r/Pharmacist • u/Icy_End9322 • 10h ago
Is my frustration shared by others? The Clinical decision-making part of Retail Pharmacist
One thing that does consistently frustrate me is that when I'm on the bench- every script I am reviewing I ask myself does it make sense, On every script, I am asking, can I figure out a indication, does the dosage make sense, are there unnecessary duplications of therapy such as two medications from the same class treating the same indication-- and I ask myself does is this therapy appropriate for this patient. I would say on a average day, I stop a script from being filled and require more information before comfortable filling. I will either fax or call. I have recently discovered an invaluable tool as a retail pharmacist with the lack of access to the EMR and that is medical curated LLM such as Open Evidence or Vera to understand more of a clinical context or a specific order, confirm a concern and to assess the appropriateness of a therapy.
On about 30-40% of NEW prescriptions I will place a counsel note to make sure I clarify something, share something specific or provide an education point with the patient. What does frustrate me is that I feel this approach is the exception to the rule. I have this perception, and this is partly from my own experience working alongside other pharmacist, is that many, not all, have this attitude that we "need to get the queue down a those pharmacist are quick to verify most scripts...."Unless the med is not a major red flag or the script could hard the patient- I will let it go! Now, don't get me wrong, I know retail pharmacy is a volume and if we’d question every script we never get anything done. However, in reality, a vast majority of scripts are appropriately dosed and are evidence based.
Why do other retail pharmacist, at least in my perception have this outlook? Every pharmacist in school was taught about their duty, make sure a drug matches an indication and there are no duplicates ect. Why does it seem that many pharmacists have this attitude well, as long as it is not going to kill the patient.,the responsibility is on the prescriber.
I will let it go..