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Experiences
with HRT:
The publicity has caused some interesting reactions, some people
seeking extra information and reassurances that their products
had not been included in the survey, but probably the most interesting
was a lady who has decided she does not want to take any HRT any
more and wanted her money refunded for the last issue of the prescription.
What have other pharmacies done?
What would they do if asked?
Incidentally Time magazine had a comprehensive article that seemed
to spell it out well.
Editor's
Note: With all that "evidenced-based medicine" out
there, how did HRT slip through?
Perhaps there is a rationale for manufacturers to refund patients
for risking their lives.
Product
Recalls:
Recently a product recall was seen for the first time in
a Guild Bulletin, (no fax no letter).
Will we ever see a web site that could be the home page for pharmacists
that show product recalls, and could it be established in such
a way that it is mandatory for pharmacists to look at it at least
twice a day?
Editor's
Note: It should not be too difficult for the Guild or the
Society to allocate a web page on their site and provide this
information. We are about patient safety, are we not?
Prescriptions that consume time in interpretation:
No strength, non-existent strength, no quantity, impossible directions,
no directions.
Most of these are hand written ( we cannot read what was wrotten!),
but computer generated prescriptions are not immune ( hormone
patches - 1 tds instead of twice a week).
Isn't interesting that even though more than three items are supposed
to be written on a form, doctors cram eight items on a form, because
they are too lazy to write the patient's name on a new form (some
scripts only have an initial and a name - no address, no Medicare
number, no date).
Had a script today for Caps 100mg 60 rept 2 (forgot to write Celebrex),
another script for Vioxx for the same patient, told to try one
first then the other if not happy with results from first.
But this was not understood by patient who tried to have both
items dispensed.
Another misinterpreted, Panafcort 5mg 60, (1mg 100) was meant
to mean both strengths were required.
If all prescriptions were computer generated and the software
intercepted inappropriate directions it would be a step towards
utopia when all scripts are electronically transmitted.
Editor's
Note: Doctors do it to each other as well.
The Division of General Practice in my area award a bottle of
wine for the most legible discharge summary generated in a month.
Some months there is no prize awarded.
Perhaps someone needs to start up a Guinness Book of Medical "bloopers"
to highlight how serious the problem is.
Insulin prescriptions:
Even
computer generated scripts seem to be for the wrong item.
This is not a problem confined to this part of the world, Adelaide
had the same problem.
It seems the only satisfactory method is to show the patient the
insulin before attempting to dispense it.
Editor's
Note: What can you say?
Just another example of unprofessional prescribing.
Therapeutic Group Premiums:
These
must be the hardest premiums to explain - has someone out there
have a simple explanation that is easily understood by people,
especially the elderly, and especially for those for whom English
is not their first language?
Editor's
Note: Complexity is what bureaucracy thrives on, because it
creates mountains of activity.
If a consultancy fee was generated for each explanatory session,
perhaps the true cost of providing government services could be
determined.
Consultants often discount their work, sometimes by 100 percent,
but generally they issue an invoice purely to demonstrate value.
Sometime it may be a useful exercise for all pharmacists to generate
an invoice as a snapshot for their unpaid work, and have some
central body render a combined statement to the federal government.
It might just provide a powerful argument when negotiating dispensing
fees.
Lies
that are related from other pharmacies:
Mersyndol Day Strength are exactly the same as Mersyndol but they
do not make you sleepy!
So how does that happen without changing the formula?
Editor's
Note: Lies or laziness?
Maybe just somebody interpreting the label without really looking.
Whether lies or laziness, it does not give the pharmacy profession
a good image, particularly when patient safety may be at risk
if when they are driving a motor vehicle.
The dilemma of what to charge for OTC items ordered on doctors'
prescriptions:
Increasingly
now that doctors list all medication prescribed on their computers,
and press the print key, we receive prescription forms for items
that used to be scribbled on post-it notes.
At least we can read them, but what is the policy generally followed?
Charge a dispensing fee when a label is generated?
Or sell at the OTC price, with or without a label?
Editor's
Note: This has always been a problem, but as a prescription
is presented for the product, there is an obligation to dispense
it. Perhaps this is one of those instances where you charge the
full price, but generate a scale of discounts to be applied to
bring it back to a consumer level of acceptance.
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