Texas: Rumor on the street

I was told – by someone I trust – that in Texas … the TX Medical Licensing Board is taking a “hard line” on pharmacists changing a pt’s prescription (LOWERING daily dose/quantity) without contacting the prescriber.

One of the basics of the practice of medicine is the starting, changing, stopping a pt’s therapy.

Apparently when complaints are filed with the TX Medical Licensing Board gets a complaint about a pharmacist changing the pt’s prescription – generally involving a controlled substance, particularly a opiate… they are going after these pharmacists for practicing medicine without a license.

All health professional licenses are managed at the state level… and these various state Medical practice act and what they say is the legal practice of medicine do not vary that much.

So if one state is looking into/doing this… the other 49 states could probably find some statue verbiage in their practice act to take action against pharmacist who are changing a pt’s prescription without conferring with the prescriber.

So if one state is doing it… it is probably within the other states practice acts to take similar actions

It is also against the Control Substance Act for a legally licensed prescriber to prescribe a controlled substance to a pt that they have not done a in person physical exam on. 

Pharmacists have neither the training nor legal authority to do a in person exam and few would not even have the space to do a in private in person exam.

So would a pharmacist found guilty of practicing medicine without a license also be in violation of the Controlled Substance Act ?

It has been reported that some of the chain pharmacies have implemented corporate policies mandating that  their employee pharmacists MUST NOT DISPENSE CERTAIN CONTROLLED SUBSTANCES ABOVE A CERTAIN DAYS SUPPLY AND/OR MGS/DAY.

I have also been told my some pts that some pharmacists will call the prescriber and tell the prescriber and demand that the prescriber LOWER the pt’s dose and if the prescriber refuses the pharmacist threatened to call the DEA on the prescriber.

Of course, if neither the pt nor the prescriber file complaints with the state Medical Licensing Board NOTHING WILL CHANGE !

4 Responses

  1. Many chronic pain patients are on disability for the condition that causes chronic pain! Would this not be refusal of service because you are disabled?

  2. it’s about time something concrete was done about pharmacists who insist on practicing medicine –i.e. determining who gets –or more often doesn’t get– a doctor-generated prescription. I’ve been outraged by the concept of “pharmacist discretion” for years, ever since it was decided that it was okay for pharmacists to allow their religious beliefs to dictate the medications others could get.

    I have known some truly wonderful, brilliant, outstanding pharmacists, and have had one catch a life-threatening medicine interaction at least once. I have tremendous respect for them …at least, for those who practice their profession intelligently and within the parameters of ethical limits. I confess I have no respect or patience for the ones who decide, whether for religious or opiophobic* reasons, to alter or deny medications to legitimate patients when the patients’ own doctor have good reasons to prescribe whatever they prescribed.

    Pharmacists are not gods. They have no business superseding doctors’ judgements just because they don’t “believe” in something. If they want to control the behaviors & care of others in accordance with their personal beliefs, they can go work in a church & try to make converts. To force others to behave according to your beliefs is to recreate the worst aspects of religious crusades throughout history. And every pharmacist who loudly abuses, accuses, and tries to shame a patient in front of others should be severely reprimanded, if not fired & have their license pulled –tho God knows, that’d cut down on the number of available pharmacists. Ever since this idea that “if you feel uncomfortable about something, deny & abuse the patient about it” became acceptable, an awful of of them have let their extreme contempt & bigotry out for loud, free runs. I’ve encountered this a number of times about pain medicine; I just thank heavens I’m old enough that my reproductive years were past before they started abusing women about reproductive medicine issues. I think the worst story I’ve heard was the woman whose fetus had died, but the pharmacist refused to give her the med that would allow her body to expel the dead fetus: https://nypost.com/2018/06/25/walgreens-pharmacist-denies-mom-miscarriage-drug-for-fetus-with-no-heartbeat/

    I never have found out if this vile pharmacist faced any repercussions.

    *which is basically a religion, anyway; a strongly held belief based upon faith, not evidence, and against which evidence & data to the contrary is denied, ignored, & has no effect. Kinda like Creationism.

  3. Good to hear! Practicing medicine without a license is a fitting description.

    I have been hopeful all states would take action like Alaska has. Alaska board of pharmacy wrote a letter to each pharmacist in the state regarding “refusals to fill”. It outlines sanctions against those refusing legitimate prescriptions and states unwarranted refusals may “call into question the knowledge, skill or judgement of the pharmacist”.

    I sent the letter to my state board of pharmacy and to the corporate office of the pharmacist who refused to fill my prescriptions. The man I spoke with at corporate office was supportive from the start. He asked the pharmacist to reconsider as there was no question about legitimacy [and they had filled the same medication for years] but she refused, citing “pharmacist discretion”. I contacted the corporate gentleman again when I discovered the letter of reprimand from Alaska, and it was well received. He offered to send it to his colleagues and that’s great but the warnings really need to come from the state licensing board.

    I hope everyone who is affected by this will encourage their state to take action and stop pharmacists from practicing medicine without a license (link to article and letter below).

    Pharmacist Steve, I sincerely appreciate your continued support the sick and injured! Thank you!!

    https://www.ktuu.com/content/news/Board-reprimands-pharmacists-over-refusals-to-fill-opioid-prescriptions-504881401.html

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