provide to particular patients.
Remember the first sentence of this blog… did the Pharmacist change the pt’s Rx? Was the Pharmacist willing to stop the patient’s medications? What part of the practice of medicine was this Pharmacist attempting to practice? Is the state board of pharmacy aware of this? Do they really care … if they are aware?
https://www.facebook.com/1094599019/videos/687636116626942/
FOR NOW, YOU ARE WITHIN
THE NORMS
