Prostate anyone????

[admin]

Originally Posted by Jill

And my point is....ITS SHOCKING !!

You are all quite correct of course, and ymdawd is right in saying this happens far too often.

A receptionist is only really "qualified" to deal with admin things - appointments etc, so I have over my years as a pharmacist wondered how they have gained so much power. The excellent response from pharout to johnep's question regarding the pharmacology of alpha blockers would obviously go completely over their heads.

I used to think the GP's actually approved of this type of thing, or possibly just turned a "blind eye" to it. A conversation with a very angry GP (not aimed at me) changed my opinion slightly. He was livid when I asked him who was giving his staff the powers to carry out tasks way beyond their skill set. His reply was "I don't know, but I will damm well find out".

I guess it's possible the odd GP does not know what some of the staff are actually doing in their name. It could possibly be compared to shop staff in the pharmacy selling P meds when you have nipped out for 10 minutes to buy yourself some lunch, even though they know they shouldn't do it. Fortunately this has never happened to me (that I know of) but it can happen to some locums when support staff knowingly disregard the pharmacists (not to mention the law) orders.

Thanks to everyone who responded.

[pharout]

Originally Posted by admin

You are all quite correct of course, and ymdawd is right in saying this happens far too often.

A receptionist is only really "qualified" to deal with admin things - appointments etc, so I have over my years as a pharmacist wondered how they have gained so much power. The excellent response from pharout to johnep's question regarding the pharmacology of alpha blockers would obviously go completely over their heads.

I used to think the GP's actually approved of this type of thing, or possibly just turned a "blind eye" to it. A conversation with a very angry GP (not aimed at me) changed my opinion slightly. He was livid when I asked him who was giving his staff the powers to carry out tasks way beyond their skill set. His reply was "I don't know, but I will damm well find out".

I guess it's possible the odd GP does not know what some of the staff are actually doing in their name. It could possibly be compared to shop staff in the pharmacy selling P meds when you have nipped out for 10 minutes to buy yourself some lunch, even though they know they shouldn't do it. Fortunately this has never happened to me (that I know of) but it can happen to some locums when support staff knowingly disregard the pharmacists (not to mention the law) orders.

Thanks to everyone who responded.

I ponder some of these things on a daily basis. I am in a bit of a different situation as I actually work with internists and family practice physicians (GPs in the UK). I see the day-to-day clinic activity. I can personally tell you that prescriptions at our organization are generated and signed by the physicians 80% of the time without looking at the prescription or patient. Our pharmacy technicians are telling patients things they have no business saying. Accountability is declining, in part due to technology! The other issue with physicians is their workload. Our docs each see about 20-25 patients per day and have 20 minutes to see a patient, chart the encounter, remember the formulary and everything we (as clinical pharmacy) tells them. It's honestly too much, so sometimes one can understand why things that shouldn't happen, happen. Docs here delegate authority to their "staff" which include registered nurses, licensed practical nurses and medical assistants. Sometimes the medical assistants tell patients things they shouldn't, however, it goes unchecked due to workload. It's only going to get worse as clinics (surgeries) get busier and busier and information technology makes decision making easier and easier. For example in my system, if a patient requests a prescription that has expired, the pharmacy generates a refill request which subsequently gets sent to the physician to refill via the computerized system we have. He/She then delegates the request to his staff to simply refill without looking at the drug, clincial situation or patient situation. It's great for improving workflow, however, it's catastrophic in terms of potential medico-legal risk. Sorry for the long rant, just trying to explain how things work here. In conclusion to admins response, I think the GPs for the most part, intend to do the right thing. However, there are many things that occur based on systems that they are unaware of, yet ultimately responsible.

[the old merlin]

The situation, Pharout, is very similar here, except that 20 minutes for a GP consultation would be regarded as long. Normally it's half that.

Many surgeries have notices warning patients that it's one problem per consultation; if you have two problems you need to book a second consultation (which may or may not be at the same surgery session)

What is supposed to happen if both are urgent I don't know!

However, to some extent twas ever thus! Repeat Rx were often rubbish in my community days 20 years ago. And in my hospital days I often signed 30 or 40 drug purchase orders at a time, and I'm sure anything could have slipped through sometimes.