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Letters to the Editor
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Fitness to practise
Unreasonable expectations
From Mr P. F. Murphy, MRPharmS
I now find myself writing to this column a second time — different
topic but the same theme; the impossible situation community pharmacists
are in. My first letter (PJ, 25 February, p230) concerned monitored dosage
systems. With these we are liable to be sued for placing medicines within
a compliance aid against the manufacturer’s advice, the flip side
being that we might be sued for not providing support to the disabled;
we are also without any useful guidance to help us determine who is actually
disabled.
Now it appears that we are to be sued for dispensing a prescription comfortably
within the usual dosage range on the basis we need to ensure “the
prescribed medicine is suitable for the patient” (PJ, 18 November,
p595). My interpretation of assessing suitability covers ensuring that
amoxicillin capsules are not prescribed to an 18-month-old and such like.
Anyone who spends any length of time at the dispensary bench would surely
agree that our liability has to end at pharmaceutically assessing each
prescription to ensure it is within the usual dose range, free from significant
interactions and presented in a form that is appropriate to the patients’ circumstances.
These pharmacists will also agree at the absurdity of communicating with
the GP every time there is a dose change in order to establish intention.
Pharmacists often make valuable interventions of this sort but it is
a giant leap to suggest that this is the “achievable norm”.
To reach this standard of care would require a massive investment in
terms of pharmacy’s access to personal medical information and
the time to be able to scrutinise routinely each prescription to the
required level. The question I would like answered is was the view of
the Royal Pharmaceutical Society sought by the judge in reaching this
decision? Either the Society (or its point of view) was ignored, which
should surely be investigated, or the Society was in agreement with this
ruling. Should this be the case, I feel it would be significantly out
of kilter with the views of its membership.
The claimant is obviously an intelligent and motivated individual with
a head for figures. Surely some of the responsibility must rest with
the patient for not realising the significance of one tablet being suddenly
replaced by two? No wonder I get leaflets about stress with the PJ.
Paul Murphy
Wallasey,
Wirral
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The
Pharmaceutical Journal