Veterinary Talk by Dr. Jim Humphries

A prescription for error and danger

Proposed changes in regulations by the Federal Trade Commission may soon require veterinarians to provide pet owners with a prescription for their petsí medications so it can be taken to any human pharmacy, as an option to being filled at the veterinary office. The reasoning behind this is to give consumers more choices that hopefully leads to cost savings, but the real world consequences may be disastrous.I recently stood in line for 15 to 20 minutes at our local giant retailerís pharmacy window. A ìpharmacy associateî tried to help; but, after two trips to the actual pharmacist for questions, she was still not clear what the problem was with simply handing me the medication. Finally, the ìassociateî walked out of the pharmacy without so much as a nod or an ìI’ll be right back.î After waiting about five minutes, I asked the other ìassociateî where this person was. ìOh, sheís gone to lunch.î Yes, right in the middle of trying to figure out a problem; and, after I’ve already waited for 25 minutes, my ìassociateî simply left me standing at the window with no one interested in helping, much less getting any closer to resolving the problem. This is truly ìcare-lessî service. This lack of real care of customers is often combined with another common problem at todayís pharmacies: a lack of adequate inventory. Even the large pharmacies simply do not often carry enough stock to fill an order for ONE patient. I canít tell you how often I hear, ìWe donít have enough to fill this right now, but if you come back in two days it should be fine.î For those of us who live in Falcon, that is often a 40-mile round trip! Weíre now required to make that trip two times because a pharmacy cannot carry adequate inventory to fill ONE prescription for ONE patient of a common drug (that, by the way, I get every month). Here, inventory controls are contributing to the lack of real customer care. But, you see, they donít care. If you take your business somewhere else, there are plenty waiting in the line right behind you. So, excellence in care is not important.Besides the waste of time and bad customer service, imagine my concern when I find out that pet owners may have to be sent to human pharmacies for their petsí drugs. About two years ago, I tried calling in many prescriptions to help clients with convenience or cost. The majority of the time the pharmacist would tell me they did not have the right strength or did not stock all weight sizes, or would have to get inventory from another store, and it would be several days. Why would pharmacies promote that they sell veterinary drugs and then not carry stock of the most common ones? I fear they are going to sell you what they have, whether it is the right dose or not. I completely stopped sending any clients to human pharmacies for this reason. But, it gets worse. The Oregon Veterinary Medical Association surveyed pharmacies and found that 35 percent of veterinary prescriptions were changed by the pharmacist (did you read that part slowly). Yes, changed by the pharmacist. Such changes can cause a drug to be ineffective or even be fatal because pharmacists have no training in veterinary medicine. The survey found that pharmacists simply think the prescribing doctor of veterinary medicine did not know the right dose, so they change the prescription and dose to match more what a human should receive. In some cases, these changes may have simply caused the therapy to be ineffective; but, in other cases, the doses or drugs suggested by a pharmacist could have been lethal.One pharmacist suggested to a pet owner that she give ibuprofen to her dog because the pharmacy was out of Rimadyl Æ or carprofen. Ibuprofen is toxic to the kidneys in dogs. Because of differences in the way drugs are metabolized between species, things like Valium, phenobarbital and synthetic thyroid hormone doses are all very different; and, if a pharmacist changes these prescriptions, bad things happen.Finally, you should know that pharmacy mistakes are scary nationwide. A Ten-Year Analysis* examined data from patientsí claims, and found that 75.3 percent arose from patients receiving either the wrong drug (43.8 percent) or the wrong dose (31.5 percent).†In claims filed between 2002 and 2011, an overdose occurred 13.6 percent of the time and death — 11.7 percent. Several high-profile death cases involving a national pharmacy chain we have right here in Falcon can be easily found on the InternetWhat is the cause? Money. National chains and the big-box stores with pharmacies are dictating that a pharmacist spend no more than 15 minutes per prescription, answer the phone in 20 seconds and cut their staff 20 percent or more. ìStaffî gets precious little training. It is about numbers, and that all adds up to careless service and mistakes. It also adds up to big money. One of the national chains paid out a billion dollars in claims from prescription mistakes. The answer: Get your petsí drugs from your veterinarian or the online pharmacy you may find on their website. Your veterinarian has the right drug, the right dose and they know all the interactions that are crucial. If you saved $5 on a prescription at a human pharmacy, is it worth a second stop with all the kids in the car, 20 minutes of waiting, rude service and the possibility of getting the wrong drug or dose? You make the call.*A collaboration between the pharmacy underwriter group CNA and Healthcare Providers Service OrganizationDr. Jim Humphries is a veterinarian in Falcon and also serves as a visiting professor at the College of Veterinary Medicine at Texas A&M University. He provides hospice and end-of-life care for pets. He lives in Falcon with his wife, horses and rescued Great Danes. www.MobilePetDocs.com

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