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PharmD's are not doctors!

Discussion in 'MSL Board' started by Anonymous, Sep 11, 2007 at 2:00 AM.

  1. Anonymous

    Anonymous Guest

    Bottom line: In the hospital setting, we are consultants to physicians. When a physician is stumped on how to treat a patient, he will call on the PharmD. Not a PhD , NP , PA or JD, but a PharmD. It only matters to us that physicians find us as an asset; who cares what the public thinks. I myself belong in treatment group with specialists (akin to the House show) where we round and treat difficult patients. My job is to develop an appropriate pharmacotherpeutic regimen. After I present my idea on how the patient should be treated, the specialists order the treatment. I believe that it took a long time to get physicians to trust PharmDs. We are here and our gig is awesome. BTW, when I present on Grand Rounds, yes, the physicians call me "Dr".
    So please, do not discount this new degree. Do yourself a favor.. google PharmD and see all the research that our fellow pharmds are doing. Like MDs , there are many types with that degree. Some poor saps like to use that degree to count pills and some of us work next to physicians ( not in front, or in back, but next ). It is your scientific aptitude that counts in this field.
    Also a nota bene : "Physician" is the title the State gives a person after a rudimentary test is passed. "Doctor" is a title given by the eductional institute.
     
  2. Anonymous

    Anonymous Guest

    ‘When a physician is stumped on how to treat a patient, he will call on the PharmD’ That could not be more BS!!! The only plausible time that would happen is if there was a contraindication and he, rightfully so, seeked your council on an alternative drug that would not interfere with another drug.

    BTW, when I present on Grand Rounds, yes, the physicians call me "Dr".
    So please, do not discount this new degree. Big freaking deal. They do that because the PharmD’s lobbied for years once the RPharm curriculums moved to PharmD programs.

    Grand Rounds? Who cares. Nurses present at grand rounds on AE management etc.


    “Some poor saps like to use that degree to count pills and some of us work next to physicians ( not in front, or in back, but next ).”

    “SOME” – Sorry try ‘MOST’ poor saps are counting pills not some. And those poor saps are not relegated to only retail most hospital and academic center pharmacists are pill counters or mixing drugs. The smallest percentage of pharmacists are researched based. Learn you facts before you use your N of 1 to describe and entire field.

    “google PharmD and see all the research that our fellow pharmds are doing” Almost all of your ‘research’ is PK PD phase I or II. Less than 1% of pivitol phase III trials have PharmD’s as a lead author. You are the guy at the bottom of the list who did the PK/PD evaluation. BIG DEAL!

    Again from the labor board and trade websites, the vast majority of R.Pharm and PharmD’s are in the retail setting(counting pills), second in the hospital or institution setting(counting pills), and a very small proportion are in the academic research setting.

    Again the PharmD was a manufactured degrees as a money grab for pharmacy schools. No one in the medical community was screaming for something more that the RPharm education. BTW a tech and a computer do 95% of your job for you in retail and hospital setting. Have fun living in your inflated world.
     
  3. Anonymous

    Anonymous Guest

    M, W, F, count pills by 2's, T, Th, Sat and Sun. , count by 5's. :) !!!
     
  4. Anonymous

    Anonymous Guest

    Poor salesbot. Delivering samples and buying lunch too much for you?

    See your psychiatrist to deal with your tiny penis issues.
     
  5. Anonymous

    Anonymous Guest

    Favorite post of them all! Some of these PharmDs have an inflated sense of worth. They can't even write a prescription for amoxil. I love the posters ripping on PAs and NPs, even though we are the ones writing the scripts that they fill.
     
  6. Anonymous

    Anonymous Guest

    Sales bot…funny. Let’s see, I sell targeted and chemo agents for cancer, never sampled a drug in my life and I could talk circles around you, and 95% of the PharmD’s out there in terms of cancer and cancer treatments. Most of the time it is the tenured oncology reps that have to show the PharmD MSL the ropes in oncology as your ‘Phd’ level education really only teaches you classes of drugs at a macro level leaving you with very little functional knowledge. In the class of drugs that is the most toxic, oncologics, the PharmD has virtually no impact, knowledge, or use, as infusion nurses mix most chemos day in and day out. Sure you can tell a doc what antibiotic shouldn’t be used with which statin…Wow thanks since if you can read and have Epocrates ANYONE can do that!

    $200K+ a year, and on average really only work 3 days a week doing mainly lunches. With this pretty laidback lifestyle I have managed to make a small fortune in stock options over the last twenty years.

    So back to the Sales Bot crack…Umm let’s see…count pills by fives, talk to the AARP crowd about glucose levels and work 50+ hours a week at CVS to make $185K versus what I do?…which is making $200K+ a year, and on average really only working 3 days a week doing mainly lunches and talking to oncologist about treatments, practice management, reimbursement, AE management, potential clinical trials, etc. With this pretty laidback lifestyle I’ve managed to make a small fortune in stock options over the last twenty years. The more I think about it your job sounds like it could easily be replaced by a robot…oh that’s right it already has in the form of a computer, a printer, the internet and a HS dropout Pharm Tech. Look I get that you were the nerds of your high school yet not smart enough to go medical school, or dental school, or veterinarian school, or for that matter chiropractic, or optometry school where pharmacy school sort of lands between. So keep wearing your cheap clothes driving your cheap cars and living in your cheap condos, and keep telling yourself your job has ‘worth’ or ‘value’. BTW you think we really care that we have to sign in at your crappy office when we come to your hospital??? We love having to sign in so we can laugh our asses off because you think you actually have power or influence and we get a chance to see the pictures on your desk and wall of your big vacation to the Sandals Resort or that new Camry or if you really ‘made it’ that C class or 3 series BMW. I’ve worked in hospitals and academic centers for 20 years and in the hierarchy of a medical center the pharmacist is one step above a orderly in terms of respect, power and influence. Go back to your hole and get off your mom’s computer and stop thinking you are anything but a joke in the health care machine. Last I checked when someone is having a heart attack or gets into a car accident they aren’t screaming, “Quick, get me a pharmacist”!
     
  7. Anonymous

    Anonymous Guest

    You are so full of BS Mr Oncology "genius".

    Go play pretend elsewhere.
     
  8. Anonymous

    Anonymous Guest

    How so? Pretty spot on to me.
     
  9. DrMookie

    DrMookie Guest

    Man... my $130,000 job as a PharmD must be make believe. Either that, or I and all my fellow PharmDs have the hospital fooled to pays us so much because we have a worthless degress. Society pays you what you are worth. Who knew right? Anyway, getting back to work. Having to figure out a therapeutic problem on a cancer patient that does not want to metabolize a drug properly. A case of pharmacogenomics; conferencing with genetics lab to determine the patient's alleles. Then I have to figure the pharmacokinetic profile for future dosing regimen... wow and it was only yesterday that we learn to count by two's in pharmacy school.
     
  10. Anonymous

    Anonymous Guest

    Why, didn't you know the oncology rep brings so much value to patient care? Didn't realize doughnuts, lunch and shiny detail pieces ever made it to the patient for consideration. Yes, oncology rep, your services are so integral to patient care that you have to bribe the "window witch" to get in to see the oncologist. The oncologist doesn't give a damn about what you have to say unless you are bringing a bribe (well you pharma guys call it an "invitation") in the form of a high-paying advisory or consultant board position during which they bitch about having to listen to you. Your two weeks of learning a new compound to pass that all-important product knowledge test qualifies you to be an expert on the package insert, but you know squat about the product itself except how to moan to your DM that no one is paying for it. My what "value" you bring.

    Guess my four years of pharmacy school, two years of fellowship and postdoc were just useless compared to you sitting in a large conference room looking at slides and role-playing all day. Of course, the horror of you actually having to share a hotel room must be unbearable. I guess those three textbook chapters that I wrote with my fellowship director, and the fifteen published articles I have written for medical journals just do not compare with you taking lunch orders and delivering doughnuts and coffee. And all of those nights I actually spent with patients administering their chemo and palliative meds were nothing, because you delivered the example LMN that the oncologist had to push you for three times while you were too busy putting Starbucks coffee and coffee cake in your mouth lying about the number of calls you made to your DM.

    Do we really think, oncology rep, that you make over $200,000? No. More like you make about half of what I do in base, and you are on a PIP because your boss ripped you a new asshole for not making your quota. While you are lying about your mileage, we are at work actually caring for patients. While you are gloating over your "President's Club" trip to Aruba, we are planning our vacations to Fiji.

    You get what you pay for, and your company pays you crap because you are crap. Have a nice life, copier salesman.
     
  11. Anonymous

    Anonymous Guest

    Oh really "Senior Oncology Rep"? Unfortunately for you, a few regulatory facts and laws contradict most of what you say.

    1) Ever hear of the OIG Guidance and December 2011 revisions? Specifically forbids reps and MSLs from working together even on an introductory basis. Prohibits MSLs and Reps from engaging in promotional activities together. If you were such a tenured rep, either you would know this or you are willfully engaging in non-compliant activities.

    2) If you are NOT a licensed health care professional, it is unethical for a physician or any other licensed health care professional to seek or take any advice from you with regard to any patient in their care. They can't even discuss a patient with you per HIPAA, even IF you have a patient assistance program requiring paperwork, that discussion is specifically prohibited. Once again, if you are doing it as a "tenured rep", then you are willfully engaging in breaking the law.

    3) Even a newly minted PharmD knows more about the mechanisms of activity and is specifically authorized and licensed to talk off-label to a physician or other prescriber. You are not. OIG December 2011 guidance makes that distinction between "scientific or clinical staff" and marketing/sales staff. If you are giving dosing advice to a physician, then you have broken the law willfully.

    4) In all hospitals which carry CMS or Joint Commission accreditation, all sterile compounding, with the exception of medications which are used in emergencies (chemo is not an emergency) must be mixed in a 797 compliant compounding facility. All chemos must be mixed in the appropriate vertical laminar flow hood (or biological isolator) and dispensed by a licensed pharmacist. Infusion nurses can mix only in private offices or clinics but not in a hospital. If you were such a "tenured rep" with hospital experience, you would know that.

    5) Nobody here thinks you make $200K a year. Then again, nobody really cares. You drive a company car, deliver lunch and in general add nothing of value to patient care. A Fedex driver or a catering driver could do your job.

    As for talking around anyone, you probably had to talk your ass off to your DM to avoid being fired for compliance violations that you mentioned yourself. At the very minimum, you are engaging in unethical behavior and illegal behavior. Please do tell us how you did not break the law.
     
  12. Anonymous

    Anonymous Guest

    1. Wrong. As long as there is not an exchange of off label information the rep can be present and there is no language on who can make introductions.


    2. As long as the patient is not ID’s by name HIPPA is not being violated. I sit in tumor boards every week with blinded patient names.

    3. PharmD’s know classes of drugs and very little past that especially on MOA.
    - Not if the dosing advice is in the label it is not breaking the law.


    4. Um jerk off the vast majority of chemo in delivered in the community not the hospital setting which has been done just fine for decades by nurses.

    5. Hate to break it to you but most oncology reps at good bio’s do make over $200K. Heck little ol’ Incyte who just hired their sales force last August had starting base salaries between $140K to $150K. I worked at DNA in the heyday and most of us were clearing $200K a year especially in launch years.
     
  13. Anonymous

    Anonymous Guest

    What did this person write that you see as being non-compliant? They didn’t mention doing anything outside the label. Also the interpretation of OIG varies greatly from company to company. I work very closely with my MSL we go on calls together and he attends my commercial/branded dinner talks. There is nothing legally that prohibits that. We are encouraged to help our MSL’s meet and engage with our customers so again your ramblings are quite nonsensical Your number two statement is also off the charts wrong. Physicians talk to reps all the time about specific yet unidentified patients, how the treatment is working what AE’s the patient may be experiencing and the rep is the first point of contact for any unsolicited requests for off label info. We carry Med Info Request all time and only if the doc checks the ‘have MSL contact me’ box that would be the only time the MSL is involved and I can tell you that it is less than 1 out of 50 that the MSL box gets checked. The only reason my physicians want to see an MSL is to get a clinical trial at their site. That’s it. After that they would rather deal with an MD medical director not a PharmD MSL as you guys have no clue how to actually treat a patient.

    “If you are giving dosing advice to a physician, then you have broken the law willfully”. – WHAT??? A rep is almost obligated to give the dosage and dosing of the drug to a physician. If not they are probably not being compliant in the efficacy, safety and dosing triad. So I have no idea what the hell you are talking about when you say a rep can’t give dosing recommendations. Sure they can as long as it is in the label! If you want to get technical about it MSL’s do not have carte blanche to talk off label either so maybe you should do some more reading yourself…


    “ In all hospitals which carry CMS or Joint Commission accreditation, all sterile compounding, with the exception of medications which are used in emergencies (chemo is not an emergency) must be mixed in a 797 compliant compounding facility. All chemos must be mixed in the appropriate vertical laminar flow hood (or biological isolator) and dispensed by a licensed pharmacist. Infusion nurses can mix only in private offices or clinics but not in a hospital. If you were such a "tenured rep" with hospital experience, you would know that. “

    95% of chemo are given in a non-hospital setting. So again not sure what you point is. My point is 95% of the time a chemo nurse is doing the job of a PharmD, quite effectively I might add…so clearly your ‘expertise’ is not all that needed!

    “Nobody here thinks you make $200K a year. Then again, nobody really cares. You drive a company car, deliver lunch and in general add nothing of value to patient care. A Fedex driver or a catering driver could do your job.”

    REALLY? If that were the case then why do companies keep hiring reps and keep lowering the MSL headcounts? We just dropped two has all they did all day was annoy the crap out of our customers via email about meaningless things! Someone must find a value in reps if they are paying us $200K, stock options and all the perks…
     
  14. Anonymous

    Anonymous Guest

    BS you have so little impact on any of the above it is silly. Boy how do all the community based oncology practices most of which do not have PharmD’s on staff manage to treat the lion’s share of the cancer patient in the country?
     
  15. Anonymous

    Anonymous Guest

    I have a cardiac arythmia and take two meds for it. I see an electro physiologist cardiologist at a major teaching center. Have a comorbidity and asked to speak with a PharmD about potential drug/drug interactions and competing metabolic pathways. When I finally got him to speak with me, he said he "normally doesn't speak tp patients" but would make an exception! When I asked him specific questions about competitive metabolic pathways, his response to me was to google the question and read me the answer. What a joke. I have a Master of Physiology and an ARNP, have 4 more years of grad school than a PharmD ( they really don't go to grad school), and I could tell him more than he knew about my drug interactions. Nurse practitioners should petition legislature to be called doctors. To call a druggist a doctor is just outrageous. It is deceptive and can be clearly harmful to patients for someone with 5 years of college, no patient care experience and no ability to prescribe or treat patients to call themselves a doctor. Shame on the decision makers who made that call.
     
  16. Anonymous

    Anonymous Guest

    I call BS on this lie. You have nothing of what you speak and are clearly a sample-dropping, lunch-catering, know-nothing Rep-bot.

    Go back to fantasy land fool!
     
  17. Anonymous

    Anonymous Guest

    Ms. NP -

    You all are not medical doctors and will never be called such. Some NPs have such an inflated since of worth. I'm a PA with masters and other degrees as well. Both my parents are doctors. They complain consistently about NPs and how arrogant they are. Walking around like they are "doctors". They even introduce themselves as being a doctor - how misleading.

    You must be one resident clueless NP on this board. Go back to your favorite play area. No body cares about your high opinion of yourself.
     
  18. Anonymous

    Anonymous Guest

    I love "Dr. Druggist" calling someone a "bot" when 95% of a pharmacist's job in this day and age is done by a computer...
     
  19. Anonymous

    Anonymous Guest

    and then comes the new health care reform. The part about everyone has to get health insurance is contestable but not the perfunctory part. That part says that pharmacists will be providers. We will charge the insurance companies for DUR and MTM. Finally, the PharmD will get paid for their knowledge and not just for added benefit to the health system. Our income will jump by at least 40%. Hospitals are preparing for this in CPOE. We are already being hammered into our heads that we have to do iVents and mark time spent on profile/progress review to create billable hours. What revolution is taking place !
    About what MD's think about PharmDs. here is a great article in a MD journal : http://www.todayshospitalist.com/index.php?b=articles_read&cnt=177

    Be warned that the article is a bit dated (2006) .
     
  20. Anonymous

    Anonymous Guest

    I love the silliness of this thread. Especially when the Repbots get all bent out of shape they're BS in Psychology is worthless and they are nothing more the lunch caterers
     

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