Sunday, April 03, 2011

The Wanton Debauchery of a Nampa Pharmacist and the Idaho Pharmacy Act

A nurse in Idaho calls in a prescription at the local Walgreens pharmacy for Methergine, an uterotonic drug commonly used in obstetrics and gynecology to prevent/control uterine bleeding.

The pharmacist allegedly asked if the medication was to be used in post-abortion care, which the nurse practitioner refused to answer citing patient confidentiality requirements. The pharmacist said the prescription would not be filled unless the question was answered. When the nurse asked to be referred to another pharmacy, the pharmacist hung up....

A complaint is made against the pharmacist, the Idaho Board of Pharmacy investigates and takes no action because:

1) You say a duty to fill Rx, I say a gentle, whispered suggestion

Turns out the privilege of being granted a state monopoly on dispensing/selling drugs does not come with a responsibility to actually, you know, fill prescriptions.

Seriously, I'm not kidding. According to the Board, the Idaho Pharmacy Act does not require a pharmacist to fill a prescription.

2) HIPAA violation, SHMIPAA violation

According to the Board of Pharmacy’s response, Planned Parenthood alleged the pharmacist’s inquiry violated privacy provisions of the federal Health Insurance Portability and Accountability Act, which the board is not entitled to enforce. Under the Idaho Pharmacy Act, releasing such information would be a violation, but requesting it is not, the response states.

No word yet from the Idaho Board of Pharmacy on whether imposing arbitrary conditions, like forcing the patient to bark like a seal, or the need for the pharmacist's blessing on matters unrelated to a drug's indication, as a prerequisite to filling out a prescription is, in fact, considered professional conduct in Idaho.

3) No organ failure and the patient is still alive, so what's the problem?

[Idaho Board of Pharmacy Executive Director Mark Johnston] stated that the argument that the patient's health could have been jeopardized by the refusal of the pharmacist was inaccurate. Johnston said, "The board's investigation confirmed that the patient received treatment elsewhere and therefore no 'grave danger' was realized." The investigation is closed "without any further action," he said.

Ah, yes, that most scientific, professional, and beloved pharmacy standard of all times, the "SSS Grave Danger", the one that applies exclusively to prescriptions for female patients of reproductive age.

In case you've been fortunate enough not to be subjected to this standard yet, best to become familiar with it. When your ability to fill prescriptions depends on the mercy and sunny disposition of your local pharmacist you never know when your time is up. So here are the "SSS Grave Danger" pharmacy standard basics.

The pharmacist can jeopardize your medical care by refusing to fill your prescription because your performance on the jumping through hoops requirement s/he imposed on you as a condition for filling the prescription was not satisfactory. That is all good, legal, and professional.

On top of that, the pharmacist has no duty to assist you in rectifying the health problem s/he created for you in the first place.

As long as you Somehow manage to get the medicine, from Someone, Somewhere, at some time before you become incapacitated and/or die, the pharmacist need not bother with a referral to a competent pharmacist.

Of course, in all fairness, a referral to a competent pharmacist in Idaho might be problematic.

Between the reckless disregard for professional standards enshrined in the Idaho Pharmacy Act and the impotence of Executive Director Mark Johnston and the Idaho Board of Pharmacy to do anything about it, it's unclear if there are any competent pharmacists left in Idaho.

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