Monthly Archives: March 2017

What Do I Do If…?

What do I do when

I get a forged or altered prescription ?

The first thing is to think of your safety.  Giving back the Rx is not a desirable solution, as it merely pushes this issue off on another pharmacist at another store.  But you should make a decision to give it back or retain based initially on any possible danger to yourself and the staff.  Do so if it seems the safest thing.
If you keep the Rx, you must ascertain that it truly is forged or altered within a reasonable time.  Once this is done, you must call the police.
A couple of notes:  what is a reasonable time?  If during office hours, usually no more than a couple of hours.  If after, waiting until the next day is usually reasonable.

 

If you feel the danger is substantial and you think the safest choice would be to fill the Rx, will the Board punish you?  No, as long as doing this is not a habit.  And if you do this for a safety reason, call the police after the “patient” leaves.

What do I do if

I catch someone in the pharmacy stealing/diverting CS?

Immediately remove the person from the pharmacy.  Terminate the person.   Check your state law–it may require you call the police and have the person prosecuted
Inform the Board of Pharmacy.  Most states have a requirement that such acts be reported.  The Board can act against the license or registration to prevent the person from being employed at another pharmacy.
Do a CS inventory to determine just how many CS doses have been stolen/diverted.  Fill out a Form 106 and provide to the DEA, Board and any other entity required by your state law.

What do I do if

There is a doctor who continually OKs early fills on CS Rxs?  Listen to your professional judgment and then listen to me.  Refuse to fill.

When a doctor OKs early fills more than one time, get a reason and document on the hard copy.  If the prescriber continues and you see no legitimate reason, refuse to fill early.   When the doc sends the patient elsewhere, notify whatever state entity you need to.

Remember, there are lots of legal cases out there that state pharmacists have liability for continual early fills

What do I do if

I forget to get all my required continuing education?

Self-report to the Board as soon as you realize your mistake.  Pay the fine and do the additional CE.  Most states will, after a period of time, permit you to get this pharmacy law violation expunged from your Board record.

Don’t try to hide it.  Your CE goes to a national database today and discovering your lack of required hours is not hard.  And the punishment for hiding it is much worse in most states and THAT does not get expunged.

What do I do if

I want to be a PIC at two locations?

Most states permit this, but usually only for a limited period of time.

Make a written request to your Board.  Nmae both locations and addresses, acknowledge you will be spending the required number of hours at each location, state why you need to be PIC at both locations, and provide a time period, at the end of which you expect the second location to have its own PIC.

Some state Boards require an appearance before the Board to discuss this.  But Boards are reasonable and they almost always allow this under reasonable circumstances

What do I do if

I am licensed in three states and one of the states punishes me for a pharmacy law violation.  Do I inform the other two state Boards?

It would not hurt to do so, and they might see your coming forward in a better light.  But punishments by Boards these days go into a national database.  The other two states will become aware no matter what.

And be prepared.  Almost all the time, the other two states will match the punishment of the original violation state.

What do I do if

My PIC quits and the other pharmacist does not want the position?

PICs in most states must be onsite 10 hours a week.  Boards overlook those weeks when a pharmacist is on vacation, ill, on a business trip, etc, so long as this does not go over 30 days.

Most Boards will allow a pharmacy to go without a PIC for up to 30 days, but check with your state Board.  Make sure you inform the Board within the required time that your PIC has left.

30 days is considered enough leeway for you to find a new pharmacist who will be your PIC.  Within the required time, inform the Board that your new PIC is in place.

What do I do if

The sole pharmacist on duty becomes ill?

Of course, the primary goal must be to go to the aid of the sick pharmacist.

I am guessing here that you mean sick enough to be unable to function professionally.  In this case, all states pretty much have law that says all pharmacy business must cease.  Even the verified prescriptions in the waiting bins cannot be sold.  If the pharmacist leaves, all pharmacy personnel must leave the pharmacy area and the pharmacy must be closed off.  If this cannot happen, the entire store must close.

What do I do if

The local doctor’s nurse leaves one voicemail but with multiple Rxs for each patient, and she talks 100 miles an hour.

Erase them.

You want to take a chance on getting something rwrong from somebody who is through spouting prescriptions before you can get your inkpen out of your pocket?  This is like bad handwriting—only one case has held a doctor responsible.  Otherwise, it is the pharmacist’s fault for not clarifying the handwriting, or the voicemail.

I listen to voicemails 3 times.  If I have any questions, I then call and have the nurse give me the prescription again, all of it.

If I have an issue like you mention (and I have), I fax a protocol to the doctor’s office and give them a couple of days to conform: no more than two patients per call, no more than a total of five prescriptions per call, birthdays must be included, no voicemails for CS after office hours, etc.  When they do not follow these protocols (and after having been warned in the fax) I

Erase them.

 

Got a “What do I do if…?” question.  Submit it to pharmacylawsource@gmail.com  When enough come to me, I will do a Part II to this blog