RE: calling a doctors office

July 19, 2008

A technician whether certified or not is not allowed to take a verbal

oral live order over the phone or in person from a prescriber

(physician). This is the explicit duty of a pharmacist.

However acting as an agent of the pharmacist you CAN make the phone

call and get the nurse or the doctor on the line to speak to the

pharmacist. You can convey the message to the nurse or the doctor that

this is what the pharmacist would like to speak to the physician or

nurse about.

Specifically any change in a new prescription constitutes a new

prescription and only a pharmacist may take a verbal oral prescription

over the phone and reduce it to writing with the one exception of a

pharmacist intern under the direction of a pharmacist.

In some states a tech may take a recorded prescription and fill it as

long as it is saved on the recorder and the pharmacist checks it or

listens to it before he or she gives a final 'okay' on the filling of

that Rx.

If any one knows of a state law or federal law change and can give me

the site address to anything contrary to the above please post it.

For years medical assistants have been allowed to give the oral/verbal

order over the phone for a physician to a pharmacist. And I have heard

rumblings that pharmacists in some states want techs to take orders

over the phone.

In some states techs can take a clarification and refill authorization

over the phone .

Hope this helps.

Respectfully,

Jeanetta Mastron CPhT BS

Pharm Tech Educator

>

> Hi everyone,

> I am a certified tech. At work the other night the pharmacist had me

> call a doctor to get a customer a cheaper antibiotic. Is a certified

> tech allowed to call to do something like that?

>

July 20, 2008

no.

From: yarger3457 <yarger3457@...>

Hi everyone,

I am a certified tech. At work the other night the pharmacist had me

call a doctor to get a customer a cheaper antibiotic. Is a certified

tech allowed to call to do something like that?

July 20, 2008

There are a couple of key points with this question.

First, recommending an alternative medication is beyond the legal scope of a

pharmacy technician. This is true in any state.

Second, I think it depends on which state you are in. Changing ANYTHING on an

existing script technically makes it a " new " script. Many states do not allow

techs to take " new " scripts.

Now if your pharmacist indicates to you WHICH drug s/he wants to use, and IF

your state allows techs to take " new " phone orders...I imagine you could contact

the MD on behalf of the pharmacist. In this way, you are acting as the

pharmacist's assigned agent--not making the recommendation yourself.

I'd like to the hear the perspective from a tech working in a state where techs

can take new phone orders.

Dora

From: yarger3457 <yarger3457 (DOT) com>

Hi everyone,

I am a certified tech. At work the other night the pharmacist had me

call a doctor to get a customer a cheaper antibiotic. Is a certified

tech allowed to call to do something like that?

July 20, 2008

Hi Jeanetta and All,

I believe the only state that allows technicians to take new verbal

phone orders is Tennessee.

On Sun, Jul 20, 2008 at 12:00 AM, Jeanetta Mastron CPhT BS Chemistry

wrote:

A technician whether certified or not is not allowed to take a verbal

oral live order over the phone or in person from a prescriber

(physician). This is the explicit duty of a pharmacist.

However acting as an agent of the pharmacist you CAN make the phone

call and get the nurse or the doctor on the line to speak to the

pharmacist. You can convey the message to the nurse or the doctor that

this is what the pharmacist would like to speak to the physician or

nurse about.

Specifically any change in a new prescription constitutes a new

prescription and only a pharmacist may take a verbal oral prescription

over the phone and reduce it to writing with the one exception of a

pharmacist intern under the direction of a pharmacist.

In some states a tech may take a recorded prescription and fill it as

long as it is saved on the recorder and the pharmacist checks it or

listens to it before he or she gives a final 'okay' on the filling of

that Rx.

If any one knows of a state law or federal law change and can give me

the site address to anything contrary to the above please post it.

For years medical assistants have been allowed to give the oral/verbal

order over the phone for a physician to a pharmacist. And I have heard

rumblings that pharmacists in some states want techs to take orders

over the phone.

In some states techs can take a clarification and refill authorization

over the phone .

Hope this helps.

Respectfully,

Jeanetta Mastron CPhT BS

Pharm Tech Educator

>

> Hi everyone, I am a certified tech. At work the other night the

> pharmacist had me call a doctor to get a customer a cheaper

> antibiotic. Is a certified tech allowed to call to do something like

> that?

>

<mailto: >

July 20, 2008

Hi ,

No. Once you call the office for the drug change that makes it a new

prescription. Technicians are also not allowed to make suggested

therapeutic interchange suggestions to doctors.

What would you have done if you made the call and the doctor asked what

drug you suggested?

Technicians (certified or not) are not permitted to take new verbal

phone orders in any state except Tennessee.

I find that pharmacists ask technicians to do a lot of things that

aren't legal (anymore) under the guise that it's their license on the

line because that's the way it always was. I say anymore because

specifically in my state (NJ) techncians weren't never even mentioned by

title until 2 years ago by the NJ-BOP. But with certification,

registration and licensure of many technicians now, we have to be much

more careful of what we actually do on the job because now our

certification, registration and license is on the line too.

On Fri, Jul 18, 2008 at 7:35 AM, yarger3457 wrote:

Hi everyone,

I am a certified tech. At work the other night the pharmacist had me

call a doctor to get a customer a cheaper antibiotic. Is a certified

tech allowed to call to do something like that?

July 20, 2008

Hey, everyone,

In Texas, no technicians (certified or not) can not take new

prescriptions from the Dr's office. Sometimes one of the technicians

will write down the Names, DOB's, Dr Names, and Dr #'s from voice

mail, saving or skipping through them if they are looking for a

specific prescription for a specific person.

I know this is going to sound slightly tacky, but I love the fact that

one of our CPhT's is also a pharmacy intern. She, because she is a

pharmacist intern, can take the types of changes that was

asking about.

Sometimes, if the Dr has a fax #, we'll fax a note to them, saying

that the patient is asking for something less expensive, what would

the Dr like to change it to? Other times, the technicians will leave

a message for the Dr's office with the same basic information:

" So-n-so was prescribed such-n-such medication, and is requesting

something less expensive, is there something you would be able to

change it to? "

With Faxes, the Dr's office is basically 'writing' the new

prescription when they fax back a response. If they call back a

response, then the pharmacist takes the information.

Yes, sometimes the Dr's office will tell the tech most of the

information. But then, I also verify it with the Dr (or the Dr's

representative) by repeating everything to them. So it's still

'taken' as a new prescription by the pharmacist.

For some things, we do have one or two techs who will call and make

the changes on the prescriptions, and I make them call the Dr's office

back and then put me on the phone. I apologize to the Dr's office

about the duplicate call, but explain to them that the pharmacist is

the one who has to take the information.

My general 'rule' is. If it's not a change in quantity, then

basically the technicians can't 'finalize' the answer. Because a

change in quantity is not a 'judgement' call. And that's basically

the law in Texas (as my brain has it locked in, at least).

Sorry for the rambling. Today was day 7 of working, so I'm off the

next two days.

Anyhow. Time to head off to bed.

Della

On Sun, Jul 20, 2008 at 10:09 PM, <cphtgenius@...> wrote:

>

> Hi ,

>

> No. Once you call the office for the drug change that makes it a new

> prescription. Technicians are also not allowed to make suggested

> therapeutic interchange suggestions to doctors.

>

> What would you have done if you made the call and the doctor asked what

> drug you suggested?

>

> Technicians (certified or not) are not permitted to take new verbal

> phone orders in any state except Tennessee.

>

> I find that pharmacists ask technicians to do a lot of things that

> aren't legal (anymore) under the guise that it's their license on the

> line because that's the way it always was. I say anymore because

> specifically in my state (NJ) techncians weren't never even mentioned by

> title until 2 years ago by the NJ-BOP. But with certification,

> registration and licensure of many technicians now, we have to be much

> more careful of what we actually do on the job because now our

> certification, registration and license is on the line too.

>

> On Fri, Jul 18, 2008 at 7:35 AM, yarger3457 wrote:

>

> Hi everyone,

> I am a certified tech. At work the other night the pharmacist had me

> call a doctor to get a customer a cheaper antibiotic. Is a certified

> tech allowed to call to do something like that?

>

July 21, 2008

Dear , , Dora, Karin and ALL,

I wish we were all correct in that no tech can take verbal orders over the phone

or only TN Techs. The truth is we are ALL wrong (although Dora come in the

closest).

I think you were thinking of the once true statement that only TN can have

techs do transfer of prescriptions from on pharmacy to another. Now several

states allow their techs to do so.

I knew that there was rumblings of states changing these laws to allow techs to

take orders over the phone, even though I was/still am against it. But right

under our noses Techs in 9 states and the DC of Colombia CAN in fact take new

verbal orders over the phone!

Since Dora asked those who live in a state where techs CAN take orders over the

phone and I asked those who know differently than I posted to please inform us,

I decided to put my fingers where I was asking others to. So I did my own

research:

I found the following information on the PTCB site. The site breaks up the

retail/communuity vs hospital/institutional techs. But they are the SAME techs.

Further the information is dated 2007 but that means it is really from 2006 and

posted in 2007 (like a care is already 1 yr old when you buy it in December).

May Pharmacy Technicians in the Hospital/Institutional Setting accept a called

in Rx from a doctors office?

The following 9 states and one district have a " YES " by them and 6 of these have

additional notes:

1. District of Columbia --- Note V: Pharmacist must verify, check, and/or is

responsible for allowed activities; except in the case of Schedule II controlled

substances, only a pharmacist may receive an oral prescription.

2. Iowa --- (no additional comments)

3. Louisiana --- (no additional comments)

4. Massachusetts --- Note AA: Certified technicians only with supervising

pharmacist authorization. (MA – dependent upon Department of Public Health

approval.)

5. Michigan --- Note G: Pharmacist must verify, check, and/or is responsible

for allowed activities.

6. Missouri --- Notes E and G, Note E: Allowed activity must be under the

direct supervision of a licensed pharmacist. Note G: Pharmacist must verify,

check, and/or is responsible for allowed activities.

7. North Carolina --- Note FF: State Board certified technicians only. G =

Pharmacist must verify, check, and/or is responsible for allowed activities.

8. North Dakota --- (no additional comments)

9. South Carolina --- Note: AA Certified technicians only with supervising

pharmacist authorization.

10. Tennessee --- Note U: If technician is certified

May Pharmacy Technicians in the Community Setting accept a called in Rx from a

doctors office? 9 states and one district have a " Yes " by their name and 7 of

these have additional notes.

1. District of Columbia --- Note S: Pharmacist must verify, check, and/or is

responsible for allowed activities; except in the case of Schedule II controlled

substances, only a pharmacist may receive an oral prescription.

2. Iowa --- (no additional comments)

3. Louisiana --- (no additional comments)

4. Massachusetts --- Note E: Pharmacist must verify, check, and/or is

responsible for allowed activities.

5. Michigan --- Notes E: Pharmacist must verify, check, and/or is responsible

for allowed activities.

6. Missouri --- Note D and Note E, Note D: Allowed activity must be under the

direct supervision of a licensed pharmacist. Note E: Pharmacist must verify,

check, and/or is responsible for allowed activities.

7. North Carolina --- Note AA: Board certified technicians only

8. North Dakota --- (no additional comments)

9. South Carolina --- Note Z: Certified technicians only with supervising

pharmacist

authorization.

10. Tennessee --- Note E and R: If technician is certified

I am astonished to say the least and not a very happy camper!

Until the US can decide upon a requirement for all pharm techs to be

EDUCATED and also a national educational standard to include pharmacology,

anatomy, physiology, chemistry, biology and pathology, I for one do not think

that taking new orders over the phone is in (or should be in) the scope of

practice or within the limations of a pharmacy technician in any state. Notice

that none of the states or D C have required education. I am very, very upset

over this. Oprah here I come! Seems every time I say that some reporting of

tech error gets on TV. Well I'm glad. I am not glad there are tech errors,

patient deaths or injuries, but I am glad finally it is getting the attention it

deserves. Techs need to go to school. So I am hoping the public outcry will

demand it.

Respectfully,

Jeanetta Mastron CPhT BS

Pharm Tech Educator

Founder/Owner of this site

Hi everyone,

I am a certified tech. At work the other night the pharmacist had me

call a doctor to get a customer a cheaper antibiotic. Is a certified

tech allowed to call to do something like that?

July 21, 2008

Dear Ann, Texpert and Educator in LA,

Please comment on this information that LA techs CAN take verbal

orders/new over the phone.

Thanks

Jeanetta Mastron CPhT BS

Pharm Tech Educator

Founder/Owner

>

> Dear , , Dora, Karin and ALL,

>

> I wish we were all correct in that no tech can take verbal orders

over the phone or only TN Techs. The truth is we are ALL wrong

(although Dora come in the closest).

> I think you were thinking of the once true statement that

only TN can have techs do transfer of prescriptions from on pharmacy

to another. Now several states allow their techs to do so.

>

> I knew that there was rumblings of states changing these laws to

allow techs to take orders over the phone, even though I was/still

am against it. But right under our noses Techs in 9 states and the

DC of Colombia CAN in fact take new verbal orders over the phone!

>

> Since Dora asked those who live in a state where techs CAN take

orders over the phone and I asked those who know differently than I

posted to please inform us, I decided to put my fingers where I was

asking others to. So I did my own research:

>

> I found the following information on the PTCB site. The site

breaks up the retail/communuity vs hospital/institutional techs. But

they are the SAME techs. Further the information is dated 2007 but

that means it is really from 2006 and posted in 2007 (like a care is

already 1 yr old when you buy it in December).

>

> May Pharmacy Technicians in the Hospital/Institutional Setting

accept a called in Rx from a doctors office?

>

> The following 9 states and one district have a " YES " by them and 6

of these have additional notes:

>

> 1. District of Columbia --- Note V: Pharmacist must verify,

check, and/or is responsible for allowed activities; except in the

case of Schedule II controlled substances, only a pharmacist may

receive an oral prescription.

> 2. Iowa --- (no additional comments)

> 3. Louisiana --- (no additional comments)

> 4. Massachusetts --- Note AA: Certified technicians only with

supervising pharmacist authorization. (MA – dependent upon

Department of Public Health approval.)

> 5. Michigan --- Note G: Pharmacist must verify, check, and/or is

responsible for allowed activities.

> 6. Missouri --- Notes E and G, Note E: Allowed activity must be

under the direct supervision of a licensed pharmacist. Note G:

Pharmacist must verify, check, and/or is responsible for allowed

activities.

> 7. North Carolina --- Note FF: State Board certified technicians

only. G = Pharmacist must verify, check, and/or is responsible for

allowed activities.

> 8. North Dakota --- (no additional comments)

> 9. South Carolina --- Note: AA Certified technicians only with

supervising pharmacist authorization.

> 10. Tennessee --- Note U: If technician is certified

>

> May Pharmacy Technicians in the Community Setting accept a called

in Rx from a doctors office? 9 states and one district have a " Yes "

by their name and 7 of these have additional notes.

>

> 1. District of Columbia --- Note S: Pharmacist must verify,

check, and/or is responsible for allowed activities; except in the

case of Schedule II controlled substances, only a pharmacist may

receive an oral prescription.

> 2. Iowa --- (no additional comments)

> 3. Louisiana --- (no additional comments)

> 4. Massachusetts --- Note E: Pharmacist must verify, check,

and/or is responsible for allowed activities.

> 5. Michigan --- Notes E: Pharmacist must verify, check, and/or is

responsible for allowed activities.

> 6. Missouri --- Note D and Note E, Note D: Allowed activity must

be under the direct supervision of a licensed pharmacist. Note E:

Pharmacist must verify, check, and/or is responsible for allowed

activities.

> 7. North Carolina --- Note AA: Board certified technicians

only

> 8. North Dakota --- (no additional comments)

> 9. South Carolina --- Note Z: Certified technicians only with

supervising pharmacist

> authorization.

> 10. Tennessee --- Note E and R: If technician is certified

>

> I am astonished to say the least and not a very happy camper!

> Until the US can decide upon a requirement for all pharm techs to

be EDUCATED and also a national educational standard to include

pharmacology, anatomy, physiology, chemistry, biology and pathology,

I for one do not think that taking new orders over the phone is in

(or should be in) the scope of practice or within the limations of a

pharmacy technician in any state. Notice that none of the states or D

C have required education. I am very, very upset over this. Oprah

here I come! Seems every time I say that some reporting of tech

error gets on TV. Well I'm glad. I am not glad there are tech errors,

patient deaths or injuries, but I am glad finally it is getting the

attention it deserves. Techs need to go to school. So I am hoping

the public outcry will demand it.

>

> Respectfully,

>

> Jeanetta Mastron CPhT BS

> Pharm Tech Educator

> Founder/Owner of this site

>

July 21, 2008

Dear Della RPh, site resident pharmacist,

It is always a pleasure and an honor to have you post and to know

that you are out there dilegently watching the site and what is going

on. It shows you care about the techs here on this site and we all

appreciate that.

I totally understand how you or any other RPh would welcome the

interns and to train them on taking scripts over the phone.

Here in California ANY change on ANY script is considered a NEW

script and MUST be taken by a pharmacist over the phone. So in CA the

tech could not take a change in quantity.

While it is true that some times nurses and doctors tell the first

person who answers the phone all that they should be telling the

pharmacist, this is why it is very important that the tech introduce

his or her self as a tech and also to interupt the caller and ask

them to speak to pharmacist, and to explain that they are a tech.

Thank you for your input as always. With the exception of the

quantity you have described the way it works in all but 9 states

(41). And no one could have done it better!

I would love to know your thoughts on allowing techs to take the

information over the phone. At least four of the 9 states and one

district do not have additional notes. So it is understood that there

are no reservations or caveats. Your Thoughts?

Respectfully,

Jeanetta Mastron CPhT BS Chemistry

Pharm Tech Educator

Founder/Owner

> >

> > Hi everyone,

> > I am a certified tech. At work the other night the pharmacist

had me

> > call a doctor to get a customer a cheaper antibiotic. Is a

certified

> > tech allowed to call to do something like that?

> >

>

July 21, 2008

So ,

WHAT state are you practicing in as a tech?

Since the PTCB data may be a bit old (2006 to 2007) I now have to ask

you to check with your own state board of pharmacy rules/regulations

and laws for pharmacy technicians. Please let us know what you find

out.

Respectfully,

Jeanetta Mastron CPhT BS

Founder/Owner

> >

> > Hi everyone,

> > I am a certified tech. At work the other night the pharmacist

had me

> > call a doctor to get a customer a cheaper antibiotic. Is a

certified

> > tech allowed to call to do something like that?

> >

>

July 21, 2008

Good information, Jeanetta - thanks for doing the research.

Fred

RE: calling a doctors office

Dear , , Dora, Karin and ALL,

I wish we were all correct in that no tech can take verbal orders over the phone

or only TN Techs. The truth is we are ALL wrong (although Dora come in the

closest).

I think you were thinking of the once true statement that only TN can have

techs do transfer of prescriptions from on pharmacy to another. Now several

states allow their techs to do so.

I knew that there was rumblings of states changing these laws to allow techs to

take orders over the phone, even though I was/still am against it. But right

under our noses Techs in 9 states and the DC of Colombia CAN in fact take new

verbal orders over the phone!

Since Dora asked those who live in a state where techs CAN take orders over the

phone and I asked those who know differently than I posted to please inform us,

I decided to put my fingers where I was asking others to. So I did my own

research:

I found the following information on the PTCB site. The site breaks up the

retail/communuity vs hospital/institutional techs. But they are the SAME techs.

Further the information is dated 2007 but that means it is really from 2006 and

posted in 2007 (like a care is already 1 yr old when you buy it in December).

May Pharmacy Technicians in the Hospital/Institutional Setting accept a called

in Rx from a doctors office?

The following 9 states and one district have a " YES " by them and 6 of these have

additional notes:

1. District of Columbia --- Note V: Pharmacist must verify, check, and/or is

responsible for allowed activities; except in the case of Schedule II controlled

substances, only a pharmacist may receive an oral prescription.

2. Iowa --- (no additional comments)

3. Louisiana --- (no additional comments) 4. Massachusetts --- Note AA:

Certified technicians only with supervising pharmacist authorization. (MA -

dependent upon Department of Public Health approval.) 5. Michigan --- Note G:

Pharmacist must verify, check, and/or is responsible for allowed activities.

6. Missouri --- Notes E and G, Note E: Allowed activity must be under the

direct supervision of a licensed pharmacist. Note G: Pharmacist must verify,

check, and/or is responsible for allowed activities.

7. North Carolina --- Note FF: State Board certified technicians only. G =

Pharmacist must verify, check, and/or is responsible for allowed activities.

8. North Dakota --- (no additional comments) 9. South Carolina --- Note: AA

Certified technicians only with supervising pharmacist authorization. 10.

Tennessee --- Note U: If technician is certified

May Pharmacy Technicians in the Community Setting accept a called in Rx from a

doctors office? 9 states and one district have a " Yes " by their name and 7 of

these have additional notes.

1. District of Columbia --- Note S: Pharmacist must verify, check, and/or is

responsible for allowed activities; except in the case of Schedule II controlled

substances, only a pharmacist may receive an oral prescription.

2. Iowa --- (no additional comments)

3. Louisiana --- (no additional comments) 4. Massachusetts --- Note E:

Pharmacist must verify, check, and/or is responsible for allowed activities.

5. Michigan --- Notes E: Pharmacist must verify, check, and/or is responsible

for allowed activities.

6. Missouri --- Note D and Note E, Note D: Allowed activity must be under the

direct supervision of a licensed pharmacist. Note E: Pharmacist must verify,

check, and/or is responsible for allowed activities.

7. North Carolina --- Note AA: Board certified technicians only 8. North

Dakota --- (no additional comments) 9. South Carolina --- Note Z: Certified

technicians only with supervising pharmacist authorization.

10. Tennessee --- Note E and R: If technician is certified

I am astonished to say the least and not a very happy camper! Until the US can

decide upon a requirement for all pharm techs to be EDUCATED and also a

national educational standard to include pharmacology, anatomy, physiology,

chemistry, biology and pathology, I for one do not think that taking new orders

over the phone is in (or should be in) the scope of practice or within the

limations of a pharmacy technician in any state. Notice that none of the states

or D C have required education. I am very, very upset over this. Oprah here I

come! Seems every time I say that some reporting of tech error gets on TV.

Well I'm glad. I am not glad there are tech errors, patient deaths or injuries,

but I am glad finally it is getting the attention it deserves. Techs need to go

to school. So I am hoping the public outcry will demand it.

Respectfully,

Jeanetta Mastron CPhT BS

Pharm Tech Educator

Founder/Owner of this site

Hi everyone,

I am a certified tech. At work the other night the pharmacist had me call a

doctor to get a customer a cheaper antibiotic. Is a certified tech allowed to

call to do something like that?

July 21, 2008

Thanks Fred!

J

Hi everyone,

I am a certified tech. At work the other night the pharmacist had me call a

doctor to get a customer a cheaper antibiotic. Is a certified tech allowed to

call to do something like that?

July 21, 2008

Hi Jeanetta,

My new updated Review Manual indicated that some states do allow this

practice and you of course indicated that I was incorrect. I guess I

at least can say I was right this once.

Kidding aside, I too wonder about the validity of allowing this

practice, even with the side note of certification as a requirement or

under the supervision of a licensed Pharmacist which can mean that

there is one in the Pharmacy setting and nothing more.

Yes mistakes are a big issue and Pharmacy Technician's are taking

allot of hits on this...but truth be told it should be the State

Legislatures who do not pass true initiatives concerning Pharmacy

Technician's, State Board of Pharmacies who refuse to even recognize

Technician's or have them registered for income purposes only, the

employer who still thinks the Technician as a subclass individual, the

Pharmacists who are unwilling to train or also feel Technician's to be

a subclass individual and of course the many Technician's themselves

who are apathetic towards their vocation.

Mistakes will continue to happen, of which many are not reported, and

patient safety will continue to be ignored simply because it is not

politically correct to do something about the current situation in

fear of upsetting individual entities such as ones mentioned above and

of course the Chain Pharmacies of which money must be made and profit

the number one concern.

Encouraging attempts, such as Florida and Ohio, though watered down

may enhance that something is being done in the media's eyes, but the

reality it is more to appease the public and nothing more as the new

regulations really do not mean much when it comes to patient safety.

Too bad these entities, including our own National and State Pharmacy

Organizations for both Pharmacists and Technicians cannot get off of

their individual butts and do something with the numbers in their

membership base in the demanding of something that has substance and

validity. Of course that would be stepping on toes and would impede

in most cases, as in the chain pharmacy, ones ability to make money or

profit.

What makes this even sadder is that there is nothing new about what I

have posted as it is essentially exactly the same posting both you and

I have discussed and submitted over ten years ago in different forums

or groups.

Joe Medina, CPhT

President/Founder Tech Lectures

http://www.techlectures.com

July 21, 2008

Okay Joe rub it in ! Ha! Ha!

But as you can see I was and am not alone in thinking that this was

not the case! But I did get off my " couch " and research it! so I

guess it goes in your next edition?

What is sad is that techs are being given more responsibility over the

last 10 years without a match in pay per se to that responsibility nor

a required education. What does this say about us as a society?

You left out the pharmacist that give more to the tech to do than

allowed by law!

Other than that you covered all that we have discussed in the past.

Jeanetta Mastron CPhT BS

Founder/Owner

>

> Hi Jeanetta,

>

> My new updated Review Manual indicated that some states do allow this

> practice and you of course indicated that I was incorrect. I guess I

> at least can say I was right this once.

>

> Kidding aside, I too wonder about the validity of allowing this

> practice, even with the side note of certification as a requirement or

> under the supervision of a licensed Pharmacist which can mean that

> there is one in the Pharmacy setting and nothing more.

>

> Yes mistakes are a big issue and Pharmacy Technician's are taking

> allot of hits on this...but truth be told it should be the State

> Legislatures who do not pass true initiatives concerning Pharmacy

> Technician's, State Board of Pharmacies who refuse to even recognize

> Technician's or have them registered for income purposes only, the

> employer who still thinks the Technician as a subclass individual, the

> Pharmacists who are unwilling to train or also feel Technician's to be

> a subclass individual and of course the many Technician's themselves

> who are apathetic towards their vocation.

>

> Mistakes will continue to happen, of which many are not reported, and

> patient safety will continue to be ignored simply because it is not

> politically correct to do something about the current situation in

> fear of upsetting individual entities such as ones mentioned above and

> of course the Chain Pharmacies of which money must be made and profit

> the number one concern.

>

> Encouraging attempts, such as Florida and Ohio, though watered down

> may enhance that something is being done in the media's eyes, but the

> reality it is more to appease the public and nothing more as the new

> regulations really do not mean much when it comes to patient safety.

>

> Too bad these entities, including our own National and State Pharmacy

> Organizations for both Pharmacists and Technicians cannot get off of

> their individual butts and do something with the numbers in their

> membership base in the demanding of something that has substance and

> validity. Of course that would be stepping on toes and would impede

> in most cases, as in the chain pharmacy, ones ability to make money or

> profit.

>

> What makes this even sadder is that there is nothing new about what I

> have posted as it is essentially exactly the same posting both you and

> I have discussed and submitted over ten years ago in different forums

> or groups.

>

> Joe Medina, CPhT

> President/Founder Tech Lectures

> http://www.techlectures.com

>

July 21, 2008

just so everyone knows i never made any suggestions.

July 21, 2008

I am practicing in PA.

From: Jeanetta Mastron CPhT BS Chemistry <rxjm2002@...>

Subject: Re: calling a doctors office

Date: Monday, July 21, 2008, 4:31 AM

So ,

WHAT state are you practicing in as a tech?

Since the PTCB data may be a bit old (2006 to 2007) I now have to ask

you to check with your own state board of pharmacy rules/regulations

and laws for pharmacy technicians. Please let us know what you find

out.

Respectfully,

Jeanetta Mastron CPhT BS

Founder/Owner

-

July 21, 2008

I wanted to comment on one of the emails stating that a technician cannot

make therapeutic changes requests. I am paraphrasing here.

I teach my students that when they have a medication that is not covered

that they look up alternates that are covered, ask the pharmacist which they

recommend and convey this to the doctor. BUT I stress they must verify this

information with the pharmacist before telling the doctor.

Many pharmacists do not know insurances and a good tech needs to understand

formularies and alternatives to medications so they can help the pharmacist

do their job. BUT again everything must be approved by a pharmacist.

Julette Barta CPhT, BSIT, MA Ed.

Pharmacy Instructor

CRY-ROP

PO Box 8640

1214 Indiana Ct.

Redlands, CA 92374

Cell 951-741-4011 Fax 909-793-6901

Internal Virus Database is out-of-date.

Checked by AVG Free Edition.

Version: 7.5.503 / Virus Database: 269.15.31/1130 - Release Date: 11/14/2007

9:27 AM

July 21, 2008

Hi Julette,

I understand what you are teaching, but I still believe it should be

the Pharmacist doing the talking to the Doctor and not the Pharmacy

Technician. Sometimes questions may come up doing this one-on-one

conversation with the MD that would require a judgemental decision.

As to why do you suggest this particular alternative? etc.

I am also curious as to how receptive your students were to the ten

Review Manual/workbooks I sent to you at no charge in honor of Larry

Nesmith, CPhT as I had not heard back from you.

Joe Medina, CPhT

---------

Re: calling a doctors office

I wanted to comment on one of the emails stating that a technician

cannot make therapeutic changes requests. I am paraphrasing here.

I teach my students that when they have a medication that is not

covered that they look up alternates that are covered, ask the

pharmacist which they recommend and convey this to the doctor. BUT I

stress they must verify this information with the pharmacist before

telling the doctor.

Many pharmacists do not know insurances and a good tech needs to

understand formularies and alternatives to medications so they can

help the pharmacist do their job. BUT again everything must be

approved by a pharmacist.

Julette Barta CPhT, BSIT, MA Ed.

Pharmacy Instructor

CRY-ROP

PO Box 8640

1214 Indiana Ct.

Redlands, CA 92374

Cell 951-741-4011 Fax 909-793-6901

July 21, 2008

There are several points that do need to be made here.

1. As an exercise in class that teaches the students classification

and using resource information and books it is an excellent exercise.

It also teaches pharmacology.

2. The practical side is that most pharmacists are not going to want

or trust a tech to offer them a choice of drugs to choose from. BUT

(see #3 and 4)

3. However as a buyer or purchasing agent a tech MUST be able to

know alternative therapies to get prices and then get APPROVAL to

order instead (substitution)for pharmacy formulary.

4. In helping adjudicate a claim it is possible that an insurance may

reject the claim and then give the tech alternative choices to present

to the pharmacist. Again the tech should NOT be making that list

themselves as that is a judgment call. We are talking law here not

practice! In practice this may be going on, pharmacists may be

allowing it and encouraging it. But Substitution is CLEARLY the

responsibility of and the duty of the pharmacist. I would highly

recommend the law CE that Ginger spoke of in a few posts back that

clearly discusses this concept at the federal level and sites the

substitution law. Even the states that have vague laws that say that

the tech can do anything that a pharmacist tells them to as long as

they over see it, FEDERAL law prevails when it is clearly stating a

more strict law. So bottom line a tech can tell the pharmacist what

drugs are on the insurance plan formulary/list instead of the drug

ordered by a physician. But it is the pharmacist who must choose and

who must speak to the doctor to discuss this substitution with respect

to the individual patient NOT the DISEASE! We treat people not

diseases. That is what pharmacists and doctors discuss! Patients'

individual cases, not systematic substitutions.

In my class, I teach my students to be the doctor, pharmacist, tech,

nurse and play each role including discussion with RPh and Dr over

drug substitution. In this way they can better understand what has to

go into this process and we use patient case histories NOT blanket

changes because it is on the formulary. They soon learn that it is

over their heads and scope of practice while learning some basic

substitutions that are made by RPh's. So in essence we are teaching

our students much the same but with different purposes or functions as

they graduate. My students will never offer opinion of substitution.

But will be able to spot a potential error on the formulary and report

it to the pharmacist. They will be able to drum up a list of potential

substitutions for ordering to get approval from a pharmacist.

5. The doctor should be told by the pharmacist as only a pharmacist

should be discussing patient therapy with a doctor or prescriber, not

a technician. This is counseling at its finest! It is NOT within the

scope of practice of a pharmacy technician. EVEN in the states that

allow a tech to take an order over the phone. Techs should not be

discussing if the order is valid, good therapy etc. ONLY a RPh should

be doing this. However IF a tech wants to convey their opinion to the

RPh then that is acceptable as long as the RPh makes the decisions and

discusses them with the Dr.

Most respectfully,

Jeanetta Mastron CPhT BS

Pharm Tech Educator

Founder/Owner of this site

>

> I wanted to comment on one of the emails stating that a technician

cannot

> make therapeutic changes requests. I am paraphrasing here.

>

> I teach my students that when they have a medication that is not covered

> that they look up alternates that are covered, ask the pharmacist

which they

> recommend and convey this to the doctor. BUT I stress they must

verify this

> information with the pharmacist before telling the doctor.

>

> Many pharmacists do not know insurances and a good tech needs to

understand

> formularies and alternatives to medications so they can help the

pharmacist

> do their job. BUT again everything must be approved by a pharmacist.

>

> Julette Barta CPhT, BSIT, MA Ed.

> Pharmacy Instructor

> CRY-ROP

> PO Box 8640

> 1214 Indiana Ct.

> Redlands, CA 92374

> Cell 951-741-4011 Fax 909-793-6901

>

> Internal Virus Database is out-of-date.

> Checked by AVG Free Edition.

> Version: 7.5.503 / Virus Database: 269.15.31/1130 - Release Date:

11/14/2007

> 9:27 AM

>

July 21, 2008

Dear All,

Allow me to clarify the following:

" 5. The doctor should be told by the pharmacist as only a pharmacist

should be discussing patient therapy with a doctor or prescriber, not

a technician. This is counseling at its finest! It is NOT within the

scope of practice of a pharmacy technician. EVEN in the states that

allow a tech to take an order over the phone. Techs should not be

discussing if the order is valid, good therapy etc. ONLY a RPh should

be doing this. However IF a tech wants to convey their opinion to the

RPh then that is acceptable as long as the RPh makes the decisions and

discusses them with the Dr. "

What I should have said is:

" Techs should not be discussing if the order is valid, good therapy etc. with

the doctor, ONLY a RPh should be doing this (with the doctor). "

Techs should definitely be conveying their suspicions of poorly written or

prescribed scripts or drugs to the pharmacists. This IS how many errors are

found. ANd this is what we as educators should be teaching! How to avoid errors

by knowing MORE pharmacology and using it to discuss with the RPH our concerns.

But this comes with formal education or with many HOURS of OJT, and is more

fully understood with formal education.

I agree with any exercise that teaches pharmacology to techs and to find/avoid

medication errors. But caution in teaching something that the student may

believe that he or she is going to be allowed to do when they graduate. My

students have to write a paper on why they are not allowed to prescribe, play

pharmacist, discuss therapy or make substitutions and why and how to speak to

the pharmacist to give them their opinions so that errors may be avoided to meet

that goal.

Respectfully,

Jeanetta Mastron CPhT BS

Pharm Tech Educator

From: Jeanetta Mastron CPhT BS Chemistry <rxjm2002@...>

Subject: Re: calling a doctors office

Date: Monday, July 21, 2008, 9:09 PM