Online comment to “FIP Panel: Pharmacists Are an Untapped Resource” (May 2013)
Please advise as to how a person with no diagnostic training, having not done an examination, not having evaluated a possibly very complex battery of simple or complex laboratory tests, not having sorted through the complex interplay of physical, physiologic and psychosocial factors and potential comorbidities, could improve upon the decision-making process of someone who has, at least in theory, met these qualifications? Gimme a break.

Is the pharmacist going to spend an hour, often with models and diagrams, explaining to the patient what his or her medical problem appears to be and what the most appropriate potential treatments, pharmacologic or otherwise, might be? If that is what is proposed, then the pharmacist is really a physician and should simply be reclassified as such.

How the pharmacy profession presumes to rectify the very real problems of overprescribing and woeful patient compliance in the face of the above, demands explanation. One cannot help but be reminded of the dangers of the combining of arrogance and ignorance. Generating broadsides at the medical profession, simplistically painting all physicians with the same paintbrush, and then proposing themselves as a solution, appears disingenuous at the very least. Or, cynic that I am, do I smell the careful, under-the-radar hand of the sophisticated, well-funded pharmaceutical industry exploiting the age-old guild-like motivations of pitting one profession vs. another?

Efforts to somehow validate this proposal with vague commentary about the cost of pharmaceutical waste in this country are equally hollow. The incredible waste, overpricing and pathetic level of medication compliance detailed in the article are certainly real. But this proposal smacks of exploitation rather than an effective solution.

We really do appreciate pharmacists’ help where they have expertise. But this effort to tread into waters where they are unqualified is not helpful—except, perhaps, to commercial interests who have no ethical commitment to, or professional responsibility for, the individual patient’s best interests, and who instead only focus on their limitless obligation to their stockholders and performance bonus.

If pharmacists really want to treat patients, why not simply go to medical school? After all, they say there is a shortage of physicians. Shouldn’t be that hard to get into medical school. And if it is, does that not underscore the concept that maybe making all these complex decisions does demand more awareness than is obtainable by pharmacy training alone?

Editor’s note: This reply was posted on the website of our sister publication, Pain Medicine News, which shares some content with PPN and is sent to U.S. physicians specializing in pain medicine.