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  #41  
Old 21 February 2014, 10:48 PM
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Quote:
Originally Posted by Lainie View Post
In the US, there is no legal requirement that a pharmacy be owned by a pharmacist. Most of them are owned by chains.
I don't believe it is a requirement in Canada either. Rexall appears to own all of their stores (as opposed to being a franchise with a pharmacist at the head of each store), even their stores in Ontario.
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  #42  
Old 21 February 2014, 11:01 PM
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Not quite. Daryl Katz is CEO of Katz Group, which owns Rexall, but is not, as far as I can tell, a pharmacist himself. But the boards of these companies may be dominated by pharmacists.

However, here is a vector for the rules in Canada - well-cited and complete. Here are the rules for Ontario and Quebec.

Quote:
ONTARIO

In Ontario, pharmacies are regulated by the Drug and Pharmacies
Regulation Act.

"...No person other than a pharmacist or a corporation complying with
the requirements of section 142 shall own or operate a pharmacy.
R.S.O. 1990, c. H.4, s. 144 (1)..."

According to section 142, "... No corporation shall own or operate a
pharmacy unless the majority of the directors of the corporation are
pharmacists. R.S.O. 1990, c. H.4, s. 142 ( 1)..."

Further details on the square footage, stocking of drugs, who can work
at a pharmacy are provided at the website below.

Drug and Pharmacies Regulation Act
http://192.75.156.68:81/ISYSquery/IRLA0A7.tmp/5/doc


QUEBEC

In Quebec, ownership of pharmacies is regulated by the Pharmacy Act.

"...Subject to sections 28 to 30, only a pharmacist, a partnership of
pharmacists or a joint-stock company all of the shares of which are
held by one or more pharmacists and all of the directors of which are
pharmacists may be owner of a pharmacy and buy and sell medications as
owner of a pharmacy..."

In certain narrow circumstances, a physician may also be granted a
permit to practice pharmacy.

Pharmacy Act
http://publicationsduquebec.gouv.qc.ca/fr/cgi/frameset.cgi?url=/documents/lr/P_10/P10_A.html
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  #43  
Old 21 February 2014, 11:03 PM
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True, but they all have more than one pharmacist on staff. I don't know how it is in the US but here only the pharmacist can give you a recommendation on which OTC medication is better for your symptoms and they talk to you about any new script, so there's always one on duty.
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  #44  
Old 21 February 2014, 11:30 PM
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Quote:
Originally Posted by Avril View Post
Hero_Mike respects his own job because he knows how hard it is. That's the bottom line.
I don't have enough details about the OP to know who was at fault, or what actually caused the mix up.
Watching ESPN today, they discussed the issues of the Miami Dolphins and how the head coach claimed to not have been aware of an issue of abuse and extreme hazing between the players - thus distancing himself from the situation and absolving him from fault. Right?

Well, they used the analogy of a restaurant and how the famous head chef may not be involved in cooking every single meal. When things go well, it is that chef's name which is praised and remembered, and that chef's bank account which grows fat. But when something goes wrong - even though the head chef didn't do the cooking, it reflects poorly upon them and said chef is the one who becomes responsible for fixing the problem. In other words, responsibility flows upward until it reaches the place "where the buck stops". So while the chef didn't cook it, it is their responsibility that something went wrong. If you don't agree with this basic philosophy, then I don't think there's anything more to discuss here.

It doesn't matter what my job is - the issue of the OP is that the pharmacist in charge (be they the owner or supervisor) is ultimately responsible for what happened here. Had the person died, it was because they, or someone reporting to them, did not do their job. We can't just handwave this away and say that people are only human and make mistakes and we hold them to an impossible standard. Even the OP quoted them as blaming the doctor's handwriting as being too hard to read. That is passing the buck - and it is unforgivable with the amount of technology we have available today, to communicate and get answers almost instantly.

There are supposed to be protocols in place to prevent this kind of error. Obviously they failed - and if they failed because less-qualified people are being unsupervised, then there's a problem. A big one.

This is precisly what happens when the occasionally difficult and specialized work that a pharmacist should be performing, is downloaded to pharmacy technicians, who earn between $13 and $14 per hour (cite here). Some of them (one in six) have no formal training whatsoever (cite here). On the other hand, pharmacists earn 3 times as much (cite here), and require much more education and certification. If their education and talent is being wasted by filling out insurance forms, then it's no surprise that people run the risk of dying from such errors.

Quote:
Originally Posted by DotBat View Post
“But having him do this is a waste of the 4-years of specific education he received.”

Isn’t that for him to decide? When he worked at a large retail pharmacy, he made double what everyone else made (partly because he worked nights and OT) and was made the head of the pharmacy pretty quickly. I think he is making good use of his 6 years at school. No one is expecting the pharmacist to guide people through insurance issues, and often times a pharmacist will direct the patient to call the company. But having some knowledge of a major plan, say Medicare, can be helpful.
See above. If the pharmacist is spending their time dealing with insurance issues, delivering prescriptions like your uncle, then maybe they aren't doing all they can to ensure that the aspects of their work that they are *uniquely qualified* to do, are being done properly. It is their job and responsibility to ensure that their staff are trained and following protocols, and, if necessary, that the pharmacist supervises each dispensing where things are in question. That includes where the doctor's handwriting was "too hard to read". That's the "waste" - that the person with the right training isn't doing the critical job.

That's why they went to school, and why they are paid the big bucks.

The OP demonstrates that not all of that money is earned.
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  #45  
Old 21 February 2014, 11:50 PM
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You haven't really addressed my point though. Your original post was about your disdain for what pharmacy has become. That pharmacists "open a container of pills, count them, and put them in another container. After that they merely recite what is found in an online database." My point was that depiction is inaccurate and insulting.


"The OP demonstrates that not all of that money is earned."

And? Every profession has people who do not deserve what they are paid.
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  #46  
Old 21 February 2014, 11:57 PM
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The OP demonstrates that one pharmacist made a serious mistake. It demonstrates nothing about the profession as a whole or its members.
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  #47  
Old 22 February 2014, 12:01 AM
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Hero Mike do you feel guilty over the Tacoma Narrows Bridge collapse? Or the Hyatt Regency Walkway collapse?

Or are Engineers such as yourself somehow immune to the "Nobody in the entire profession is allowed to ever make a mistake without proving the entire industry is lazy and shiftless."
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  #48  
Old 22 February 2014, 01:15 AM
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Quote:
Originally Posted by Lainie View Post
What problem? I see no evidence that med mixups like the one in the OP are widespread.

According to this article they are more common than they should be. Usually they only make the news when there is a death.

http://consumer.healthday.com/encycl...rs-646512.html
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  #49  
Old 22 February 2014, 01:28 AM
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Quote:
Originally Posted by Sue View Post
According to this article they are more common than they should be.[/url]
And would is the "should be" rate of errors?
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  #50  
Old 22 February 2014, 02:02 AM
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Quote:
Originally Posted by JoeBentley View Post
Hero Mike do you feel guilty over the Tacoma Narrows Bridge collapse? Or the Hyatt Regency Walkway collapse?

Or are Engineers such as yourself somehow immune to the "Nobody in the entire profession is allowed to ever make a mistake without proving the entire industry is lazy and shiftless."
I was waiting for this - not specifically about Tacoma Narrows (which isn't very similar) but about the engineering profession.

Here's the thing - engineers and their ilk frequently work on large projects where many people are involved. There are systems and checks where any one person's work is reviewed and checked by many people, multiple times. The really big mistakes - think of, say, the Challenger disaster - happen because of a systematic failure, and not an individual failure. It lacks the "personal" interaction of what happens in the OP, and I would think, really, that the OP should have followed much the same pattern. In other words, there should have been a system where at least two people independently check a prescription. And by independent I mean that a person looks at it without any prior information - saying to someone "check that prescription for 30 viagra" violates that principle. Is that too much to ask when a life might be at stake?

We consider it a reasonable protocol where pharmacists need to lock up and secure scheduled narcotics, so is it really too much to ask that pharmacists (not the techs, but the people making the big bucks, the ones with the "big shoulders" who can take the responsibility) to double check any prescription with a reasonable chance to kill? I don't think an overdose of Lipitor (for cholesterol) is likely to happen, but the drug in the OP sure is.

Where I work, we have internal and external audits, multiple checks and sign-offs on a project that is going to be a multi-billion dollar investment. A lot of time and effort is spent on this. Why? Lessons have been learned over the bodies of many dead people. Far too many. And the things we do - like the engineers involved with the Challenger disaster - are not easy things to do. Counting pills, and identifying them visually, well, you be the judge.
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  #51  
Old 22 February 2014, 02:08 AM
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Quote:
Originally Posted by Hero_Mike View Post
so is it really too much to ask that pharmacists (not the techs, but the people making the big bucks, the ones with the "big shoulders" who can take the responsibility) to double check any prescription with a reasonable chance to kill?
Yes but morphing that into "You are never allowed to ever make a mistake period" is... whether it is too much to ask is pointless since it is impossible.

Any prescription drug can be dangerous. That's pretty much why they are prescription drugs and not OTC in the first place. No system of check and balances can be perfect and the little "Ah this one pharmacist messed up on of the bajillion orders that they filled that year so the entire industry is nothing but a bunch of over payed lazy louses" skit, which you routinely do some variation of, is just wrong.
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  #52  
Old 22 February 2014, 02:28 AM
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Quote:
Originally Posted by Hero_Mike View Post
Here's the thing - engineers and their ilk frequently work on large projects where many people are involved. There are systems and checks where any one person's work is reviewed and checked by many people, multiple times.
Engineers never work on small projects, on which only one person with the necessary skills is involved?

Quote:
Originally Posted by Hero_Mike View Post
there should have been a system where at least two people independently check a prescription. [ . . . ] is it really too much to ask that pharmacists (not the techs, but the people making the big bucks, the ones with the "big shoulders" who can take the responsibility) to double check any prescription with a reasonable chance to kill?
You seriously expect every small town pharmacy to have two pharmacists on duty every minute of every day?

And "a reasonable chance to kill" could apply to nearly anything, not only to drugs that are obviously hazardous -- if only because giving someone a drug that does nothing instead of one that could have kept them alive can be fatal.

Quote:
Originally Posted by Hero_Mike View Post
the things we do - like the engineers involved with the Challenger disaster - are not easy things to do. Counting pills, and identifying them visually, well, you be the judge.
Do you seriously think that that's the only thing a pharmacist does?

Maybe you should trot out and take the exams, then. If that's really all there is to it, you should pass easily; and if it really were a license to print money, then you could be rich in no time.

Look, Hero_Mike: as I believe somebody else already said in this thread: lots of jobs look brainless and easy to people who know nothing about what's involved in them. Doesn't mean that they are either one.
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  #53  
Old 22 February 2014, 02:32 AM
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Quote:
Originally Posted by JoeBentley View Post
And would is the "should be" rate of errors?
Would? Do you mean what? IMO the acceptable rate is zero. Realistically of course that's never going to happen. The article in very sympathetic to the plight of pharmacists and makes a point of not throwing around wild accusations but of calmly discussing why errors are happening and what can be done to prevent them.
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  #54  
Old 22 February 2014, 02:34 AM
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Quote:
Originally Posted by Sue View Post
IMO the acceptable rate is zero. Realistically of course that's never going to happen.
Those two sentences don't really work together.
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  #55  
Old 22 February 2014, 02:37 AM
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Quote:
Originally Posted by JoeBentley View Post
Those two sentences don't really work together.
Seriously? This is the battle you want to fight? That consumers must accept a level of pharmacy error because that's just the way it's got to be? There will always be mistakes that doesn't mean we choose an error rate and complacently say "well as long as the error rate is 2% or 5% or whatever it's all good and let's say no more about it and try not to reduce it even further". And given how quickly you responded to my post it's unlikely you read the article I am citing. It's far more on your "side" of this ongoing debate here than you seem to assume.
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  #56  
Old 22 February 2014, 02:44 AM
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Quote:
Originally Posted by Sue View Post
Seriously? This is the battle you want to fight? That consumers must accept a level of pharmacy error because that's just the way it's got to be? There will always be mistakes that doesn't mean we choose an error rate and complacently say "well as long as the error rate is 2% or 5% or whatever it's all good and let's say no more about it and try not to reduce it even further".
I'm saying nothing about giving up on improving. I'm simply saying you can't assign some impossible standard of perfection to a job simply because their job has more dire consequences when it fails.

The only "battle I want to fight" is to say that a job having a greater potential for damage cannot equate to a zero tolerance for failure.

It's not like we don't assign higher standards. A pharmacist goes through more training then a burger flipper and a neurosurgeon under goes more training the a pharmacist based on simple risk probability. We just can't take that number to "100%."
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  #57  
Old 22 February 2014, 02:44 AM
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Quote:
Originally Posted by erwins
Yeah, I've had to get medicine compounded at the pharmacy for myself, for SO, and for a pet.

I'm curious, Hero Mike, what professions other than engineering that you don't have disdain for.
Quote:
Originally Posted by Hero_Mike View Post
Unemployed lawyers.
I'm catching up on the thread, and I know this was back on page one, but...

Really? Was that supposed to be funny? Or intentionally offensive?
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  #58  
Old 22 February 2014, 02:49 AM
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I am thinking the latter. If Hero_Mike is uncivil, does that mean all engineers are uncivil?
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  #59  
Old 22 February 2014, 04:34 AM
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Quote:
Originally Posted by JoeBentley View Post
It's not like we don't assign higher standards. A pharmacist goes through more training then a burger flipper and a neurosurgeon under goes more training the a pharmacist based on simple risk probability. We just can't take that number to "100%."
It appears, though, that the pharmacists (you know, the ones with "more training than a burger flipper") are doing less of the work and more of it is being downloaded to technicians, which, if you read my cited post, don't necessarily require any post-secondary education or special training. Is this, perhaps, part of the problem?

The thing is that we do assign higher standards and the last few percent are very high - that zero error is approached asymptotically but never achieved. This does not mean that we do not try. Are we there yet? The OP leaves me lacking in faith.

Thorny Locust - let me reiterate this for you one more time. The OP referred to the filling of a prescription - a prescription of factory made medication. It did not require compounding. It did not require mixing or preparation. It obviously required a call to the doctor to confirm what was written in the prescription pad, but that is, apparently, asking too much. This was, quite literally, a case of "counting pills, identifying them visually, and dispensing to the patient". A textbook case. Easy-hanging fruit. Routine. And still they got it wrong.

If these highly-trained pharmacists can't get that right, then there is something very wrong. Spare me the over-wrought appreciation for these "dedicated professionals". They screwed up, and because the profession is, by and large, self-regulating, they probably don't publish (or at least "moderate") statistics on such errors.

Counting pills should be just as easy as counting money, or did you miss my cite where they earn 3 times the median income of the average American?

And that is, perhaps, why we should hold them to a higher standard. A person of lesser ability and education might be able to do 90% of their work, with 90% accuracy, but I think it's safe to say that people demand better for their money, especially when their life could be at stake.
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  #60  
Old 22 February 2014, 12:23 PM
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We do hold them to a higher standard. It isn't that they can't get it right. It's that once, out of billions of prescriptions, someone got something wrong. And that was newsworthy. That is not some kind of critique on the entire profession, let alone on all professions other than engineering.

Meanwhile, your claims about engineers never making serious mistakes because of all those checks and balances doesn't hold up. Granted, the engineers themselves may not have caused all of these errors. But by this logic, they should be taking responsibility for at least most of them, because they make more money than the people who put their designs together.
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