Monday Rx | November 26th, 2018 | Should Doctors Stay in Their Lane?
Season’s Greetings! I hope you found time to rest, share and connect with friends and family, especially after two profound tragedies struck our community.
As most physicians know, there is a dispute between the National Rifle Association and the medical community. Physicians released an editorial recently saying they disagree with the NRA. The NRA told “anti-gun” doctors to “stay in their lane” after a series of research papers about firearm injuries and deaths was published in the Annals of Internal Medicine, including new recommendations to reduce gun violence. The NRA wrote in the tweet, “Someone should tell self-important anti-gun doctors to stay in their lane. Half of the articles in Annals of Internal Medicine are pushing for gun control. Most upsetting, however, the medical community seems to have consulted NO ONE but themselves.”
Why am I sharing this news? The tweet was posted hours before a gunman opened fire in the Borderline Bar & Grill in Thousand Oaks, California, killing 12 people before turning the gun on himself.
Several tweets from doctors, including trauma surgeons and emergency room physicians, included graphic images of what operating tables or hospital scrubs can look like in the bloody aftermath of a gunshot wound case. In response to the NRA, Dr. Sue Bornstein, chair of the American College of Physicians’ Health and Policy Committee, co-authored Monday’s new editorial with the journal’s editor-in-chief, Christine Laine, and executive editor, Dr. Darren Taichman.
In addition to caring for gun-related injuries and their long-term consequences, “we need rigorous research to better understand the crisis, test solutions, and learn how best to implement and sustain those that work,” they wrote.
“To date, the ability to study important questions that might help reduce firearm-related injury has been hampered by a lack of funding and a worry among researchers that studying anything related to guns could put their research careers at risk. This needs to be fixed,” they wrote.
“Doctors have a responsibility as health care professionals and scientists to seek the answers to questions related to health and safety. And we won’t be silenced in using what we learn to better care for our patients,” they wrote. “Those who seek to silence progress toward finding solutions to the crisis of firearm-related injury are traveling a lane that leads, literally, to a dead end. We’re going to stay in our lane and keep moving forward.”
“Physicians, particularly the trauma care physicians and emergency medicine physicians, see the end result of gun violence, and it is a very brutal, powerful thing. One thing that is apparent to many of them is because these injuries are so devastating, prevention is particularly important,” one physician wrote.
And sadly, physicians and other health professionals are all too often the victims of gun violence themselves, as last week we learned about the tragic death of Dr. Tamara E. O’Neal and a pharmacy resident and a police officer.
So, should Doctors stay in their lane?
I’d like to hear from all sides of this debate and your ideas on how to address this problem. Should all sides come together to respectfully debate the issues? And, rather than tweeting, posting and distributing editorials or negative ads, would a conversation focused on solutions be an option? Or pie in the sky?
Please share your opinion with me.
Also, related to the recent fires, a state of emergency was declared earlier this month for three California counties—Los Angeles, Ventura and Butte—due to the effects of the Hill, Woolsey and Camp wildfires, which have destroyed homes and businesses, threatened critical infrastructure and caused the evacuation of residents.
The California State Board of Pharmacy reminds pharmacists and prescribers of state laws that can help in caring for patients displaced by emergency relocations. Below are requirements for furnishing prescription drugs, providing emergency refills without prescriber authorization, and operating a mobile pharmacy in a declared emergency area from California Business and Professions Code sections 4062 and 4064:
Section 4062. Furnishing Dangerous Drugs during Emergency; Mobile Pharmacy
- Notwithstanding Section 4059 or any other provision of law, a pharmacist may, in good faith, furnish a dangerous drug or dangerous device in reasonable quantities without a prescription during a federal, state, or local emergency, to further the health and safety of the public. A record containing the date, name, and address of the person to whom the drug or device is furnished, and the name, strength, and quantity of the drug or device furnished shall be maintained. The pharmacist shall communicate this information to the patient’s attending physician as soon as possible. Notwithstanding Section 4060 or any other provision of law, a person may possess a dangerous drug or dangerous device furnished without prescription pursuant to this section.
- During a declared federal, state, or local emergency, the board may waive application of any provisions of this chapter or the regulations adopted pursuant to it if, in the board’s opinion, the waiver will aid in the protection of public health or the provision of patient care.
- During a declared federal, state, or local emergency, the board shall allow for the employment of a mobile pharmacy in impacted areas in order to ensure the continuity of patient care, if all of the following conditions are met:
- The mobile pharmacy shares common ownership with at least one currently licensed pharmacy in good standing.
- The mobile pharmacy retains records of dispensing, as required by subdivision (a).
- A licensed pharmacist is on the premises and the mobile pharmacy is under the control and management of a pharmacist while the drugs are being dispensed.
- Reasonable security measures are taken to safeguard the drug supply maintained in the mobile pharmacy.
- The mobile pharmacy is located within the declared emergency area or affected areas.
- The mobile pharmacy ceases the provision of services within 48 hours following the termination of the declared emergency.
Section 4064. Emergency Refill of Prescription without Prescriber Authorization
- A prescription for a dangerous drug or dangerous device may be refilled without the prescriber’s authorization if the prescriber is unavailable to authorize the refill and if, in the pharmacist’s professional judgment, failure to refill the prescription might interrupt the patient’s ongoing care and have a significant adverse effect on the patient’s well-being.
- The pharmacist shall inform the patient that the prescription was refilled pursuant to this section.
- The pharmacist shall inform the prescriber within a reasonable period of time of any refills dispensed pursuant to this section.
- Prior to refilling a prescription pursuant to this section, the pharmacist shall make every reasonable effort to contact the prescriber. The pharmacist shall make an appropriate record, including the basis for proceeding under this section.
- The prescriber shall not incur any liability as the result of a refilling of a prescription pursuant to this section.
- Notwithstanding Section 4060 or any other law, a person may possess a dangerous drug or dangerous device furnished without prescription pursuant to this section.
For additional information, contact the Board of Pharmacy at (916) 574-7900 or visit the board’s website at pharmacy.ca.gov.
Healthcare Awards Week is Here!
It’s Gala Week! With five days to go until the Patient Care Foundation’s 7th Annual Los Angeles Healthcare Awards, we are excited to honor healthcare industry leaders. Proceeds from the 2018 Healthcare Awards will benefit medical student programs at the Charles R. Drew University of Medicine and Science (CDU). Tickets are almost sold out, but if you are interested in attending, please contact us.
Learn more about the honorees here.
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