Thursday, August 19, 2010

Pharmacy Plan will Hurt Quality Control

By Cristina Alarcon, Special to Coquitlam NOW, August 13, 2010
Next time you walk into a drugstore, you may want to ensure your prescription has been properly filled and checked by a real apothecary -- a pharmacist, that is.

And if you or your loved ones are on a complicated medication regime and technicians are doing the final check on your medicine, then perhaps you ought to be signing a consent form.

This is because the College of Pharmacists of British Columbia has decided to pursue the licensing of technicians by Dec. 31, triggering a debate among community pharmacists who fret over liability, the profession's integrity and public safety.

For years now, the pharmacy profession has been easing the technical aspect of the job, first via specialized technology, then via technical support, but never before by leaving order entry, preparation and final check of prescriptions to unsupervised, largely under-qualified personnel.

While the college claims that pharmacists will still be ensuring the appropriateness of the drugs prescribed to begin with, quality control will certainly give way to monetary gain.

If one pharmacist must oversee the appropriateness of hundreds of scrips churned out daily by an army of techs, major mishaps will undoubtedly occur.

This idea may well work in a hospital setting, where errors are quickly caught and contained. Not so out in the community where once the wrong drug goes out that door it's gone -- and so, perhaps, is the patient.

But let's face it: most people have no clue just how much care goes into filling prescriptions. From searching for drug incompatibilities to making phone calls to refusals to fill when directions are inadequate or the wrong drugs are prescribed for a given condition -- you name it, good pharmacists catch it. There are myriad prescribing errors made and caught daily. This is far from mindless work.

Yet from their ivory towers academics believe the technical and cognitive aspects of this work can be separated -- imagine a chef who cannot cook, a plumber who cannot use a pump -- while drug store chain owners greedily wait to cash in on the techs' much-lower wages.

The regulation of pharmacy technicians will ultimately result in the creation of a new health-care professional and new registrant of the College of Pharmacists of BC.

Regulated pharmacy technicians will essentially take over the technical functions of the pharmacists' job, and pharmacists will be sitting back sipping margaritas by their pools, waiting for a call from their lawyers over the next casualty.

No really, the idea is to free up the pharmacist for consultation on disease management and drug care, but for a hefty, never-before-seen fee. Thus the most readily accessible health-care professional will be available no more, and your drug reviews and queries will be charged speedily to your Master Card or Visa.

Largely taken over by bureaucrats, academics and drug store chain owners, the College of Pharmacists of BC is giving in to their vested conflicts of interest. Meanwhile, the college board is conveniently silencing those who oppose their agenda by claiming that all must speak with "one voice."

Most recently, input was seemingly sought from the public on proposed bylaw changes that would create this new technical profession. Yet board member Bev Harris (a Coquitlam pharmacist) was reprimanded for speaking in a public forum to point out the problematic draft changes. And so it appears the consultation process was merely a sham. Fruitful discussion was never really the aim.

Over 500 community pharmacists have petitioned the college to hold off on bylaw changes that would give technicians the authority to take over their dispensing functions after a mere eight months of training. Technician certification, rather than licensing, is what pharmacists would like to see.

And it's not that pharmacists want to go back to all that counting and licking and sticking. Trained technicians are already helping greatly with that and much more.

While providing appropriate and timely services, pharmacists want to be sure that no errors are made along any step of the way, and that what your label says you're getting is really what's in the bottle.

A wrong drug or dosage may not be life threatening when you are young and healthy, but it may be lethal if dispensed to your 80-year-old mother or to your two-year-old son.

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Cristina Alarcon is a Vancouver pharmacist.

© Copyright (c) Coquitlam Now


Jesurgislac said...

Problem is... it's pretty unconvincing to claim you're an oh-so-qualified professional, when you are also arguing that (a) you have a right not to let your customers have emergency contraception (b) this is NOT promoting abortion.

See, if you knew enough to be a really professional medical person, you'd know that emergency contraception prevents abortions. Now, if you know that, and still want to be allowed not to let your customers have it, then you're knowingly promoting abortion among your customers.

But if you ignorantly suppose it's an "abortifacient" like pro-lifer anti-science sites say, and are innocently refusing to supply it because you think it causes abortions, then you are certainly not sufficiently educated to count yourself a medical professional.

Of course, the middle way is: you know it's not an abortifacient, you know it prevents abortion, but you're unprofessional enough to think you have a right to express disapproval of a woman who has sex for pleasure and doesn't intend to conceive. But claiming that you hate abortion is a convenient, thoroughly hypocritical excuse.

Which is it? Pro-abortion, ignorant, or hypocrite?

Health Tips said...

"Pharmacy Plan will Hurt Quality Control" I like your topic good.

Cristina Alarcon said...

Dear Jesurgislac, I am certainly not pro-abortion, nor am I ignorant about the current debates in scholarly circles with respect to the mechanism of action of levonorgestrel-only PlanB. While some invitro studies have found it not to prevent implantation of live embryos (in a petri-dish), this may not be extra-polated to mean that the product is never able to prevent implantation in vivo... (in the womb). If you are interested, I can provide you with links to articles that debate mechanism of action. For now, the drug company does not deny prevention of implantation as one of the possible mechanisms of action. So I will neither dispense nor promote the product. BTW, I think your comment belongs to another article. This one is about regulating pharmacy techs.

Erin said...

As a technician, it is disappointing to see such upheaval about this subject. I was very excited to see the regulation/licensing process started in BC as I believe we need to have better education that is standardized and continued throughout our whole career, not just an eight month diploma program. Taking the bridging programs (to add to the 9 years of hospital and community working experience that I have) has brought me back up to date with some of the information I admittedly forgot from not using it on a day-to-day basis. I feel that ALL techs should have continuing education so that we can support the pharmacist correctly. In my eyes, this regulation is not for techs to "take over" the dispensary and cause patient harm, but to perform the same job functions they are now, but more safely and effectively. I would never assume to perform a task that was outside of my professional capabilities (or personal comfort zone) and would always adhere to the bylaws written by CPBC and NAPRA. I am saddened that pharmacists are quitting their careers instead of working WITH the College to create a better solution. After all, this is just the beginning of regulation and there are a lot of creases to iron out.