Raw deal for pharmacists causes backlash for liver patients

Pharmacists today are expected to fill hundreds of prescriptions a day and consult with patients about their medications. This takes some time - especially if the patient is taking many medications or is taking a new medication for the first time.

With liver patients some treatments can run in the range of over $50,000, so insurance plans are very careful to require that the patients get all the assistance that they may need in order to be adherent and comply with their doctors’ instructions. This is managed care. These treatments will not work for a patient if the patient is not following the regimen. Federal mandates hold the pharmacist accountable for ensuring that the patient understands how to use the prescribed medications, for example the new treatments for hepatitis C.

This would not be so difficult if the doctor, nurse or case manager, and pharmacist were on the same page - and were all being paid accordingly for the work they do. However, the most important elements connected with the consultation that the pharmacist provides the patient are education, training, time, and effort, and for these pharmacists are not compensated.

To keep their businesses afloat, pharmacists must focus primarily on what relates to the process of filling prescriptions. For pharmacists to fully employ their skills and drive the best possible health outcomes, an incentive must be provided that will help them properly meet the needs of patients and raise the standards of care. Then the healthcare system would be able to sustain patient-centered care in our society.

Until pharmacists are given an equal footing in the healthcare process, I see roadblocks in the care of people with viral hepatitis and other chronic conditions.

Professional pharmacists are the backbone of patient care when it comes to knowledge of the medications we take. If their place is not recognized and respected, then patients will continue to be deprived of access to a very valuable part of their care. The potential to reach the best possible health outcomes is hampered, and the overall cost of care increases, because of the greater risk of error.

In terms of patient care, the extent to which pharmacists are trained is far greater than is utilized. I always tell people who have questions about their medications to ask their pharmacists, because the training that doctors receive in medical school does not come anywhere near addressing what a pharmacist knows.

Next time pick up the phone and discuss your question with your pharmacist, I tell people. And if the pharmacist tells you to go back to your doctor, it is because a medication or dose needs to be changed and the pharmacist has recognized the necessity.

Also ask yourself, I tell them, what other profession you know of in which a person works or performs duties of their job without compensation. If the government requires them to do a job, then compensation must be provided.

Free service, free fall!

A onetime laboratory scientist at UCSF, William Remak is a survivor of liver cancer and two transplants. The organizations he established to help patients with liver disease have grown into networks in 26 states. He chairs the National Association for Hepatitis Task Forces and California Hepatitis C Task Force, and is on the steering committee of the California Chronic Care Coalition. E-mail him at William Remak wmremak@pacbell.net.