Kansas Anti-Birth Control Bill

As I was perusing the interwebs last night I stumbled across numerous people complaining about a bill that the state of Kansas just passed concerning birth control.

"I've been on birth control (I chose to) for the last few years. I think it's bulls**t that certain states have laws that allow pharmacists to deny women BCP's if they believe it's immoral. Last I checked this is 2012, not 1960!"

"Controlling birth-control is another way to control women; something our society is very fond of. We're treated like inept children who cannot be trusted to function on their own. I can only get access to 1 month supply's at a time, and one of the arguments is that women might 'over dose' themselves on their BC so we shouldn't be given too many months supply at a time. I wish I was kidding.  It's controlling women, controlling our bodies, and owning us. Every woman regardless of opinion on BC should be furious with this."

"So I would be screwed if I lived in the states. I suffer from ovarian cysts and the only thing keeping me from unbearable pain and surgery to remove the cysts or in a worst case scenario my ovaries is the pill."

I feel quite passionate about this bill too, but I am sad that the government feels as though it is necessary.  The public looks at the pharmacy and sees it as nothing more than a dispensary.  A place to get the medicine that a doctor, PA, nurse practitioner, or dentist prescribed.  A place where a pharmacist has no business second-guessing what a health practitioner prescribed for.  A place where the pharmacist simply dispenses the medication, and has no emotion or opinion about it.


A pharmacist should be able to question the validity of a prescription.  If a patient is constantly refilling medications early, or too late, then maybe they are taking them improperly to begin with.  If they are taking numerous medications in the same drug class, that also needs to be looked at.  If they are doctor shopping and getting numerous medications, that should be flagged.


I agree that a woman should be able to decide what to do with her own body and should feel free to go wherever she welcomes to receive this treatment.  I do not, however, believe that a practitioner should be forced to do something that he or she is uncomfortable with.


From one of the excerpts that I found here:

"No person shall be required to perform, refer for, or participate in medical procedures or in the prescription or administration of any device or drug which result in the termination of a pregnancy or an effected of which the person reasonably believes may result in the termination of a pregnancy, and the refusal of any person to perform, refer for, or participate in those medical procedures, prescription or administration shall not be a basis for civil liability to any person.  No medical care facility, medical care facility administrator or governing board of any medical care facility shall terminate the employment of, prevent or impair the practice or occupation of or impose any other sanction on any person because of such person’s exercise of rights protected by this section."

Basically, from my understanding, it is saying that a medical professional has the right to refuse service to a patient due to their religious and/or spiritual affiliations and beliefs.

Hm.  Okay.  I understand that aspect of the bill.  Freedom of beliefs should be enjoyed by all people.

The only issue that I take with this bill is the "...the refusal of any person to perform, refer for, or participate...."

So a medical professional can refuse the service AND not be obligated to refer the patient who would do such a service?  That seems quite childish and unprofessional to me.  "I don't believe that what you're doing is right even though it is your choice to make about your own body, so I'm not even going to help you find someone who would.  :-P !"

A medical professional is a person who wants to help a patient as much as possible and do what they can to complete such tasks.  However, a professional should not feel as though they are threatened of being fired, demoted, or just blacklisted for doing what they feel is right for themselves.

If the bill removed the "referring" clause, I think I could stand behind this idea.

P.S. - I am a female who has been taking oral contraceptives on and off for the past 3 years.  I take it for the lovely cramping, acne, and PMS issues (severe depression and anger), as well as a contraceptive.  I have taken Plan B before and have no issue providing it to patients.

Please let me know your thoughts.

So much to say!

So many things have occurred since my last posting.  I have finished my first year as a pharmacy student.  I passed all of my spring semester classes, and was only 0.10 points from making Dean's List.  I'm so happy to be done with the year though.  Now I get to crochet and read as much as my heart desires!

My school is a tad different than most pharmacy schools.  Instead of completing internships and rotations during the summer between school years, we do them during the semester on a designated day.  However, we are trying the summer rotations this year.  I am completing my retail phase right now and will participate in the institutional phase (hospital) in the fall.

I am with a local, somewhat private pharmacy / knick knack store that has 2 other locations within the state.  They cater to a much older crowd, and I like it in a lot of ways because there is not a lot of red tape to go through to do what you feel is best for your patient.

"Oh look, we're running low on [drug].  We'll order some more, but in the meantime give [patient] our last #15 and we'll owe them the rest when it comes in."

No three day loans!  You can loan them as much as you want!  And the on-orders come every day of the week!

The patients know the technicians and the pharmacists, and will sometimes just stop by to chat.  It's truly surreal...

However, given that it is largely populated by the elderly generations, there can be some short fuses for all parties involved.  Needless to say one technician is no longer with us in the pharmacy because things became a little too heated.

All that aside, I feel very welcomed into my rotation site.  I feel more accepted there in the 2 weeks I've been there than in 10 months at my workplace.  It truly makes a huge difference depending on the people that you work with.  If I hadn't just received health and 401K benefits at my workplace, I would seriously consider asking to be hired onto my rotation site...

Biggest Critic

Tonight was awful.  I'm so happy to have a day off tomorrow because I'm in just a... depressed mood about myself.  I'm my biggest critic in anything.  If I say or do something that I later realize was the slightest error, I will replay it over and over in my head.  I guess it's kind of a punishment.  I can't ever let anything go, even if it's all fixed and no harm, no foul.

Tonight I worked the troubleshoot queue.  A prescription came up that said someone in the pharmacy had called the doctor to alert them of a prior authorization.  Okey doke.

I noticed in the rejection that the insurance would pay for #10 in a 30 day fill.  Ah, the prior authorization must have gone through!  At least they'll cover #10...  *checks prescription*  Doctor had written for #90?!  That must be a typo...  *fix to #10 and fill!*

It gets filled.  The floater pharmacist verifies and bags it.  The patient picks it up and I tell them what the insurance will cover.  They say that it's supposed to be a maintenance drug, but whatever.  They are pleased with a $0 copay and leave.  If that's what insurance will cover, then so be it.

Later on I ask the stable pharmacist about the quantity and dosage and am told that we were waiting on the prior authorization because it is for maintenance.  That low dosage is to keep it in their system at all times.

I feel guilty.  I feel upset.  I feel stupid.  I feel like I've let down my pharmacist, the one who depends on me to make their job easier.  I've just increased their workload ten-fold.  I feel so disappointed.

I call the patient later on when possible and let them know of our mistake.  They understand (patients up here seem to all the time...  it's quite amazing) and say that they will bring it back so we can resubmit the claim to the insurance for #90.

The pharmacy manager comes by to do some shopping and the whole story is relayed to them.  The look of...  well... not surprise, because who could be surprised that it was me who released the prescription?  Disappointment.  Frustration.  Exhaustion.

The patient brought it back and we resubmitted it.  Now we wait for the prior authorization.

I'm never working the troubleshoot queue again.

However, no one else ever does either.  I've never seen other techs working on it.  Prescriptions can be stuck in there for an hour if the pharmacist is too busy before it will show up on their screen again....

Yes.  Tomorrow's day off cannot come soon enough....

Stupid classes and their stupid requirements...

I am so mad right now.  I need to be careful to not write back anything horrendous to the teacher, so therefore, I am going to rant about it instead.

We have internship during the school year.  I am with the health department.  I have been having a great internship in which I'm involved in numerous different sections of the department and get to see lots of ways we help patients.  Awesome.  I'm involved in numerous projects and see different things each week.  Wonderful.

I have been getting 100s on all of my papers in this class.

Well, for this one paper I wrote how I was "bored" because the preceptor left me alone for half an hour (and really for more like 1.5 hours, but I was being nice) and I had nothing to do.  That's because I had finished what they wanted me to do and were elsewhere.  I didn't have my computer to work on anything else.  What am I supposed to do, start roaming around the hallways or look through their desk to find something else?  Umm...  no.

Then we had a class where we talked about cultural competency.  I got a freakin' 60% on this paper.  WTF.

"I am concerned that you were "bored" when your preceptor was not available to you.  Perhaps you need to be a little more assertive in finding things to do or explore.  Have you had an opportunity to be involved in any of the clinics such as STD or immunization clinics?  Your description of Professor ***'s "game" was interesting but [I] would have like[d] to see you explore a bit more of how the concept this [of] game was illustrating may be helpful to you in your practice."

Ok, for one, I have already been a part of the STD and immunization clinics.  Did you NOT read my other papers?  Another, me writing about how that game presented how people have difficulty communicating and how it can lead to stereotyping and racism should have been all I needed to describe what I got out of the lecture.  Being racist and sexist = bad for pharmacy business.  Apparently I have to spell it out and make it idiot-proof.

I really want to write a nasty email to this professor.  I'm not the first person to get a bad review due to "not being involved" and truthfully writing about how I felt.  Others get penalized for writing how they never get any experience with patients, and are told off because "rawr rawr rawr you should be with your patients and be more active in your internship rawr rawr rawr."  Apparently I need to badger my preceptors to get them to have me do stuff, even though there is ABSOLUTELY NOTHING TO DO.  I just want to point out her poor grammar and thump her on the forehead.  I don't feel that I can say anything though because she will hold a grudge and that will affect my future grades.

We are encouraged to write about our feelings and experiences.  And NOT WRITE ABOUT WHAT WE THINK THE TEACHERS WANT TO HEAR.  I feel as though I have been lied to.

A rose by any other name...

I was working on something arbitrary when I overhear this exchange:

Technician: "Yes ma'am, can I help you?"

Lady: *mumble mumble* "Willow bark."

Technician: "I'm sorry, what was that?"

Lady: *mumble mumble* "I'm looking for willow bark...."

Technician: "Umm...  Ok.  What is their date of birth?"


Funny thing is, you can almost be guaranteed that some child, somewhere, has the name "Willow Bark."

Leap!

Just goes to show how stressful school is when I'm contemplating quitting, suicide, or self-harm when I fail a quiz for the third time in a row.

It's freakin' pharmaceutics.  Industrial pharmacy.  IT SHOULD NOT BE THIS DIFFICULT.

However, it will be extremely difficult for me to make a B in this course now.  How sad.

Work is hard.  We left the pharmacy in disarray yesterday.  The shipment was not put on the shelves.  There were still 25 fills to complete, and the pharmacist still had ~20 to final check.  I'm sure the pharmacy manager was thrilled this morning when they opened....  -_-

In other news, I'm doing rather well in my other courses, all things considering.  I'm looking at making at least Bs in everything, whereas last semester I was praying to pass with a C.  It's nice to have a buffer.

We're having legislature day next Monday in where everyone is going to the capitol to view what sort of bills they're thinking of passing.  One is requiring prescribers to check the controlled substances database to avert people from doctor shopping before they even get to the pharmacy.  Seems to be doing well and has numerous supporters.  Another is attempting to change pseudoephedrine back into a prescription, which is not getting much backing.  However, seeing how a new meth lab is found every night on the news in this state, much less the city, I don't see why not...

A couple other bills they're looking into:

• creating a MTM and setting out funding sources for this program and requiring 3rd party payers to pay a fee to pharmacists
• expanding immunization types to pharmacists
• include pharmacists and pharmacies in defining "health care provider"
• prohibit pharmacists from refusing to dispense medications without a valid reason
• prohibit pharmacists from refusing to dispense medications unless they have told their employer the reason why they decline to dispense
• prohibit tobacco sales from pharmacies
• allow unlicensed personnel to administer medicines when patient is unable to do so
• examine cases with unintentional overdose death
• prohibit a person from having more than 2 Rxs for a specific controlled substance or any with a similar therapeutic use if they are filled within 72 hours of eachother, unless patient can provide an affidavit from prescriber
• have pharmacies submit info to the controlled substances database within 24 hours instead of once a week
• require name and address of person picking up for someone else if medicine is controlled
• permit pharmacists to prescribe certain medications without an order by a prescriber
• require Medicaid to annually review and adjust rates paid providers
• require prescribers to prescribe Naloxone with opioids

So yeah, more than a couple, but I thought they were interesting.

Oh Silly Dreams...

I have Monday mornings off from class, so I usually get to sleep in a bit more than usual.  It was certainly welcomed after I worked for the past 4 days.

However, my brain doesn't want to shut off!  I dreamt that I was still at work.  It was awful.

I was working at the cash register, checking out patients and sending them on their way.  An older lady came up and gave me her name, "inaudible gibberish" and said she was here to pick up her prescriptions.  I asked her 3 times to repeat her name, and each time she became more aggravated.  I never did find out what her name was, but the doctor had never called in the medicines.

Right at that moment she asked me where the gibberish ice was.  I had never heard of such a thing.  She claimed that this was the worst service that she's ever gotten before, and would have me fired.  Luckily, another customer knew what she was talking about and took her to the vitamins.  For ice.  WTF?

Five minutes later she comes back to pick up her EIGHT prescriptions, which were actually ready!  I was shocked.  I asked for her name again - "gibberish"  She once again got super pissed at me and wanted to speak with the manager.

I never found out her name.

I have work again tomorrow night, but after that I'm done for the rest of the week.  I'm very excited, considering how often I've worked recently.  However, the only reason I have so much time off this week is due to the large amounts of tests and quizzes.  Bah.