Should pharmacists be able to write prescriptions?
What is your view on pharmacists and on whether they should attain provider status as we do deal with medication therapy and adjustments? I’m a bit curious because from what I notice in New England, a lot of the pharmacists get looked down upon especially by doctors here because of the old school style and such. Thanks! Haha -justanothernguyenpharmdrph
Honestly, I’m not a huge fan. We have different training and different jobs, so we shouldn’t be doing the same things. I’m not a pharmacist so I probably shouldn’t compound antibiotics in my office. I do, however, like the public health laws that have given pharmacists the ability to give vaccines. I’m all for that.
As for monitoring medications and their dosages, I think it depends on the setting. In the inpatient or nursing home setting, we often have pharmacy-driven protocols for dosing of antibiotics and other drugs that require therapeutic level checks. This helps decrease errors and harm to patients on an institutional level. But in the outpatient setting, I think the prescriber should be the one monitoring levels and making dosing adjustments because they will ultimately be liable for anything that goes wrong and they have to consider the patient’s other conditions and medications. In my experience in primary care, the more cooks in the kitchen, the more the broth is spoiled if you know what I mean.
It makes me really nervous to think of someone who hasn’t been trained in physical exam skills and physical diagnosis (and all the anatomy, physiology, pathology, etc behind it) treating patients. Knowing the treatments is great, but if you don’t know how to properly diagnose the things you prescribe treatment for, you’re dangerous. I mean, I’m a family doc. I haven’t filed for appendectomy privileges at my hospital because I’m not a surgeon. I don’t pretend to be able to do what a surgeon does because they have different training than I do. For me to attempt to take out someone’s appendix would be malpractice. We have different training and different jobs, and we’re both equally needed, but for us to try to do each other’s jobs would just be scary.
Even these minute clinics popping up in pharmacies worry me. They are supposed to be treating simple stuff, which is great in theory, but patients often don’t know what’s simple and what’s complex, and I worry that bad things will be missed simply because patients are presenting to a place that only expects to treat simple things.
My other problem with any “non-doctor” provider gaining provider status is that inevitably, they don’t share the same amount of liability that doctors do. I feel that if a person is granted the ability to do what doctors do, they should also be held to the same standard as doctors and carry the same risks that doctors deal with. This means being held accountable by state medical boards, carrying malpractice insurance, and having to go through all the hoops of testing and licensing requirements.
It may be an unpopular opinion, but ultimately, if people want to write prescriptions, they should be doctors, NPs, or PAs.