TYRE-DI am so dead tired. Spent the entire morning seeing and reviewing patients. The referrals started coming in at 10.30 am. The latest referral was 20 minutes ago just when I finally managed to sit down and was about to sink my teeth into a very rigor-mortised piece of fried chicken thigh, rice liberally moistened by sardine sauce and a few pieces of near-fossilised cucumber. Ugh! The referral was just to "get your permission to start iv Tazocin because the pharmacist insists that an ID physician give the permission first". I happily suggested that they consult the Chest Physician since he also has the power to start Tazocin and the patient has Ventilator-Associated-Pneumonia (VAP).
Over here, everyone has a hand in 'managing' the patients, including the pharmacists who usually haven't a clue as to how critical a patient's condition is but yet has the power to determine what antibiotics should or should not be given and who should prescribe them. It's a lot like the superpowers in the UN with their veto power.
I don't hate them really, they are just part of a huge conspiracy to 'save money'. Of course they have their own good reasons and I am all for using the correct therapy for the correct ailment and to check abuse; but sometimes it gets too ridiculous when people who have not seen the patients themselves have the the power to veto your decision simply because "you are not authorised to give this antibiotic". Sigh!
I have 2 hours to see another 5-6 referrals; gather 4 sets of scans and write a short summary for each of them for the X-ray conference tomorrow and pray that the referrals would stop coming in. :-)
Better get to work.
posted by Jimbo @ 6/07/2006 01:56:00 PM
2 Comments:
At 6/07/2006 05:40:00 PM,
The Leech said…
From your other post, you seem like quite a broad minded fella. I am a pharmacist. Hhhm, I guess that it doesn't strike you that what we hope to achieve is correct usage of drugs and not a quick way "to save a buck." Oh the times when we screened and found that an antibiotic was started when not warranted. That goes for other drugs. But I am not here to be antagonistic. I wish that I could say, "To hell with the guidelines." That would certainly make life easier for me...and you. Trust me, if I wanted easy, I would not be here. But like you, I have a responsibility to the patients and that responsibility is to ensure that they are getting the correct drug, the correct way. I am sure that there are ways of working together that doesn't leave you and me feeling frustrated at the end of the day.
At 6/08/2006 07:52:00 AM,
Jimbo said…
Hi BlueCheese,
Thanks for your comment. Like I said, I don't hate you guys. I very well understand that pharmacists have their job to do and I appreciate their role. It's for the greater good that the guidelines are in place. God knows what a lot of doctors precribe at their whims and fancies. The frustration stems from the fact when for once a non-medical unit doctor decided to think properly and prescribe the appropriate medication, they are hampered by the very same guidelines, thus resulting in unnecessary referrals and frustrations all around.
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