Mandatory Counseling? Debate and Discussion. 
This past week, my pharmacy advocacy class had a great discussion on the topic of mandatory counseling. This subject has been brought about by recent changes in legislation in other states in the country that require by law that pharmacists counsel on every new prescription. This has both good and bad connotations to it. We went into great depth and detail about the pros and cons of a law that forces mandatory counseling into practice. Although I don’t think that many of us were convinced either 0ne way or another, I do believe that the discussion we had was extremely productive and enlightening.
After doing some research of my own prior to class, I was convinced that mandatory counseling inside a busy community pharmacy was doing the profession a disservice. I thought that legislation like this would steal autonomy away from pharmacists and just create another hoop to jump through during a busy day. The current atmosphere in most community pharmacies isn’t conducive to interruption-free work which can make processing prescriptions dangerous if too much is going on around the pharmacy. In my mind, before class, adding in mandatory counseling would just add to these interruptions and take away from the pharmacist’s ability to evaluate what is truly important. During the discussion, however, my opinion on this began to morph into more of a grey area that I wasn’t expecting.
Big points for
- this would help to protect the pharmacist’s role
- it would increase contact time with the patient
- we would be able to cut down on adverse drug reactions and errors
Big points against
- increased interruptions for the pharmacy team
- takes autonomy away from the pharmacy team
- trying to counsel on “new” prescriptions that are just refills (somewhat redundant)
- patients may have to wait for the pharmacist to have to time complete required counseling
Interesting points and questions
- How would this affect hospital pharmacists?
- If we keep on stretching our pharmacy teams so thin, at what point are we making unethical decisions?
- Could this bring up more clinical opportunities for pharmacists?
- Would this force community pharmacies to begin shifting their resources less towards dispensing and more towards clinical roles as we stretch our time even further?
- Where does reimbursement for time come into play?
All of these points mentioned essentially brought the class to one conclusion. The answer to mandatory counseling isn’t black and white whatsoever. It is much more grey than any of us expected. My viewpoint definitely changed throughout our discussion. I think that mandatory counseling could play a role in the profession, but it needs to be set up in a way that is beneficial and not redundant for the pharmacy team. In my eyes, I think that every new therapy and therapy change should be counseled on. In my experience, this is what many pharmacists do already. The mandatory counseling idea could be used to reinforce counseling on new therapies and therapy changes.
The forum discussion that we had in class was very beneficial for tearing the details of this topic apart. Providing pros, cons, and questions of concern was a great way to insert detail into the discussion. People saw things pop up that they weren’t thinking of and were then forced to address it from their viewpoint. This discussion process helped to have a productive and non-biased conversation about an important new topic.
If you would like to learn more about why mandatory counseling is becoming a hot topic, follow these links. The first one is a pharmacist advocating for mandatory counseling. The second link is to a discussion thread with pharmacists talking about first-hand negative and positive experiences with this type of legislation in other states. Enjoy and become more informed!
https://forums.studentdoctor.net/threads/mandatory-counseling-questions.1274841/
