 |
 | Home | Contact Us | FAQ | Search & Site Map | Link to Us |
 | Sign In | Join | Other 45 Sites in Network |
Medical Forum / General / General / February 2006pharmacists asking for sexual history of morning-after pill users
Morning-after pill privacy concerns raised Guidelines on morning-after pill raise concerns from women's health groups Pharmacists may ask for personal data such as sexual history and home address Dec. 2, 2005. 04:34 AM ELAINE CAREY MEDICAL REPORTER Canadian pharmacists are being advised to collect a woman's name, address, phone number and sensitive details about her sexual activity before dispensing the so-called morning-after pill. The guidelines, put out by the Canadian Pharmacists Association, have drawn concern from women's health groups, which say the rules are discriminatory and raise privacy issues. Anne Rochon Ford, co-ordinator of Women and Health Protection, a coalition of groups concerned about drug safety and funded by Health Canada, said she's not aware of any other behind-the-counter drug where pharmacists are asked to gather data before dispensing it, which "makes (the drug) look suspect and very loaded." But Janet Cooper, senior director of professional affairs for the pharmacists' association, said the information is necessary to determine whether the pill will be used appropriately and effectively, since it doesn't work if taken more than three days after intercourse. She said the information is to be kept in the pharmacy's computer "so that if she came in a month later for another one, that would mean she probably needs to be advised to get better contraception." "We've been concerned about this since day one," said Abby Lippman, chair of the Canadian Women's Health Council and an epidemiologist at McGill University. "I think it's an invasion of privacy - why should women have to go through this?" Pharmacists are also charging a "counselling fee" of about $20 on top of $20 for the pill, putting it out of reach for many women, she said. The fee is government-paid only in Quebec, Saskatchewan and British Columbia. Health Canada moved the emergency contraceptive levonorgestrel, or Plan B, from being a prescription to a behind-the-counter drug in April, making it available to women of any age. A woman is required to ask the pharmacist for it so she can be counselled about its use. The pharmacists' association immediately posted guidelines on its website. They include giving women a screening form to fill out that asks for personal identification, the time when they last had unprotected sex, the number of times they have had unprotected sex since their last menstrual period, and what form of birth control they use. The information should be stored in the pharmacy's computer, the guidelines state. "These are highly personal, interrogative questions, and it's disturbing," Ford said. Women taking this pill are already under stress, and "the last thing they need is this kind of interrogation," she said. "We are a bit stumped why they have gone to this degree," she said. "This is just so over the top, unnecessary and unproductive." Most pharmacies don't have a private place to counsel women, so it must be done in public. It should be up to the woman to ask for advice about taking it, Ford said. The working group and the Canadian Women's Health Network are advocating that the drug be taken off the drug schedule completely so it could be made available at grocery and variety stores. That has the support of the Society of Obstetricians and Gynecologists and other groups, Ford said. Cooper said the guidelines aren't mandatory but "this is considered best practice. As an association, we can give guidelines but we can't dictate. If a woman actually did not want to provide this information, a lot of pharmacists are going to use their best judgment. "If a woman was really uncomfortable, the first thing I would do was tell her that there is a code of privacy and the pharmacist has to keep it absolutely private," Cooper said, adding the goal is to make the drug available without a prescription but at the same time allow women to get advice from pharmacists. While pharmacists have a privacy code, "nothing is private anymore" when information goes into a computer, said the health council's Lippman. "It's not a drug people are going to be abusing; it's not regularly used and it's not harmful if it's taken too late and she's already pregnant. The side effects are nausea and vomiting - nobody would want to take it regularly. There's just no reason for this." www.thestar.ca fairuse > Morning-after pill privacy concerns raised > Guidelines on morning-after pill raise concerns from women's health [quoted text clipped - 14 lines] > drawn concern from women's health groups, which say the rules are > discriminatory and raise privacy issues. COMMENT: Bah, just the Canadian government looking to protect women from themselves. > But Janet Cooper, senior director of professional affairs for the > pharmacists' association, said the information is necessary to [quoted text clipped - 4 lines] > that if she came in a month later for another one, that would mean she > probably needs to be advised to get better contraception." You see? Nanny government at work with the computers. Enjoy. SBH > Morning-after pill privacy concerns raised > Guidelines on morning-after pill raise concerns from women's health [quoted text clipped - 14 lines] > drawn concern from women's health groups, which say the rules are > discriminatory and raise privacy issues. COMMENT: Excuse me? This is merely your Canadian government trying to protect you from yourselves. Enjoy. SBH > Pharmacists may ask for personal data such as sexual history and home > address And before levonorgestrel became OTC, the same questions were asked by the doctor writing the prescription for it, so what's the point? MB >> Pharmacists may ask for personal data such as sexual history and home >> address > > And before levonorgestrel became OTC, the same questions were asked by the > doctor writing the prescription for it, so what's the point? uhhh...maybe that the doctor has a right to ask such questions... pharmacists on the other hand do not pharmacists surely can and should give patient education...but beyond that...esp as to keeping computer track of when a lady got some of this med...is not within the pharmacy scope of practice > MB > > Pharmacists may ask for personal data such as sexual history and home > > address [quoted text clipped - 3 lines] > > MB Maybe none. Presumably when the Canadian doctor asks you your sexual history, it eventually goes to a centeral computer in Ottawa, too. So maybe there's no difference if the pharmacist enters the data, or the doctor does. Either way, the Governor General and parliament and your various provincial officers need to know this information, in order to serve you. Apparently. SBH > > > Pharmacists may ask for personal data such as sexual history and home > > > address [quoted text clipped - 12 lines] > > SBH It's the pharmacists' professional association which has written the morning-after pill guidelines; not any government. Apparently, the pharmacy association does have a privacy code related to identifiable registration, diagnostic and treatment data. This pharmacists' privacy code has been over-ridden, and is government by, the RIGHT-WING CONSERVATIVE Alberta government. This purile piece of legislation is called the Alberta Health Information Act. Brought to us (once again....Steve...since you seem to have a disconnect here) by a CONSERVATIVE RIGHT WING GOVERNMENT hell bent on privatization. So, this is being done to aid private for profit healthcare, not a nanny government. The Alberta Health Information Act is unique in Canada (as is the neo-Nazi governemtn here) and allows horribly invasive access; sharing and disclosure to other health care workers and administrators of private patient information; sharing and disclosure to other Ministries (and soon third-party payers and police) for a wide variety of purposes. The sharing of private information is based on an honour system, and the information will be shared among God knows how many or who, without the patient's knowledge or consent. I repeat: this was brought about by a conservative government to aid in turning the provincial universal healthcare system over to PRIVATE FOR PROFIT American companies. Got that? This devastation of an individual's rights comes about by a governement that apes and worships the ideology that you do. This RIGHT WING CONSERVATIVE government says they don't need to disclose to the patient that his/her private health information has been shared. After all, it wasn't shared to benefit the patient, but to benefit privatization, and private for profit insurance requirements. Until this RIGHT WING conservative government's trampling of individual rights, the private insurers didn't have enough actuarial data on which to base premiums. Thanks to a decade of increasing collection of such information by a RIGHT WING conservative government determined to destroy universal health care; it was not possible. Happy now? > > > > Pharmacists may ask for personal data such as sexual history and home > > > > address [quoted text clipped - 53 lines] > > Happy now? COOMENT: No. Your definitions suck. "RIGHT WING CONSERVATIVE" in Canadian medicine is still somewhere way left-of-center pink, by US standards. But all this is typical, inasmuch as whenever overgoverned Lefties get some piece of overgovernment they don't like, they always scream fascism. SBH > > > > > Pharmacists may ask for personal data such as sexual history and home > > > > > address [quoted text clipped - 64 lines] > > SBH What ?.... you want to engage in a "my government is more right-wing than yours" argument? The Alberta government is uniquely right-wing & conservative, in Canada, and elsewhere, and bolstered in its perversion of the rights you say you champion by your president Bush (who has a family history of this kind of Nazism, by the way.) I think making a list of the user of the morning-after pill is against our privacy rights, seeing as taking the morning-after pill doesn't endanger anyone. Because when it comes to having AIDS (referring to the recent CFL allegations) and if you are not letting your partner know then you basically are killing them which is murder, therefore I am for the government in keeping track of people with STD's just as I am for the government noting sexual offenders and telling their neighbourhood, etc. Just my opinion. >Morning-after pill privacy concerns raised >Guidelines on morning-after pill raise concerns from women's health [quoted text clipped - 10 lines] >address, phone number and sensitive details about her sexual activity >before dispensing the so-called morning-after pill. Most likely they are trying to be sure that the person who buys the medication is the one who is going to take it. If it is available OTC anyone can go in and purchase it. Maybe even stockpile it or resell it. Ora The "sexual history" is only relevant in terms of ensuring that the drug is taken within 72 hours of intercourse for effectiveness (otherwise a physician referral, for example to administer an IUD, should be made). It's also an opportunity to explore the possible need for STD evaluation for the patient and/or their partners. And never mind the possibility that reportable activities such as sexual abuse, statutory rape, etc. may be happening. All of this is quite within the pharmacist's professional realm and is no more "a big deal" than a physician or nurse asking the same types of questions. The pharmacist may also inquire the patient's medical and drug history to make sure there's no drug interactions, adjustment in dose, etc. I think all this will start to make more sense once people get over the percetion that the pharmacist is just a 7/11-type shopekeeper who has no business poking into people's health-related business. It's precisely because of the need for pharmacist intervention that the stuff is sold only in a pharmacy. If not, why not just have it at the supermarket check-out aisle? Sadly, I think some people will think that's a good idea too. > >Morning-after pill privacy concerns raised > >Guidelines on morning-after pill raise concerns from women's health [quoted text clipped - 16 lines] > > Ora > The "sexual history" is only relevant in terms of ensuring that the drug > is taken within 72 hours of intercourse for effectiveness (otherwise a [quoted text clipped - 15 lines] > check-out aisle? Sadly, I think some people will think that's a good > idea too. And even if one agreed that any of this was under the pharmacist's pervue Gregory (which I do not) exactly where will this counselling take place? You've just guaranteed this young woman won't come to you; who can neither offer her privacy nor guarantee it, who do not have knowledge of her other medical history and have no right to it, and who she must wait in line to see while someone else (her neighbour, the mother of the boy in her chem class?d) checks-out the shampoo you also sell. You and your organization are out of line. > > >Morning-after pill privacy concerns raised > > >Guidelines on morning-after pill raise concerns from women's health [quoted text clipped - 16 lines] > > > > Ora I for one (surely there are others) don't care too much for the juicy details of people's sexual adventures. But before I will give somebody Plan B in good conscience, I do need to know when it happened, if you're taking other meds, whether the last period was, etc. And yes I will also tell this person that perhaps a visit to the clinic for an STD checkup is a good idea if it was a new partner. That's professional responsibility. And pharmacists are bound as much as physicians or health care providers to maintain patient confidentiality ... this includes having the conversation conducted in an area away from the "mother of the boy in chem class". Of course you can go to a public health clinic and get Plan B (this time for free even), but the public health nurse it going to (or at least attempt to) go through essentially the same drill. But alas, it's different, because it's not a pharmacist. Me and "my organization" (what, the Plan B nazis?) ... what wonderful napalm. > > The "sexual history" is only relevant in terms of ensuring that the drug > > is taken within 72 hours of intercourse for effectiveness (otherwise a [quoted text clipped - 47 lines] > > > > > > Ora It is the Alberta pharmacist's organization that advises their members to follow this line of questioning. There is virtually no drugstore I am familiar with that has private counselling areas. And no, the other side of the cash register doesn't qualify, nor do the eye level partitions right out front and centre, across from cosmetics. One would have to write the questions so they wouldn't be overheard. Just the idea that a pharmacist would be asking these questions will turn young woman away. No matter how you rationalize it Gregory, this comes across as judgement. Pharmacist's will kill this initiative while using it to shoehorn their way into an stated initiative to take on much of what has previously been the physician's role. > It is the Alberta pharmacist's organization that advises their members > to follow this line of questioning. [quoted text clipped - 6 lines] > these questions will turn young woman away. No matter how you > rationalize it Gregory, this comes across as judgement. I totally agree...perhaps a few non judgement ?? such as "are you taking other meds"....to pick up the few that might interact... other sexual stuff...has NO place in a drugstore... > Pharmacist's will kill this initiative while using it to shoehorn their > way into an stated initiative to take on much of what has previously > been the physician's role. > There is virtually no drugstore I am familiar with that has private > counselling areas. And no, the other side of the cash register doesn't [quoted text clipped - 3 lines] > these questions will turn young woman away. No matter how you > rationalize it Gregory, this comes across as judgement. Private counselling areas do exist, and not just in a few stores. For those that don't have it, there is always somewhere in the place that can work. There's also a printed "questionnare-type" format of the screening process, so yes, you can decide to write your answers (or check boxes) if you want. Just like any other health provider, it's all a matter of who you go to. > Pharmacist's will kill this initiative while using it to shoehorn their > way into an stated initiative to take on much of what has previously > been the physician's role. Well pharmacists always have had a place in drug therapy, something that is very different from what a physician does. It's just that other areas (say somebody's diabetes, or hypertension) are not necessarily as sensitive as people's sexual behaviour. > > There is virtually no drugstore I am familiar with that has private > > counselling areas. And no, the other side of the cash register doesn't [quoted text clipped - 10 lines] > check boxes) if you want. Just like any other health provider, it's all > a matter of who you go to. Most of the women who will use this don't live near Yonge and Bloor. It's the 17 year old in Moose Jaw who will in all likelihood not get this. Even in a city, I have not seen anything such as you describe. Pharmacies are chains, and floor layout is the same. Nor would I go from drugstore to drugstore trying to find one with this private counselling area (the broom closet) and, a female pharmacist, a male pharmacist who was older and I might possibly feel more comfortable with, or an actual pharmacist, not some retail trained assistant. > > Pharmacist's will kill this initiative while using it to shoehorn their > > way into an stated initiative to take on much of what has previously [quoted text clipped - 4 lines] > areas (say somebody's diabetes, or hypertension) are not necessarily as > sensitive as people's sexual behaviour. I've only observed them trying to sell devices to those with the illness and condition you've mentioned, who in fact most often know more about what they're dealing with than any phamacist. And as I said, try getting an actual pharmacist. "I don't know" should be emblazoned across the "private counselling area", which is barely big enough for one's chequebook and credit card. > Most of the women who will use this don't live near Yonge and Bloor. > It's the 17 year old in Moose Jaw who will in all likelihood not get [quoted text clipped - 6 lines] > pharmacist who was older and I might possibly feel more comfortable > with, or an actual pharmacist, not some retail trained assistant. Well I won't debate your personal experiences, and I'd agree that quality is far from being uniform. Even in Toronto, it's not a "Yonge and Bloor" phenomenon (the only things that are conspicuous at Yonge and Bloor are the strip clubs ... the intersection is really quite a hole if you ask me). I wonder if it's a coincidence that mail-order and cross-border pharmacies are really thriving in Alberta. I'm surprised that you'd feel more comfortable with a male pharmacist "who is older". I feel fairly out of touch with them. > I've only observed them trying to sell devices to those with the > illness and condition you've mentioned, who in fact most often know > more about what they're dealing with than any phamacist. And as I said, > try getting an actual pharmacist. "I don't know" should be emblazoned > across the "private counselling area", which is barely big enough for > one's chequebook and credit card. Again I won't argue with you've seen with your own eyes. But (good) pharmacists do do a lot, particularly "behind the scenes" with patients with chronic conditions (dealing with their myriad of GPs, specialists, home care nurses, etc.) But that's quite another topic. > > Most of the women who will use this don't live near Yonge and Bloor. > > It's the 17 year old in Moose Jaw who will in all likelihood not get [quoted text clipped - 16 lines] > I'm surprised that you'd feel more comfortable with a male pharmacist > "who is older". I feel fairly out of touch with them. I was putting myself in a young woman's place. I can handle you. But a 17 year old under stress may not. Probably cannot. It's embarrassing, verges on prurient, and unnecessary. And as I've pointed out, the violation of privacy begins from square one, right there in the pharmacy. So you're going to tell me her privacy is paramount to you. Uhuh. What are you doing on this at UHN University of Toronto student health? You're Gregory Poon, PhD in pharmacy? > > I've only observed them trying to sell devices to those with the > > illness and condition you've mentioned, who in fact most often know [quoted text clipped - 7 lines] > with chronic conditions (dealing with their myriad of GPs, specialists, > home care nurses, etc.) But that's quite another topic. >> > Most of the women who will use this don't live near Yonge and Bloor. >> > It's the 17 year old in Moose Jaw who will in all likelihood not get [quoted text clipped - 22 lines] > violation of privacy begins from square one, right there in the > pharmacy. So you're going to tell me her privacy is paramount to you. totally agree > Uhuh. > [quoted text clipped - 13 lines] >> with chronic conditions (dealing with their myriad of GPs, specialists, >> home care nurses, etc.) But that's quite another topic. > I was putting myself in a young woman's place. I can handle you. But a > 17 year old under stress may not. Probably cannot. It's embarrassing, > verges on prurient, and unnecessary. And as I've pointed out, the > violation of privacy begins from square one, right there in the > pharmacy. So you're going to tell me her privacy is paramount to you. > Uhuh. It's beside the point, but if I ever encounter difficult situations, it's very seldom the 17-year olds. If anything it's the 30/40-somethings who might be more self-conscious. And yes, professionally, her privacy is paramount to me, because that's the way I'd like to have it, and it's the law. And at the end of the day, there'll be the documentation to prove it. Really, the only militancy I've experienced on this is from people on this thread. > What are you doing on this at UHN University of Toronto student health? No UHN is my research affiliation. U of T student health is on campus, and I guess you'll be happy to learn that it doesn't have a pharmacist. I practice at a community pharmacy. > You're Gregory Poon, PhD in pharmacy? > [quoted text clipped - 9 lines] > > with chronic conditions (dealing with their myriad of GPs, specialists, > > home care nurses, etc.) But that's quite another topic. > > I was putting myself in a young woman's place. I can handle you. But a > > 17 year old under stress may not. Probably cannot. It's embarrassing, [quoted text clipped - 18 lines] > and I guess you'll be happy to learn that it doesn't have a pharmacist. > I practice at a community pharmacy. Sometime over the next week I'll pick a pharmacy and go in and ask for Plan B. Of course this won't really be fair, because I'm not going to be intimidated by his questions. I'll pick a young one. I'll ask lots of stuff. > > You're Gregory Poon, PhD in pharmacy? > > [quoted text clipped - 9 lines] > > > with chronic conditions (dealing with their myriad of GPs, specialists, > > > home care nurses, etc.) But that's quite another topic. ironically...this precise topic was the first topic on the View show this morning...a very heated discussion... discussed role of the pharmacist (??)...privacy issues..etc.. but MOSTLY was the question of WHAT PLan B does?? does it ONLY prevent conception...or does it MAINLY prevent implantation... if the latter..it is basically an abortificant.. again...from what I read...either scenerio could be the issue...MOST references include either as a possible cause.. and PLEASE do not keep referring to "inducing a period"... bleeding resulting from a lost pregnacy is NOT a period in any true sense.. > and PLEASE do not keep referring to "inducing a period"... > > bleeding resulting from a > lost pregnacy is NOT a period in any true sense.. Well, no. That's no more correct than saying that every period means a lost pregnancy. A spike in estrogen and/or progestin, followed by their withdrawal, will result in menstruation whether it's a woman's own pituitary/ovaries ticking, or from an OC (including Plan B). The only situation for which this is not true is if implantation has taken place and the embryo sustains the hormones. It's basic physiology, not voodoo. Or if you want to take the converse, taking Plan B during pregnancy will have little or no effect on the pregnancy. It's Plan B, not RU-486. >> and PLEASE do not keep referring to "inducing a period"... >> [quoted text clipped - 11 lines] > Or if you want to take the converse, taking Plan B during pregnancy will > have little or no effect on the pregnancy. It's Plan B, not RU-486. I was not the one who used the word "induce menstrual bleeding" in the context of plan b.... It is the Alberta pharmacist's organization that advises their members to follow this line of questioning. There is virtually no drugstore I am familiar with that has private counselling areas. And no, the other side of the cash register doesn't qualify, nor do the eye level partitions right out front and centre, across from cosmetics. One would have to write the questions so they wouldn't be overheard. Just the idea that a pharmacist would be asking these questions will turn young woman away. No matter how you rationalize it Gregory, this comes across as judgement. Pharmacist's will kill this initiative while using it to shoehorn their way into a stated initiative to take on much of what has previously been the physician's role. It's precisely because of the need for pharmacist intervention that the stuff is sold > only in a pharmacy. If not, why not just have it at the supermarket > check-out aisle? Sadly, I think some people will think that's a good > idea too. Since some pharmacists ignore doctor's prescriptions (and their own State law) by refuseing to dispense the morning after pill, then maybe selling it O.T.C. in a supermarket would be a good thing. Should we judge the morning after pill by what people say that God thinks of it or judge it by it's safety and effectiveness? > It's precisely because of the need for pharmacist intervention that the > stuff is sold [quoted text clipped - 7 lines] > after pill by what people say that God thinks of it or judge it by it's > safety and effectiveness? Supermarkets aren't often 24 hour in Canada, so perhaps the morning after pill should also be sold in 24 hr drugstores, in campus washroom dispensers, and in campus residences. This all reminds me of pre-1966 when women had to show a marriage certificate to get the birth control pill. >>> This all reminds me of pre-1966 when women had to show a marriage > certificate to get the birth control pill. ???? not in civilized nations...like the usa "Gregory Poon" <gpoon@uhnres.utoronto.ca> wrote in message > The "sexual history" is only relevant in terms of ensuring that the drug > is taken within 72 hours of intercourse for effectiveness (otherwise a > physician referral, for example to administer an IUD, should be made). Idiot. There is absolutely no reason to take a sexual-activities history just to get that message across. > It's also an opportunity to explore the possible need for STD evaluation > for the patient and/or their partners. And never mind the possibility > that reportable activities such as sexual abuse, statutory rape, etc. > may be happening. All of this is quite within the pharmacist's > professional realm and is no more "a big deal" than a physician or nurse > asking the same types of questions. It's invasive. It discourages people from asking for this drug when they need it. There is a (somewhat justified) perception that the information won't be held in the strictest confidence. > The pharmacist may also inquire the patient's medical and drug history > to make sure there's no drug interactions, adjustment in dose, etc. I [quoted text clipped - 5 lines] > check-out aisle? Sadly, I think some people will think that's a good > idea too. With a few exceptions, it is. What, exactly, is so dangerous about providing this OTC? How is it worse than selling condoms etc? moo > "Gregory Poon" <gpoon@uhnres.utoronto.ca> wrote in message > [quoted text clipped - 4 lines] > Idiot. There is absolutely no reason to take a sexual-activities history > just to get that message across. Cool, I'm going to try that too! Idiot. Nobody is trying to "get that message across". The pharmacist is simply making sure that Plan B is appropriate given the time frame. And you are free to keep the juicy details to yourself. > It's invasive. It discourages people from asking for this drug when they > need it. There is a (somewhat justified) perception that the information > won't be held in the strictest confidence. Well it is. And it's the law. But people are free to their own perceptions. > > The pharmacist may also inquire the patient's medical and drug history > > to make sure there's no drug interactions, adjustment in dose, etc. I [quoted text clipped - 8 lines] > With a few exceptions, it is. What, exactly, is so dangerous about > providing this OTC? How is it worse than selling condoms etc? You're right, there's nothing particularly "dangerous" about Plan B. But it's important that people are taking it in such a way that is therapeutically appropriate, namely, that it's going to be effective. "Gregory Poon" <gpoon@uhnres.utoronto.ca> >> "Gregory Poon" <gpoon@uhnres.utoronto.ca> wrote in message >> [quoted text clipped - 10 lines] > appropriate given the time frame. And you are free to keep the juicy > details to yourself. It's sounding more appropriate when I use it, still. The pharmacist can simply inform the customer of the time frame. No need to ask anything. If that simple fact escapes you you aren't ready for the rest of the conversation. >> It's invasive. It discourages people from asking for this drug when they >> need it. There is a (somewhat justified) perception that the information >> won't be held in the strictest confidence. > > Well it is. And it's the law. But people are free to their own > perceptions. It isn't. And the fact of law does nothing to enhance the perception of it in the minds of many potential customers. >> > The pharmacist may also inquire the patient's medical and drug history >> > to make sure there's no drug interactions, adjustment in dose, etc. I [quoted text clipped - 13 lines] > But it's important that people are taking it in such a way that is > therapeutically appropriate, namely, that it's going to be effective. Then give them a pamphlet and a verbal warning about any risks and serve the next customer. moo > "Gregory Poon" <gpoon@uhnres.utoronto.ca> > >> "Gregory Poon" <gpoon@uhnres.utoronto.ca> wrote in message [quoted text clipped - 16 lines] > that simple fact escapes you you aren't ready for the rest of the > conversation. But there is a difference between "informing" and "counselling" (i.e., having an actual conversation about the matter). Incidentally the drug comes with a lovely product insert that tells you just about everything the pharmacist should go through with you, so why isn't that enough? Your getting the drug from a pharmacist means the pharmacist has a professional responsibility to ensure that s/he is giving out the right drug for the right situation (for an OTC, given the interaction with the patient). "Informing" does not achieve this. If you think this is a load of BS, consider the flip side: the pharmacist is quite likely liable if s/he gives out the Plan B more than 72 hours after intercourse, the treatment fails, and the pharmacist fails to demonstrate that s/he has asked the question and obtained an answer from the person. Actually the irony is that many pharmacists wished they didn't have to take (and document) a proper history before giving out something like Plan B; it takes time, it requies an effort to communicate (sometimes under fairly awkward circumstances). They'd rather be doing something much easier like, filling some kid's prescription for amoxicillin. > >> It's invasive. It discourages people from asking for this drug when they > >> need it. There is a (somewhat justified) perception that the information [quoted text clipped - 5 lines] > It isn't. And the fact of law does nothing to enhance the perception of it > in the minds of many potential customers. No, but it's still the law. > >> > The pharmacist may also inquire the patient's medical and drug history > >> > to make sure there's no drug interactions, adjustment in dose, etc. I [quoted text clipped - 16 lines] > Then give them a pamphlet and a verbal warning about any risks and serve the > next customer. <Sigh> Maybe we should do that with chemo too. Yes yes yes, Plan B isn't chemo ... > moo > > "Gregory Poon" <gpoon@uhnres.utoronto.ca> > > >> "Gregory Poon" <gpoon@uhnres.utoronto.ca> wrote in message [quoted text clipped - 69 lines] > > Then give them a pamphlet and a verbal warning about any risks and serve the > > next customer. > <Sigh> Maybe we should do that with chemo too. Yes yes yes, Plan B > isn't chemo ... And that's somewhere else you have no business assuming a role. > >Actually the irony is that many pharmacists wished they didn't have to take (and document) a proper history before giving out something like Plan B; it takes time, it requies an effort to communicate (sometimes under fairly awkward circumstances). They'd rather be doing something much easier like, filling some kid's prescription for amoxicillin. The nerve of her eh Gregory. First of all, having a sex life when you're stuck there behind the counter under the fluorescent light which makes you look all kinda greenish and definitely no studmuffin. The slut, taking up your valuable time when there are (chorus swells) teeny children with bacterial thingeys to be cured. "Gregory Poon" <gpoon@uhnres.utoronto.ca> >> > Cool, I'm going to try that too! Idiot. Nobody is trying to "get that >> > message across". The pharmacist is simply making sure that Plan B is [quoted text clipped - 11 lines] > comes with a lovely product insert that tells you just about everything > the pharmacist should go through with you, so why isn't that enough? It should be. But maybe the customer can't read. (Now you'll suggest that interpreters be on hand at all times.) And, it's an easy thing to quickly run over the basics of this drug. > Your getting the drug from a pharmacist means the pharmacist has a > professional responsibility to ensure that s/he is giving out the right [quoted text clipped - 5 lines] > demonstrate that s/he has asked the question and obtained an answer from > the person. Oh pfui! If that were true, pharmacists would have to have consent forms signed in triplicate for recommending asprin. > Actually the irony is that many pharmacists wished they didn't have to > take (and document) a proper history before giving out something like > Plan B; it takes time, it requies an effort to communicate (sometimes > under fairly awkward circumstances). Yeah. Like acting against their idiotic religious or mysoginistic beliefs. >> >> It's invasive. It discourages people from asking for this drug when >> >> they [quoted text clipped - 10 lines] > > No, but it's still the law. Which means SFA. Have there been numerous breaches, accidental or otherwise, of this law? Do try to be specific in your answer. >> > You're right, there's nothing particularly "dangerous" about Plan B. >> > But it's important that people are taking it in such a way that is [quoted text clipped - 6 lines] > <Sigh> Maybe we should do that with chemo too. Yes yes yes, Plan B > isn't chemo ... Your point? moo > > "Gregory Poon" <gpoon@uhnres.utoronto.ca> > > >> "Gregory Poon" <gpoon@uhnres.utoronto.ca> wrote in message ~~~~~~~~snip~~~~~~~~ > > >> It's invasive. It discourages people from asking for this drug when they > > >> need it. There is a (somewhat justified) perception that the information [quoted text clipped - 7 lines] > > No, but it's still the law. What law Gregory? It's my understanding that the Alberta pharmacy association does have a privacy code related to identifiable registration, diagnostic and treatment data. But this pharmacists' privacy code has been over-ridden, and is governed by, the Alberta Health Information Act, which allows horribly invasive access, sharing and disclosure to other health care workers and administrators of private patient information; sharing and disclosure to other Ministries (and soon third-party payers and police) for a wide variety of purposes. This sharing of private information is based on an honour system, and the information will be shared among God knows how many or who, without the patient's knowledge or consent. > What law Gregory? > [quoted text clipped - 9 lines] > shared among God knows how many or who, without the patient's knowledge > or consent. I don't know about Alberta, but in my neck of the woods (Ontario), it's called the Personal Health Information Protection Act: http://www.ocpinfo.com/client/ocp/OCPHome.nsf/web/Personal+Health+Information+Pr otection+Act+2004!OpenDocument Many pharmacies have gone to crazy lengths to ensure that they are in compliance with the law. So much so that the Privacy Comissioner of Canada actually receives complaints from people that some pharmacies are requiring written consent from patients before rendering certain services. sorry greg...but you are "somewhat" wrong... > The "sexual history" is only relevant in terms of ensuring that the drug > is taken within 72 hours of intercourse for effectiveness the above statement is true... (otherwise a > physician referral, for example to administer an IUD, should be made). this one is not...for instance..."adminster an IUD??"....sorta demonstrates that perhaps you do not know HOW an IUD is used...not to mention ..that other forms of contraception might well be more appropriate > It's also an opportunity to explore the possible need for STD evaluation > for the patient and/or their partners. sorry...THIS is totally none of your business!!! just because I may be pregnant has nothing to do with the possibility of STD's...do you ask every female picking up OCP about this?? if you do...you are outa line And never mind the possibility > that reportable activities such as sexual abuse, statutory rape, etc. > may be happening again...may be true///BUT... All of this is quite within the pharmacist's > professional realm and is no more "a big deal" than a physician or nurse > asking the same types of questions. this is not....counseliing etc re rape etc..ARE NOT within the scope of practice of a pharmacist....thus are a much bigger deal than a doctor,,nurse..etc asking about this > The pharmacist may also inquire the patient's medical and drug history > to make sure there's no drug interactions, adjustment in dose, etc. ahhh...THIS you are correct in...tho the PLan B comes only in one dosage if I am not mistaken..also...can you name another drug it would interact with?? I > think all this will start to make more sense once people get over the > percetion that the pharmacist is just a 7/11-type shopekeeper who has no [quoted text clipped - 3 lines] > check-out aisle? Sadly, I think some people will think that's a good > idea too. actually...if pharmacists DO begin to ask such invasive questions...then I vote for it going on the condom aisle >> >Morning-after pill privacy concerns raised >> >Guidelines on morning-after pill raise concerns from women's health [quoted text clipped - 18 lines] >> >> Ora Excellent point. "...if pharmacists DO begin to ask such invasive questions...then I vote for it going on the condom aisle" > Excellent point. > > "...if pharmacists DO begin to ask such invasive questions...then I > vote for it going on the condom aisle" COMMENT: Not so funny. And ironic, too, since Once Upon a Time there wasn't a condom isle in the US. Condoms and other OTC contraceptives were back behind the pharamacist's counter where the kids couldn't get them. And the pharmacist asked all kinds of invasive questions to customers who wanted them. And you know what? Often this was mandated by laws, right up to 1977. In Connecticut it was actually illegal for married couples to use birth control until 1965--- nevermind how this was going to enforced. Outrage at this particular statue, which was aimed at marketting of birth control devices, went all the way to the US supreme court, which couldn't really find anything specific in the federal constitution which prohibited states from making such damnfool invasive laws. So the Supremes did what they usually do, which was invent a law. In this case a "right of privacy" which they seemed to see one of the ammendments (see Griswold vs. Connecticut. 1965). Strangely, the court only sees this one when they want to. It wasn't until 1977 (Carey vs. Population Services International-- look it up) that the court struck down New York laws which (you guessed it) restricted distribution of nonprescription contraceptives to those over 16 years of age (which checking of age naturally by pharmacists) and limited the distribution of nonprescription contraceptives through licensed pharmacists. Which meant (up to then) no grocerystore condoms in NY. That ruling was based on Griswold. So all this pharmacist-as-sex-cop stuff has a fairly gruesome history in the US. If you think the government can't intrude in stuff like this, you don't know your history. They can. They have. It's hard, in this post-AIDS world, to imagine the world was ever the way it was before, but these condom battles in the US were all fought and won (at great cost) before HIV and AIDS were ever heard of. SBH >So all this pharmacist-as-sex-cop stuff has a fairly gruesome history >in the US. If you think the government can't intrude in stuff like >this, you don't know your history. They can. They have. It's hard, in >this post-AIDS world, to imagine the world was ever the way it was >before, but these condom battles in the US were all fought and won (at >great cost) before HIV and AIDS were ever heard of. Remember the defensive labelling? "Sold for the prevention of disease only." And it wasn't all that long ago that it was illegal to *inform* people about contraception. > Excellent point. > > "...if pharmacists DO begin to ask such invasive questions...then I > vote for it going on the condom aisle" Why do people get offened when these questions come from a pharmacist (Doctor of Pharmacy), but have no problem when there asked by a physician (Doctor of Medicine)??? If the majority want it over the counter then put it over the counter, but they should also put a block on lawsuits when people abuse the medication. It's not candy...theres a reason why a pharmacist has been asked to oversee its use...I do think its crazy that some pharmacists choose not to dispense for personal reasons,b ut ...you see this type of behavior in all professions....its sad, but that should not minimize the important role your pharmacist plays in your health. Hormones should not be taken lightly... Dr. John P. Calvillo Clinical Pharmacist >> Excellent point. >> [quoted text clipped - 4 lines] > (Doctor of Pharmacy), but have no problem when there asked by a > physician (Doctor of Medicine)??? I personally think it is not the context of the questions...but the context of where they take place.... I don't know of any other health care professionals that work in a store...where the ONLY privacy..if any..is provided by some sort of counter top "shield" or whatever when asked by a physician...or NP/PA...who also "practice" medicine..the interaction takes place within the confines of an exam room..perhaps the provider's private office....NOT in a store where others are casually shopping and may overhear the conversation If the majority want it over the > counter then put it over the counter, but they should also put a block > on lawsuits when people abuse the medication. I think most would agree with that.. BTW...do pharmacists get sued if a condom "they" sold breaks or is used incorrectly??? and the person gets pregnant...or gets an STD?? I hardly think so... what about OTHER otc meds ...ie does the pharmacist get sued if a person has an allergic reaction to ANY substance that can be casually obtained OTC?? of course not > It's not candy...theres a reason why a pharmacist has been asked to > oversee its use...I do think its crazy that some pharmacists choose not [quoted text clipped - 3 lines] > > Hormones should not be taken lightly... yes I agree with that...and perhaps plan b should NOT be otc ...I believe it may have been placed in that status because of the short time line for its effective use.... other than occasional untoward drug interactions....use of plan b if NOT indicated will not cause any more harmful effects than say...taking a cold remedy..or whatever...and pharmacists are not up in arms that they may be "sued" if someone say...bleeds from aspirin...or gets liver failure from too much tylenol.. I see plan b and the above in the same context pharmacists surely are a very important part of the healthcare team..and i have very great respect for you all..... I just don't think that in this context you should be asking ANY sexually explicit questions ...OTHER than "do you know this is only effective within the first 72 hours"...etc..and asking about other meds they may be on > Dr. John P. Calvillo > Clinical Pharmacist > > Excellent point. > > [quoted text clipped - 6 lines] > counter then put it over the counter, but they should also put a block > on lawsuits when people abuse the medication. Because a doctor of pharmacy is not a doctor of medicine. I hope that's clear enough. > It's not candy...theres a reason why a pharmacist has been asked to > oversee its use...I do think its crazy that some pharmacists choose not > to dispense for personal reasons,b ut ...you see this type of behavior > in all professions....its sad, but that should not minimize the > important role your pharmacist plays in your health. The questions are too invasive and not anyone else's business let alone a pharmacist's. > Hormones should not be taken lightly.. Damn right. And when your profession did take the issue of hormones lightly we believed you. Our mistake. For this; a simple question, a pamphlet, a warning and a caution to contact a physician are all that should come from a pharmacist. As to your concern about litigation. This is Canada. While in theory it's not impossible, it's also not very likely. . > Dr. John P. Calvillo > Clinical Pharmacist Sorry to hear your lack of respect for pharmacists...your opinions are your right... If you ever want to get educated on the extensive training a pharmacists recieves please drop me a line and it would be my pleasure. > Sorry to hear your lack of respect for pharmacists...your opinions are > your right... > > If you ever want to get educated on the extensive training a > pharmacists recieves please drop me a line and it would be my pleasure. What it comes down to, at the end of the day, is the perception pharmacies are just a source of pharmaceuticals and what pharmacists do in terms of ensuring that these things are used safely and effectively, are entirely irrelevant. It has nothing to do with training. Pharmacists can be D.Sc. and all win Nobel prizes and it wouldn't matter very much for some people. It's just particularly discouraging when you hear this view from colleagues in other health care fields. >> Sorry to hear your lack of respect for pharmacists...your opinions are >> your right... [quoted text clipped - 9 lines] > very much for some people. It's just particularly discouraging when you > hear this view from colleagues in other health care fields. if you are referring to me...you are all wet never did I indicate that I do not have knowledge of..and respect for...your training, education,,and value to the entire gamut of healthcare... the issue here..started as..and continues to be..whether a pharmacist...ANY pharmacist...can provide the privacy to ask sexually explicit questions when dispensing plan b and then one of you challenges with "why should the questions be acceptable from a doc..but not a pharmacist" I repeat..doctors and other providers...do not ask questions in a STORE!!! why is that so difficult to understand?? THAT is what the issue is...not that YES it is YOUR realm to provide patient education ...within the limitations rendered you because you practice in a public place...it is NOT comparable to exam rooms and private provider's offices.... again...you continue to insist your ?? is necessary to provide you with documentation,,etc... again..I ask..what about all the OTHER otc products?? how do you protect yourself in THOSE cases?? > > Sorry to hear your lack of respect for pharmacists...your opinions are > > your right... [quoted text clipped - 9 lines] > very much for some people. It's just particularly discouraging when you > hear this view from colleagues in other health care fields. Well Gregory what do you have to tell us about this? >CTV TORONTO > Wed. Dec. 7 2005 6:11 PM ET [quoted text clipped - 3 lines] > >Ontario pharmacists are being told to stop asking women about their >sexual history before dispensing the so-called morning-after pill. >This comes in response to a request from the province's privacy >commissioner. > >Commissioner Ann Cavoukian says the Ontario College of Pharmacists >has agreed to tell its members to not use a contentious voluntary >screening form that asks sensitive questions. > >The document asks a woman for her name, address, phone number and >details about her sexual activity. > >The Canadian Pharmacists Association had advised pharmacies to gather >the information to help determine whether the pill, which can prevent >pregnancy within three days after sex, was being used appropriately. >Cavoukian says the practice has raised concerns that demanding such >sensitive information could discourage women from asking for the >emergency contraceptive. > > > Sorry to hear your lack of respect for pharmacists...your opinions are > > > your right... [quoted text clipped - 9 lines] > > very much for some people. It's just particularly discouraging when you > > hear this view from colleagues in other health care fields. <<repost story with better formatting>> Well Gregory what do you have to tell us about this? I note the order to desist came about because of a complaint to the Ontario Privacy Commissioner. Pharmacists told not to ask sexual history Canadian Press Ontario pharmacists are being told to stop asking women about their sexual history before dispensing the so-called morning-after pill. This comes in response to a request from the province's privacy commissioner. Commissioner Ann Cavoukian says the Ontario College of Pharmacists has agreed to tell its members to not use a contentious voluntary screening form that asks sensitive questions. The document asks a woman for her name, address, phone number and details about her sexual activity. The Canadian Pharmacists Association had advised pharmacies to gather the information to help determine whether the pill, which can prevent pregnancy within three days after sex, was being used appropriately. Cavoukian says the practice has raised concerns that demanding such sensitive information could discourage women from asking for the emergency contraceptive. http://toronto.ctv.ca/servlet/an/local/CTVNews/20051207/morning_after_pill_05120 7/20051207?hub=TorontoHome > Well Gregory what do you have to tell us about this? I note the order > to desist came about because of a complaint to the Ontario Privacy [quoted text clipped - 25 lines] > > http://toronto.ctv.ca/servlet/an/local/CTVNews/20051207/morning_after_pill_05120 7/20051207?hub=TorontoHome It's not an "order to desist". It doesn't order anything at all. The advisory concerns the use of the CPhA screening form which in any case isn't universally used. And the issue is not that pharmacists are gathering information from patients, but that the form is designed in such a way that identifies the patient. The notice from OCP is here: http://www.ocpinfo.com/client/ocp/OCPHome.nsf/web/Emergency+Contraception+Screen ing+Form!OpenDocument In fact "the Privacy Commissioner stressed that pharmacists should continue to provide information to patients who request this drug, to _gather information_ and to educate and counsel patients. Pharmacists _should ask questions of patients if necessary in the course of providing this service_ but should not record personal health information in a manner which identifies individual patients." (My underscores) This merely reconfirms Plan B as any other behind-the-counter (Schedule II) drug ... just as pharmacists don't give out Tylenol #1, or Nix, or KCl, etc. etc. without getting an appropriate history. People aren't required to provide personal identification for this. And neither should they for Plan B. But the onus is still on the pharmacist to ensure that the sale is therapeutically appropriate, just as it is for Tylenol #1, and Nix, and KCl, etc. etc. Moving on ... I must have missed the post yesterday where you said you weren't recording and didn't support recording of the woman's private information. I did see you say women weren't required to give the information (or all the information can't remember your exact words). That came after another poster dragged it out of you. What the pharmacy association says and what the privacy commission says are two different things. It's not over yet. >I must have missed the post yesterday where you said you weren't > recording and didn't support recording of the woman's private [quoted text clipped - 4 lines] > What the pharmacy association says and what the privacy commission says > are two different things. It's not over yet. actually I believe he distinctly said..several times...that HIS purpose in "recording the details" was to protect him if the drug was taken innappropriately..and some female came back and sued him thus..."personal" data WAS very much a part of greg's plan(no pun intended..plan b...get it??) > >I must have missed the post yesterday where you said you weren't > > recording and didn't support recording of the woman's private [quoted text clipped - 11 lines] > thus..."personal" data WAS very much a part of greg's plan(no pun > intended..plan b...get it??) The Ontario privacy commission only applies to Ontario (where the commissioner is a woman who acted on her own 'complaint', if you will). So this will have to be dealt with jurisdiction by jurisdiction. I see this issue is heating up in the States too in a slightly different way. Check google news. > > Sorry to hear your lack of respect for pharmacists...your opinions are > > your right... [quoted text clipped - 9 lines] > very much for some people. It's just particularly discouraging when you > hear this view from colleagues in other health care fields. ~~~~~~~~~~~~~~~~~~ Looks like the few "militant" posters here--your description of us--are not alone in their thinking Gregory: Privacy concerns raised about morning-after pill rules Last Updated Dec 6 2005 09:10 AM CST http://www.cbc.ca/sask/story/morning-after051206.html CBC News A new Saskatchewan protocol for dispensing the morning-after pill that includes a question about recent sexual history is raising concerns about women's privacy. The drug levonorgestrel, sometimes known as Plan B, is 89 per cent effective at preventing pregnancy if women take the first of two doses within 72 hours of having unprotected sex. In April, Health Canada approved it for sale without a prescription. Pharmacists in Saskatchewan and other provinces keep the pill behind the counter. They're required to provide counselling and ask women a series of questions, such as when the customer had her last period and when she had unprotected sex. That information, along with a woman's name, phone number and address, remains on file. Unfortunately, this will deter some women from going in to get the pill, according to Dr. Donna Stewart, a professor of women's health at the University of Toronto. "They're worried about confidentiality, they're worried it's going to get around town they had a scare," she said. Stewart has concerns in particular about young women in rural Saskatchewan. "In small communities, young women are very hesitant to have these discussions with pharmacists when they often know them or they're family," she said. "Moreover, many of these pharmacists don't have a private place in which to speak with these young women and that deters young women from seeking this out." Ray Joubert, the registrar of the Saskatchewan College of Pharmacists, the questions are necessary so the pharmacist can assess the appropriateness of therapy and help the woman make sure the medication is taken properly. Women's groups across the country want pharmacists to stop asking question and put the drug on the shelves next to other non-prescription medication. > Sorry to hear your lack of respect for pharmacists...your opinions are > your right... > > If you ever want to get educated on the extensive training a > pharmacists recieves please drop me a line and it would be my pleasure. I know what training a pharmacist receives. I respect the profession within it's purvue and mandate. ...if we don't let you assume this paternalistic misogynistic role we don't respect you.... Will you two quit this b.s. ?! > > Sorry to hear your lack of respect for pharmacists...your opinions are > > your right... [quoted text clipped - 9 lines] > > Will you two quit this b.s. ?! Wonderful. So what adjectives do you have for the female pharmacists? May I suggest "maternalistic self-hating" perhaps? Then again the it's the beauty of a newsgroup. People are free to fling feces behind a smart alias. Sort of like the course evaluation form undergrads fill out. > > > Sorry to hear your lack of respect for pharmacists...your opinions are > > > your right... [quoted text clipped - 12 lines] > Wonderful. So what adjectives do you have for the female pharmacists? > May I suggest "maternalistic self-hating" perhaps? Paternalistic and misognistic thinking are gender-free. You're free to think and behave differently. > Then again the it's the beauty of a newsgroup. People are free to fling > feces behind a smart alias. Sort of like the course evaluation form > undergrads fill out. What I do here isn't a patch on what your association advises and you defend. Any comment on being stopped in your tracks by the Ontario privacy commission? > Sorry to hear your lack of respect for pharmacists...your opinions are > your right... The public's attitude towards pharmacists WILL change in the near future. Every Pharm.D. student we've had during their rotations for the past couple of years is dead set against retail--every one! They're posturing themselves for jobs in industry, public health services and so on. The jobs are there, and in many cases these young grads will retire with a pension before age 50. Five or ten years ago, I believed the P.D. thing was unnecessary, but I now believe it's needed to turn the profession around. My alma mater is now offering a six year dual degree program--Pharm.D. and Law. Considering the ridiculous actions that have been taken against pharmacists in certain states, the law degree may be quite useful. A good idea. Lose the shampoo. Earn the consumers respect, don't demand it. > > Excellent point. > > [quoted text clipped - 17 lines] > Dr. John P. Calvillo > Clinical Pharmacist Careful now, John, the napalms are blind. ;-) "DRRX" <johnpaulcalvillo@hotmail.com> wrote in message >> Excellent point. >> [quoted text clipped - 4 lines] > (Doctor of Pharmacy), but have no problem when there asked by a > physician (Doctor of Medicine)??? Is it possible you don't see the potential discomfort created by asking women for their intimate sexual history? Note that it's almost always guys defending this bullshit practice. > If the majority want it over the > counter then put it over the counter, but they should also put a block > on lawsuits when people abuse the medication. Sure. Let's work on that one... moo >It's not candy...theres a reason why a pharmacist has been asked to >oversee its use...I do think its crazy that some pharmacists choose not >to dispense for personal reasons,b ut ...you see this type of behavior >in all professions....its sad, but that should not minimize the >important role your pharmacist plays in your health. Important role, eh? Just what does a pharmacist do? Don't tell me about compounding pharmacies nor hospital pharmacies nor what they did back in the days when it was "Three drops of eye of newt, a smidgen of ground bat wing...etc" but concentrate on the local chain branch or the independent pharmacy. As near as I can figure they: - count pills (not even that when it's something pre-packaged) - stare at the monitor a lot - rewrite and print the physician's instructions on a label - collect the co-pay or the full amount - make the customer wait an hour or so for the above ++++++++++ If you really do something that's more than a high-schooler (grade schooler?) could do please share the information. Oh-My-God, what a group of bitter, spiteful people. GP, et al, post their thoughts/opinions/whatnot on the matter, and the group of y'all start personal attacks, and nit-picking, and now attacking the profession as a whole. For Christ's sake people, grow up! On Fri, 09 Dec 2005 06:59:54 +0000, LecherousLouie wrote: >>It's not candy...theres a reason why a pharmacist has been asked to >>oversee its use...I do think its crazy that some pharmacists choose not [quoted text clipped - 3 lines] > > Important role, eh? And what, pray tell, does LecherousLouie do (other than try his/her best to antagonize people)? > Just what does a pharmacist do? Don't tell me about compounding > pharmacies nor hospital pharmacies nor what they did back in the days [quoted text clipped - 5 lines] > > - count pills (not even that when it's something pre-packaged) Nope. Tech does that. (Of course these answers are only from my experience in a retail setting. YMMV) > - stare at the monitor a lot Ding, Ding, Ding. Correct! And most of the time its to play solitaire. Weee!!! > - rewrite and print the physician's instructions on a label Two right so far. Way to go Louie!! > - collect the co-pay or the full amount Sorry. Tech/Cashier does that. > - make the customer wait an hour or so for the above YES! 3 out of 5. Not bad. This is my favorite part of the job! Sometimes, I make 'em wait for 2 hours just to see the expressions on their faces. It's a real hoot. > ++++++++++ > > If you really do something that's more than a high-schooler (grade > schooler?) could do please share the information. No can do. It's a secret. You have it pegged pretty well though, although you flatter us (me, anyway) by giving more credit than due. Y'all have a Very Merry Christmas! > (otherwise a > > physician referral, for example to administer an IUD, should be made). > > this one is not...for instance..."adminster an IUD??"....sorta demonstrates > that perhaps you do not know HOW an IUD is used...not to mention ..that > other forms of contraception might well be more appropriate Sorta demonstrates that you do not know pharmacists don't administer an IUD as part of their work. Pray tell what other forms of emergency contraception is appropriate in a "morning after" scenario? > > It's also an opportunity to explore the possible need for STD evaluation > > for the patient and/or their partners. [quoted text clipped - 16 lines] > practice of a pharmacist....thus are a much bigger deal than a > doctor,,nurse..etc asking about this Where do you get the idea that pharmacists counsel people about rape? I was talking about a professional (legal) obligation to report possible cases of sexual abuse. If a 13-year old comes in for Plan B, that would be cause to think about reporting to Children's Aid. > > The pharmacist may also inquire the patient's medical and drug history > > to make sure there's no drug interactions, adjustment in dose, etc. > > ahhh...THIS you are correct in...tho the PLan B comes only in one dosage if > I am not mistaken..also...can you name another drug it would interact with?? Wow I'm amazed you agree. Drugs that Plan B (or any OC) interacts with: carbamazepine, vaproic acid, cimetidine, phenobarb, ketoconazole, etc. etc. (What, pharmacists go to school?) Many of these induce the metabolism of steroid hormones, and the dose may need to be increased to ensure they work (or use something else). In that case, I'd still give the drug if the person insists, but I'll definitely suggest a physician referral. >> (otherwise a >> > physician referral, for example to administer an IUD, should be made). [quoted text clipped - 6 lines] > Sorta demonstrates that you do not know pharmacists don't administer an > IUD as part of their work. Pray tell how pharmacists "administer an interuterine device?? which has to be inserted via a pelvie exam?? or are you referring to another form of contraception?? Pray tell what other forms of emergency > contraception is appropriate in a "morning after" scenario? actually an IUD is NOT concerned appropriate for morning after protection... not to mention that it HAS to be inserted during menstrual bleeding...thus..is not an "after" contraception prior to plan b...some docs would "try" and induce bleeding/miscarriage with strange concoctions of oral contraceptives... to answer your ??....morning after scenario is intended to prevent implantation..possible prevent the egg from reaching the sperm in the tube...thus..why it needs to be given asap IUD is NOT appropriate....I have never heard of a provider inserting one simply to terminate a conception...and still wonder HOW a pharmacist would "adminster" an IUD...except perhaps to fill a script for one,,which is then taken to a provider..woman is placed into stirrups..etc etc... or am I missing something?? are pharmacists doing pelvics in the back room now?? >> > It's also an opportunity to explore the possible need for STD >> > evaluation [quoted text clipped - 4 lines] >> every >> female picking up OCP about this?? if you do...you are outa line please answer the question... do you ask females picking up OCPs about rape,,STD etc...if not..why would you think it is part of the sale of plan b >> And never mind the possibility >> > that reportable activities such as sexual abuse, statutory rape, etc. [quoted text clipped - 15 lines] > cases of sexual abuse. If a 13-year old comes in for Plan B, that would > be cause to think about reporting to Children's Aid. the above is about the ONLY situation that might fall within the purvew of a pharmacist scope of practice...tho one must remember that many 13 year olds are having consenual sex... in practice ...we do NOT report every and any 13 year old that comes in for birth control script...in this state..13 year olds can have abortions without parental knowledge...would be a big leap to call in CP service for every teen seeking contraception... >> > The pharmacist may also inquire the patient's medical and drug history >> > to make sure there's no drug interactions, adjustment in dose, etc. [quoted text clipped - 11 lines] > the drug if the person insists, but I'll definitely suggest a physician > referral. actually I did know that....but again...plan b comes in only one dose... > >> (otherwise a > >> > physician referral, for example to administer an IUD, should be made). [quoted text clipped - 11 lines] > > or are you referring to another form of contraception?? The whole line of conversation has gotten out of hand, but my point was exactly that pharmacists don't administer an IUD (which was obvious), and yes, if you go through the literature, an IUD is a possible measure to prevent implantation beyond the 72-hour window for OCs. As you can imagine, of course, it is not a popular course of action for most women. But it's out there. > Pray tell what other forms of emergency > > contraception is appropriate in a "morning after" scenario? [quoted text clipped - 6 lines] > prior to plan b...some docs would "try" and induce bleeding/miscarriage with > strange concoctions of oral contraceptives... All OCs, including Plan B, will cause bleedinig eventually in the form of a period. Don't get caught saying "miscarriage" now ... people might think you're trying to have an abortion. > to answer your ??....morning after scenario is intended to prevent > implantation..possible prevent the egg from reaching the sperm in the > tube...thus..why it needs to be given asap The drug doesn't affect fertilization (which is what you're referring to); it prevents implantation of the zygote onto the uterus which could be several days after fertilization. The "definition" is that if implantation doesn't occur, it doesn't count as a contragestive. And it's true: taking Plan B (or any other OC) after implanation will have generally no effect on gestation (thus the big deal about the 72 hours). There have been strange case reports about some women taking OC throughout pregnancy thinking that they weren't pregnant and gave birth to perfectly fine babies. > >> sorry...THIS is totally none of your business!!! just because I may be > >> pregnant has nothing to do with the possibility of STD's...do you ask [quoted text clipped - 3 lines] > please answer the question... do you ask females picking up OCPs about > rape,,STD etc...if not..why would you think it is part of the sale of plan b No, not as a matter of policy, but if there's palpable evidence that something is seriously wrong (e.g., physical trauma, looks like she's under 14, she's accompanied by someone she's clearly uncomfortable with and that person is not a parent/guardian), then yes I will quite likely probe around a bit. Nobody said it's a mechanical deal. > the above is about the ONLY situation that might fall within the purvew of a > pharmacist scope of practice...tho one must remember that many 13 year olds [quoted text clipped - 4 lines] > without parental knowledge...would be a big leap to call in CP service for > every teen seeking contraception... You're right, but you don't know a priori with whom the 13 year old has had sex. _That_ is the issue. > actually I did know that....but again...plan b comes in only one dose...< |
Enable EMail Alerts
Start New Thread
Reply to this Message