Maybe it varies from state to state … or is it a federal license?
Prompted by an argument I saw on the tube that a pharmacist was obligated to provide a product he had a personal belief against …
Are they licensed so that they have and maintain an ability to safely distribute drugs.
Or are they licensed to provide healthcare services in a manner required or approved by the government that grants the license.
Pharmacists are licensed by the state. The state of Illinois gives the reasons for licensing as follows (from the Pharmacy Practice Act ):
IOW, we don’t want just anyone handing out chemicals that can kill people.
Remember that there are more kinds of pharmacist than the guys at Walgreens. My dad, for example, is a pharmacist at Children’s Memorial Hospital. He’s responsible not only for counting out pills but for educating patients, doctors and other pharmacists about new drugs and research, for formulating medications that don’t exist off the shelf, for coming up with novel ways to administer meds in strange situations (ie. you have a medication designed only to be administered orally and a kid born with no mouth - what do you do?), and, of course, for the ever-present checking of drug/herb/OTC/diet interactions.
While a doctor may know one or two medications for any particular condition, the pharmacist must know (or have quick access to information on) dozens of them. Often, when the one or two the doctor knows doesn’t work, she’ll come ask someone like my dad for more ideas or more current research. PDAs have certainly made this faster, and, to some small degree, equalized the playing field a bit. But it takes a hell of a lot of training to get really good and really fast and really thorough. And a good pharmacist can not only regurgitate knowledge, but understand enough of the chemistry of the drugs and the biochemistry of people to make educated hypotheses about the potential action and side effects of drugs even if they’re not in the literature.
Pharmacists are highly trained medical professionals although they are often not treated as such by the public. They don’t usually do the pill counting in the busy retail pharmacies. That is what pharmacy techs are for. Pharmacists have to manage the supply of drugs from coming into the pharmacy out to the patient. Mistakes can obviously be deadly. They are supposed to be experts on all the drugs and some claim that they should know more than the physicians that prescribe them. They can give consultations about prescriptions to patients and they can prescribe a limited number of drugs themselves. Pharmacists can extend many prescriptions in an emergency. They also need to watch out for prescription fraud.
Yep. Compounding pharmacists make up products that are not available commercially. In the 80s there were several people who lost eyes/eyesight when their eye drops were improperly compounded.
Cite
Pharmacists are also responsible for insuring compliance with a number of statutes, some examples I can recall from clerking at a small pharmacy in the late 70’s:
-Narcotic prescriptions must signed by the doctor. Most other prescriptions don’t require a signature.
-A valid prescription must carry the patients address. Docs almost never do this, so the tech or clerk at the counter has to ask, and the pharmacist checks for that.
-The pharmacist is responsible for the security of the drugs. A pharmacy is not allowed to be open to the public unless a pharmacist is physically present.
In addition, during the year or so I was at the pharmacy, two cases of prescription drug abuse were caught, (patient seeing two docs to double up on dosage) one case of a forged prescription, one case of a doc writing for inappropriate dosage, and several interaction issues. If we filled 30 'scrips it was a busy day, so I imagine that a really busy pharmacy would deal with such issues on a nearly daily basis.
ICU nurse checking in.
We can’t be expected to know everything about every drug we give patients. Sometimes we have compatibility issues with multi-drug combinations we need o know or be reminded of. Back in the “bad old days” we mixed our own pressors (drugs that keep blood pressure elevated) and chemo. Now pharmacists do that.
In fact, most in-hospitals pharmacists are now PharmD’s…Doctor of Pharmacology. Good folks to have around. A night doesn’t go by that I don’t call the pharmacist about something!
Maybe I missed it, but aren’t they “licensed” by the DEA to be able to handle “the hard stuff”?
They (and pharmacies) are *registered *with the DEA to dispense controlled substances, yes. But you have to be licensed by your state in order to register with the DEA.
AFAIK in California, all prescriptions must be signed, but only the more strictly controlled substances – Schedule II mainly – have to have the patient’s address, and they are not refillable.
IANAP, but in my opinion to cite controlled drug laws as a primary reason for licensure trivializes the profession. I’ve always believed that the pharmacist is, or should be, much more than the gatekeeper of controlled substances. They need to understand lots of biochemistry and pharmacology, and I imagine the ethical standards that are required must go far beyond just “don’t give narcotics out to people who don’t have scripts.”
The pharmacists in the hospital where I work also respond to Code Blues and major traumas.
They calculate the doses of the various drugs the doctors request, then draw them up for the nurses. The do this in the ICU as well as the ER.
I was told it frees up at least one RN to do other critical things.
Nitpick: PharmD is short for “Doctor of Pharmacy”. A pharmacologist may well have a PharmD, but more likely has a PhD.
Robin
I love my pharmacist. It makes his day when I ask his opinion about what to use for pain, hay fever, etc. He also watches out to make sure that my meds don’t conflict.
Thanks for the input everyone. The general/anecdotal responses seem to be focusing on the safety issues.
I wonder if the Illinois statute cited is typical with it’s references to “public interest” and “confidence of the public” which could be used to force pharmacists to take actions that they are morally against.
Based on my experience yesterday, I think maybe it’s only first-time CII scripts that have to have the address on them. I went to fill two yesterday, one each for my wife and me, and hers didn’t have the address on it. I think that’s because she’s already been using it. Mine on the other hand was a new med for me, and it does have my address on it.
It may be worth noting that my state also requires licensing of barbers, nail salons, pawnbrokers, boxing promoters, auctioneers, and landscape architects. Licensing of pharmacies just isn’t that unusual.
^Funeral homes, car dealers, cosmetologists are licensed by Pennsylvania’s Bureau of Occupational and Professional Affairs. As are veterinarians. 