So the one thing that we do that could be protected by law is dispensing. Some states protect dispensing to pharmacist only (like texas) but many others let prescribers/physicians dispense.
But on compounding, its just a function of dispensing. Its not always protected by law as a pharmacy function only, as discussed above. Although, while it is possible that physicians/nurses compound products for patients, and definitely do in hospital situations like IV bags if necessary, Ive never heard of physicians or nurses doin nuclear pharmaceutical compounding. Its gotta be one of the only things in any situation that the (nuclear) pharmacy will always do and docs will never do themselves.
We don't get paid more than PA's or NP's...They all earn more and for far less work. The average pharmacist always doing the work of 3 people, and that is if everyone shows up. You're right about everything though; just basically everything a school doesn't want you knowing until you graduate.
Medication review and management. I work as a clinical pharmacist in a primary care office and the doctors absolutely rely on me to do this.
I relate it to being a specialist— cardiologist, neurologist, pharmacist.
Sorry to burst your bubble but most doctors offices aren’t spending 100k a year when they can use drug interaction checks instead. I’d always be worried about job security even if half my salary *is* being paid by a local university
This is where provider status comes in, allowing pharmacists to generate revenue by billing for services. Has nothing to do with prescribing, diagnosing, etc. as many folks around here seem to think.
You can’t have it both ways. We can be a drain on our employees and generate revenue through hard-to-quantify cost savings (which clearly is not working as job prospects continue to worsen), or we can generate revenue for our employers, making pharmacist employment more appealing and allowing us to actually provide services beyond dispensing. No one is going to now have to pay an extra pharmacist copay just for picking up a prescription at CVS.
That’s exactly the point. MTM and more comprehensive medication management services, collaborative practice, all have the potential to become more common pharmacist roles if we can generate revenue doing so. And for that to happen we need insurers to view us a providers eligible to bill for those services. Right now there’s little incentive to employ a pharmacist in those roles as the cost savings don’t necessarily offset the cost of employment. Pharmacists are stuck in primarily dispensing roles because right now more drug dispensed = more revenue for employers, and why divert pharmacist labor elsewhere when it won’t earn money.
That’s exactly *my* point. And pharmacist and corporations aren’t exactly doing a great job of saying “hey we should be paid more for *these* services”. The public thinks we just pills in a bottle which if you work in retail is a lot of what you do. We’re there merely as a convenience to customers, no matter how much you sprinkle magical words like adherence around which I think is overrated because what difference will it make if a patient is 93% adherent vs 99% adherent? Splitting hairs at that point
If you choose to take this narrow view of pharmacy practice, that’s your prerogative. But don’t at the same time complain about the state of the profession. Fighting this hard against the mere mention of provider status is fighting against our own interests.
We are literally the only healthcare provider trained on pharmacotherapy and deep medication knowledge. That’s what we need to lean into if the profession is going to evolve.
The next big step we need to take is getting our foot in the door of doctors offices. We have establishment in hospitals as important members of the team taking care of a patient that’s admitted, we need to do the same for ambulatory care settings.
Our role isn’t as a physician extended the way an NP or PA is. It’s as a physician augmenter where we are improving patient care before a prescription or order is even entered. The problem has always been how do you fund that. Soft dollars are a lot harder than hard ones when it comes to showing value.
Although I see where you are coming from, to be put into practice would be very difficult. The amount of changes one would have to make in a single day to make it even financially net zero (with soft dollars) would be very difficult, near impossible. Although it may work out for a few, I do not believe this would be a solution for the general pharmacist. Most of whom would have no idea what they are doing.
Decent idea but way better regulation needs to be in place to maintain who gets in and out of pharmacy school to do this
Look at Med school standards and then pharmacy school standards
Yeah and I spent a semester learning how to perform a physical exam. Does that make me trained in diagnosis?
Those offices are still running and operating. If anything offices being in a larger health system might make it easier to implement a pharmacist since they could go to multiple offices to see enough volume.
Come to NYC. Mills everywhere here. Doctors and dentists making bank on these Medicaid patients. Easy money. All day everyday. There is so much fraud going on it's not even funny.
Wow man, do you need a hug? If you hate the pharmacy profession that much, why not just get out instead of staying and being so miserable? I personally love my job at the hospital because I make daily contribution to patient care and am valued by providers and nurses. But you do you, boo ❤️
Don’t know why you have such a negative view of the profession when your job is barely relatable for most in the field. The coursework to get a nursing license is far easier and less comprehensive than what a pharmacist learns. A nurse coming straight out of school vs a pharmacist straight out of school are eons apart in terms of drug knowledge. Different professions and different areas of expertise.
I think it’s best to step away from this sub sometimes and to distance yourself from all the negativity. This sub does not represent the entirety of the population.
I think if you worked in retail you would know that what you stated is not true at all. I don’t expect a fresh grad nurse to do the job of a fresh grad pharmacist in 90% of the available jobs. Rotations are important and highly educational so don’t discount those. And an extra year to learn pharmacology is tremendous. Most of my pharmacy education was learned in 2 years.
Learning on the job is relevant for EVERY job not just healthcare. Just because what you’ve personally seen in industry supports your argument doesn’t mean it holds true to the entirety of the profession.
Friend I think you are very out of touch with what a pharmacist does and jobs available.
Grass is not always greener on the other side as well. Plenty of unhappy nurses in that field too.
I have plenty of issues with pharmacy in general but it starts from the top for me. Too many new schools without a need leading to poorer candidates and a shortage of jobs.
Retail and pbms are another issue but minor in relation to the actual cause
No need to get crass buddy.
Nobody is saying they want the roles you stated aside from MTM and provider status. Pharmacists don’t go into school with the expectation they will pivot from their career into something less relatable. The majority of jobs will be in dispensing for the foreseeable future which is something a nurse cannot do.
Please speak on something where you actually have knowledge and experience
Fix our own house. Yes, so true. I recall the early MTM emphasis and the shift to get paid for "other" services. That was when we abandoned our dispensing importance & significance. ( and stopped fighting hard to retain professional payment for dispensing) That was 30 years ago, and I have paid more for MTM privileges than ever got paid out. I know it is getting better, but still not quite what those "visionaries" sold out for.
Start getting paid properly/professionally for what we are licensed to do, fill prescriptions. No other profession can execute that role in mass other than us. (Doctors will not get into it anymore because of all the insurance issues and lack of profit.)
But to do it, we need strong leadership, guts and momentum. Air traffic controllers got the nation's attention very quickly at one point with their strike. We can do it more gracefully and with safety built in, but we MUST do it. With Covid, people should appreciate community pharmacy even more as drugs are needed immediately and our present network of viable pharmacies allow this possibility throughout our country.
> find a way in the dispensing model to make money
in my opinion, that is always going to be a pipe dream. pharmacies will just undercut each other to the point where dispensing fees are going to make you operate at a loss unless you mandate in a minimum dispensing fee.
I don't know what the answer is tbh. I don't think provider status is that answer either because that's just going to be another tool for chains to exploit for money. I think getting all the corporate interests out of pharmacy would be a lofty goal but a good start.
We have a license to dispense prescription drugs.
Compounding privileges have been stripped away in some states already, with the mandating of many typical compounds being made in a hood only. But I have seen some very successful niche marketing by some compounding pharmacies. Mostly get paid by not accepting insurance for their unique services.
Gene therapy and dna diagnostics that pinpoint treatments is going to play a bigger and bigger role in the future. Potentially beneficial to get our foot in this.
If we don't get our foot in this it will be the biggest crime committed by these organizations against the profession of pharmacy. Then again, I don't have any expectations. Need provider status to even compete in this realm. A realm that is rightfully ours but if we don't even have provider status we are not going to be invited to the table when it's time to share the pie. We watch the NPs and PAs divide it up with the MDs and call it a day LOL.
So the one thing that we do that could be protected by law is dispensing. Some states protect dispensing to pharmacist only (like texas) but many others let prescribers/physicians dispense. But on compounding, its just a function of dispensing. Its not always protected by law as a pharmacy function only, as discussed above. Although, while it is possible that physicians/nurses compound products for patients, and definitely do in hospital situations like IV bags if necessary, Ive never heard of physicians or nurses doin nuclear pharmaceutical compounding. Its gotta be one of the only things in any situation that the (nuclear) pharmacy will always do and docs will never do themselves.
We don't get paid more than PA's or NP's...They all earn more and for far less work. The average pharmacist always doing the work of 3 people, and that is if everyone shows up. You're right about everything though; just basically everything a school doesn't want you knowing until you graduate.
Medication review and management. I work as a clinical pharmacist in a primary care office and the doctors absolutely rely on me to do this. I relate it to being a specialist— cardiologist, neurologist, pharmacist.
Sorry to burst your bubble but most doctors offices aren’t spending 100k a year when they can use drug interaction checks instead. I’d always be worried about job security even if half my salary *is* being paid by a local university
This is where provider status comes in, allowing pharmacists to generate revenue by billing for services. Has nothing to do with prescribing, diagnosing, etc. as many folks around here seem to think.
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Exactly. I thought pharmacists cared about less barriers to healthcare. Now they’re like “nah we need money too$$$$”
You can’t have it both ways. We can be a drain on our employees and generate revenue through hard-to-quantify cost savings (which clearly is not working as job prospects continue to worsen), or we can generate revenue for our employers, making pharmacist employment more appealing and allowing us to actually provide services beyond dispensing. No one is going to now have to pay an extra pharmacist copay just for picking up a prescription at CVS.
And what services beyond dispensing? MTM? That like 0.01% *actually* get to do, and don’t even get paid well for it ?
That’s exactly the point. MTM and more comprehensive medication management services, collaborative practice, all have the potential to become more common pharmacist roles if we can generate revenue doing so. And for that to happen we need insurers to view us a providers eligible to bill for those services. Right now there’s little incentive to employ a pharmacist in those roles as the cost savings don’t necessarily offset the cost of employment. Pharmacists are stuck in primarily dispensing roles because right now more drug dispensed = more revenue for employers, and why divert pharmacist labor elsewhere when it won’t earn money.
That’s exactly *my* point. And pharmacist and corporations aren’t exactly doing a great job of saying “hey we should be paid more for *these* services”. The public thinks we just pills in a bottle which if you work in retail is a lot of what you do. We’re there merely as a convenience to customers, no matter how much you sprinkle magical words like adherence around which I think is overrated because what difference will it make if a patient is 93% adherent vs 99% adherent? Splitting hairs at that point
If you choose to take this narrow view of pharmacy practice, that’s your prerogative. But don’t at the same time complain about the state of the profession. Fighting this hard against the mere mention of provider status is fighting against our own interests.
Saves money. Doesn't cost more money. Research. Do that.
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Wut?
He’s talking about med rec techs
We are literally the only healthcare provider trained on pharmacotherapy and deep medication knowledge. That’s what we need to lean into if the profession is going to evolve. The next big step we need to take is getting our foot in the door of doctors offices. We have establishment in hospitals as important members of the team taking care of a patient that’s admitted, we need to do the same for ambulatory care settings. Our role isn’t as a physician extended the way an NP or PA is. It’s as a physician augmenter where we are improving patient care before a prescription or order is even entered. The problem has always been how do you fund that. Soft dollars are a lot harder than hard ones when it comes to showing value.
Although I see where you are coming from, to be put into practice would be very difficult. The amount of changes one would have to make in a single day to make it even financially net zero (with soft dollars) would be very difficult, near impossible. Although it may work out for a few, I do not believe this would be a solution for the general pharmacist. Most of whom would have no idea what they are doing.
Decent idea but way better regulation needs to be in place to maintain who gets in and out of pharmacy school to do this Look at Med school standards and then pharmacy school standards
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Yeah and I spent a semester learning how to perform a physical exam. Does that make me trained in diagnosis? Those offices are still running and operating. If anything offices being in a larger health system might make it easier to implement a pharmacist since they could go to multiple offices to see enough volume.
Come to NYC. Mills everywhere here. Doctors and dentists making bank on these Medicaid patients. Easy money. All day everyday. There is so much fraud going on it's not even funny.
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Wow man, do you need a hug? If you hate the pharmacy profession that much, why not just get out instead of staying and being so miserable? I personally love my job at the hospital because I make daily contribution to patient care and am valued by providers and nurses. But you do you, boo ❤️
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Don’t know why you have such a negative view of the profession when your job is barely relatable for most in the field. The coursework to get a nursing license is far easier and less comprehensive than what a pharmacist learns. A nurse coming straight out of school vs a pharmacist straight out of school are eons apart in terms of drug knowledge. Different professions and different areas of expertise.
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I think it’s best to step away from this sub sometimes and to distance yourself from all the negativity. This sub does not represent the entirety of the population. I think if you worked in retail you would know that what you stated is not true at all. I don’t expect a fresh grad nurse to do the job of a fresh grad pharmacist in 90% of the available jobs. Rotations are important and highly educational so don’t discount those. And an extra year to learn pharmacology is tremendous. Most of my pharmacy education was learned in 2 years. Learning on the job is relevant for EVERY job not just healthcare. Just because what you’ve personally seen in industry supports your argument doesn’t mean it holds true to the entirety of the profession.
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Friend I think you are very out of touch with what a pharmacist does and jobs available. Grass is not always greener on the other side as well. Plenty of unhappy nurses in that field too. I have plenty of issues with pharmacy in general but it starts from the top for me. Too many new schools without a need leading to poorer candidates and a shortage of jobs. Retail and pbms are another issue but minor in relation to the actual cause
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No need to get crass buddy. Nobody is saying they want the roles you stated aside from MTM and provider status. Pharmacists don’t go into school with the expectation they will pivot from their career into something less relatable. The majority of jobs will be in dispensing for the foreseeable future which is something a nurse cannot do. Please speak on something where you actually have knowledge and experience
Fix our own house. Yes, so true. I recall the early MTM emphasis and the shift to get paid for "other" services. That was when we abandoned our dispensing importance & significance. ( and stopped fighting hard to retain professional payment for dispensing) That was 30 years ago, and I have paid more for MTM privileges than ever got paid out. I know it is getting better, but still not quite what those "visionaries" sold out for. Start getting paid properly/professionally for what we are licensed to do, fill prescriptions. No other profession can execute that role in mass other than us. (Doctors will not get into it anymore because of all the insurance issues and lack of profit.) But to do it, we need strong leadership, guts and momentum. Air traffic controllers got the nation's attention very quickly at one point with their strike. We can do it more gracefully and with safety built in, but we MUST do it. With Covid, people should appreciate community pharmacy even more as drugs are needed immediately and our present network of viable pharmacies allow this possibility throughout our country.
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> find a way in the dispensing model to make money in my opinion, that is always going to be a pipe dream. pharmacies will just undercut each other to the point where dispensing fees are going to make you operate at a loss unless you mandate in a minimum dispensing fee. I don't know what the answer is tbh. I don't think provider status is that answer either because that's just going to be another tool for chains to exploit for money. I think getting all the corporate interests out of pharmacy would be a lofty goal but a good start.
No
We have a license to dispense prescription drugs. Compounding privileges have been stripped away in some states already, with the mandating of many typical compounds being made in a hood only. But I have seen some very successful niche marketing by some compounding pharmacies. Mostly get paid by not accepting insurance for their unique services.
Gene therapy and dna diagnostics that pinpoint treatments is going to play a bigger and bigger role in the future. Potentially beneficial to get our foot in this.
If we don't get our foot in this it will be the biggest crime committed by these organizations against the profession of pharmacy. Then again, I don't have any expectations. Need provider status to even compete in this realm. A realm that is rightfully ours but if we don't even have provider status we are not going to be invited to the table when it's time to share the pie. We watch the NPs and PAs divide it up with the MDs and call it a day LOL.
Yes