THE BATTLE BETWEEN PHARMACISTS AND DOCTORS – PART 1
If you’re a pharmacist and you’ve had to work in close relation with a doctor, then I’m sure you can describe the experience in one word. I love doctors, I’m a huge fan of doctors. I respect them as professionals, but sadly some doctors don’t respect pharmacists as professionals (emphasis on some).
When I was doing my internship at a military hospital in Accra, I was excited. Imagine me fresh out of school, brimming with knowledge and waiting for the opportunity to show how much I knew. The interns were in charge of examining prescriptions and dispensing. One beautiful Tuesday I was given a prescription, as soon as I saw the prescription I knew my moment to be a hero and save someone had arrived. The prescription was Hydrochlorothiazide 25mg daily, metformin 500mg bd, and diclofenac 100mg bd. I was so excited, I had caught a prescription error. I felt “wow, this is what I have been trained for, my knowledge and learning will save the day”. I took the prescription to our supervising pharmacist. She looked at it and said, “Oh, okay… em… Change it to what it’s supposed to be”. I was surprised, I said “Pharm, I think we need to contact the doctor who wrote the prescription”, after all we were working in a hospital, and we could call the doctor or just walk to his office. She looked at me and said, “Okay, if you want to tell him, go ahead”. I didn’t expect that, I thought she was going to tell him herself. Regardless, I went to the doctor’s office. When I saw him I politely pointed out the error I had discovered. He looked at me and said, “I know what I wrote, that’s what I intended”. “But Doctor, thiazides are contra-indicated for diabetics, and the diclofenac is higher than the recommended daily dose, and also I don’t think it’s the best choice for a patient in her condition”. At this point he looked at me like I had insulted him. He told me that I should not question his prescription. I headed back to the dispensary thinking to myself, “maybe there are exceptions or special cases when this is allowed”, I just wished it could be explained to me, after all I was there to learn. When I got back to the pharmacy, our supervisor asked me how it went, and I told her. She told me not to worry, that she knows that doctor, his prescriptions are usually filled with errors and he is not easy to correct, so they usually just make the adjustments. In my mind I was thinking, “this is not right, what if there is a justification for this prescription” but at the same time should we blindly dispense what we have been given. Either way, the patient suffers it in the end.
The health care practice needs to be more integrated, there should be collaboration for the patient’s sake. We all make mistakes and we can learn from each other. I have always felt tension between pharmacists and doctors, even during ward rounds, most pharmacists just hover in the back like shadows, and we are the drug experts. We should be consulting on all things medication. We need to raise our standards, learn more, so we can contribute more. A lot of pharmacists just turn into dispensers who have refused to increase their knowledge, add value to themselves and improve their professionalism. So, when they are called upon they cannot contribute update information that can benefit their patients.
Pharmacists and doctors need to learn to put the ego aside and work together for the benefit of the patient.
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