A screwed up system

I learned in pharmacy school that pharmaceutical care or the therapeutic thought process is a systematic way to review your patients’ medications to determine if there are any drug-related problems to address, to prevent or to manage. It goes on to discuss how we should review all the signs and symptoms, onset and time frame and the possible causes or etiologies to arrive at the conclusion of any problems and to design a plan to fix or prevent them.

That’s bullshit.

Sorry Dr. Linda Strand. I don’t mean to insult your work that you have devoted in your pharmacy career.  The four year of brainwashing in my school left me confused with what I really need to do to help my patients.

Now I realize it’s just one fancy name to describe how we apply our day to day problem solving skills to identify, prevent or fix any  problem related to the patients’ drug therapies.

So skip the jardon and say what it really should say. Fix the problem or prevent the problem.

But I find nowadays when I conduct medication reviews, I am distracted with so many sideline responsibilities, from reviewing the high dose opioids that our patients may need to taper off before being delisted, to introducing the medication management initiative which will save the system money, not to mention the endless paperwork associated with our wonderful enhanced Medscheck program.

I find all these additional responsibilities are taking away the attention that I should give to my patients. But what I find frustrating is that we don’t pay enough attention to the process of doing all the work. I wish someone can apply lean process management or Sig Sigma process improvement to pharmaceutical care, therapeutic though process or whatever name you give to your medication review process.  I am drowning in paper work. I feel a lot of my time is wasted on documentation, covering our ass and pleasing someone else, rather than to focus on our patients, to help fix and prevent their drug related problems and to make their lives a little better.

Such a screwed up system.


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My name is Cynthia Leung and I am a practicing pharmacist in Kingston Ontario, Canada. This blog is for me to share my ideas, opinions and perspectives on how medications are used in our health care system. Note that these posts are my own opinions and do not represent the opinions of my current or former employers and / or organizations that I may belong to. Any possible case scenarios described in my posts would be modified to maintain patient confidentiality. This blog is not a platform for professional advise for patients or health care providers and the content is not meant to support any clinical decisions or replace professional opinions. Also the images are either taken or created by the author, or adapted with permissions. I hope you will enjoy reading my posts!

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