Are pharmacists sufficiently trained?

JdotJ

Whitewavemark2

Wish I hadn’t started the thread now. 😄

So do I, much like most of your threads whereby you goad into provoking a reaction.

Well, I think it's a valid topic for a thread.

I think we all know that the current plans for the NHS involve more people who aren't necessarily trained as doctors. Like many, I'm sceptical, but I can also see that if the parameters are tightly controlled, people such as pharmacists, para medics, nurse prescribers, etc have an important role to play.

Quite honestly, we diagnose ourselves quite a lot of the time and we know what treatment is needed. Unfortunately, some of the treatments we give ourselves aren't good, so I think it's useful to have quick access to somebody with a better knowledge of drugs than the average person, with the proviso that people will be advised to see a doctor if the diagnosis is unclear.

I'm thinking in particular of eye infections. Like countless others, one of my children was prone to them. I knew what to do and I also knew when it was serious enough for an antibiotic ointment to be prescribed. I don't know how many times I dragged my daughter to the pharmacist for a second opinion and to buy little phials of sterile water. It was always so frustrating to be told that an antibiotic was needed, but I need to see a GP to prescribe.

I also remember being taken to a pharmacist when I broke my arm as a child. My parents didn't know whether the arm was broken because it didn't hurt. The pharmacist took one look at me and told my parents to take me to A and E. However, if it had have been a bad sprain, I guess I could have been given a bandage and told to rest my arm and saved valuable hospital time.

Always leave minor injuries dry and as open as possibly consistent with hygiene.
Never use antiseptic creams; they invariably make things worse.
Normally you would expect to trust an actual pharmacist; their training is long and hard and they know more about substances than many doctors do, but diagnosis is not in their remit.

I’d say some are some aren’t last year I went to dentist with pain in my gums he give me some antibiotics i said are they ok with my medication I’m on he said yes but ask the pharmacy to make sure. I asked she checked on screen and she said yes so I went ahead and took them 12hrs later I was blue light to hospital my blood pressure was crazy high then flat dropped crazy low I was blacking out and somehow rang 111 who sent an ambulance I spent 4days in hospital on a drip with broken ribs and fractured shoulder. Dr at hospital said on the website that all medical professionals see in red i shouldn’t have been given the pills so for me no i don’t trust them all

Callistemon21

It depends.

Not all pharmacists are trained to Masters degree level.

Some are pharmacy assistants.

That's not true. As a pharmacy assistant of 7 plus years, I can say with confidence that there's a lot a properly trained pharmacy assistant knows and does, but he/she is most definitely NOT the same as a pharmacist, who has undergone many years of extremely specialised training and exams.

I have been in a queue many times where pharmacists have given advice and no documentation of the event seems to happen. Where is the traceability and accountability I wonder. It feels to me very much as though the public are being sold the idea of easy access specialist care where the pharmacists have no or at least very little training in such things. They are after all specialists in pharmacutical matters and not GPs and I feel very sorry for them having had this role forced on them.

*infected.

But if it's still red &sore perhaps it IS infected? Certainly sounds like it to me,🤔our new local pharmacist is very good,but trouble is when your on holiday you don't know what they are like.However I'd have thought an antibiotic OINTMENT would have been a better suggestion for an infested foot blister not an oral antibiotic.(several years ago DD had an infected ingrowing toenail and that is what she was given by a dr-it cleared up infection ok.Then he treated the nail.) Same when other DD had an infection down side of a fingernail-what I'm saying is maybe a Doctor would rather treat something small topically rather than by swallowing tablets-but I'd have thought that would be a first step even from a pharmacy.Maybe they had'nt finished all their further training yet as I'm sure some pharmacists CAN already prescribe.🤔

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I’ve just had a phone call off a trained pharmacist who was very knowledgeable about other medications I’m taking. I’m going on statins and he’s ordered certain blood tests to check levels in my other meds very carefully described different things @nswered questions and was very good. No problems with me trusting them at least he had time to explain.

Whitewavemark2

Wish I hadn’t started the thread now. 😄

So do I, much like most of your threads whereby you goad into provoking a reaction.

At a time when GP services were running well, no-one went to a pharmacist for a diagnosis. It is telling that this route has only become more prevalent as proper medical services have dwindled and people cannot get appointments with their GPs.

Casdon

Sorry if this is a bit of an essay, but it’s not true now, although maybe it was more so 20 years ago.

Community pharmacies have been involved in diagnostics for decades, offering a range of services including pregnancy testing and blood pressure checks, mole inspections and anticoagulant monitoring.

Many diagnostic services in pharmacies involve more than simply asking customers to take a test, with the pharmacy team involved in giving treatment advice and support as well.

Pharmacists are highly trained if they become prescribers, and they work within very tightly governed protocols. For common conditions requiring antibiotics, a community pharmacist will be a safe alternative to seeing a GP. They already treat patients with all sorts of other conditions.

Pharmacists are also hugely valued members of GP practice teams, they are highly sought after and there are not enough of them to meet the demand from practices. It’s very common for GPS to refer patients within the practice to the pharmacist, as they understand far more about drug interactions than the average GP, and keep patients with multiple co-morbidities safer.

This is a complementary, and equal quality service to GP care for specific conditions, which modern GPs value greatly because it allows them to concentrate on complex cases who really do need GP expertise.

This - according to the NHS website - is what pharmacists study: preparation of medicines. action and uses of drugs and medicines including physiology, biochemistry, microbiology, pathology and pharmacology. pharmacy practice, covering laws and standards, managing symptoms, promoting healthy lifestyles and advising on drug therapy and medicines use.

The fact that "Community pharmacies have been involved in diagnostics for decades," does not make it right - it is simply a reflection of the fact that there are insufficient doctors.

The first rule of medicine (after Do No Harm) is that diagnosis precedes treatment and that diagnosis needs to be made by a medically qualified person.

I have had excellent help from pharmacists in hospital. The consultant called them in to find a way of dealing with my intractable pain, coupled with drug sensitivities.

Pharmacists are excellent in their knowledge of drugs, their interactions and uses but they are NOT diagnosticians, nor should they be asked to be ... unless of course they undergo medical training.

They should not be used to plug gaps in medical services. We are gradually sliding into a situation where non qualified people are making diagnoses and we must resist this.

Patients access healthcare through lots of routes, mainly self selecting,but if you ring 111, go to A&E or Minor Injuries or contact your GP surgery here in Wales, this is what’s followed.
111.wales.nhs.uk/pdfs/31912_Minor%20Ailments%20Services_Leaflet_English_FINAL%20WEB%2021.17.pdf

But who decides if a patient needs to see a GP or a pharmacist ( if the practice does have a pharmacist)?

Sorry if this is a bit of an essay, but it’s not true now, although maybe it was more so 20 years ago.

Community pharmacies have been involved in diagnostics for decades, offering a range of services including pregnancy testing and blood pressure checks, mole inspections and anticoagulant monitoring.

Many diagnostic services in pharmacies involve more than simply asking customers to take a test, with the pharmacy team involved in giving treatment advice and support as well.

Pharmacists are highly trained if they become prescribers, and they work within very tightly governed protocols. For common conditions requiring antibiotics, a community pharmacist will be a safe alternative to seeing a GP. They already treat patients with all sorts of other conditions.

Pharmacists are also hugely valued members of GP practice teams, they are highly sought after and there are not enough of them to meet the demand from practices. It’s very common for GPS to refer patients within the practice to the pharmacist, as they understand far more about drug interactions than the average GP, and keep patients with multiple co-morbidities safer.

This is a complementary, and equal quality service to GP care for specific conditions, which modern GPs value greatly because it allows them to concentrate on complex cases who really do need GP expertise.

Luckygirl3

They are trained in pharmacy - they are not diagnosticians. Therein lies the problem. Their job is to have a thorough knowledge of drugs and to advise as to what is available and what might best suit the problem - but only after a proper medical diagnosis has been made.

This is yet another example of fobbing people off because there are not enough medics - another is sending people for physio before a diagnosis has been made.

Thank you for putting the subject more succinctly than I could.
You are right they are not diagnosticians. Like a GP or a Consultant.

Callistemon21

Have you read the whole thread, Bella23?

Although I can't spell surprisingly I can read and have read the whole thread.
I think it is passing too much extra to the pharmacies and with my experience this week I think have proved it in my case.
Both our pharmacies are a round trip of 16 miles. I was told by one they were closing down and left to find another myself. I order my prescription through Patient Access which I did last week.
Knowing I have quite a lengthy prescription I gave them a week and then phoned to see if it was in.
I was curtly told by the pharmacist that no they weren't she could not tell me when they would be and not bother her again with trivialities she was too busy .
This morning my DH has gone into town to see if anything has arrived as I have now run out of tablets. This is a Boots I am talking about.
If she hasn't got time to put up her prescriptions what if someone walks in with a rash or an infection how is she going to have time to read all their notes like a GP would if you had an appointment? No time to read their medical history, if they are given access and note any allergies let alone major ongoing health issues.

Germanshepherdsmum

I have found qualified pharmacists to be very knowledgeable. I have often relied on their advice and wouldn’t hesitate to do so again. They are also far more available than doctors nowadays!

Me too.
Obviously knowing the effects certain medicines have on the body necessitates learning something of the conditions that require those particular medications.

GPs are not always spot on with diagnoses as we well know.
A&E departments are so under pressure now that student doctors are often the second point of contact for patients after a nurse.

I have found qualified pharmacists to be very knowledgeable. I have often relied on their advice and wouldn’t hesitate to do so again. They are also far more available than doctors nowadays!

They are trained in pharmacy - they are not diagnosticians. Therein lies the problem. Their job is to have a thorough knowledge of drugs and to advise as to what is available and what might best suit the problem - but only after a proper medical diagnosis has been made.

This is yet another example of fobbing people off because there are not enough medics - another is sending people for physio before a diagnosis has been made.

So glad you are on the mend. Hope it all heals up quickly.

Bella23

Whitewavemark2

I give up.

None of you have got the point. If she now had the ability to prescribe and give me an oral antibiotic she would have done so. But it would have been the wrong diagnosis. And she would have given a patient antibiotics that were unnecessary.

I can see what you mean Whitewave mark . The pharmacists will not have our notes like doctors do and be able to look back at allergies etc. Some people are actually allergic to certain antibiotics, my late father was highly allergic to penicillin.
If the pharmacist had been able to prescribe you would have been given antibiotics that you did not need and might even have been allergic to.

Community pharmacists do have electronic access to GP patient case records, in Wales at least, with the patient’s consent. I’m not sure about if they do in England.

Have you read the whole thread, Bella23?

Whitewavemark2

I give up.

None of you have got the point. If she now had the ability to prescribe and give me an oral antibiotic she would have done so. But it would have been the wrong diagnosis. And she would have given a patient antibiotics that were unnecessary.

I can see what you mean Whitewave mark . The pharmacists will not have our notes like doctors do and be able to look back at allergies etc. Some people are actually allergic to certain antibiotics, my late father was highly allergic to penicillin.
If the pharmacist had been able to prescribe you would have been given antibiotics that you did not need and might even have been allergic to.

Remember to take some probiotic with the antibiotics by the way….