Beware the unintendented consequences of a win-win-win

Well Happy New Year all! I guess you could say Pharmacist Jamie was on a bit of a break. Enjoying a little family time during the holidays and keeping up with my day job has consumed the past few months. So I thought why not kick off 2016 with a controversial topic!

The weekly Wednesday #RxChat got the ole wheels turning today. We were discussing new regulations and laws in our states and how they will effect our current practice. The chat quickly turned to the dispensing of birth control pills without a prescription. Looks like Oregon and California are allowing pharmacists to dispense these hormonal contraceptives without a valid prescription.

A win-win-win-wait…

Looks like everyone is saying it’s a Win Win Win. Win for women advocates. More access to contraceptives … just like men! The politicians won this one. Win for physicians. Their offices won’t be as crowded. They can focus on time spent with patients who need them. Win for patients. A young woman in California stated “I think it’s really wonderful,” Anne Wong. “It’s a drag to have to go to clinic and talk to the doctor to get birth control pills – it takes a chunk out of your day.” Wow! Now a patient can walk into their local pharmacy and pick up their pack of pills. Super.

Wait…where is the win for pharmacists? If you aren’t thinking about this it doesn’t surprise me. We are usually on the end of any decisions. We usually accept our fate and ask what do we charge for the over the counter packs?

I am having many issues with this regulation. Not only from a pharmacist stand point, but from a public health standpoint. Let me get my thoughts in order. So first of all, women no longer have to visit a OB/GYN to obtain monthly birth control pills. They have been declared ‘safe and effective’. Great. I have taken them for years. Glad they are safe. What about the patient’s who will not see a regular physician. Most women aged 16-36 will only see their OB/GYN. It’s a yearly appointment. Yes, the waiting rooms are crowded and sometimes the day is long. So what? That is the only time in 365 days that patient may see any type of medical doctor.

Many will disagree, but my oath said “Do not harm”

Above all, I believe that first and foremost. Annual preventative health visits with OB/GYN do more than give you a ticket to get your pills each month. They do blood work, check blood pressure, depression work ups, screenings. Here’s my other concern. Many STIs can present without a single symptom. These are recognized during annual visits. Patient and partner are treated. One stop in the transmission spread. Breast cancer has really become a treatable disease. Early detection has been a huge step in the right direction! Mammograms can be performed earlier than 45 if your family history makes a case. What happens to a woman in her early thirties experiencing some depressive symptoms? She is too busy with family and work to focus on herself and may think it’s normal. When she visits her OB/GYN for that annual visit they are going to check for any signs and symptoms of mental illness. I’m serious! Look at how many of your antidepressants are written from these docs.

Speak up

And yes after further research I found Oregon and California will both be requiring pharmacists to perform certain ‘health screenings’. Give me a break. So more patient counseling and interaction without a reimbursement for clinical time! Come on pharmacists. Speak up! Oh and they may require a pharmacist to complete an hour of CE credit about oral contraceptives. I wish I had that shocked looking emoji face to post here. (and another question… women can buy condoms… Will men be able to buy oral contraceptives for female use?)

Maybe I’m totally off base with my stance on this subject. I cannot feel good about taking a young woman out of the OB/GYN office. I also do not feel good about doing more health screenings without a proper reimbursement and acknowledgment of my services. You guys know me and know I love a good discussion. Feel free to share any thoughts.


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