D-Rock Posted November 15, 2008 Report Share Posted November 15, 2008 A group of Harvard researchers published data in the American Journal of Public Health in 2006 that showed Canadians had better outcomes (including better access) than Americans in terms of health and we spend half as much on healthcare as they do. I remember that article, and it was really interesting (Lasser, Himmelsteing, Woolhandler, 2006 if someone wants to read it). But it's really important to remember that they did it by phone, which they acknowledge clearly under-represents people who are very-low income, who are most in need of easy access to care. Also, once you take into account the response rates, a disproportionate number of Canadians were surveyed, with 0.0018% of Americans surveyed and 0.01% of Canadians surveyed. Nearly six times the relevant population was sampled among Canada. Plus, the Canadian population sampled was healthier. Furthermore, it acknowledges differences in attitudes and regional representation. I still think it's a really good study, but lets face it, most people would get along fine without a doctor and perhaps even be happier not to be nagged about smoking and diet and meds while not realizing their shortened life expectancies unless something catastrophic happened. For those who this is not true, the disadvantaged, they didn't get to take part. Touting the merits of our health care system against the United States' is pretty laughable. Here's a report on a more recent/appropriate comparison. http://www.fcpp.org/main/publication_detail.php?PubID=2020 If those results don't frighten you, they should. Again, as someone said, don't believe a think tank. Especially one that touts the majority of its funding comes from charitable organizations but won't list them as anything other than "foundations", with small and large businesses being the next major supporters. My chief concern in the permission to allow pharmacy renewals of prescriptions is that we will lose a portion of the gains that have been made in chronic disease management by the flow-sheets and necessary components of the regular visits. For example diabetic foot exams, BP checks, fundoscopy (not that ever really shows anything), etc. If these components are performed by the pharmacy and recorded IN A NATIONAL HEALTH CARE RECORDS SYSTEM THAT ALL HEALTH PRACTITIONERS CAN ACCESS (just thought I'd throw that in there), then I think the prescribing/renewing ability can be beneficial for everyone involved. Plus, substituting a generic for the brand name is often good. On the other hand, not all drugs within a class work the same for everyone, e.g. triptans for migraine and anti-psychotics for schizophrenia, so making economic substitutions of one class member for another is not in a patient's best interest at all times. Link to comment Share on other sites More sharing options...
monkey799 Posted November 16, 2008 Report Share Posted November 16, 2008 Bang on... As for "prescribing" for minor ailments, I'd like to mention an anectodal story that happened to me. I was all high and buzzy after taking a pharmacokinetics class a few years ago and had learned about just how much pharmacists knew about medications, etc. Anyway, one day - I developed these ithcy red patches on my chest and figured I'd go to the pharmacy to see a pharmacist rather than my FP, b/c it wasn't too irratating and I didn't want the hassle of seeing the FP (making appointment, waiting, etc), I wanted a solution fast. Anyway, I go and and explain to the pharmacist that I had been going to a public gym and thought that it might have been something from that, they took a look and said it was an infection and I should take polysporin. Didn't even tell me that I should probably go and see my doc - she was so certain of herself. Anyway, I take the polysporin and it didn't do anything. A few hours later my neck is swollen and the patches are all over my body. Went to the emerg and it turns out I had hives, that it was an allergic reaction. Excellent example. Pharmacist may like to argue that they can prescribe for "minor" complaints, but they definitely are not able to tell what is minor and what is not. They may make good husbands and wives (as med students / residents / attendings like to joke about) and sometimes be useful in suggesting dosage and cheaper generic drugs, but they have NO BUSINESS in prescribing or altering prescriptions unless they know how to diagnose and care for patients. Similarly physicians have no business in filling prescriptions and selling drugs. C'mon everyone, this is clearly unjustified and unethical territory encroachment, its motivation purely greed for more money and power. I urge all MDs do whatever it takes to BOYCOTT this. I am standing up for my family physician colleagues. Link to comment Share on other sites More sharing options...
rogerroger Posted November 16, 2008 Report Share Posted November 16, 2008 I concur. It also potentially further muddies the ethical waters via opening another door for pharmaceutical corporations to skew interactions with health care professionals... The CMA should fight this one to the end. Link to comment Share on other sites More sharing options...
meme me Posted November 16, 2008 Report Share Posted November 16, 2008 They may make good husbands and wives That's uncalled for. Grow up. Link to comment Share on other sites More sharing options...
A-Stark Posted November 16, 2008 Report Share Posted November 16, 2008 Someone ought to get a sense of humour... Anyway, short-term temporary extensions of existing prescriptions seem okay - but anything else is outside pharmacists' area of expertise. Link to comment Share on other sites More sharing options...
monkey799 Posted November 21, 2008 Report Share Posted November 21, 2008 Apologies if my words appeared disrespectful and offended anyone. Link to comment Share on other sites More sharing options...
meme me Posted November 25, 2008 Report Share Posted November 25, 2008 Recent Globe article: http://www.theglobeandmail.com/servlet/story/RTGAM.20081121.wlpharma21/BNStory/specialScienceandHealth/home Link to comment Share on other sites More sharing options...
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