INTERVIEW WITH A PHARMACIST
Interview Questions:1. Why are certain over the counter medicines behind the pharmacy counter or locked?They are regulated in the state because PSE containing products has been used for meth.2. What are some of the things a pharmacist wishes a provider never told their patients?Your medication will be covered but medications in formulary 2 are not covered.3. What is a prior authorization?When insurance requires more information from a doctor in order to cover the medication4. How can we make it easier for a patient to get his/her medication if the one we prescribed is not covered by the insurance company?Call the doctor or fax to change the medication to an alternative one.5. If I write "substitute" on the hard copy, what can you change it to? A generic of the same drug.6. What does "brand medically necessary” mean?You cannot change it to generic only brand name can be dispensed.7. Can a pharmacist change a medication without talking to the prescriber?No.8. If an ARNP works with a doctor who's allowed to prescribe controlled medications and signs a controlled script for a patient, will you be able to fill this medication? No, controlled medications can only be prescribed by a physician that has a DEA number, ARNP's do not have this although they have a license.9. What type of medications cannot be called in or faxed in to the pharmacy? Weight loss medications like thentermine and CII prescriptions cannot be faxed or called in except in the case of hospice care. 10. What haven't I asked you that I should have?Can a patient get 90 days supply for more convenience on maintenance medications?
Thank You Note:
Dear [Pharmacist name],
Thank you very much for taking the time to answer my questions in regards to the nature of your profession. I understand that you are a very busy individual, and your input has helped me gain a better understanding of the profession of pharmacy as a whole. I hope that your experience with me was as positive for you as it was for me. You have definitely helped shape my view on pharmacists and their occupation, and I appreciate your candor.
Analysis of Interview
People often look at doctors as the primary caregivers and gatekeepers to the prescription medicine world, but this recognizes only half the truth about the medical community and the different roles that are played within the medical community (Choe et al., 2012). The role of the physician is undoubtedly important—the physician is responsible for seeing and diagnosing the patient—but physicians are not infallible, and sometimes they do not have all the information necessary to make a perfect decision about the drugs that a patient should be ingesting (Lai, Trac, & Lovett, 2013; Choe et al., 2012).
While the role of pharmacists may change based on their geographical location, the overall role of the pharmacist in the United States is generally the same regardless of the state in which the pharmacist practices his or her craft (Choe et al., 2012). The pharmacist’s main job is to help patients get well and overcome their health issues—the pharmacist does this in conjunction with the patient’s doctor.
There is no doubt that a patient who has a caring, attentive pharmacist is a very lucky patient indeed, because good pharmacists can ensure that patients receive the correct medication in the correct dosage, but can also ensure that patients are receiving their medication in a timely manner, and that they are not paying more than they need to be paying for their medical care (Choe et al., 2012). Without pharmacists and their knowledge of medicine and the insurance system, there is no doubt that many people—mostly elderly and the young—would have problems getting the medications they need in certain circumstances (Chui et al., 2014).
Many people misunderstand the role of the pharmacist, and believe that the role of the pharmacist is to dispense the medicine that the doctor prescribes blindly. However, there are many restrictions on the things that pharmacists are able to do with different medicines; they must be very aware of the different medical interactions between drugs and must be capable of determining when those interactions might be dangerous (Mossialos et al., 2013; Mossialos et al., 2015).
The pharmacist interviewed for this paper discusses the most common issues that pharmacists face in the United States; for instance, some of the questions revolve around prescription drugs and their generic versions. It is common for pharmacists to substitute a generic version of a drug for a name-brand version to keep costs low on the medicine, and pharmacists are trusted to make this decision unless the doctor deems the name-brand drug something that is medically necessary.
Another interesting thing that the pharmacist discusses in some depth is the extent to which pharmacists have to work with insurance companies. Insurance companies are known for being problematic and difficult to work with; having to “sell” why a person needs a prescription to an insurance company seems like something that would be a huge headache for most people, but it is something that many pharmacists work with on a daily basis. Although questions were not asked specifically about insurance and dealing with insurance companies, it is something that is very interesting, and something that should be dealt with in more depth. Insurance companies are often problematic to work with, so any tips or tricks on the part of a pharmacist could be useful to almost anyone.
Despite their professionalism and high levels of education, pharmacists are very restricted by the law in regards to what types of prescriptions that they can dispense and how they can dispense those prescriptions. They are also bound by the rules of the insurance companies, because if the insurance companies refuse to pay for prescriptions, the company that the pharmacist works for will also go unpaid for a prescription—something that could, potentially, cause the pharmacy to lose a lot of money if the drugs dispensed are expensive.
In some places, an expanded role for pharmacists has been considered, especially in places where it is hard to find ARNP or physicians. In these places, it has been suggested that pharmacists, as medical professionals, should be able to have limited diagnostic and treatment options with their patients (Lai, Trac & Lovett, 2013). It has also been suggested that options like Plan B pills for emergency contraception should be kept behind the pharmacists’ glass and only given to those who have had specific instructions on their use (Chui et al., 2014).
While most people only interact with pharmacists when they require medication for some reason, the role of the pharmacist is actually quite complex. The pharmacist must develop a working knowledge of many different drugs, and must be careful to ensure that there are no adverse interactions between drugs that have been prescribed to a certain patient by different physicians. They must have an excellent ability to talk to people and to ensure that people understand the instructions associated with taking their specific medications as well.
Choe, H. M., Farris, K. B., Stevenson, J. G., Townsend, K., Diez, H. L., Remington, T. L., & Standiford, C. J. (2012). Patient-centered medical home: developing, expanding, and sustaining a role for pharmacists. American Journal of Health-System Pharmacy, 69(12), 1063.
Chui, M. A., Stone, J. A., Martin, B. A., Croes, K. D., & Thorpe, J. M. (2014). Safeguarding older adults from inappropriate over-the-counter medications: the role of community pharmacists. The Gerontologist, 54(6), 989-1000.
Lai, E., Trac, L., & Lovett, A. (2013). Expanding the pharmacist's role in public health. Univers J Public Health, 1, 79-85.
Mossialos, E., Naci, H., & Courtin, E. (2013). Expanding the role of community pharmacists: Policymaking in the absence of policy-relevant evidence?. Health Policy, 111(2), 135-148.
Mossialos, E., Courtin, E., Naci, H., Benrimoj, S., Bouvy, M., Farris, K., & Sketris, I. (2015). From “retailers” to health care providers: Transforming the role of community pharmacists in chronic disease management. Health Policy,119(5), 628-639.