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Wednesday, May 7, 2008


I was counseling an elderly lady on the phone. My boss was standing next to me working on the computer. He heard "We did not all go to the same school at the same time so our training may be a little different." He is cracking up and I have to bite my tongue not to laugh.

What he didn't hear of the conversation was what a different pharmacist had answered to the same question I just answered and she wanted to know why the two were different. So you don't have to ask in "comments" she wanted to suck on a piece of candy to help with irritation in her throat because she took an 8 ounce glass of water with a heaping teaspoonful of metamucil in it the night before and her throat is kind of dry and rough this morning. Then she wanted to know if drinking water would be better or if she should call her doctor because of the irritation. I told her to either try both or whichever she was more comfortable with but she didn't necessarily need to call the doctor unless the throat irritation got worse throughout the day or she had a fever with it which could be something other than metamucil irritation. She thought maybe she had taken too much metamucil and overdosed. I told her it is not absorbed by the body so it is not a problem for the little over the teaspoonful that she used. It does have several warnings about choking on the package.

The reality of modern medicine is similar to that of technology. The advances are coming faster and cheaper as time goes on. It can be baffling to keep up with it all. I don't think any one person could possibly process and effectively use ALL of the information available and becoming available at any given time. The best we can do in pharmacy is keep up with the latest on newly documented bad problems with medications, everything we had been taught previously, and keep up with new treatment protocols and monitoring parameters for better patient outcomes. I would say we need to keep up with new drugs coming out but since most of them have been slight modifications of existing drugs with the same side effects, efficacy, safety, etc. there really isn't any "new drug" info to learn.

I always encourage patients to get second and even third or fourth opinions if it is something serious. Hospitals have teams and divisions that treat specific problems. There are even divisions within teams like an infectious disease team having another team that exclusively treats immunocompromised patients. This is necessary because there is a lot to process and a life in the balance. At the end of the day we want every patient to get better and eventually go home OK.

I like to complain that the continuing education system in place is not sufficient to supplement our knowledge necessary to give patients the best possible care. Some institutions and chains sponsor their own education programs. Many professional medical groups have yearly meetings that include a variety of continuing education lectures. Is it enough? I am not sure it is. No great all-encompassing solution easily presents itself so keep up with what you can and save some lives.


Anonymous said...

Love to hear comments from the blog-readers about the system for CE in UK (continual updating on particular topics)

Phathead said...

I think we're not too far away from pharmacists becoming specialists in certain areas (whether its beta blockers or general diseases or whatever). Seems to me that would be the best course of action in the long run.

Un-PC RPh said...

phathead, I think you're right. I work for a specialty pharmacy who's focus is PAH (Pulmonary Hypertension). Some of the drugs on the horizon are so specialized and require so much specific knowledge and clinical monitoring that there is no way a retail drug store pharmacy could manage the therapies.

Phathead said...

Right, just look at the bio-drugs that are on the horizon which are way more complex than current drugs. Those are the future right there, and RPhs will have to become specialized. But then again, what do I know, i'm young lol