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> pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor. It sounds like you have a pretty misguided idea of how pharm

> pharmacy shouldn't be allowed to decide not to fill it, as if they know better than your doctor. It sounds like you have a pretty misguided idea of how pharmacies and pharmacists worked before Covid. You’re describing a situation where pharmacists act at the behest of doctors who know best, when in reality pharmacists have always had some level of independent authority over what drugs get dispensed to whom thanks to their expertise. It’s part of the pharmacists job to watch out for bad prescriptions, both in terms of abuse (e.g. opioids) improper dosages, and unintended side effects and interactions between drugs. In some states pharmacists have their own ability to prescribe medicine on their own. I’m not sure exactly how much control a pharmacist should have over whether a valid prescription is filled, but the idea that they’re only expected to blindly fulfill the order of your doctor is not correct, and never was. In fact, they probably know more about the drugs you’re prescribed than your doctor does, as that’s their entire speciality. (Especially given the long and sordid history of doctors pushing drugs on the basis of pharmaceutical sales reps, doctors often actually know very little about what they prescribe).

nobody9999 5y ago
>t sounds like you have a pretty misguided idea of how pharmacies and pharmacists worked before Covid. You’re describing a situation where pharmacists act at the behest of doctors who know best, when in reality pharmacists have always had some level of independent authority over what drugs get dispensed to whom thanks to their expertise. It’s part of the pharmacists job to watch out for bad prescriptions, both in terms of abuse (e.g. opioids) improper dosages, and unintended side effects and interactions between drugs. In some states pharmacists have their own ability to prescribe medicine on their own. Absolutely. I had to fire my doctor after he prescribed a sulfa drug to me, even though I'd made it clear that I have an allergy to sulfa drugs. In fact, I would never have known (well, until I became sick/dead) that the drug prescribed was a sulfa drug if the pharmacist hadn't known the drug involved and checked it against known allergies. He contacted both me and my doctor and a different drug was prescribed. In fact, it's entirely possible that I'm alive today thanks to the expertise and knowledge of the pharmacist.
cableshaft 5y ago
Not really disagreeing that a pharmacist might know more about the drugs than a doctor. I wasn't warned about the potential side effects of Ciprofloxacin once, just told it was an "antibiotic" by the specialist I saw, and the pharmacist did clue me in about some side effects, which I promptly had some of the worst ones after a single pill. I might not have made the connection it was a bad reaction to the pills without their warning, at least not so quickly. I continued to have side effects off and on for years afterwards. I learned my lesson and now do my own research before just taking any medicine a doctor wants to prescribe now. But I still don't think pharmacists should be able to just override the decision of a doctor. Make sure the person is fully informed of potential dangers, side effects and correct usage, sure, but not override the doctor. The doctor has had an opportunity to examine and talk to the patient at length, multiple times over multiple visits, and know their history and specific needs, the pharmacist doesn't know any of that background and are most likely just making assumptions. I mean if it's literal rat poison or a dose guaranteed to kill the person is being prescribed, maybe they can hold off on fulfilling it and alert authorities, but otherwise? Opioids are a major problem, as there are addicts that cycle doctors to get multiple prescriptions so some doctors might not realize it's being overprescribed, but that's a matter of addiction and abuse and I don't know how a pharmacist is expected to know when it's being abused or not, unless they're getting them all filled at the same pharmacy. Again, they're not spending enough time with these people to know what their situation is. The most interaction I have with my pharmacist is "Picking up a prescription." "Verify your address please?" "My address." "Okay this has these side effects and you should only have it after a meal." "Okay thanks." Yeah that's totally enough for them to make a medical decision on my behalf. /s If anything, I think them deciding when to withhold medicine could make them MORE liable, not less, because they're inserting themself into the decision process. What if their withholding fulfillment of a prescription results in that person dying? If the doctor said yes and they said no, that seems to open up room for litigation to me.
- ashtonkem 5y ago
  > But I still don't think pharmacists should be able to just override the decision of a doctor. You’re free to believe that, but understand that this is well in the “wishes and hopes” territory more than a factual understanding of how doctors, patients, and pharmacists actually interact. Personally I believe the idea that we’d spend a huge amount of time and effort as a society training a whole class of specialists and then declare that they must abide by the decisions made by a generalist to be quite odd. Your personal doctor isn’t able to override your oncologist, so why should they be able to override the experts on prescribed medicine? > If anything, I think them deciding when to withhold medicine could make them MORE liable, not less, because they're inserting themself into the decision process. I’m sorry, but that’s clearly motivated reasoning and completely unrelated to the actual law. Pharmacists are subject to medical malpractice laws just like every other type of doctor, there’s no magical “I didn’t insert myself into the process therefore I’m not liable” clause.

nobody9999 5y ago

>t sounds like you have a pretty misguided idea of how pharmacies and pharmacists worked before Covid. You’re describing a situation where pharmacists act at the behest of doctors who know best, when in reality pharmacists have always had some level of independent authority over what drugs get dispensed to whom thanks to their expertise. It’s part of the pharmacists job to watch out for bad prescriptions, both in terms of abuse (e.g. opioids) improper dosages, and unintended side effects and interactions between drugs. In some states pharmacists have their own ability to prescribe medicine on their own. Absolutely. I had to fire my doctor after he prescribed a sulfa drug to me, even though I'd made it clear that I have an allergy to sulfa drugs. In fact, I would never have known (well, until I became sick/dead) that the drug prescribed was a sulfa drug if the pharmacist hadn't known the drug involved and checked it against known allergies. He contacted both me and my doctor and a different drug was prescribed. In fact, it's entirely possible that I'm alive today thanks to the expertise and knowledge of the pharmacist.

cableshaft 5y ago

Not really disagreeing that a pharmacist might know more about the drugs than a doctor. I wasn't warned about the potential side effects of Ciprofloxacin once, just told it was an "antibiotic" by the specialist I saw, and the pharmacist did clue me in about some side effects, which I promptly had some of the worst ones after a single pill. I might not have made the connection it was a bad reaction to the pills without their warning, at least not so quickly. I continued to have side effects off and on for years afterwards. I learned my lesson and now do my own research before just taking any medicine a doctor wants to prescribe now. But I still don't think pharmacists should be able to just override the decision of a doctor. Make sure the person is fully informed of potential dangers, side effects and correct usage, sure, but not override the doctor. The doctor has had an opportunity to examine and talk to the patient at length, multiple times over multiple visits, and know their history and specific needs, the pharmacist doesn't know any of that background and are most likely just making assumptions. I mean if it's literal rat poison or a dose guaranteed to kill the person is being prescribed, maybe they can hold off on fulfilling it and alert authorities, but otherwise? Opioids are a major problem, as there are addicts that cycle doctors to get multiple prescriptions so some doctors might not realize it's being overprescribed, but that's a matter of addiction and abuse and I don't know how a pharmacist is expected to know when it's being abused or not, unless they're getting them all filled at the same pharmacy. Again, they're not spending enough time with these people to know what their situation is. The most interaction I have with my pharmacist is "Picking up a prescription." "Verify your address please?" "My address." "Okay this has these side effects and you should only have it after a meal." "Okay thanks." Yeah that's totally enough for them to make a medical decision on my behalf. /s If anything, I think them deciding when to withhold medicine could make them MORE liable, not less, because they're inserting themself into the decision process. What if their withholding fulfillment of a prescription results in that person dying? If the doctor said yes and they said no, that seems to open up room for litigation to me.

ashtonkem 5y ago
> But I still don't think pharmacists should be able to just override the decision of a doctor. You’re free to believe that, but understand that this is well in the “wishes and hopes” territory more than a factual understanding of how doctors, patients, and pharmacists actually interact. Personally I believe the idea that we’d spend a huge amount of time and effort as a society training a whole class of specialists and then declare that they must abide by the decisions made by a generalist to be quite odd. Your personal doctor isn’t able to override your oncologist, so why should they be able to override the experts on prescribed medicine? > If anything, I think them deciding when to withhold medicine could make them MORE liable, not less, because they're inserting themself into the decision process. I’m sorry, but that’s clearly motivated reasoning and completely unrelated to the actual law. Pharmacists are subject to medical malpractice laws just like every other type of doctor, there’s no magical “I didn’t insert myself into the process therefore I’m not liable” clause.