Alan Chartock | I, Publius: Let pharmacists fill void left by doctor shortage
GREAT BARRINGTON — It is not easy to find a doctor. The whole landscape has changed, with not enough general practitioners to go around.
They are supported, in some cases, by nurse practitioners and physician assistants. These are often well-meaning people but it just isn't the same as having access to fully credentialed doctors.
Some of us remember the days when doctors would arrive at your house with a black bag and a stethoscope. Those days are long gone.
The Fairview emergency room in Great Barrington where I live is heaven sent. These people really know their stuff. They have to. Hospitals are buying doctors' practices and the doctor patient relationships are changing, sometimes for the worse. So what's to be done?
One possibility is to allow pharmacists to prescribe drugs, on a state-by-state basis. This is a very complicated matter. You can't dismiss the role that money plays in the medical and pharmaceutical professions.
The pharmacists and the doctors will tell you, and I believe them, that the most important consideration is the health of the patient. It kills me that if you are in a strange city and away from your drug store and you need a few pills to tide you over, a local pharmacist, even of the company that you trade with, can't get you a few pills.
Of course, we know that there are European countries where you can buy most non-addictive medications over the counter.
We know that getting a pharmaceutical degree is no easy matter. We are talking about five years of hard work. In many cases, the pharmacists have more basic knowledge than the docs do. They have to know about drug interactions and what medicines should not be prescribed to folks with various medical conditions like diabetes.
Some will tell you that there is a checks and balances system in place so that the docs and the pharmacists are watching each other. One pharmacist told me that doctors are no longer able to compound their own drugs, something they formerly could do.
Each state makes their own regulations and each profession has lobbyists galore to protect themselves. Many people believe it's ludicrous to have to ask a doctor for an antibiotic every time you need one.
On the other hand, the docs and many pharmacists will tell you that we have over-prescribed these drugs to the point that they are losing their effectiveness. Both the doctors and the pharmacists know that and there will always be those who would besmirch the motives of the other group.
For example, I know some who believe that some pharmacists are in league with the drug companies, otherwise known as "big pharma." Frankly, my beloved pharmacists have never ever done anything that would suggest I use a different drug than that which has been prescribed, even when I have asked them about it.
As for the doctors, there is always the question of whether they have kept current on the various new medications. Then there's the big question as to whether what they prescribe is safe. We all know that while the Food and Drug Administration lays hands on new drugs, it isn't until millions of people take them that we really find out what bad stuff comes with them.
As for me, I think that we need to loosen the rules to the point that we make it far easier for these trained and very ethical pharmacists to hear a medical complaint and use their knowledge to help us.
Hey, if physician assistants and nurse practitioners can prescribe, it is nonsense not to give that right to pharmacists. And by the way, I am not so sure that all druggists want that responsibility, but we are in a crisis and this seems to be one small way to help get people the assistance they need.
Alan Chartock, a Great Barrington resident, is president and CEO of WAMC Northeast Public Radio and a professor emeritus of communications at SUNY-Albany. The opinions expressed by columnists do not necessarily reflect the views of The Berkshire Eagle.
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