2 answers
Alexa
Student
Southwick, Massachusetts
2
Questions
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Will pharmacists get prescribing rights?
The prescribing rights have increased for both physician assistants and for nurses in the hospital setting. Today, pharmacists are still mostly confined to the pharmacy, and there are less pharmacists that are going from room to room and checking on patients. I believe that this will most likely stay the same due to pharmacists not wanting to cross the line into physician territory. But in cases of physician shortages, pharmacists could be the one’s called upon to see certain patients and help prescribe them medications. There are areas where nurses have more prescribing rights, this could possibly turn into pharmacists also having prescribing rights. #healthcare #pharmacy #pharmacists #hospital-and-health-care #rights #prescribing #prescription
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2 answers
Bruno E. Perri, RPh, FASCP, BCGP
Independent Certified Geriatric Consultant Pharmacist
5
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Bruno E.’s Answer
This is an excellent question, and the previous response provides good insight. As mentioned, there are legal and legislative issues that have to be resolved before pharmacist prescribing becomes a reality. Since most pharmacy practice-related laws are in the purview of the individual states, the various states' board of pharmacy rules and regulations likely have to be amended, through regulatory or legislative actions. Here in Washington State, the state board of pharmacy (PQAC) has established Collaborative Drug Therapy Agreement (CDTA) regulations, to define and regulate CDTAs. I would suggest that you review the attached pdf file for more specifics on the state of the practice in Washington state.
http://www.doh.wa.gov/Portals/1/Documents/Pubs/690285.pdf
Another potential issue for pharmacists is getting compensated for these provided services by state, federal governments and insurance companies as health care providers. Pharmacists have to obtain National Provider Identifier (NPI) numbers. A lot of this activity is due to the implementation of HIPPA regulations.
https://en.wikipedia.org/wiki/National_Provider_Identifier
CDTA protocols in Washington state have been associated with vaccination programs, and the use of naloxone for opioid overdose programs.
http://prescribetoprevent.org/wp2015/wp-content/uploads/PHLRKnowledgeAsset_Naloxone_FINALfull_8June15.pdf
http://www.doh.wa.gov/Portals/1/Documents/Pubs/690285.pdf
Another potential issue for pharmacists is getting compensated for these provided services by state, federal governments and insurance companies as health care providers. Pharmacists have to obtain National Provider Identifier (NPI) numbers. A lot of this activity is due to the implementation of HIPPA regulations.
https://en.wikipedia.org/wiki/National_Provider_Identifier
CDTA protocols in Washington state have been associated with vaccination programs, and the use of naloxone for opioid overdose programs.
http://prescribetoprevent.org/wp2015/wp-content/uploads/PHLRKnowledgeAsset_Naloxone_FINALfull_8June15.pdf
This was helpful for me too as an outsider of the pharmacy profession. Thanks!
Nick Collins, MS, CRNP, CNS
Nick Collins, MS, CRNP, CNS
Critical Care & Cardiogenomic Clinical Nurse Specialist | UCSF Faculty
14
Answers
San Francisco, California
Updated
Nick’s Answer
This is a good question - non-pharmacist and non-MD here. First, prescription covers the whole realm of "orderable" services - not just pharmacology. So if your ordering your also ordering (aka prescribing) non-pharmacological interventions as well. Also, PharmD's education would have to be adjusted to incorporate training such as physical exam skills, if the end goal is to be independent practitioners.
That being said, I'm a huge proponent at getting pharmacists outside of the pharmacy and at the bedside. My background is in cardiac surgery and critical care nursing - PharmDs are an indispensible resource and essential to the critical care team. I agree that your statement has merit and there are indeed specialities that would tremendously benefit from having a pharmacist provider. However, the support of pharmacists having prescriptive authority raises some questions regarding checks and balances (i.e. Writing orders and being able to access drugs immediately) and the possibility that some pharmacists might not want contact with patients directly. I know this sounds callous, but some pharmacy professionals I know personally prefer to maintain an arms length distance and be adverse to patient contact. They like hanging out at the pharmacy!
Medical practice would have to be legislated, which is possible in some states. However that also is a challenge, there have been political battles in state legislatures between medicine and nursing organizations to obtain prescriptive authority. So you'll have to consider that perspective as well.
I'd get involved in your state's and national pharmacy society. For my part, I'll ask a few of my pharmacy-counterparts here at UCSF.
That being said, I'm a huge proponent at getting pharmacists outside of the pharmacy and at the bedside. My background is in cardiac surgery and critical care nursing - PharmDs are an indispensible resource and essential to the critical care team. I agree that your statement has merit and there are indeed specialities that would tremendously benefit from having a pharmacist provider. However, the support of pharmacists having prescriptive authority raises some questions regarding checks and balances (i.e. Writing orders and being able to access drugs immediately) and the possibility that some pharmacists might not want contact with patients directly. I know this sounds callous, but some pharmacy professionals I know personally prefer to maintain an arms length distance and be adverse to patient contact. They like hanging out at the pharmacy!
Medical practice would have to be legislated, which is possible in some states. However that also is a challenge, there have been political battles in state legislatures between medicine and nursing organizations to obtain prescriptive authority. So you'll have to consider that perspective as well.
I'd get involved in your state's and national pharmacy society. For my part, I'll ask a few of my pharmacy-counterparts here at UCSF.