Regarding your March 7 article "JCAHO reconsiders abbreviation protocols," the notion that some physician groups are resisting use of unsafe abbreviations is mind-boggling. When a physician insists on his own personalized list of abbreviations, as opposed to the official compendia used by most hospitals, he is, in effect, saying he doesn't care. It is just another version of the "I'm too busy" excuse. If he is "too busy" to practice safely, then perhaps another line of work is in order.
Twenty years' experience in hospital pharmacy taught me the meaning of Murphy's Law: If it can go wrong, it will. It also taught me that a cavalier attitude among physicians is all too common.
The difference between mg and mcg is a factor of one thousand, and T.L.C. can represent the abbreviation for tender loving care or triple lumen catheter, but not both. Mis-interpretation of orders is easy enough when the physician writes ambiguously or illegibly, but an indifferent attitude toward specificity and precision is truly a prescription for disaster. All too many physicians, some of them foreign-born, lack the ability to prescribe with clarity and in a manner that excludes most possibilities for misinterpretation.
Ron Slade Sr., Pharm.D.
What we charge Regarding Dale E. Metzler's letter in your Feb. 21 issue, Mr. Metzler said he charges $60 an hour for a consultation. Consider the following going rates:
There is a message here.
M. Fogel, Ph.D., R.Ph.
Downside of DTC ads The question of whether or not Vioxx should be allowed back to the marketplace, as posted as an Instant Poll on your Web site in March, is oversimplifying the situation. Journal articles report that the COX-2 NSAIDs were overused by physicians for patients who really did not need them.
The overuse of COX-2 and other drugs has a definite effect on drug interactions and healthcare costs. Physicians are pressured by patients who see DTC (direct-to-consumer) advertisements in the media and by company sales reps to write for these drugs. Rather than taking the time to discuss the merits or appropriateness of the drugs with their patients, the physician writes a prescription. Physicians have lost the practice of serious discussions about their patients' health and the need for lifestyle changes.
Sam Schiffman R.Ph.firstname.lastname@example.org
Pharmacy can be exciting I just finished reading your Letters section and found that the pharmacists who wrote to you sound a lot like those sounding off in other pharmacy journals. If these pharmacists are so miserable in their current jobs, find another one. Or, better yet, they should find another profession.
I work in a rural community hospital with 285 beds and have done so for 13 years. I work 40 hours a week, I have six weeks of vacation per year, and I make over $90,000 a year, not including overtime.