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Nov 13, 2007 -- Pharmacists should be empowered to write prescriptions

Since the late 1980s, Clark has thought it's crazy that medications can only be dispensed when a doctor writes a prescription. Many other countries have their pharmacists write scripts and dispense the medication. The FDA is now considering adopting a similar policy. We're not talking highly addictive things like Vicodin or Oxycontin here; we're talking about two-week cycles of antibiotics and other relatively benign medications. Clark loves this idea. Doctors are already overworked and in short supply. Because pharmacists are very well-trained and knowledgeable about medications, it's almost a no-brainer to allow them to pick up some of the slack. The Los Angeles Times reports that Kaiser Permanente pharmacists already have the authority to write and fill their own scripts.

Pharmacists are a vastly underutilized resource. To treat them like clericals who just fill prescriptions isn't Clark Smart. The numbers of primary care doctors are down 50 percent, so empowering pharmacists to write prescriptions is one possible solution to the shortage. Clark knows doctors will be up in arms about his feelings on this issue, so he's ready for the fallout on the Clark Stinks forum! On a related noted, Minnesota has banned pharmaceutical sales reps from giving free gifts and meals to doctors. These kinds of sales practices subtly influence the brand choices doctors make when they write prescriptions. Now The New York Times reports that the pharmaceutical companies have come up with yet another tactic to influence the selection of scripts; they're wooing nurses and office managers since they can't get to the doctors anymore!

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  • Clark might want to rethink this idea
    7/13/08 NY Daily News article, excerpt:

    Drugstore slipups a prescription for death
    BY JORDAN LITE
    DAILY NEWS STAFF WRITER

    Sunday, July 13th 2008, 9:23 PM

    New York pharmacists filled an estimated 210,000 prescriptions with the wrong drug or dose in 2006, putting patients at risk of illness and even death, a new analysis shows.

    The problem is worst at chain stores that fill more than 200 prescriptions every day - some at a clip of one every two minutes, said Sen. Jeff Klein (D-Bronx, Westchester).

    "Something as important as [filling] someone's lifesaving drug shouldn't be rushed," Klein said.

    New York doesn't track prescription errors - something Klein has proposed changing.

    Few patients report the errors, and only a small fraction of pharmacies are punished by the state, he said.

    Between 2005 and 2007, 1,275 such complaints were made to the state Office of the Professions, which disciplined pharmacies in 106 of those cases, Klein said.

    Klein's error rates are estimates, extrapolated from 2003 findings by Auburn University.

    He applied the Auburn University results to the 210 million prescriptions processed in New York in 2006 to come up with the estimated error rate.

    The Auburn study found that pharmacies that process more than 250 prescriptions daily make four mistakes every day, and that one in 1,000 are health-threatening.

    Research by Ohio State University has estimated that 2.2 million dispensing errors occur nationally each year.
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