Comments on: My take: Mandate wars, reimbursement, ignoring physicians http://www.kevinmd.com/blog/2008/02/my-take.html medical blog Mon, 23 Nov 2009 01:35:28 -0500 http://wordpress.org/?v=2.8.4 hourly 1 By: Chris, Pharm.D. http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83364 Chris, Pharm.D. Tue, 05 Feb 2008 21:35:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83364 I agree with physician oversight. I do not advocate the "Minute Clinics" and other retail clinics that do not have a physician present. I like the North Carolina model which has licensed "Clinical Pharmacist Practitioners." The initial diagnosing and prescribing is done by the physician. Follow ups for drug titration, etc can be done by a CPP that has a practice agreement with that physician. The CPP works for the physician much like a PA or NP. I agree with physician oversight. I do not advocate the “Minute Clinics” and other retail clinics that do not have a physician present. I like the North Carolina model which has licensed “Clinical Pharmacist Practitioners.” The initial diagnosing and prescribing is done by the physician. Follow ups for drug titration, etc can be done by a CPP that has a practice agreement with that physician. The CPP works for the physician much like a PA or NP.

]]> By: Justin http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83348 Justin Tue, 05 Feb 2008 16:14:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83348 Chris,<br/><br/>Yes, I agree, drug therapy management is a pharmacist's job...in conjunction with a physician who is actually providing patient care. <br/><br/>What you're proposing sounds like a pharmacist vying for increased income by skirting their scope of practice. Seems like a common theme in health care.<br/><br/>Justin Chris,

Yes, I agree, drug therapy management is a pharmacist’s job…in conjunction with a physician who is actually providing patient care.

What you’re proposing sounds like a pharmacist vying for increased income by skirting their scope of practice. Seems like a common theme in health care.

Justin

]]> By: Chris, Pharm.D. http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83346 Chris, Pharm.D. Tue, 05 Feb 2008 13:31:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83346 Anonymous: Pharmacotherapy Specialists do not work in retail pharmacies. They work in physician offices and hospitals. If you investigated, you may be surprised at the amount of education and training required to obtain that certification. Also, you may want to Google "Asheville Project" and read a little on whether or not pharmacists are qualified to manage chronic disease states.<br/>Justin: Drug therapy management is part of a clinical pharmacist's job description. I guess everyone thinks of the old man behind a counter counting pills...it's just not that way anymore. Anonymous: Pharmacotherapy Specialists do not work in retail pharmacies. They work in physician offices and hospitals. If you investigated, you may be surprised at the amount of education and training required to obtain that certification. Also, you may want to Google “Asheville Project” and read a little on whether or not pharmacists are qualified to manage chronic disease states.
Justin: Drug therapy management is part of a clinical pharmacist’s job description. I guess everyone thinks of the old man behind a counter counting pills…it’s just not that way anymore.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83342 Anonymous Tue, 05 Feb 2008 04:03:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83342 I totally agree with your point Kevin. If the politicians want to keep jacking up the system. Be my guest. They've been screwing it up for decades now. There's nothing I'd rather see than a total meltdown. And contrary to Pete Stark's beliefs I can do alot of other things beside medicine. Don't push me you might not like want you get and you may have no one when you really need it. At least I know I can call in a favor for me and mine. Pete Stark, not so much. I totally agree with your point Kevin. If the politicians want to keep jacking up the system. Be my guest. They’ve been screwing it up for decades now. There’s nothing I’d rather see than a total meltdown. And contrary to Pete Stark’s beliefs I can do alot of other things beside medicine. Don’t push me you might not like want you get and you may have no one when you really need it. At least I know I can call in a favor for me and mine. Pete Stark, not so much.

]]> By: justin http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83339 justin Tue, 05 Feb 2008 03:04:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83339 Chris, <br/><br/>If you wanted to be a physician you should have gone to medical school.<br/><br/>Justin Chris,

If you wanted to be a physician you should have gone to medical school.

Justin

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83337 Anonymous Tue, 05 Feb 2008 02:32:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83337 i don't think pharmacist should be doing more and i think most docs feel the same way. i think they are fine in their field, but a complicated diabetic having their care managed by a pharmacist. Can you even see their feet from the pharmacist window? It's absolutely vital for the exam. Plus do a ophthalmologic exam or a ekg? I guess if you just want to add another appt to the patients list of chronic appts and pull more dollars out of the system, that would be a fine idea. i don’t think pharmacist should be doing more and i think most docs feel the same way. i think they are fine in their field, but a complicated diabetic having their care managed by a pharmacist. Can you even see their feet from the pharmacist window? It’s absolutely vital for the exam. Plus do a ophthalmologic exam or a ekg? I guess if you just want to add another appt to the patients list of chronic appts and pull more dollars out of the system, that would be a fine idea.

]]> By: Chris, Pharm.D. http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83334 Chris, Pharm.D. Tue, 05 Feb 2008 02:08:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83334 One way to help with the primary care physician shortage may be to expand drug therapy management that is done by QUALIFIED pharmacists. Chronic disease states such as diabetes, asthma, and heart failure could be managed by a Board Certified Pharmacotherapy Specialist (a licensed pharmacist with advanced training and testing beyond that of a regular pharmacist) and free up more time for a primary care physician to work on the more acute cases. Just a thought. One way to help with the primary care physician shortage may be to expand drug therapy management that is done by QUALIFIED pharmacists. Chronic disease states such as diabetes, asthma, and heart failure could be managed by a Board Certified Pharmacotherapy Specialist (a licensed pharmacist with advanced training and testing beyond that of a regular pharmacist) and free up more time for a primary care physician to work on the more acute cases. Just a thought.

]]> By: DermDoc http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83333 DermDoc Tue, 05 Feb 2008 02:05:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83333 I'm a Pats fan in San Diego where there was celebration in the streets today. <br/><br/>It been a long, bad day. Not as bad as Tom Brady's, but a long, bad day nonetheless.<br/><br/>I'm afraid the Pats waned while the Giants waxed last night. They simply lost the physical game. <br/><br/>Offensive line wherefore art thou? I’m a Pats fan in San Diego where there was celebration in the streets today.

It been a long, bad day. Not as bad as Tom Brady’s, but a long, bad day nonetheless.

I’m afraid the Pats waned while the Giants waxed last night. They simply lost the physical game.

Offensive line wherefore art thou?

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83327 Anonymous Mon, 04 Feb 2008 20:43:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83327 Anon 3:19,<br/><br/>They haven't ever mentioned fixing the physician shortage, addressing access problems, reimbursement from Uncle Sam. They just like giving the feel good message that once we all get insurance, we'll all be well taken care of. They're clueless. And that scares the absolute hell out of me. Anon 3:19,

They haven’t ever mentioned fixing the physician shortage, addressing access problems, reimbursement from Uncle Sam. They just like giving the feel good message that once we all get insurance, we’ll all be well taken care of. They’re clueless. And that scares the absolute hell out of me.

]]> By: Anonymous http://www.kevinmd.com/blog/2008/02/my-take.html/comment-page-1#comment-83326 Anonymous Mon, 04 Feb 2008 20:19:00 +0000 http://clients.emmense.com/kevinmd/2008/02/my-take-mandate-wars-reimbursement-ignoring-physicians.html#comment-83326 I wouldn't conclude that physicians aren't included in the planning of the candidate's proposed health care policies based on they did not say the words "physicians" or "doctors" during the debates. I wouldn’t conclude that physicians aren’t included in the planning of the candidate’s proposed health care policies based on they did not say the words “physicians” or “doctors” during the debates.

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