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Comment Re: DEA declares running illegal (Score 1) 112

Thanks. I'll have a read through the papers this weekend. I'm a bit bummed that some of it's from the 70's and 80's. Doesn't mean that it's invalid, just means that there might be new information because our understanding of genetics and brain pathways has come a LONG way since then. Anyway, it's a starting point and I appreciate it.

Comment Re:The problem is economics and liability (Score 1) 152

Some states allow doctors to give you medication directly (besides those little sample bottles). Those are called dispensing practitioners and they often need another special certification on their license.
Can a robot do the job of a pharmacist? No more than they can do the job of a doctor. Ever try one of those online diagnosis things? Exactly. It's not just about facts and observations. It's about clinical insight and experience, too. There exist today programs that attempt to stop the errors and they're OK at best. Usually what ends up happening is that the prescribers get alert fatigue and turn off the notices for all but the most egregious of errors. I mean, seriously, JNC guidelines might say that anyone with stage II hypertension gets 2 drugs automatically. Doctor prescribes those drugs. System pops up error about therapeutic duplication. Can you imagine how annoying that would be to click past 20, 30, 40 times a day? A pharmacist knows exactly what's going on and just moves on with checking the rest of the prescriptions.
Plus, sometimes the doctor does seemingly stupid things on purpose. I've seen (multiple times, I might add) vaginal cream prescribed for a male...with nosebleeds. The doctor figured it might help hydrate the nasal mucosa. Did it work? I don' t know. Would a machine have ever let that through? Probably not.
That being said, a pharmacist does a lot more than just make sure you're doctor's not asleep at the wheel. They also take on clinical functions. In the VA system, they have the authority to change therapeutic choices after the patient has been diagnosed by the doctor. Think about it. Pharmacists spend as much time learning about drugs as the doctor does learning about your body. It only makes sense that the body expert figures out what's wrong and the drug expert optimizes the therapy. Maybe in 10 or 20 years those informatics systems will be good enough to do the double checking pharmacists can get on to some real work.

Comment The problem is economics and liability (Score 1) 152

Insurance companies have squeezed nearly all the profit out of the pharmacy. So, even for a high volume store a lot of the corporate people are loathe to allow more than one pharmacist to be working at any one time. Pharmacists aren't cheap at around $1/minute. And when you're only making $1-2 per script, that's even more expensive. The problem, though, is that, by law (and for good reason), nearly everything that happens in the pharmacy needs to go through the pharmacist. Best cough med? Only the pharmacist can answer. Dangerous med? Needs counseling? Only the pharmacist. New phone in? Only the pharmacist. Then, every single prescription needs to be checked and signed off on by the pharmacist. You have to understand that literally the only person behind the counter who has more than a few months formal training is the pharmacist and that, again by law, they are ultimately responsible for ANYTHING that goes wrong behind the counter. The pharmacist legally needs to be involved in everything that happens in the pharmacy and everything that happens takes them away from finishing your prescription. Don't get me started on insurance rejects. Those can literally take all day.
This pretty much sums it up. It's irreverent, but it sums it up.
As for centralizing, we're doing that. Several chains (Walgreens and Wal-Mart come to mind) have invested in centralized pharmacies that fill maintenance meds with robots and deliver the filled prescriptions to the local pharmacy. They can fill thousands of scripts in a single night. It's a HUGE time saver when it works right (which it usually does).
As far as e-prescribing goes, all the pharmacies are on board and most of the doctors are coming around. it's usually a lot better than the illegible handwritten scripts. It just allows for new forms of stupid, though. I've gotten no shortage of prescriptions telling me that patients use their diabetic testing supplies orally. REALLY?

Comment Some of them do (Score 2) 152

What your asking about is called "Unit of Use" in the industry and quite a few companies offer them. If they don't and it's a popular drug, other companies called pharmacy repackagers will do it for them. For the most part, I love them. I just grab your drug off the shelf and slap a label on it. No counting, no verifying that the right pill just came out of the open bottle, nothing. Just labeling. That's the easy part, though. The reason it takes so long are the myriad of other distractions: the phone, insurance rejects, bad handwriting, patient inquiries, etc. Then there's also that other part: making sure the doctors aren't trying to kill you. Not all medications get along nicely. Some combinations will make you feel ill, some will make one med not work, and some will just outright kill you. Your primary care might not have gotten the memo from your cardiologist that he just changed your blood pressure medication. So, that antidepressant that slows down your heart a little bit along with that other med from your cardiologist may cause your heart to pump too slowly to perfuse your body. If I don't catch that and give you your med, you could die. So, I have to call one (or possibly both) of your doctors to see which is more important for you. There's more that goes on behind the counter besides lick, stick, count, and pour.

Comment Re:That's probably (Score 1) 152

Right, and that probably speeds up the process for you by a LOT. Like I said, though, it's not just you. Other people's meds can hold up your order. Most systems in retail pharmacy prioritize on a first-come-first-served basis. There are other priorities in there (like if you won't be back until tomorrow or if you just had 4 teeth pulled and you're bleeding on my counter), but there's little manual prioritizing. So when I'm trying to type up your prescription, but I keep getting a reject for someone who's been there for an hour, the computer is going to make me take care of their problem first. Your paying cash just means that I won't have any issues with YOUR prescription when I finally get to it.

If you want a pretty good, over-the-top description of a pretty bad day (and possibly a good laugh), check out this blog article. It's extremely irreverent but covers quite a few of the problems that we actually do deal with in a given day.

Comment It depends on the state (Score 3, Interesting) 152

It depends on the state. Neither Ohio or PA required anything back in 2008 (not sure about now). Here in Florida, we just started registering the technicians a few years ago. Prior to that, there were national certifications like the ExCPT and the PTCB which could help you land a job (and hopefully get payed better) but was NOT required. You literally just had to have a high school diploma and some semblance of competence. Now you either got grandfathered in (with like 1000+ hours) or you complete a board approved training program (which can be completed on the job as long as it's done within 6 months of hire).
But when I started many years ago as a pharmacy tech, I spent two days in a computer room doing training then I was counting pills and helping patients.
You are right, however, about IV compounding. In most hospitals it's done by a tech. The FDA has gotten crazy strict about it lately after a lot of mishaps, so now you need to take a lot of training in USP 797 before they will even let you in the clean room.

Comment That's probably (Score 2) 152

Honestly, as far as the US is concerned, that's probably the result of socialized healthcare. When you only have one insurance company and one formulary to deal with, it's a lot easier for the doctors to write for something that's going to be payed for. And, if they know it won't be payed for, they don't need to wait for the pharmacy to let them know before they start the paperwork for a prior authorization.
A LOT of what slows down your prescription here in the states is third party rejections. Even if it's not your med, it may take me a few minutes to call the insurance company to get the override for a therapy change that they should have let me put in myself. That's assuming I don't have to write up a fax and send it in to the doctor so THEY can get an override. It's obnoxious.
Considering Canada has socialized medicine, though, I have no idea what's slowing them up.

Comment It's not just IT (Score 5, Interesting) 152

I work in pharmacy and I can't tell you the number of people over me who aren't even certified as a pharmacy technician. They either came up through the retail division or through some MBA pathway and they sit there and make decisions about how a retail pharmacy should run without having worked in any sort of pharmacy. It's how you get stupid stuff like a 15 minute guarantee that prioritizes speed over patient safety.
It's difficult because the executives at the top don't understand why it's a problem. How are you supposed to bring your issues to someone who has no idea how those issues impact your daily life? I mean, how long does it take to put a sticker on a bottle and fill it with pills? I can imagine it's the same in IT. In a previous life I'd fallen into a couple of IT positions (by virtue of "knowing computers" better than the other people at the small business) and trying to explain security to them is like trying to explain an egg shell to a brick wall. I can only imagine what IT people in a dedicated department must go through trying to justify themselves to 20 layers of management. Good luck.

Comment No. It pretty much IS public domain (Score 4, Insightful) 102

I'm sorry but I read your submission and it quotes the article saying "the world’s most popular song belongs to...the world." What other interpretation is there besides that meaning it's public domain? As the AC below (and the articles) state, the song was published in 1922 without a notice of copyright. Under the laws governing copyright at the time, that means that they could not assert copyright on the Happy Birthday words. It's public domain.
I guess, theoretically, some cockroach could crawl out of the woodwork tomorrow and say "but look, my great grandaddy published the words WITH the copyright statement in 1921! I own the words!" Yes, it's possible, but not particularly likely. The only group to ever assert copyright on it was Warner and the chain of holders before they finally purchased it. At this point it might as well be over.

Submission + - SPAM: Science Confirms: Being a Good Dad Kills You Earlier (if Youâ(TM)re a Beetl

knotherfacez writes: In a study that in no way has to do with human fathers, scientists at the University of Cambridge found that all the good dads inÂthe burying beetle world were dying younger.

Burying beetles, BTW, are these nasty-ass bugs that find dead birds and mice and bury the carcass. They then lay their eggs near it, and the larvae hatch, crawl into the carcass and feed on the dead animal and we all throw up just thinking about it.

But were going somewhere with this.

British scientists conducted a study with these dryheave-inducing beetles and found two important characteristics: first, that larvae receiving no infant care were far worse at parenting themselves once they had their own brood of disgusting carcass-eating beetles (and died younger), and second, that the good fathers picking up slack for bad mothers (or mums as they call them in the UK) died much younger than fathers receiving moreÂparenting help around the house. The dead animal carcass house.

The super-disgusting burying beetle.

If theres anything interesting about this study, its that scientists found that good beetle-parents were made non-genetically; as long as a beetle received good parenting (from any source), they would become a good parent.

Good quality parents produce offspring that become good parents themselves, while offspring that receive poor parenting then become low quality parents, said lead researcher Professor Rebecca Kilner from the Department of Zoology at the University of Cambridge. Our experiments show how parental care allows offspring to inherit characteristics of their parents, but non-genetically.

Though the research only applies to theseÂnasty-ass beetles,Âhumanity might operate on similar terms, though research indicates that even good parents are screwing their kids upÂany damn way. In the meantime,Âsingle fathers and those compensating for a slacking spouse should make sure to take a moment here and there to relax, lest they find themselves dead earlier, being buried by beetles and having larvae feed off their insides.

Link to Original Source

Submission + - SPAM: EU ministers agree to refugee quota deal

anticerne11 writes: EU interior ministers voted to distribute 120,000 refugees within Europe at emergency talks on Tuesday amid deep divisions over how to handle the continent's worst migration crisis in decades.
Link to Original Source

Submission + - "Happy Birthday To You" now public domain

Duckman5 writes: As mentioned on multiple occasions. The popular song "Happy Birthday To You" has recently been the subject of a lawsuit between a couple of documentary filmmakers and Warner/Chappell Music.
The judge in the case, George H. King, has finally issued his ruling and according to NPR and the LA Times, that song is finally in the public domain. Warner is still apparently "considering our options," so this may not be the end of it, but it seems to be a turn in the right direction.

Some programming languages manage to absorb change, but withstand progress. -- Epigrams in Programming, ACM SIGPLAN Sept. 1982