Is the Federal government pressuring pharmacies to make bad decisions? Information provided to the Colorado Conservative Examiner yesterday (June 01, 2013) may contain the answer. Three months ago, the Colorado Conservative Examiner was approached by a nationally renowned medical professional. The Doctor of Osteopathy, a top ranked Colorado practitioner and lauded pain management and narcotics addiction specialist, expressed deep concerns over a new “policy” at Kroger pharmacies (read the full Kroger article here).
When contacted by the Colorado Conservative Examiner, Kroger denied any policy that essentially “blacklists” physicians. A Kings Soopers pharmacist (owned by Kroger) in Arvada admitted there was a policy against “certain physicians,” but he added that Kroger was only following the policy of the Federal government.
The Kroger investigation is still underway, but it appears that Walgreens has also joined the fight against chronic pain. Unfortunately, some in medicine feel the national pharmacy is on the wrong side of the fight, and now, a second accomplished medical professional has approached the Colorado Conservative Examiner for help exposing bad policy Colorado pharmacies.
On June 01, 2013, a confidential source in the medical community provided the Colorado Conservative Examiner with a copy of a letter that was mailed to countless Colorado medical providers. In the letter, Walgreens detailed their amended policy toward dispensing controlled substances in one page letter that placed the “blame” on the Federal government (pictured in the slideshow);
“Under Federal regulation, pharmacists have a responsibility to ensure that each prescription for a controlled substance is “issued for a legitimate medical purpose.” (21 U.S.C. 820) To make that determination, pharmacists may need to gather additional information, including patient diagnosis and expected length of therapy. This will be necessary on some, but not most, prescriptions. We understand this diligence takes extra time, for our patients, and for you, our partnering physicians…”
The Walgreens letter to prescribers explained that the revised policy is good for America;
“Our country is experiencing a serious and rapid increase in the abuse of prescription controlled substances. The safety of our patients and the general public requires that all health care professionals increase vigilance to stem the abuse of these drugs and prevent death and injury.”
Meanwhile, what has the retail giant done to prepare patients for the fact that Walgreens pharmacists will ultimately determine if their physician’s prescriptions are “worthy” of being filled?
Flyers are plastered on the drive-through window and the pharmacy counter windows of the Walgreens located on forty-fourth and Wadsworth (pictured in the slideshow images). It is safe to assume this method of informing the public is common to all Walgreens locations. The photocopied announcements state that the new policy could result in the delay or denial of a patient’s prescription by Walgreens. There was no other explanation nor were there instructions for the patient to learn more.
This policy by Walgreens essentially makes the pharmacist the ultimate decision maker in a patient’s overall care. Unfortunately, many if not most pharmacists are wholly unequipped to make such determinations as illustrated by the Bureau of Labor Statistics website;
Pharmacists must have a license from the State in which they work. After high school, it usually takes at least 6 years of study, including college and pharmacy school, to become a pharmacist. The person must also pass a certification test. People who want to be pharmacists should be good at science and math (full report by the BLS here).
It usually takes 6 years of study to become a pharmacist… Conversely, the BLS also explains what it takes to become a doctor;
Becoming a doctor requires more training than most other jobs. It usually takes at least 11 years to become a doctor: 4 years of college, 4 years of medical school, and 3 years working in a hospital. For some specialties, doctors may have to work in a hospital for up to 8 years [a total education/work-study of 16 years] before they are fully trained (full report by the BLS here).
Physicians have twice the training and knowledge of a pharmacist; specialized physicians (such as the Doctor of Osteopathy who approached the Colorado Conservative Examiner about Kroger in March 2013) have much more training than the standard “doctor” described above by the BLS.
Considering the BLS information, is a pharmacist with six years of training and work-study better qualified to ascertain the medical necessity and legitimacy of a prescription than a physician with 12 to 16 years of education and work-study?
Furthermore, is it best for the patient to leave decisions about their care in the hands of a profit-fueled retail giant instead of an impartial physician that does not benefit financially from selling certain prescription medications? It seems the potential for fraud and abuse is escalated with the new policy by Walgreens, but only time will tell.
To gain a deeper perspective, the Colorado Conservative Examiner interviewed several veteran chronic pain patients on June 01, 2013. A patient named William, who asked that his last name remain confidential, read the Walgreens letter to prescribers and was reminded of an event from 2009;
“Several years ago, I stood in line at Walgreens waiting to fill a prescription. An elderly woman ahead of me was very casual with the staff as she asked the pharmacist, ‘Have you heard of this crazy OxyContin stuff?’
The pharmacist replied, ‘Yes… We have people fill that drug every day.’ Then she added, ‘You know…they call it hillbilly heroin.’ Both women chuckled and had a “moment.” I looked down at my prescription for OxyContin, a drug that I did not want to take in the first place, and I left immediately. It was one of the most degrading and embarrassing experiences of my life.”
If the Walgreens’ photocopied signage read, “…your physician may be contacted to verify a prescription is valid,” then patients like William would accept that. Instead, the letter and posted information specifically states that Walgreens pharmacists may need additional information, like the patient’s diagnosis and the length of the proposed therapy, to make their (unqualified) determination of “legitimate medical purpose.”
William looked at the letter from Walgreens and lamented;
“Now, pharmacists who call OxyContin ‘hillbilly heroin’ will have all the control over my quality of life. Most of them only see a drug-seeker when they look at me, and they will have the final say about treating my chronic pain? Most physicians do not even understand how to treat chronic pain [sic].
A pharmacist definitely does not have the knowledge, training or experience to determine the validity of my prescriptions. I can see the change in a pharmacists face and demeanor the moment they pull up my records and see long-term narcotic use, the discrimination begins almost immediately.
On top of the obvious profiling I face almost every time I enter a pharmacy, every day that my medication is delayed…is another day I spend in a living hell.
How do I explain that to some 25-year-old kid who graduated from school [pharmacological school] six months ago and doesn’t have a clue about treating chronic pain? Even a one day delay is potentially catastrophic to my mental health and physical wellbeing, but I’m sure that most pharmacists could care less.
The Colorado Conservative Examiner will continue to investigate this story. This article was meant to educate the customer about changes at Walgreens. Readers who want to express their opinion about the Walgreens policy about the good faith dispensing of controlled substances should call 1-800-Walgreens, visit www.walgreens.com, or visit the Facebook page of the national pharmacy and retail giant (located here).
View Indomitable: The Chonic Pain Survival Guide at http://www.youtube.com/watch?v=5mwF-KUXn2I
Visit Indomitable: The Chronic Pain Survival Guide on Facebook at https://www.facebook.com/ChronicPainSurvivalGuide