Posted on 01/15/2019 10:26:03 AM PST by Sean_Anthony
As more doctors retire, less students study medicine due to its difficult, long, expensive training, nurse practitioners’ and physician assistants’ roles expand, more doctors are brought from third world countries. Could pharmacists’ fill the void?
As I have recently experienced during a recent ER visit in northern Virginia, many cases presenting themselves are cases of sniffles of illegal aliens and their children who use the ER as their primary physician because ER visits are free to them, paid for by the U.S. taxpayers.
A seven-year study just released on January 10, 2019, by the University of Waterloo in Canada found that pharmacists could dramatically reduce ER visits by “incorporating them with an expanded scope into the community or hospital emergency departments,” thus reducing the overcrowding of emergency rooms (ERs).
Diagnosing?
NO
Stationing ICE agents in the ER could fix this too.
My wife is a pharmacist and a darned good one, but she is no doctor and can only suggest medicines to treat symptoms.
It depends upon what the heck they mean by “incorporating them with an expanded scope into the community or hospital emergency departments,”.
Far too many drugs in the U.S. require a prescription to be dispensed. There are many minor ailments that a pharmacist should be able to dispense drugs for after hearing your symptoms that now require a visit to a doctor to get. If that’s what they mean then yes.
I travel internationally a lot and many countries don’t require prescriptions for common drugs. For example, in Dubai a few months ago I was able to walk into a pharmacy and ask for some blood pressure medication I was running low on, no prescription, they just sell it to you.
For medical advice I typically visit the returns counter at Home Depot.
For basics I have no problem. I had a Pharmacy student for a housemate in college. Brilliant guy.
They are basically doctors with a chemistry degree.
For a lot of things I self-diagnose anyway. I don’t go to the doctor frequently but when I’m sick, I often know what I have and what I need to kill it off.
It would be very convenient to go to the pharmacy, cough a couple times, let them ask the symptoms and prescribe the proper anti-biotic.
I generally get a whopper case of bronchitis annually and going to the doctor is a real pain just to get the same pills every time.
If the first treatment regimen doesn’t work, then go in to the doc.
The solution is Clinics within a short distance of every ER. That way, anyone who wasn’t insured for the ER or their insurance company wouldn’t pay could either pay up themselves or go to the clinic. It can’t work unless (1) neither hospitals nor pharmaceutical companies have any control over the clinics and (2) clinics have “low cost options” for all ailments. Then, if people aren’t insured or they think their co-pays are too high, they can choose for that. It would also be used by people who don’t want to poison their bodies with drugs, legal or illegal.
No they are not. They under stand the chemistry and pharmacodynamics very well. They have no training in pathophysiology or diagnosis and should not prescribe. Don’t get me started on how PAs and NPs are equals to physicians either....
“For medical advice I typically visit the returns counter at Home Depot.”
# Me too. Linda is terrific !
I’m already seeing this addressed through things like the Minute Clinic in CVSs.
They aren’t doctors they are called Nurse Practicioners, I think. They administer basic physicals, vaccinations, basic cold/flu diagnosis, referrals, etc
Very astute observation. My daughter is an APRN in a hospital cardiovascular testing setting. She also sees CHF patients in an adjunct clinic setting. She is smart enough to know she does not have all the answers. She will integrate her treatment plans with the hospital pharmacist, respiratory therapists, nutritionists and social workers. No one can cure CHF, but through a team approach she gives her patients a shot at a better quality of life.
Want to solve the ER overcrowding crisis? Most of the overcrowding is caused by people on Medicaid who use the ER as their Primary Care Clinic. I’ve worked on and off in ER’s for most of my career. Add a $2 copay to their ER visit and most of them wouldn’t come in. Trust me, that’s all it would take.
Allow pharmacists to diagnose and treat? Will not end well.
“less students study medicine due to its difficult, long, expensive training”
No, they don’t study medicine because it isn’t profitable anymore due to government interference.
I worked in a coumadin clinic for years as a clinical pharmacist. We actually did a better job than our very skilled docs with this. We did it every day and became very good at it.
We also had a lipid clinic and diabetes clinic. All these clinics took a large load off of our docs.
In inpatient we also did a lot of antibiotic monitoring and adjustment of doses.
All of these clinics were run under a strict protocol. It worked.
I personally would have no problem monitoring and changing drug therapy “once the physician” has made the diagnosis. That is what I also did with our antibiotic team. The docs really appreciated us as we took over some very time consuming jobs. That gave them more time to do their most important job of being a diagnostician. Pharmacists are not trained as diagnosticians!
Relative to giving immunizations that is no big deal. Just do it, provided you are properly trained for it and certified.
I did a retrospective study on our coumadin clinic. The clinic run by pharmacists saved about 7000 dollars a year on each patient. The savings were due to reduced hospital admissions and reduced drug interactions. It amounted to several million dollars a year. It paid for the salary of each pharmacist in the clinic and all the other pharmacists working in the hospital. We did good work!
In the hospital we also served another function, my hospital was a teaching hospital. Every order written by a doc was reviewed by a pharmacist. The vast majority of these orders were good orders. On occasion we had to intervene as it was a very bad order that could harm. On occasion we would call the doc to change a rational order for a drug that was very expensive, if we had a cheaper and equally effective drug for the condition.
Years ago the docs resented us as meddling in their job. Drug therapy has become extremely complex today. Now the docs welcome our presence as part of their team.
As mentioned above, we pharmacists are not diagnosticians, but we do know how to treat a disease once diagnosed by the docs.
ps
Two years retired now and I just fly my glider and teach kids how to fly. Life is good!
Absolutely The Coumadin clinics are a blessing and I ageee clinical pharmacists are very good at dosing Coumadin, antibiotics and other medications. They are an integral part of the team and attend daily rounds at the hospital I work at. But they monitor and dose medications after I diagnose and prescribe and I don’t think they would want it any other way. What this article is saying is we should allow pharmacists to prescribe which I don’t think is a good idea
I’m an intelligent prson and I drive a car every day but you wouldn’t want me working on your brakes.... nor would I want to
I agree 100%.
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