Yep. Some pharmacies do sell this stuff over the counter. A few larger stores might have it behind the counter (because they do mix some stuff on their own).
Also, a physician’s assistant generally has a fairly narrow scope of practice. Most of the PAs I’ve dealt with (and I’ve dealt with a few) will let the MDs prescribe for the more serious problems, but they can and do prescribe for routine, common problems.
Robin
Zowie, Duck Duck Goose. I didn’t think of those excellent points! You make so much sense.
Who would you rather have counting and checking your pills? A Pharmacy Tech making $6-10 per hour, or a licensed pharmacist make much more? There’s a ‘verification’ process that all pharmacists have to go thru before they give you your prescription. Not only do they have to check for interactions, but they have to verify that you’re getting the actual medication you’re supposed to. While it appears that the pharmacist is simply counting pills, they are also checking the pills against either a picture, or a description of the pills. I’d want someone licensed, with something to loose from screwing up, rather than a tech with next to nothing to loose. And by the way, the pharmacist usually only personally counts the controlled substance drugs, but will verify the pill type for every script.
As far as the consultation aspect, that cannot be overstated. A computer system can only do so much. For the most part, most pharmacy computer systems check the drug you’re getting against your previous prescriptions filled at their chain, and the insurance company also checks on the med when it is submitted for billing (prior to you recieving the drug). These 2 types of checks are very effective, but don’t take into account anything over the counter, or any cash prescriptions you bought at another pharmacy. Only a trained, skilled pharmacist can answer these interaction questions properly.
In a Hospital/Institutional environment it will be likelier that the pill-counting, IV-bag preparation, and some basic compounding will be done by PharmTechs, under a few Pharmacists’ supervision. At Rite-Aid, though, it’s more efficient for the Pharmacists to outnumber the Techs since that way you’re always covered for the shifts (besides, Pharmacists in the chain stores, though generally better paid, are worked like beasts by the company. At least that was the consensus back in the late 80s when I worked at Mercy in Baltimore)
Gosh DDG, that is a heavy load. I’m assuming that’s the Pre-Pharm program you mean, not the Pharm.D., which comes next, right? To do all that, with any deficiancy whatsoever in highschool (that is not taking almost all honors or AP classes), you’d need most of a full BA/BS anyway, it seems! So again, why do Pharm.D. programs seem to expect only two years of undergrad? Why not go the full-monty and require a four year degree (especially if weeding people out is a major factor). I mean, Med School requires all that and more, and still expect (under normal circumstances) a full Bachelor’s.
Not to mention you need a working knowledge of calculus to understand drug metabolism/elimination kinetics. Many, many drugs don’t follow first-order kinetics - their rate of elimination from the body doesn’t change linearly with dose.
“…pays as poorly as pharmacy…” You’re joking, right? Phamarcists can easily make $90,000 straight out of school, and I live in Ohio.
A friend of the family is a pharmacist, and whew, it’s a tough job. As was mentioned previous the pharmacist is actually liable for every medication they give you. They’re required to understand the interaction between medications, they have to interpret the perscriptions given by the doctors (a no easy task), they’re required to control abuse of drugs by keeping track of patient history in addition to knowing how all the drugs interact with ones body. This friend said it was very normal for them to catch incorrect prescriptions from doctors - a few a week. That’s one of the main reasons they’re there. Apparently once a doc diagnoses your problem they basically look it up in a book and send you off to the pharmacist who can then figure out if what the book says is correct for your particular situation. The interesting bit is that even if the doc prescribes something which isn’t correct but the pharmacist still fills it out as per the prescription, it’s the pharm that takes the hit, not the doctor.
All in all - I have a huge respect for those guys. It’s a rough job, and extremely hard to get into.
-n
The Pharmacists I know, make $40 an hour base, coming straight out of college. Within two years they make six digits, easily. I would rethink just how highly educated and all-knowing your local Pharmacist is.
There is a shortage of Pharmacists within the US, and right now, any Pharmacist that graduates will be making six digits with a secure job. Apparently only a thousand graduate every year or so.
This is what I have gathered from talking to interns, and actual Pharmacists…
A few pharmacists go on to work in industry, often as R&D or formulation chemists (discovering new drugs or figuring out the best way to package it - tablet, capsule, liquid, cream, etc). You most definitely want these people to have learned much more than what a computer could tell them!
There are, increasingly, degrees in pharmaceutical technology/sciences which are intended to cover this area of the industry, but a few of these people are pharmacists, at least in their initial training.
In my experience, most of what you guys say is true. I’m an Rx Clerk at a SavOn in southern California, and I’d wager that a good portion of a pharmacist’s day consists of counting pills and watching the minutes pass on the clock.
But there are times when things happen that cannot be fully understood by a technician who only knows how to type data into the computer and fill a prescription as it’s stated. And who is a technician to argue with a doctor if their computer tells them a prescription is incorrectly prescribed? A doctor needs someone to consult with who actually knows what he’s talking about. If there existed a computer system that could do the job of a pharmacist, then we could simply eliminate pharmacies all together and have MD’s dispense medications directly to patients.
Not to mention that a technician without a sufficient background in pharmacy would most likely not legally be allowed to consult patients who have obscure questions that aren’t in their computers. As has been said, only a pharmacist or pharmacist intern is allowed to consult patients as it is.
There is, as has also been stated, the risk involved when you get a group of people together and place them in a position where controlled substances are easily accessible. You do not want some technician making 10 bucks an hour having access to some of the medications that are in pharmacies without the direct supervision of a licensed pharmacist who has everything to lose if caught stealing narcotics.
Now, assuming that doctors make no mistakes and that prescriptions are always legible and easily understood, then yes, just about anyone could count tablets and fill prescriptions. But doctors are human and make mistakes, and prescriptions aren’t always going to be written correctly. Therefore, it is in the best interest of the health industry to have educated professionals deal with these issues because of the risks involved with botched prescriptions and human error.
Then, you could say the same about a MD. A tech could use a program, enter the symptoms, the program would mention what other questions are to be asked, what examinations/tests should be conducted, and according to the results, would tell what ailment the patient is suffering from, and depending on his age and condition would print a prescription. The MD/technician would only have to know how to conduct some basic procedures, as ordered by the programm. What’s the difference?
By the way, I know there are actually medical expert programms, though I just can’t remember what they’re used for. Symptomatology of rare diseases, perhaps?
My WAG – it carries over from the days before the degree title got standardized as a “doctorate” (there were holdout jurisdictions as late as the 80s! in other threads we’ve discussed that not all ‘doctors’ are created equal) and it was a self-contained both initial and terminal degree. There apparently took root a strong tradition that Pharmacy is not really a “graduate” program that you add on to your undergraduate degree but a specific, distinct single professional track.
Ug. That parses awkwardly. I’m referring to how, like Law at one time, you could go straight into it as an undergrad and afterward not require any additional Master’s or (Academic) Doctorate to become a professor of the same subject.
Actually that sort of thing used to be more common. I think medical schools often used to admit students without a bachelor’s degree, provided they had taken appropriate science courses at the undergraduate level. My father got his MD in 1948, and he has no other degree. Of course, another factor in his case was that, when he started college, WWII was still going full blast, and the military really needed doctors. So the colleges had compressed, four-quarter schedules in which pre-med students would take anatomy, chemistry, biology, and so on. Unlike today, in spite of not requiring a bachelor’s degree for admission, it does seem that medical schools back then did expect their students to already have taken a “pre-med” curriculum based largely on science. This was unlike today, when most med schools seem to say, “just major in anything, but make sure you do well.”
As for my dad, he finished too late to serve in WWII, but they got him a couple of years later, for service in Korea.
I used to know a physician who dropped out of college as soon as he was accepted to Medical School, but before graduating. He was just finishing his residency when I knew him, about six or seven years ago, so it was certainly possible then, at least, and probably still is.
I’m pretty sure when Med Schools say “major in anything,” they still want you to have a pretty extensive list of science and related courses, along the lines of what Duck Duck Goose’s daughter is taking. (I said Medical Schools require “all that and more,” but I think it’s actually pretty similar.) What they mean is, if you want to take all the pre-med reqirements, plus major in History, more power to you. They don’t discourage it, because any student who can do all that has clearly demonstrated both well-rounded interests and the ability to perform well accademically without sleeping!
JRDelirious, I understood exactly what you meant. I think there used to be several professional degrees like that. I know a Master of Divinity was a BD or STB (Bachelor of Systematic Theology) until the '60s, even though it did require already posessing a Bachelor’s Degree for acceptance, at least at my school. Odd, though, that only Pharmacy kept that understanding, even when it became a doctorate.
This may be true in very limited parts of the country (many parts of California, for example), but is definitely not the norm. I live in a place where the average pharmacist income is higher than the national average, but there are no staff pharmacists or even pharmacy managers (excluding owners), even those who have been working for 30 years, who earn six figures. Our raises are about 1% per year, and in general someone just entering the field earns only slightly less than someone who’s been working for a long time. In fact, in my company everyone earns the same hourly rate and miniscule bonus, regardless of years of experience.
Pharmacists count pills, nothing more. The computer will handle all the drug interaction warnings. The catch is some of the pills that pharmacists count are things like Dilaudid, Oxycontin, and methamphetamine (Desoxyn). Substances with high recreational value, and a high street value. It takes a minimum of a few years of brainwashing to get a pill counter who will not snatch a few of said pills for him/herself to take or to sell. Pharmacists must believe “drugs are bad” much moreso than the average person.
It’s like training a monkey to work at a banana stand and not take a banana every now and then. It takes years of training, or “education.”
Even so, there are still plenty of pharmacists who do snatch a pill every now and then; usually by counting short and pocketing the difference, knowing if the customer bothers to count his pills it will be the druggy-customer’s word against the honorable well-trained pharmacist’s.
Yeah, sorry, it wasn’t clear. That’s all just the prerequisites, before she actually goes to pharmacy school at SIU.
Kalt:
Geez, you’re an awful cynic. 
Did a pharmacist shoot your dog or something? :rolleyes:
On behalf of my daughter, and the pharmacist she works for at Walgreen’s (a peach of a guy), and all the folks in this thread who have family members who do a bangup honest job of pill-rolling…
CITE, dammit.
I understand that there is the occasional pharmacist who gets caught stealing–and the fact that when it happens, it makes CNN.com headlines, means, to me, that it’s actually quite rare–but either put up a cite for your statement that there are “plenty” of them out there who steal pills from customers, or withdraw the comment.
For one thing, what’s a pharmacist gonna do with the occasional pilfered Oxycontin? Is he gonna steal one pill from each of 100 customers until he has 100? He makes, at a minimum, $60,000 to $90,000 a year, and as noted, many of them make in the six figures–he’s going to jeopardize that by selling drugs on the street? And you don’t think that eventually that’s going to catch up with him, that 100 Oxycontin regulars aren’t going to start noticing that they’re frequently a pill short?
FTR, I ran this past my daughter, and she says that there is one of those public service posters on the wall at the pharmacy, that says something like, “Don’t share pills with your family and friends, it’s illegal” and it shows a genially smiling pharmacist with a trayful of pills, and a group of his (presumable) family and friends. But she says the ethics-education emphasis is on “don’t make up fake prescriptions for pills for family and friends”, not “don’t snitch pills from customers”.
Because while taking quantities from pills from the inventory for your friends and family would be illegal, snitching pills from customers would be illegal–and stupid. When you can make up a fake prescription for as many Oxycontins as you want, and nobody will ever know, why steal from customers? And thus it doesn’t occur to the State of Illinois that pharmacists would need to be warned against that.
It happens all the time, but rarely if ever can the customer do anything about it, let alone prove what’s going on. If the customer actually comes back and says “the prescription was for 90 pills and i only have 89” the pharmacist can either put the pill he took back and say “sorry, miscounted” or say “sorry I double counted those and there were 90.” The latter happens all the time. Yes, all the time. And no, it doesn’t make CNN headline news. The only time I can recall a pharmacist making the headlines is when he (and it’s always a male) refuses to fill a woman’s birth control prescription because Mr. Pharmacist doesn’t believe in birth control. You know, a case of “jesus doesn’t want that prescription filled.” That happens every now and then, especially down here in Texas, and always makes the news. It’s happend twice (that I know about) this year alone.
I had a friend in college who had severe back problems and was on all sorts of narcotic painkillers (like oxycontin, dilaudid, MSContin, Norco). This happened to him several times. If you go onto a chronic pain message board and read the stories, you’ll see that this is fairly wide-spread. The only way the pharmacists are going to get caught is by a security camera… and they certainly know where to stand so as not to get caught.
Either he’ll sell it to a friend or take it himself. Oxycodone (the active ingredient in oxycontin) is quite euphoric, to say the least. They can go up to a dollar a mg on the streets. That means an 80mg oxycontin pill can be sold for around $80. Pocketing that one pill can pay for a week’s groceries. Of course the pharmacist is not going to be standing on street corners selling drugs. He or she will sell them to a close friend or acquaintance. Most likely, though, the pharmacist will just take them himself. Being able to have a few really nice pills a week (for free!) would make counting pills for a living worth the trouble for many people.
Well it would surely be illegal, but not stupid at all. Rather quite clever. There is basically no way a competent pharmacist would ever get caught shorting the occasional patient by a pill or two. First of all it is rare that the patient actually bothers to count his or her pills. If that happens and the customer is short, the burden is on the customer to prove that there was a miscount when dealing with controlled substances. That burden cannot be met by the customer. If they short you on a non-controlled substance like Clarinex or Synthroid or Viagra, the fact that these are not the type of pills people seek out and take recreationally is enough to meet the burden and get your missing pills. If they short you on a controlled substance, however, the presumption is that you took the pill and are now trying to score an extra one. You cannot win unless the pharmacist was caught pocketing it on camera (unlikely) or actually admits to what he did (even more unlikely).
Illegal, yes. Unethical, yes. Stupid, no.
Pharmacists cannot prescribe or dispense controlled substances, especially Schedule II controlled substances like Oxycodone. In fact, I don’t know of any state that allows pharmacists to prescribe even legend drugs (prescription but not controlled substance, like clarinex or viagra). Doctors write prescriptions, not pharmacists. Even if they could, stealing from the customer by giving them n-1 pills out of a valid doctor’s prescripton for n pills and pocketing the extra pill is the only guaranteed way for a pharmacist to get away with it. The pharmacy must account to the DEA for EVERY controlled substance pill. Pocketing the extra pill and shorting the customer is the only way to snatch a few pills a week and still have every pill accounted for.
Happens all the time. I wouldn’t make up something like this. And yes, I’m a cynic, and for very good reasons.