OPINION & EDITORIAL
Just what the doctor ordered
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Also by Cynthia Martens:
- America maintains unhealthy obsession with body image (February 10, 2006)
- Genocide not limited to Holocaust (January 27, 2006)
- Undergraduate fears of commencement unjustified (February 3, 2006)
- Outbursts in class unacceptable (April 7, 2005)
- Teacher evaluations not always effective (February 17, 2006)
Related Stories:
- Lessons from Europe (March 8, 2005)
- Lautenschlager right to pursue FDA suit (December 13, 2005)
- Morning after pill must remain prescription-based (March 23, 2006)
- A good Plan (May 3, 2007)
by Cynthia Martens
Tuesday, January 25, 2005
As the Food and Drug Administration wavers over whether to make emergency contraception available over the counter (the way it is in that ungodly country, France) I’m reminded of how many obstacles girls still have to trip over to get basic health services.
Not so long ago a pharmacist in Menomonie, WI, Neil Noesen, refused to fill a student’s prescription for birth control pills because he said he would suffer spiritually. He was accused of being unprofessional, and the case went to court.
A pharmacist’s job is to fill prescriptions and answer questions, not to moralize about customer decisions.
What if a girl wanted to buy a sexy bra, and the salesclerk said no because she felt it was inappropriate or too provocative? Or a checkout clerk refused to sell beer from the liquor aisle because he didn’t believe in drinking? Or a librarian refused to let you check out the New Testament because she was Jewish?
I’m a vegetarian, but when I waited tables, I delivered any meal a customer ordered, steak or tofu. If you can’t handle filling prescriptions you don’t agree with, don’t become a pharmacist.
The only time pharmacists should intervene is when they notice a patient’s prescription clashes with another medication, perhaps one prescribed by a different physician. Pharmacists should never second-guess a doctor unless they spot a harmful combination of drugs; the lines between the roles of physicians and pharmacists shouldn’t blur.
Pharmacists also have no business asking personal questions (such as whether a girl is using birth control pills for contraception.) They may not approve of every drug on the market, but their personal objections, religious or otherwise, shouldn’t prevent a patient from having a prescription filled. Whether she is on the pill because of cramps or because she’s having sex, a girl’s doctor prescribed her birth control pills. Presumably there was a patient-doctor discussion about her individual needs.
When men get Viagra, pharmacists never ask if they’re sleeping with their spouses, if they saved themselves for marriage, or if they’re in monogamous, heterosexual relationships.
Girls who come in with doctors’ prescriptions for birth control (and so who must be religiously at peace with their decision to go on the pill) have a right to have their prescriptions filled, no questions asked. If college girls feel they cannot safely fill their prescriptions, they are being intimidated out of their health rights.
Mr. Noesen’s attorney said any punishment would violate Noesen’s constitutional right to religious expression. Noesen’s right to religious expression is tied to his right to free speech: he is free to speak out against birth control or in favor of abstinence before marriage. Preventing a girl with a prescription from getting her pills goes beyond free speech.
If a pharmacist really isn’t comfortable filling a prescription, the pharmacy should be responsible for calling in someone who is.
Sexual activity is nothing new, and at University of Wisconsin, you don’t have to witness bartime to know many students are sexually active. Of course not all of them are. But personal decisions such as whether to abstain before marriage should be just that — personal. At the end of the day, if a girl wants to go on birth control, and a doctor prescribes her pills, she should be able to get them without fear of being grilled by a pharmacist whose religious views do not match her own. And if a girl needs emergency contraception, she should likewise be able to get it without difficulty. The morning after pill, NorLevo, has been available in France without prescription, without parent authorization and for free for teenagers under the age of 18 since January 2002. Let’s hope the FDA follows suit.
You have a right not to answer personal questions about your health. And you have a right to have your prescriptions filled. If you are refused service, take action.
It’s your business. Not mine.
Cynthia Martens (cmartens@badgerherald.com) is a junior majoring in Italian and European Studies.
Anonymous (January 25, 2005 @ 10:00am):
Word, sister.
Anonymous (January 25, 2005 @ 1:57pm):
Throughout most of this article, the woman buying the birth control is made out to be the victim, but this sword cuts both ways.
Imagine being forced to give someone just enough rope for them to hang themselves. Imagine being forced to kill someone, or imagine being ordered to steal. That's how this pharmacist views this issue, and it's how many people do.
I don't understand why there can't be a compromise here. Eventually, you can't save people from themselves. But that doesn't mean you have to do whatever anyone tells you, either. The pharmacist should just direct the woman where else to go. That way, the woman gets her medicine, and the pharmacist hasn't violated his own ethics.
Why this refusal to compromise?
Anonymous (January 25, 2005 @ 2:01pm):
"Imagine being forced to give someone just enough rope for them to hang themselves. Imagine being forced to kill someone, or imagine being ordered to steal. That's how this pharmacist views this issue, and it's how many people do."
Then the pharmacist is an idiot. The pharmacist's job is to dispense medications as ordered by doctors. The ONLY exception is when said medications would interact badly with other medications the patient takes, in which case it is the pharmacist's job to bring the dangerious interaction the patient's attention and that of his/her doctor, who would then prescribe something else. Pharmacists are not entitled to set social policy by denying medicine ordered by a doctor.
It's not a question of compromise. It's a question of the pharmacist overstepping his bounds. If he's that uncomfortable fulfilling the prescription himself, he should find someone else to fill it.
Anonymous (January 25, 2005 @ 3:13pm):
Isn't that what the above poster pretty much insinuated?
Anonymous (January 25, 2005 @ 3:17pm):
Assisted suicide is illegal, murder is illegal, stealing is illegal. Taking birth control IS LEGAL. It's not like somebody is forcing the pharmacist to break the law. This is just another lame excuse for "certain people in society" to try and take away a woman's control over her own reproductive rights. Sorry, but nobody- especially not fat old bald politicians or the Walgreen's pharmacist- should have the right to tell a woman what she should do with her reproductive capabilities.
Anonymous (January 25, 2005 @ 4:16pm):
"Why this refusal to compromise?"
I think that would be a good compromise, but it would be one that the pharmacists in question would not be satisfied with. They feel that even transferring the prescription to another pharmacist violates their ethics, and that the only acceptable action is to tear up the prescription and ask the customer to leave.
That said, it is ridiculous that pharmacists are making such a big deal out of this. If you're going to join the military you might have to shoot someone, and if you become a pharmacist you might have to dispense contraceptives. The only possible excuse would be if one completed his pharmacy training before contraceptives were invented. Otherwise, give me a break.
Anonymous (January 25, 2005 @ 5:31pm):
Say what you want about the whole subject of making emergency contraception OTC and a woman's right to choose, but I must take offense at your bastardizing/ignorance of the profession of pharmacy. There's more going on behind the counter than many of you realize, and saying that pharmacist interventions and actions are warranted only in the case of drug interaction and that the pharmacist's job is only to dispense medications is ludicrous. Our job is to ensure that, not only do you get the right medication and that you don't drop over dead when you take it, but also that you get the most out of what you are taking. We as pharmacists are charged to probe with questions that may, at times, be a bit personal, but the fact of the matter is that the pharmacist is a health care provider, just like you doctor or nurse, not a fast food employee who simply makes sure your order is right and sends you on your way. Do you have any idea how many unplanned pregnancies occur in this country every year due to misuse of contraceptive measures (not just condoms but oral contraceptives as well)? You should not be so quick to condemn a pharmacist's line of questioning to determine if you are using things correctly, because trust me when I say many people don't. We ask because we are required to ask, not only on the state licensing exam and by Wisconsin state law, but also because we are trying to provide health care and do what it best for you. A single person's actions do not represent the actions of us all. Speaking of which, to the writer of the comment about "THEY feel that..." and that "PharmacistS are making I big deal out of this" I pose a question. How many pharmacists have you talked to about this that you know that ALL of us are making a big deal out of this? This was one guy who was exercising HIS right (or what he thought was his right anyways). I do believe he overstepped his professional bounds by not transferring the prescription and should be treated accordingly, but please consider whose integrity you are bringing into question when your write things like this about my profession.
Anonymous (January 25, 2005 @ 5:35pm):
"Then the pharmacist is an idiot. The pharmacist's job is to dispense medications as ordered by doctors."
So an idiot is someone with strong ethical convictions, or is it just that he should not be allowed to act on them? You seem to portray pharmacists as little cogs. They're not. They're people just like you and me. This is half the issue: you say he should be forced to do it, that he doesn't have a choice. People are very complex, and you're overlooking half of the people involved here.
"Pharmacists are not entitled to set social policy by denying medicine ordered by a doctor."
One guy. One time. That's hardly social policy. You can go to another one.
"If he's that uncomfortable fulfilling the prescription himself, he should find someone else to fill it." Exactly! So why force a poor guy to do this?
******
"Assisted suicide is illegal, murder is illegal, stealing is illegal. Taking birth control IS LEGAL. It's not like somebody is forcing the pharmacist to break the law."
Just because something is legal doesn't make it right. Nearly all people feel that adultery is wrong, but we don't stone people to death or make them wear scarlet letters anymore.
"This is just another lame excuse for 'certain people in society' to try and take away a woman's control over her own reproductive rights."
I view this as a conflict between the rights of the pharmacist and the rights of the woman getting birth control. The pharmacist has the right to not do something he considers ethically wrong. The woman has the right to her medication. Seeing as how there are lots of pharmacies, a compromise here will be ok if the woman goes to another store.
We're talking about birth control here. There is no mainstream group I can think of that is strongly against birth control. Abortion? Of course. Birth control? No. Women's rights, however, have supporters all around the country. The MAN isn't coming to oppress you and steal your medication.
******
"I think that would be a good compromise, but it would be one that the pharmacists in question would not be satisfied with."
Good point. Both sides need to give in a little here, and I hope pharmacists do too.
Anonymous (January 25, 2005 @ 5:49pm):
You are a fucking idiot! Before you speak, why don't you think. And while you are at it, try to get an education!
Anonymous (January 25, 2005 @ 6:11pm):
Does anyone else hope that the next time this uneducated (not likely to graduate) junior has an infection and needs antibiotic treatment (and doesn't dare tell her pharmacist that she's on birth control) get's pregnant as a result?...Then, we'd have 2 more people likely to be using the medicaid system instead of one.
Anonymous (January 25, 2005 @ 6:28pm):
"You should not be so quick to condemn a pharmacist's line of questioning to determine if you are using things correctly, because trust me when I say many people don't."
Fine, so long as you're asking for our benefit, not because you have some sort of personal religious or political agenda. If you're asking for the sort of reason that Neil Noesen did, you're violating our rights.
Anonymous (January 25, 2005 @ 6:57pm):
I agree, but he's one pharmacist in a few thousand. Please keep that in perspective.
Anonymous (January 25, 2005 @ 7:27pm):
Leave it to an Italian and European Studies major to enlighten me about my pharmacy profession.
Anonymous (January 25, 2005 @ 7:27pm):
If a pharmacist tore up my prescription, I'd have him arrested for destoying my property.
Doesn't selling condoms have the same result?
Anonymous (January 25, 2005 @ 7:32pm):
Technically a prescription isn't your property, it's a legal document. I don't think it's owned by anyone.
Anonymous (January 25, 2005 @ 7:38pm):
You should probably research what a pharmacist roles are before you go and bash them. Any pharmacy student on campus reading this article will be furious. Way to make yourself look like an idiot. There is a lot more to pharmacy than telling a patient if the will be a drug interaction!
Anonymous (January 25, 2005 @ 8:06pm):
I am astonished that the Badger Herald allowed this article to be published. The editiors of this paper must be as clueless as the student who wrote this article. I think the point was missed. Pharmacists are not asking women if they are taking contraceptives because they are nosy, but rather because several commonly prescribed classes of medications reduce the effectiveness of oral contraceptives. The reason, Ms Martens, the pharmacist asked you if you were using the oral contraceptive to prevent pregnancy was most certainly because you were picking up a medication that reduced the effectiveness of the contraceptive. Many agents reduce the enterohepatic recirculation of estrogen and progesterone (the drugs in combined oral contraceptives if you didn't know) and therefore reduce the levels of estrogen and progesterone necessary to either prevent ovulation, or inhibit the implantation of the egg in the uterus. Contrary to your simple-minded answer, the pharmacist asked a few questions for your benefit. If you were using the birth control to help control acne, then the reduced effectiveness of the contraceptive while taking an antibiotic for example, would not be significant. However, if you were using the contraceptive to prevent pregnancy, then I think you would be glad that the pharmacist told you about this interaction with the antibiotic and the birth control so you would not have an unexpected pregnancy. Next time you berate a pharmacist, critically think about why the individual asked you questions, and what did he or she have to gain by asking such questions.
Your Friendly Neighborhood Pharmacist
Anonymous (January 25, 2005 @ 8:15pm):
This chick obviously failed logical reasoning 101.
Anonymous (January 25, 2005 @ 9:59pm):
Your article has been forwarded on to pharmacy student colleagues acrossed the nation, which includes >90 schools of pharmacy...I know your not a math major, but can probably figure out that this will generate more than a few responses...you are welcome in advance! ;-)
Anonymous (January 25, 2005 @ 9:59pm):
Ms Martens, you need to take your head out of your ass and get real!
Anonymous (January 25, 2005 @ 10:34pm):
I am astonished that an Italian and European Studies major would critize a pharmacist's attempt to help a patient through questioning them about medication uses. I am upset at the insults that you threw against a profession that you obviously know so little about. Yes pharamcists ask patients questions to learn whether or not drug interactions are present but this is only a small portion of our jobs. We ask why you are taking a particular medication, not to be judgemental, but rather to make the consult be the most beneficial to you. News flash: Drugs generally don't just have one use. I'm sure that if we didn't do it, we could look forward to having enlightened people such as yourself sue us for this too! As a pharmacy student, I do not for a second condone the discussed pharmacist's behavior. I even agree with you that the pharmacist had a professional obligation to direct his patient to another pharmacy. This does not give you the right however, to insult actions that pharmacists make on your behalf. Maybe next time before you go and insult ~500 highly intelligent students on campus who are devoting their careers to help better patients lives, even unworthy ones such as yourself, you do a little reaseach on the Doctor of Pharmacy Program!
Aaron Johnson (January 25, 2005 @ 10:45pm):
When did it become acceptable for writers to publish an article, in nearly complete ignorance about the subject in which they were writing? It looks like someone needs to revisit the principles of their own prospective profession before blindly lashing out and deriding another.
People are ignorant about the true role of Pharmacists because; unfortunately, for many years, dispensing was their only role. Anybody with an eye on the future of our health care system knows that this will change in the next decades. While it is true that doctors currently make the decision of which drug to prescribe, they are not the most qualified persons to do so, Pharmacists are. The strength of doctors is in their ability to diagnose. That makes them absolutely indispensible; however, med students spend no more than one school year(probably less) learning what Pharmacy Students learn in four. As a future Pharmacist, I look forward to working more closely with Doctors in this shared role as a "Drug Information Specialist" to improve the quality of patient outcomes and minimize the duration and cost of treatment.
Anonymous (January 25, 2005 @ 10:59pm):
We should be educating more people than just Ms Martens or the readers of this newspaper about the profession of pharmacy. I was never big on the idea of being involved with professional societies, but I guess that even they might have a role.
I think all involved need to come to the realization that the issues being raised are very much seperate from the role/oath/expectation of a pharmacist, or any other liscensed professional.
If medications are unsafe for use without regulations, and liscensed health care professionals including physicians, pharmacists, nurses, or whoever are unable to safely and appropriately provide medications to an individual, then maybe the society should not allow a liscensed few, let alone anyone, to have control over these medications.
I won't try to define "unsafe," "professional," "appropriately," or "control;" I leave that to society as a whole who also liscenses us, protects us, and is composed of us.
I will not attempt to define "liscense," "society," "protects," "composed," or "us" either.
I wish these issues were black and white, but they aren't.
By the way, I'm thinking about running for President of the United States in 2008.
Anonymous (January 25, 2005 @ 11:02pm):
cynthia, good luck getting your next prescription filled.
Anonymous (January 25, 2005 @ 11:02pm):
Ms Martens: You know NOTHING about what you are writing. Do you know even HOW to write an article? You don't have any of your facts right. At the same time, what kind of editors run this newspaper? Why don't you learn how to check your facts before writing such an article.
Anonymous (January 25, 2005 @ 11:03pm):
Ms Martens: You know NOTHING about what you are writing. Do you know even HOW to write an article? You don't have any of your facts right. At the same time, what kind of editors run this newspaper? Why don't you learn how to check your facts before writing such an article.
Anonymous (January 25, 2005 @ 11:06pm):
John Kerry supports you.
Or does he?
Anonymous (January 25, 2005 @ 11:12pm):
Who's John Kerry?
Anonymous (January 25, 2005 @ 11:41pm):
As a student here at the University, I know well enough the strength the UW has a center for diversity and freedom of thought and speech. I also know, however, that I would never THINK of publishing an article on Italian and European Studies and what I think people with these degrees should do and say. I have nearly 4 years of pharmacy school completed and know that my job as a pharmacist means not only to check if a "patient's prescription clashes with another medication," but to also make sure that the patient knows everything there is to know about the chemical they are going to put into their body. I also have to be sure that patient will be safe to take the medication. I have had doctors and nurses thank me for catching allergies, drug interactions, incorrect directions, and duplicate therapies. These have all been caught because of excellent patient consultation and questioning...and I am still in school. If I were to only intervene in the case of interactions, some patients would have no idea how to use their inhaler, or that some birth control pills need to be taken within a three hour window each day or they are less effective, or how to use the PEG solution they need for their colonoscopy, or any number of other pieces of information that could harm the patient if not confronted. I am offended and apalled at the author's lack of class and integrity in writing this article. I hope she seriously considers looking into what her pharmacist is doing for her every time she fills a prescription. She would be very surprised.
Anonymous (January 25, 2005 @ 11:55pm):
It is unfortunate that so many people, including someone who is "educated" like yourself, don't realize what a huge impact pharmacists have in the role of health care. It doesn't benefit a pharmacist to ask about your med history, it benefits the patient! A pharmacist is someone who is concerned in the best interest of the patient, their health, and their overall quality of life. Nobody is being judged or looked down at in a pharmacy. As a future pharmacist, I hope that these responses to your article, help you not only to realize how important pharmacists are in health care, but allow you to think about the way that you are displaying your opinions and your "intelligence" to your colleages as well as the world.
Anonymous (January 26, 2005 @ 12:04am):
You recently published an article about the role of pharmacists. I would be interested to know what you base your opinions on. I failed to see evidence of any research on your part of pharmaceutical care as it stands today. As a second-year pharmacy student, I would like to enlighten you.
You said "A pharmacist's job is to fill prescriptions and answer questions, not to moralize about customer decisions." First of all, I don't think you know all the work that goes into filling a prescription. It definitely is more than counting pills and pouring them into a vial. Allow me to give you an overview. We keep track of every medication and disease state of every patient (not customer) that we serve. We identify drug interactions with current medications and diseases. We also keep track of our patient's allergies. Then, as a service to the patient, we find the most cost effective way for the patient to get the drug they need, whether it's by choosing a generic or by enrolling in a manufacturer discount program. (Yes, there are cheaper alternatives within our own borders!)
Regarding the moral issues: A person who is against birth control believes that it is murdering unborn children. By not allowing the child to be born and to live, you are ending their life and thus, murdering them. You simply cannot equate this with buying a sexy bra or checking out the New Testament. Those things don't cause harm to anyone. A pharmacist who is pro-life should not be required to enable others to do what they know in their hearts is wrong and they have every right to transfer those prescriptions to another pharmacy. It would be discrimination against the pharmacist to force them to dispense a drug in a situation that goes against their morals. Pro-life physicians don't have to perform abortions, so this is no different.
"Pharmacists should never second-guess a doctor." I beg your pardon. In 2007, I will graduate as a Doctor of Pharmacy. That is the degree of every graduating pharmacist in the country, and it has been for years. (Please note the "PharmD" behind the name of your pharmacist the next time you go in for a refill.) No one studies drugs more extensively than a pharmacist, and we do have a right to question physicians when it comes to drug therapy. As you hinted at in your article, pharmacists are responsible for finding drug interactions in their patients' profiles. Did you also know that we might suggest a more cost-effective alternative to the doctor? We may also serve as an advocate for a patient if the doctor insists on prescribing a drug that they don't want. In addition, we need to know what the drug is being used for because that often determines what the correct dose is and if an interaction will be a problem or not. For example, there are many drugs out there that decrease the efficacy of oral contraceptives (OC). Our patient can be taking their OC for a number of reasons. We have to ask them if they're taking it as a means of birth control so we can advise alternative methods of birth control of not. Perhaps their other drug can be changed in order to maintain the efficacy of their oral contraceptive. We ask personal questions for a reason, not to pass judgment.
"Presumably there was a patient-doctor discussion about her individual needs." To assume is to make an ass out of "u" and me. If my license is at stake, I will not assume anything. I especially will not assume that the doctor knows everything about a patient's health care. An appointment with a doctor is often a rushed interaction that takes place in about 10 minutes. It's simply not possible to catch every potential problem in that short span of time. Also, many patients see more than one physician. There are infinite possibilities for a doctor to miss vital information when it comes to their patient's overall well-being. A pharmacist serves as a built-in checkpoint in the system. When you take the pharmacist out, you put patients at risk. But if you trust your 10-minute encounter with one of your doctors, that's your call.
Regarding the morning-after pill: post-coital emergency contraception is a very powerful drug. There are severe side effects and the experience is "unpleasant" at best for anyone who takes it. I hope I never see the day when the FDA approves it as an over-the-counter medication. It is available as a prescribed medication now, so don't tell me that patients don't have access.
In the future, if you choose to publish anything, please go to the source (i.e., talk to a pharmacist, in this case) and make yourself aware of the facts first before giving false information about a profession.
Nicole Peterson (January 26, 2005 @ 12:09am):
This letter is written in response to the Cynthia Martens editorial entitled, "Just What the Doctor Ordered" from the Tuesday, January 25th edition of the Badger Herald.
While I do not disagree that Neil Noesen's actions were wrong and unprofessional, he was within his legal rights to refuse to fill the prescription, just as it is a physician's right to refuse to write a prescription. The fault in his case lies in that as he refused to transfer the prescription, he left the patient with no other options for health care, and that fundamentally goes against the principles for which our profession stands. However, I do not believe that his case can be generalized to the profession as a whole.
Pharmacy practice as it currently stands operates under the following statement:
"Pharmaceutical care is the responsible provision of drug therapy for the purpose of achieving definite outcomes that improve a patient's quality of life (Hepler and Strand 1990)." Our profession has made great strides in the last decade to bring the quality of medical care patients receive to a new standard level. No longer is the field of health care a number of separate professions operating under the same roof. Now, the health care field operates under the concept of health care teams, in which physicians, pharmacists and nurses all work together with the patient to determine the best treatment options and the best method for their provision. I believe that your fundamental misunderstanding of the practice of pharmacy lies in the statement that "A pharmacist's job is to fill prescriptions and answer questions, not to moralize about customer decisions." I have italicized the word customer to emphasize the difference in views; to myself and my fellow pharmacy students, you are not a customer, you are our patient. In being our patient, you are entitled to a certain level of care that a customer at a store does not receive. You are entitled to our professional expertise on medications and their interactions, side effects, contraindications, dietary considerations, allergic possibilities, correct dosage and administration, as well as our double-check on the physician prescription orders. I absolutely disagree with your statement that, "Pharmacists should never second-guess a doctor unless they spot a harmful combination of drugs; the lines between the roles of physicians and pharmacists shouldn't blur." For every prescription that comes through a pharmacy, the pharmacist has a legal responsibility to prevent error, and the assumption that if a physician wrote it, it must be correct is downright dangerous. Physicians, while experts in the field of diagnosing and treating illnesses, are by no means experts in the field of pharmacy. Most medical schools require 2 semesters or less of pharmacology, which considering the enormous responsibility undertaken in prescribing medications, is wholly inadequate. In every situation, I personally would want my pharmacist, with their four years of specialized training in the chemistry, pharmacology and therapeutic use of medications to be the one checking the physician's orders.
Finally, as far as the statement, "Pharmacists also have no business asking personal questions," how would it be possible for me to best do my job, that is to protect the health and well being of my patients, without asking for pertinent, and often personal, health information? To cite your own example, if I do not ask a woman if she is using her birth control pills as a contraceptive, rather than for cramps or irregular menses, then how would I know to inform her that an antibiotic prescription she brings in may decrease the effectiveness of her birth control and that she should use a back up method for 7 days beyond the end of the antibiotic treatment? Therefore, in many contexts, inquiring about sexual habits, as well as tobacco, alcohol and caffeine use is highly pertinent and necessary to provide the best patient care.
In conclusion, I will say that you are right in saying that a person has every right to refuse to answer personal medical questions. However, in the end, it is not the pharmacist who is harmed, it is the patient, because without all possible information, patient care and medication efficacy cannot be maximized, and the best therapeutic outcomes cannot be achieved.
Anonymous (January 26, 2005 @ 12:09am):
I don't presume to know anything about Italian and European Studies, and I certainly don't publish my uneducated guesses. I think you would be well advised to do the same. In the future, stick to what you know or go to the source for some education.
Anonymous (January 26, 2005 @ 12:18am):
"I mentioned that prior to this column, I lived in the news department. I hope that I will not leave behind all my news instincts and that this column will draw heavily on actual reporting. I hope my column will never become condescending or preachy." Cynthia Martens (January 17th, 2005, Badger Herald)
Hmmmm...it only took 8 days for her to lose her news instincts and become condescending and preachy. I wonder how long it will take her to realize writing editorials is probably not the best choice for her.
When did not checking facts become "actual reporting"?
Apparently one pharmacist who makes a mistake gives the entire profession a bad name. I just feel bad for the reporters of the Badger Herald and the Italian majors at the UW. Look at the person who is representing them.
Jonathan (January 26, 2005 @ 3:05am):
Posters Might Be Pharmacy Majors---They Most Certainly Are Not English or Journalism Majors
The recent uproar over this article is amusing to say the least. Here we have pharmacy majors accusing the writer of not understanding the progressively dynamic field of pharmacology. At the same time, it seems many of these posters do not know how to read and analyze the main point of a opinion column. I think it's pretty clear from the start of the article that the author is making a point about access to birth control among young women. Furthermore, the example she used is one in which a pharmacist tried to moralize a prescription. I am not a pharmacist. I have never studied the field. I'm gonna put this one out there though; I don't think many people believe pharmacists should be judging the moral implications in the area of birth control for what prescriptions they fill. Someone posted in length that it was legal for pharmacists to refuse prescriptions. I don't care if its legal or not, it's not right to refuse based on personal issues of morality. Lastly, even though this is an isolated incident, I don't think this is an isolated incident of women being inhibited from going about their daily life. Maybe a sociology major could help all of us out with that one. Jonadude1@aol.com
Anonymous (January 26, 2005 @ 3:45am):
ah, you crazy americans and your drugs.
Anonymous (January 26, 2005 @ 6:20am):
I am very disappointed with this article because the main point is supposed to be that some pharmacists refuse to fill birth control and that this is wrong. Cynthia Martens fails to stay on topic and instead, decides to explain what a pharmacist should or should not do, and she makes terrible assumptions without researching the matter. If one is going to explain the role of a pharmacist, one should make sure she knows what she's talking about! At least this is in the "Opinion & Editorial" section because this is simply bad writing.
Anonymous (January 26, 2005 @ 6:21am):
To respond to the most recent post accusing PharmD majors of not being english or journalism majors - if the point of this article was merely the availability and accessibility of contraception, then there is no reason to make harsh judgements regarding a profession the writer appears to know very little about.
Just to clarify the view of pharmacists on the issue regarding the right to refuse filling particular prescriptions - here is the official statement from the American Pharmacists Association (APhA) regarding the pharmacist's conscience clause:
APhA recognizes the individual pharmacist's right to exercise conscientious refusal and supports the establishment of systems to ensure patient access to legally prescribed therapy without compromising the pharmacist's right of conscientious refusal.
In other words, to echo something Nicole Peterson wrote - while a pharmacist has the right to refuse a prescription, they are also obligated to help the patient find someone who will fill their prescription, so long as it is a legal prescription.
If this was not done by the Menomonie pharmacist, then this type of activity is not condoned by the profession... but that does not mean a pharmacist's sole responsibilities are to fill prescriptions and answer questions. It is much more than that.
However, I wouldn't want to elaborate on all of the positive roles pharmacists play in society in order to advance patient care. It might take away from the "true" point of the opinion article. I'll leave that to english and journalism majors that are far more qualified to assess compositions. It's ok for everyone to assess the expertise of pharmacists, however. We don't mind, honestly.
Anonymous (January 26, 2005 @ 6:30am):
I will make this short and sweet. If nothing else, the article somehow villifies pharmacists making them seem like these big judgemental pill counters. Anyhow, I think most people will see from their personal experiences that pharmacists are almost always very professional, appropriate and not judgemental.
If the point of the article truly was to make an argument for the availability of birth control it could have been done in a more tactful way. Instead of focusing on how one pharmacist screwed up, she could have talked about society making young woman who take birth control feel alientated.
Anonymous (January 26, 2005 @ 7:47am):
To quote Jonathan: "Here we have pharmacy majors accusing the writer of not understanding the progressively dynamic field of pharmacology. At the same time, it seems many of these posters do not know how to read and analyze the main point of a opinion column."
What, pray tell, what supposed to be the main point of the editorial? Pharmacy student outrage and pharmacology aside, the article's logic is so muddled that it's nearly impossible to even find the main point.
In her first paragraph, Ms. Martens states, "I'm reminded of how many obstacles girls still have to trip over to get basic health services." By placing this statement in the first paragraph of the article, it is asserted as the main topic of the piece.
However, in the third paragraph, Ms. Martens states, "A pharmacist's job is to fill prescriptions and answer questions, not to moralize about customer decisions." Is this the focus of her piece?
An opinion article cannot be comprised only of the writer's opinion. It must be supported by facts. The only true facts I could identify in that article were how long NorLevo has been available in France and the statement by Noesen's attorney. The date of the incident between Noesen and Amanda Phiede is never even mentioned.
Even the statement that Noesen "was accused of being unprofessional, and the case went to court" is false. Yes, he was accused of being unprofessional, but Phiede filed her complaint with the Department of Regulation and Licensing, and the case has been taken up by the Pharmacy Examining Board. While I am not a lawyer, I believe I can make a safe assumption that being "unprofessional" is not against the law; rather, it is against the ethics of one's chosen profession.
The entire argument of the article is based on one statement regarding Noesen's spiritual suffering if he dispensed the prescription. No other information was offered. Ms. Martens statement regarding her experiences as a waitress are irrelevant; no comparison exists between a vegetarian serving meat dishes to patrons and a pharmacist serving his patients.
If a "journalist" is trying to pursuade readers to believe her opinion, facts must be used in support. The argument must be organized. This article was disorganized and lacked facts, and the purpose was not achieved.
Oh, and Jonathan: next time you want to assert that pharmacy students are not english majors, you may want to check your own spelling and grammar. Some of it is rather dreadful. I won't stoop to correcting it here.
As for my background, I have an extensive background in journalism, have written for the Milwaukee Journal-Sentinal, and won awards for my writing before I decided to go to pharmacy school. I graduate in May 2006.
Anonymous (January 26, 2005 @ 12:09pm):
Posts have been made by both pharmacy students, and non-pharmacy students. Both have valid points and valid reasonings behind what they believe. However, I lean more toward the side of the pharmacy students on this argument. This article has a valid concept...that pharmacists should not use their own values and morals to influence what prescriptions are filled. On that issue, I fully agree. However, what I think most pharmacy students are getting at here is that the article suggests that pharmacists should never ask personal questions...to which I fully disagree with. Also, it appears that the writer is singling out pharmacists here, and not placing blame on doctors or other providers that refuse to prescribe medications. In fact, I emailed the writer, and she wrote back to me claiming that if doctors refuse to write a prescription for birth control, that at least the girl can go to another doctor. Well, if this is the case, then I think pharmacists should be able to do the same and not dispense a prescription...and just send the girl to another pharmacy. I admit that the incident in menomonee is definitely wrong...but that in no way should imply how other pharmacists may handle the situation. It just appears to me that the author is making a generalization on a specific incident, and applying it to the entire field.
Anonymous (January 26, 2005 @ 1:01pm):
I think all the logical reasons for why pharmacists ask, sometimes personal, questions have been stated by the very educated pharmacists and pharmacy students that have written comments here.
However, I am sad that this is the only place that these comments can be seen. The women on this campus need to be informed about all the good things a pharmacist can do, because they will be influenced by this article into thinking that all pharmacists are going to violate their rights.
The best thing that could happen is for the Badger Herald to print another article (filled with actual facts) about how vital pharmacists are to the health care system.
Please do not let one poorly informed women make all pharmacists seem bad for the actions of one!
Anonymous (January 26, 2005 @ 4:10pm):
This article not only makes pharmacists sound irrational and unimportant, but the writer suggests that medical doctors know more about drugs than pharmacists do! A pharmacist is not the equivalent of a cashier, Cynthia Martens. It's time to start acknowledging the intense schooling a pharmacist goes through and the endless amount of information one can provide.
Anonymous (January 26, 2005 @ 4:22pm):
I agree.
If the issue is access, talk about different methods of getting the medication to the individual.
If the issue is morality, then talk about morality and religion.
If the issue is professional duty, then talk about that.
Anonymous (January 26, 2005 @ 4:23pm):
I agree.
If the issue is access, talk about different methods of getting the medication to the individual.
If the issue is morality, then talk about morality and religion.
If the issue is professional duty, then talk about that.
Anonymous (January 26, 2005 @ 4:24pm):
I agree.
If the issue is access, talk about different methods of getting the medication to the individual.
If the issue is morality, then talk about morality and religion.
If the issue is professional duty, then talk about that.
Anonymous (January 26, 2005 @ 6:36pm):
Plus, the fact that this was an abortofacient is an EXTREMELY large piece of relevent information here. There's an important distinction between emergency contraceptives and traditional ones to many many people, and to deliberately sidestep this is being unkind to readers.
I know this seems a little bit of a tangent, but I'm confused with this article. Is it about emergency contraception? Is it about that one case? Is it about first amendment rights for both people?
Anonymous (January 26, 2005 @ 8:51pm):
Hello I am a male Doctor of Pharmacy student and I do agree with Ms. Martens that pharmacists should not try to impose their religous views on people. It is true that there is a double standard (why is it okay for men to get Viagra, but a woman has to feel attacked). Pharmacists like Mr. Noesen, make it tougher for others in the field who do want to make a difference, and his refusal to dispense oral contraceptives makes us all look bad. Hopefully pharmacy can come up with a way to satisfy ultra conservative pharmacists' (maybe christian pharmacies), while saving the integrity of the majority of pharmacists(both religious and non-religious).
I disagree with Ms. Marten's view on the fact that we should not ask any other information, unless there is a problem. The profession of pharmacy has changed because health care has changed with the many advances in medicinal therapies. Ms. Marten's comments are understandable because we as pharmacist have done a horrible job in educating the general public of what it is that we do (it is not just counting pills). Pharmacists have no access to patient charts and most of the time patients use multiple pharmacies, and see multiple doctors. The only way to ensure that there are no drug-drug or disease-drug interactions is to ask questions, which may seem personal but are necessary to ensure safety, and make sure that they are recieving the most from their treatment.
I personally would love people to view the profession of pharmacy as being an important part of their health care. I hope that the actions of only a handful of pharmacist's does not change the views of those who read this article for the profession as a whole.
Anonymous (January 26, 2005 @ 9:56pm):
While I know that it is your opinion about us women having trouble getting "basic health services," I disagree with what you are talking about. Emergency contraception is not a basic health service. FDA has not approved the "morning after pill" because it is unsafe for use over the counter. It could lead to young women not going and getting their yearly exam, which could lead to increased risk of STDs and other medical problems. Now, I do not always agree with what the FDA does, but in this instance, they are very wise about not putting it on OTC. Also, you are skewing the so-called "role" of a pharmacist. Pharmacists are not there to only fill prescriptions. And they DO need to ask personal questions. Many times doctors will rely on pharmacists to decide what is best for the patient because of the lack of knowledge of the doctor. This means that the pharmacist needs to play a big role in the healthcare of an individual. Also, pharmacists are considered doctors now because of the education they are recieving. They are learning almost as much as "regular doctors" are taught. I know this might suprise some people, but its true. Furthermore, I do not agree with what the one pharmacist did in your example, but I feel that you should give pharmacists more credit. I know that I get upset with some of the big chain stores, but I am sure that there is a new generation of pharmacists heading into work who are going to change that. Give that a chance. And please, try to change your mind about pharmacists. They are there to help.
-jbb
Anonymous (January 26, 2005 @ 10:02pm):
"I don't care if its legal or not, it's not right to refuse based on personal issues of morality."
It's not right to force someone to perform an action that goes against their own beliefs either. A pharmacist is not an ATM machine. There is responsibility on the part of everyone in the pharmacy setting (clerks, technicians, and the pharmacist him/herself) to make sure a patient's prescription is accurate. I know there is a general feeling in the public that the pharmacist is nothing more than a drug dispensing machine, but when there is a technician error and the wrong prescription is given out, or a compounding error occurs during a custom prescription and patients are hurt, then people scream for more regulation and pharmacist supervision.
I am not an english or journalism major, but the way she presented her essay puts forth her opinion on what the role of pharmacist should be, and people commented on that. If a reader sees something he/she found inaccurate in a piece of writing, they should be free to try to comment as they please. Have you ever stopped to think that maybe the main point of their comment was to simply clariy a misperception that they found in the essay?
Anonymous (January 26, 2005 @ 10:17pm):
Also, for the "male doctor of pharmacy student's" post a few above this, please do not assume that because the pharmacist did not fill the script, he was a Christian. There are many other religions out there who do not agree with birth control. I will not list them, but please be aware of that and do not blame everything on "Christians".
- a Christian PharmD student
Anonymous (January 26, 2005 @ 11:24pm):
To Jonathan: We pharmacy students are not "Pharmacy majors." We have to apply and be admitted to pharmacy school just as one is admitted to medical school. We are professionals, "DOCTORS of Pharmacy." Since when is an undergrad majoring in English a "doctor of English?" Not until he/she gets his PhD.
Anonymous (January 27, 2005 @ 12:28am):
Little Cindy-Lou-Who, who's cents are not quite two...FYI a vast number (roughly 50%) of the students in any given Pharm.D. class already have a bachelor's or even master's degree in a variety of areas including English, Foreign Language, History, Chemistry, Biology, Genetics, and many other natural science, social science, and political science fields. (However, I'm quite certain none carry a European studies major less they would be unemployed.) Nonetheless, our doctorate degree is a for year professional degree with a minimum prior undergraduate requirement of two years of which most students complete 3-4 years...again since you're not a math major, this adds up to 6-9yrs. of schooling for most of us...And another FYI, if you refer to Wisconsin State Regulatory law you'll find out that a pharmacist has the right to refuse the dispensing of ANY prescription that they would deem to be in harm to the patient or society (born or unborn)...oh and we have to take 3 exams to become licensed, a CONSULTATION exam, medication related exam, and a LAW exam (not even "Regular Doctors" take a law exam) interesting isn't it...Perhaps you can save some face or waiting for a few extra hours in the pharmacy the next time you want a script filled, but writing a PUBLIC apology (perhaps front page) in an upcoming issue.
Anonymous (January 27, 2005 @ 12:59am):
I have a few problems with this article.
1. This article is jumbled with multiple issues - the legal issues of dispensing emergency contraceptive, the pharmacists role in the health care system and patient counseling. what is the primary point of this article?
2. Pharmacists shouldnt just trust the doctor and not intervene!! Physicians are not perfect and are human and therefore are capable of making mistakes.
3. Pharmacists ask about pills being used for contraception or for acne because if someone is using the pill for acne and they miss a pill it isnt as big of an issue as when someone taking the pill for contraception misses a pill.
4. shouldnt we all be mature enough to talk about these matters? If you arent ok talking to a pharmacist about why you are using bc pills then should you be doing things that require you to use them?
5. ECP isnt safe for everyone.
6. Pharmacists have to question patients about EVERYTHING because patients dont just volunteer up all information needed to make a clinical decision. Patients also dont know that over the counter meds can interact with prescription meds, what those interactions are or what side effects they might experience if combined with other prescription medications.
7. IF YOU WANT TO COMMENT ON WHAT A PHARMACISTS JOB SHOULD BE THEN BECOME A PHARMACIST
Jamie (January 27, 2005 @ 1:01am):
I found this link in a pharmacy student forum on a popular blogging site and was immediately intrigued.
I agree that the pharmacist in question had no business moralizing the prescription at hand. I also agree that the author effectively relayed the main idea of the article, she did so with one VERY untrue statement, which is why the pharmacy students are "in an uproar". "A pharmacist's job is to fill prescriptions and answer questions .. .." This is where she went wrong. Those few words, regardless of context, undermine the entire pharmacy profession. Are you suggesting that when a drug addict comes into the pharmacy month after month, hopping doctors and pharmacies in order to fill more Vicodin and Soma prescriptions, pharmacists should turn a blind eye and give it to the "patient" because the DOCTOR said so? Doctors are not omniscient. And before you whine "it's not the same", no, it's not, but it's still a question of morality that peeks out from unde your blanket statement that a pharmacist shouldn't "question". THAT'S OUR JOB. And oh, here too:
Pharmacists should never second-guess a doctor unless they spot a harmful combination of drugs; the lines between the roles of physicians and pharmacists shouldn't blur.
Of course they have to blur!!! You'd be surprised just how little your doctor knows about medication, and if you don't believe me, ask a doctor and a pharmacist the same questions about a prescrpiton the doctor has decided that you need to put in your body. And I'm not even going to begin, here, to explain what a crucial link a pharmacist represents in everyone's healthcare team, that's an article that deserves it's own forum.
While I understand the point Cynthia was trying to make, a responsible journalist, whether she's writing an editorial or otherwise, will make sure their facts are correct and strong enough to stand alone, not only within the context of their controversy, and these two statements DO NOT come close to being correct, even IN context.
Bottom line:
Write whatever you want, but don't get pissy when someone gets upset when your incorrect statements reflect poorly on something he or she has dedicated his or her life to (eg, the pharmacy profession).
Sincerely,
Jamie Wisneski
Pre-professional VP APhA-ASP, St John's University chapter
Jamcaica, New York
jamie.wisneski03@stjohns.edu
Anonymous (January 27, 2005 @ 1:11am):
The editor of this paper might want to exercise some additional ethical judgement when publishing articles attacking health care professionals. Even though it is an editorial article Ms Martens should have done better research. She could have contacted a pharmacist to ask why they do what they do. This article is very obliously written by an individual uneducated in the ways of the world because these non dispensing pharmacists are isolated incidences. I am tired of people attacking pharmacists. Why isnt she attacking the health insurance providers for not covering ECP dispensed without a prescription by a pharmacist? Why isnt she attacking physicians for not following state legislation to write legible prescriptions - one of the top reasons for medication errors. Why isnt she attacking students for having unprotected sex? Why isnt she attacking the FDA for allowing medications to be available Over the Counter when they interact with prescription medications?
Maybe Ms Martens could busy herself with this instead of attacking professionals.
M Sopalski (January 27, 2005 @ 1:18am):
I just wanted to add something. I am from the "other UW", the University of Washington in Seattle, and am also a Doctor of Pharmacy student.
Everything that could be said, has already been eloquently said by Wisconsin SOP students. I applaud you.
Recently our own school newspaper wrote a 2 part series on "Drugs @ the UW" investigating SSRI and stimulant use in college students. Not one single pharmacist was interviewed.
Let this be a reminder to us, as student pharmacists, that we still have a lot of work to do in the field of policy, and the public's perception of us.
As a former journalist myself (Anchorage Daily News Co Chief, Perfect World 99-00), I am horrified that this "opinion column" got past the Chief Editors chopping block.
Cheers
M Sopalski
Unversity of Washington School of Pharmacy
Anonymous (January 27, 2005 @ 4:28pm):
Cynthia, I want to applaud you for unapologetically stating your opinion. (And not anonymously...)
I am a 4th-year Pharm.D. student at the UW, and I appreciate the attention that you have brought to an important subject. To me, a health care provider's refusal to provide care based on morality and the pending topic of non-prescription emergency contraception both speak to the crucial issue of access to health care in this country. I hope that you (& your readers, as polarized as they seem to be) continue to work toward removing barriers to health care. (Interpret that as you will.) :-)
On a personal note, I just want to clarify the attitudes of the majority of pharmacists I know on the topic of dispensing sensitive medications. It's difficult for me to even put into words how much I value the trust of my patients. I can only imagine how betrayed I would feel if, in my most vulnerable moment, I felt judged and harrassed by someone I trusted, and it would be a cold day before I put a patient in that position. 99 out of 100 pharmacists that you (or your readers) approach with your most embarrassing or uncomfortable needs will respond to you professionally and give you the expert advice that we so pride ourselves on. Most of us find more satisfaction with our roles as patient advocates than with any other function of our jobs, and if you come to us in your darkest hour, we will do whatever we can to help you.
I personally believe that a healthcare provider is obligated to provide whatever care is safe and legal--and that's my standard every time I fill a prescription. I believe in "legislating from the pharmacy" just about as much as I believe in "legislating from the bench." And I believe in First Amendment rights. But pharmacists (like all other HCPs) should hold themselves to a different (not higher) standard. Patient care comes first, and politics, religion, and morality come second. Whether we like it or not, most of us know exactly when we're crossing those lines. And if we choose to ignore them--well, what goes around, comes around, and the day will undoubtedly come when we are on the receiving end of someone else's judgment.
For my patients, the day will never come when I refuse to provide them care based on "moral grounds."
Thanks for taking the time to read this, and keep fighting for what you believe in!
Lindsey Wilhelm
lawilhelm@wisc.edu
Anonymous (January 27, 2005 @ 4:35pm):
A point of clarification: postcoital ("emergency") contraception is not, in fact, abortifacient: Plan B and others like it will not displace an implanted embryo. Feel free to look it up.
Anonymous (January 27, 2005 @ 7:13pm):
What the pharmacist did was care for the fact that there is a potential embryo involved and he CHOSE not to get involved in something that FOR THIS PATIENT did not treat ANY disease or health condition...
What the author of this article did is berate something she clearly didn't understand.
Emergency contraception AND birth control are abortifacients.....they kill an embryo. The definition posted above that says they're not because they don't displace an implanted embryo was a NEW definition created in 1970 to try confuse the issue. Look at any medical or pharmacy textbook prior to then and find out, (and the current Stedman's Medical Text too). Even current literature admits the action of these agents in not allowing current embryos to implant (they're alive for 7 days by the way prior to implantation...just look at any medical textbook on how to predict a pregnancy due date and it's based on date of conception (meaning pregnancy had to have started before implantation)!).
-a pharmacist
Neil Noesen (January 27, 2005 @ 9:42pm):
I understand the author's point-of-view. In all religious freedom cases the courts need to decide if the right of religious freedom is somehow causing harm to individuals or society.
The questions remain:
- what is "health care"?
- what is "harm"?
neil noesen
pharmacist
Neil Noesen, pharmD(cand) U of MN (January 27, 2005 @ 10:19pm):
hi. I was just wondering if there are any 1st or 2nd year pharmD students out there reading this who are interested in a one or two week summer institute scholarship (all expenses paid including tuition, travel, lodging, food):
(1) the "theology of the body" with Christopher West July 10th-15th, 2005, Quarryville, PA (50 miles west of Phily) - earn two credits available through Creighton University (may or may not be transferable to the UW)
(2) NaProTechnology certification program with
Dr. Thomas Hilger's (M.D) medical applications of fertility awareness (Omaha, Nebraska)
***PLEASE contact me at noesen@gmail.com***
Yours in solidarity for pharmaceutical care,
Neil Noesen, pharmD(cand.) U of Minnesota
noesen@gmail.com
Anonymous (January 27, 2005 @ 11:13pm):
Surely you agree that this is not the forum to debate the definition of life. Quoting textbooks and dictionaries in a few lines in response to a college newspaper opinion is a painfully simplistic treatment of the subject, don't you think? And what pharmacist would expect others to accept medical information from an anonymous source?
Anonymous (January 28, 2005 @ 1:09am):
I just have to say to all of you "pharmacy students" that while you are making a HUGE case out of how this article should not insult your profession, in each of your comments posted, you have all taken stabs at the physicians part in the medical system. If you were to ask me, you all are contradicting yourselves, which makes this all worse because that seems to be what had you "in an uproar" to begin with. And, doctors do not go to school for eight years and have to go through residencies, fellowships, etc. for no reason. Doctor's are more than qualified to write out prescriptions, or else they would not be given the power to do so. They take countless biology, chemistry, and anatomy and physiology classes on top of the pharmacology classes, as well as all of the other classes that they are required to take tht are pertinent to the field because they have to understand how the body works and what the drugs they prescibe will do to help the patient, as well as HARM the patient. Doctor's do make mistakes, but so do pharmacists, nurses, techs, and the list goes on. Anyone that is human makes mistakes. That would be why anyone in the medical field carries MALPRACTICE INSURANCE! Hell, even students are required to carry insurance.
Also, no one is denying that pharmacists play a role in the medical field. And no one is trivializing that role. However, you seem to be doing just that to the role of the physician in all of your comments. Well, I'd like to see you walk into your doctor's office and tell him that you think he doesn't know much about the drugs he's prescibing and he'll think that you must be the incompetent one in that room. Funny how you put physicians down in all of your comments, but the next time you're sick, run to the pharmacist and tell him all about it. Funny, he'll tell you he can't do anything about it UNTIL YOU SEE YOUR PHYSICIAN. And if you're really, really sick, maybe you'll think twice when the drug that your phycisian prescibes is helping you to feel better.
The main point of this girl's artical was to say that a girl should not be given the third degree or refused birth control because of a pharmacist's moral or religious views on the topic. Think about it...if the doctor had refused to write the script than the article would have been about the doctor. She wasn't purposefully trying to insult your profession. She was simply pointing out that the act of this particular pharmacist was wrong. It appears to me that she was simply standing up for the right that a woman has to obtain and take birth control.
Anonymous (January 28, 2005 @ 8:30am):
M.D.'s are more qualified to DIAGNOSIS conditions, but I would not necessarily say more qualified to write out prescription medications for that diagnosis...And yes, we pharmacists have malpractice insurance as well to cover our mistakes AND yours...We also do residencies, and in some cases fellowships.
Anonymous (January 28, 2005 @ 7:09pm):
You wrote:
"We're talking about birth control here. There is no mainstream group I can think of that is strongly against birth control. Abortion? Of course. Birth control? No."
-Have you not heard of Catholicism?
Anonymous (January 30, 2005 @ 10:29am):
Re: Jonathan
First of all, this "writer" can write whatever she sees fit (Lord knows I did)... but please do so in a respectful manner. Downing a profession (and making ridiculous comments on its current state -- "A pharmacist's job is to fill prescriptions and answer questions" -- is not only unprofessional as a journalist (which term I use lightly in this case), but also is disrespectful to Pharmacy.
For your information, this "writer" (though writers will generally research their topic before throwing ridiculous comments) leads the story with this:
"As the Food and Drug Administration wavers over whether to make emergency contraception available over the counter (the way it is in that ungodly country, France) I'm reminded of how many obstacles girls still have to trip over to get basic health services.
Not so long ago a pharmacist in Menomonie, WI, Neil Noesen, refused to fill a student's prescription for birth control pills because he said he would suffer spiritually. He was accused of being unprofessional, and the case went to court."
The lead to the entire article is how a pharmacist "infringes" on basic health serivces to "girls" (which is hilarious that the "writer" says girls and not women in an article about young women's hardships, LOL).
-- I think the posters (All these wonderful PharmD Candidates) hit the main point on the nose, and the writer should have reconsidered her slander against this trusted profession.
P.S. Are you sure you are an English major? - "a opinion column."
And by the way, "I am not a pharmacist. I have never studied the field. I'm gonna put this one out there though" <--- you do realize what happens when the uninformed "put things out there"... some people can be so dense.
Former Columnist
Current Doctor of Pharmacy
Teacher to the Uninformed
Anonymous (January 30, 2005 @ 2:13pm):
This author should apply for a job with CBS news.
Anonymous (January 30, 2005 @ 6:45pm):
ETA: just wanted to clarify that my above comment was not meant to represent my school's chapter APhA-ASP or APhA as an organization, it was simply my own opinion. My apologies.
Anonymous (January 30, 2005 @ 7:02pm):
-->>>> Jamie Wisneski
PharmD student
Anonymous (January 30, 2005 @ 10:19pm):
I believe all the arguments have been made fairly well. So, instead of repeating what others have already said in this feedback string, I present to you some excerpts from this author's previous column on January 17:
"Discussions grow much more lively when you can't label the issues; you are then forced to consider them more carefully, without lapsing into emotional knee-jerk reactions."
"This column will not engage in bashing France."
"I hope that I will not leave behind all my news instincts and that this column will draw heavily on actual reporting. I hope my column will never become condescending or preachy."
"I'd like to take student topics that may be familiar in many ways and give them a fresh spin by doing a little research, making some phone calls, asking hard questions and challenging conventional thinking."
How quickly things can change.
-yet another PharmD student
Anonymous (January 31, 2005 @ 8:45pm):
FYI:
In the UK, since 1995 the occurance of Syphilis has risen OVER 1000%. Researchers were shocked. They looked into it and found out that in 1991 the "morning after pill" became OTC. This led to people no longer practicing "safe sex" and the rise in STDs.
intresting...
Anonymous (February 4, 2005 @ 6:34pm):
Jerry Seinfeld on pharmacy:
"Look out, everybody, gimme some room. I'm going to take them from this big bottle and I'm putting them in this little bottle...putting pills in a bottle with a white jacket on, I don't know why you need a diploma for that."
Anonymous (February 11, 2005 @ 9:34pm):
I am a pharmacist and I cannot believe why this is such a big issue. Well actually I can. My 2 cents on the issue as a retail pharmacist is the woman was mad about being inconvenienced. It seems every day we are being subjected to fill prescriptions faster, manage insurance more, and turn the pharmacy more into McDonalds every day. Please join the line of 5 people staring at me, because their 5 to 10 minutes is more important than me filling the prescription right. People act as if their 1 or 2 prescriptions are all we have to do. When we really have to be worried about 2-300+ every day. If the pharmacist has an objection (religious or otherwise) to filling a prescription, they shouldn't have to do it. If people don't like it they can go somewhere else. Big deal. Should a woman have a right to demand that her doctor perform an abortion just because he/she is a doctor??? NO. I understand customers are the livelihood to ANY business, but the volume and crap we are being forced to put up with is getting ridiculous.
Anonymous (February 20, 2005 @ 2:51am):
It is simple, please be informed what you are writing about prior to writing. Obviously, you are ignorent of the profession of pharmacy. I am a pharmacist with my Doctorate from Ohio Northern University. Medical Doctors get 7 months of "general" pharmacology versus pharmacist get 4 plus YEARS in depth-I know this because a few of my best friends are MDs- I agree that the pharmacist that you are writing about was unprofessional in approach, however, as a pharmacist I have the responsibility to ensure that the medications my patients receive are safe and appropriately prescribed. The messages other pharmacist/ pharmacy student have posted say it clearly- no more needs to be said. However,before you tell my what my rights are in treating patients, you go to pharmacy school, get your doctorate, and then we'll talk. Until then, do not seek attention in topics which you have no grasp. I take great pride in my profession. While I personally do not have an ethical issue with dispensing birth control, it is a decision for the pharmacist to make, not a student studying journalism. I understand it is your assignment to write, and while "ethical issues" gets the attention of the public, if you are ignorent on the topic, reader will recognize that and will lose respect of you as a journalist- it's simple get your facts straight!
Anonymous (February 20, 2005 @ 4:14am):
To the person who said we are attacking MDs- that is NOT the truth. You, like the writer, are ignorent or unable to read. What we said, is that the expertise of the MD is to diagnose, the pharmacist to treat. So here is a little lesson for you...If a patient comes to me for assessment of a medical problem, that patient is referred to a MD, because MDs DIAGNOSE.
To all the people who are saying "this article is not an insult on your profession but on this particular pharmacist"...you too must be ignorent, because, she did not focus on the unprofessionalism of that pharmacist, she focused on whether a pharmacist has the right to decide to dispense a particular medication. WE HAVE THAT RIGHT.
To the people who say, we are in uproar, you are damn straight we are, why because we are sick and tired of people with NO MEDICAL EXPERTISE telling us how to care for our patients!!
There is a reason why certain medications are OTCs and certain ones are prescription. There are risks involved with the drug of this article, such as stroke, heart attacks
I have asked female and male patients personal questions. FYI for the writer that is called pharmacist: patient interaction.
So since you are all so smart, answer this, a young female brings a new script for birth control to the pharmacy. I, as her pharmacist, talk to her and realize that she is a smoker and I refuse to dispense that medication. Did I judge her because she smokes? No, multiple clinical trials have proven that women who smoke and take birth control are at HIGH RISK for clotting (which can cause heart attacks, strokes, etc). I as the pharmacist am able to make that assessment.
Here is another scenario. A female patient comes to the pharmacy with a script for Accutane (a medication commonly used for acne). When I talk to her, I ask her if she is on birth control. Am I being judgmental or inappropriate? You may think what does an acne medication have anything to do with if she is sexually active and using contraception. Accutane like many medications are not safe in pregnancy. It is recommended that women on this medication are on birth control (as long medically safe for that patient) because the effects on the fetus are so harmful. I am asking her this question because I would not want her to get pregnant, have an unhealth baby or even more so a miscarriage.
I have refused to fill scripts for men with heart conditions who asked their doctor for Viagra and the doctor refused. The patient went to another doctor, did not tell him of his heart condition, that required him to be on Imdur (a vasodilator), got a script from the doctor, brought it to the pharmacy to be filled. I refused to fill it and explained to him that Imdur taken with Viagra can drop his blood pressure EXTREMELY low and can cause DEATH. He didn't understand, He said "My doctor wrote that script, you have to fill it".
ABSOLUTELY NOT!! Pharmacists are 50% liable for that patients health. And trust me, I didn't refuse because of a potential law suit. I did not fill it because he is my patient and I care about his well-being.
I know these are examples in which the patient was at risk for harm and as a young female (26 years old), I am completely for women having rights, but what you need to understand is that when a doctor, or pharmacist is giving care, we do what's best for the patient.
The reason why a sales clerk does not have the right to refuse a woman a sexy bra is because that woman is NOT HER PATIENT. She is not treating her. The same goes for a person selling alcohol.
So although this writer may be well intentioned, she did insult pharmacists. My intensive years of study and training does not equate to retail job in the sense of selling a product. The sales clerk is selling a product, is not liable for the customers health, is not the customers health care provider.
I personally support that birth control is a persons right (if it is prescribed safely), however, the fact of the matter is that to dispense any medication is MY DECISION as a pharmacist. The same as the prescibe any medication is the MD's DECISION. And for those of you who think, well the MD's decision is only based on medical evidence, think again! Physicians have the right not to prescribe birth control the same as pharmacist have the right not to fill a script for birth control.
Again, quit being dramatic. There are plenty of pharmacies. And although I disagree with denying a woman birth control because of moral belief, I will not fill a script for a drug that induces abortion. yes that is a moral issue for me. the fact that i'm not filling it isn't because i am judging her, as the law permits, she has the right to decide to have an abortion, but as the law permits, i have the right to not fill a script as a pharmacist.
So despite what the writer thinks, or anyone else thinks, pharmacists, doctors, etc are highly trained professionals and DESERVE to be treated with respect and appreciation for the medical decisions they make to ensure your health.
As far as the pharmacist of topic, yes that is unprofessional. it should have been dealt with in a different manner. shame on him. however, the shame is the approach, not the decision. (even though like i said i do not have MORAL issues with birth control, he did- IT WAS HIS DECISION NOT TO DISPENSE.
Anonymous (February 20, 2005 @ 4:25am):
You are ignorent of pharmacy for posting this. Jerry Seinfeld ignorent for saying it. FYI a pharmacy tech puts pills in the bottle. they do not go to school. if it so happens that you are written a script with an incorrect dose, or a drug interaction, or a disease state interaction, etc etc. not only are you ignorent you must be stupid also
Jerry Seinfeld on pharmacy:
"Look out, everybody, gimme some room. I'm going to take them from this big bottle and I'm putting them in this little bottle...putting pills in a bottle with a white jacket on, I don't know why you need a diploma for that."
Anonymous (March 29, 2005 @ 8:25pm):
I think Cynthia Martens hit the nail perfectly on the head. It really is not the pharmacists' job to second guess what doctors say. What is written on the prescription, you give. Now a drug addict is obviously not going to, month after month, get a prescription from a doctor so that he can satisfy his habits. But if he does, the pharmacist has no option but to give him what he wants. How does he know if he is an addict or not? It could be that the person looks like an addict but needs the pills he wants for some reason. And don't tell me pharmacists know more than doctors, please. I don't want to malign a profession, but the two are just not the same. The amount of training and dedication that goes into studying medicine is vastly more than that in pharmacy. You might know a few doctors that appear sloppy, but you can't use that to generalize.
But its the question of morality that I most agree with with Cynthia Martens. Who the hell is this guy Noesen to dispense it?This is not even the case of a supposed drug addict, this is one of pure religious or moral fervor getting in the way of professional conduct. The woman in question, the college girl, has a right to getting the prescription drugs she wants, and the pharmacist has to do it. He may not agree with her conduct, but he has to do it.
Or else, find himself another job, for which his zeal might be better suited. Why not become a priest and moralize about contraceptive drugs if you feel so strongly about it? But to use those views to justify professional misconduct should not be tolerated. His behavior, as was pointed out, was not about free 'speech'. It was free 'action' that resulted in someone being denied what she wanted, but which she had a right to get.
Jack
Anonymous (January 18, 2006 @ 4:55pm):
I'm a third year pharmacy student and found your article to be hilarious. Frankly, it is my opinion that reporters should do a little research before making ridiculous comments about things they obviously know nothing about. The pharmacist is a very important member of the health care team, and is long past the days of merely dispensing. Most med schools have a little over one semester of pharmacology. Pharmacists spend four years of higher education concentrating on pharmacotherapy, greatly decreasing the amount and degree of drug related morbidity and mortality in this country. So next time you're assigned to write an article, maybe stick to something about the mall, or the latest Tom Cruise movie.
