Has some Pharmacists decided to practice medicine without a license ?

In listening to the attached video, remember … that one of the basics of the practice of medicine is the starting, changing or stopping a pt’s therapy. Pay attention to what the pharmacist is saying, telling the prescriber!

This is a video of a recent discussion between a prescriber and a pharmacist, regarding a pt that has lost her regular prescriber because of retirement.  I know who the prescriber is on the phone call, but I do not know who the Pharmacist is,  but suspect because of a few things stated by the Pharmacist… he works for a CHAIN.

Notice that the Pharmacist did not look at the pt’s PDMP history… all he is focused on is either the MME and/or Narxcare score, ignore the pt’s long term history of being on these medications for years.

He seems to be fixated on some arbitrary number and a “line drawn in the sand”  I suspect that this pharmacist works for one of the three chain pharmacies that made an agreement with 50 state AG’s & others. In which they agreed to reduce the opioids and/or controls that they dispense. https://www.pharmaciststeve.com/dea-surrogates-are-trying-to-throttle-the-availability-of-controlled-meds-to-pts/ This Pharmacist seems to be VERY RELUCTANT to explain what and where the criteria behind the “RED FLAG” that he is quoting came from and “hell bent” on refusing to dispense any medications above this seemingly arbitrary MME/day.

Since the Controlled Substance Act was signed into law in 1970, Pharmacists have not been allowed to change a C-II Rx for any reason – including verbal order from the prescriber.  Maybe, part of the lawsuit settlement to reduce the amount of controls those 3 chains dispensed. Gave them a special dispensation on that part of the CSA, as long as they are reducing the number of opioids they dispense?

I find it quite appalling that this Pharmacist had no interest to know if this pt was a confirmed ultra fast metabolizer by pharmacogenomics – which would be justification for the pt to have a higher dose and/or he no concern .. he was happy to enter into his pharmacy computer system a “corresponding responsibility rejection”, which would voided the pt’s C-II Rx and would most likely intentionally the pt into cold turkey withdrawal.

Last week 12 Kansas City area CVS locations close as pharmacists walk out over working conditions  I wonder if these Pharmacists walked out because CVS dictated how they were to practice pharmacy, what meds they can fill, what meds they can’t fill, and they are to limit how many controlled med doses they can provide to a particular pt?

Remember the first sentence of this blog… did the Pharmacist change the pt’s Rx? Was the Pharmacist willing to stop the pts medications? What part of the practice of medicine was this Pharmacist attempting to practice? Is the state board of pharmacy aware of this?  Do they really care … if they are aware?

Some Apple products will not play the above audio/video file

here is a audio only file that seems to play on Apple products

4 Responses

  1. This pharmacist said ” we need to ” guess what pharmacist. You are not responsible to get her under anything, its the Drs and patient’s decision

  2. Hello Pharmacist Steve, I couldn’t play this video on my tablet & I was wondering where I could find this video or what is called so I could listen. Thanks for all the work you do, it’s appreciated.

    Jessica Agee

    • I just converted that audio/video file into an audio-only file and it seems to play on Apple products – at least the ones that I have … which are both a new Iphone and Ipad. I edited the post and that file is at the bottom of the post as a separate link. It is about 5% of the size of the audio/video file and loads a lot quicker and should be easier to share due to the smaller size

Leave a Reply