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July 20th, 2013 - 01:11:52 AM
I completely agree. I do agree that the role of the pharmacy technician can be expanded to that extent. I do agree that technicians can independently refill a prescription that was previously checked by a pharmacist, but this assumes that nothing has changed on the patient's profile since that last prescription check was made. The thing that I am referring to is how would we have the technicians act in a situation where the refilling of a prescription becomes "clinical"? For example, if a new allergy is reported, or if the patient presents a brand new prescription to be filled, or any other change to their profile that might be clinical in nature. My idea is to forward these to the pharmacist. I am curious to hear suggestions from others, especially professors of pharmacy schools and pharmacists as well, as to how something like this can be addressed if we were to expand the technician role to this extent.
July 23rd, 2013 - 03:14:16 PM
Jon, in the scenarios you questioned in your comment, clearly the technician would get the pharmacist to address any new DUR alert that might occur when entering the refill into the dispensing system; just as it happens now.
I have been a Pharmacy Technician for 18 years and I understand the concerns about technician training. I started before there was any sort of standardized training, and we have come a long way since then. But, I strongly agree with the position in the article that the issue that many pharmacists are really concerned about is job security. I can’t blame them, without strict guidelines and standards in place it might be easy for large chains to take advantage of the situation and just use it as a way to be even more profitable. That isn’t the result that we are looking for.
As with pharmacists, there are varying degrees of capability, experience, and motivation among technicians. There are bad technicians, good technicians, and Super Techs! Create the opportunities to attract people with the aptitude and motivation to be Super Techs, and you will advance the pharmacy profession as a whole.
Currently, because of limited opportunities for advancement and the lack of roles beyond typing prescriptions and handling insurance issues, the role of the Pharmacy Technician is seen more as a "job" than as a “career" to many. I am very fortunate to be in a position where I am able to use my experience and knowledge in a much greater capacity. But, I don't know of more than a small handful of opportunities like mine. Does my role test the limits of my pharmacy technician training? Absolutely! I wouldn't have it any other way. I've sought out education and training above and beyond what is required so that I can be effective in my job. I've gained the respect of pharmacy professionals in my
Community and I even precept P4 PharmD students.
By raising standards, assigning greater responsibility (and accountability), and providing the opportunity for career advancement we can elevate the role of the Pharmacy Technician to that of a desired professional career. To be truly successful in this endeavor we must:
• Establish consistent standards for Pharmacy technicians, likely adding different levels of licensing similar to Nursing. (Pharmacy Technician I, II and III? Pharmacist Assistant?)
• Establish a standard method for incorporating existing technicians into to new roles.
• Set policies that dictate pharmacist/technician (+ tech type) ratios based on volume of work.
• Encourage and set the expectation that this is not meant as a method for reducing costs/increasing profits for business, but rather to improve patient care by freeing up the pharmacist to have more time for direct patient care.
• Consider looking at billing opportunities for certain encounters at the pharmacy such as MTM and expanded educational visits (such as one-on-one diabetic education or smoking cessation counseling).
I love my job, but outside of the position I am in, there aren’t a lot of fulfilling opportunities available for Pharmacy Technicians. Like anyone, we want to be able to work towards something better. I strongly encourage continued and open-minded conversation regarding expanding the roles of the Pharmacy Technician. Give us the opportunity, and we will show you just how Super techs can be!
Carmen Admire, CPhT
July 28th, 2013 - 02:19:28 PM
Carmen, I absolutely agree. Since I cannot hear the conversations going on at the management level where I am employed, I cannot imagine what their thoughts are on a role of such nature. I am wondering if the management at all pharmacy settings would welcome this kind of role for technicians? I have this feeling that they might be resistant to such change (which I would hate for them to feel, by the way) especially since many places are having trouble hiring technicians due to the new licensing requirements. I'm in Illinois, and ever since the state started requiring newer technicians to be certified, many pharmacies seem to be having trouble hiring technicians due to the fact that there is now an exam that stands in the way of licensing. Although I hate to see people not being able to get jobs because companies are expecting certification as a requirement for employment, I absolutely LOVE the idea of seeing pharmacy technicians elevated to a level that would benefit pharmacists and allow them to practice at the top of their license.
August 2nd, 2013 - 06:31:32 PM
I am been a pharmacy director for the past 35 years at six hospitals. While I agree with the need for standardized technician training, I am adamantly opposed to mandating that pharmacy technicians attend an ASHP accredited technician training program before they can take the PTCB exam. Now I understand why ASHP is advocating for such, as they have much to gain from such a proposal. Future technicians do not, as ASHP accredited programs are not plentiful. In rural states like NM there is only one in our state, the 5th largest state in area in the country. It would create a technician shortage and adversly impact patient care. ASHP can suggest training standards that state boards of pharmacy can adopt for technicians that they must complete under the direction of the PIC before they take a certifying exam.
Graduating and practicing pharmacists should be worrying more about finding a job, and keeping such, instead of the technician initiative that will more than likely not permit them to practice at the "top of their license". It is no secret that there is and will be a pharmacist surplus into the future. Our schools are graduating far too many pharmacists to secure their revenue stream, and more schools have been built to cash in on the number of students who wish to become pharmacists.
I hate to say, but practicing at the "top of your license" will be an impossibility if you canot find a job, or are replaced by technicians with an expanded role of responsibility. Let's not delude ourselves folks, the chain stores don't care if you practice at the "top of your license" and they are the major employers of pharmacists. They want the job done at the lowest cost possible. If that means doing more with techs and less with pharmacists, with an expanded tech role, some of us will be lucky if we can use our license!! I remember in the late 70's when an opening for a pharmacist would draw 30 plus applicants. None of us want to see that repeated, but that appears to be the current direction of our profession!!
August 14th, 2013 - 02:41:20 PM
Already practice at the “Top of my license.” That’s why I can’t get a job. No one wants pharmacists to be pharmacists. They want production, period. Have worked with more techs who were better than the other pharmacists on my team.
However, techs are not qualified to perform judgmental tasks. Regarding refills. What if someone’s NTG,
β- agonist, use sky rockets? We need to call. Did they spill them? Or are they suddenly needing more?..
Triage to specialist is warranted, STAT.
What if the previous (or me) tech/pharmacist made an error? Have seen many. Checking refills is a very important task. Most practitioners don’t realize it.
What if a new drug interaction(not yet in the computer) is missed? Have stopped Ticlodipine 250 TID. (Filled for years at mail order (2010). It’s an OD (BID) and the drug requires regular blood work.
New dosing. Tamiflu. My techs were mystified by the 60mg BID dose. The patient’s mom could hear them. I explained about the Japanese kids having SE. Hence the lower dose.
No tech can replace a proactive, up-to-date, pharmacist. That said. I could have never practiced at the top of my game without all the wonderful techs I worked with.