Under controversial regulations proposed by the California State Board of Pharmacy, drugstore prescriptions could be filled by a "pharmacy technician" instead of a licensed pharmacist.
The changes--the subject of a hearing Wednesday in Los Angeles--would allow persons who have completed a brief training program to count tablets, pour medications and prepare labels. The board says this step is intended to free the pharmacist to spend more time instructing patients about medication dosage and storage, side effects and drug interactions.
But critics say they fear it will lead to errors in filling prescriptions.
Focus on Hospitals
Lorie Rice, executive officer of the pharmacy board, said the proposed changes would also regulate pharmacy technicians in hospitals. Although trained by individual hospitals, such pharmacy workers have operated without state certification for 20 years.
Technicians certified by the board after a 480-hour training course would perform tasks described in the proposal as "manipulative and/or repetitive non-discretionary functions related to the processing of a prescription in a licensed pharmacy" under the "direct supervision and control of a pharmacist."
That means, said board member Robert Toomajian, chairman of a special committee that examined the issue for 18 months, "counting, pouring, licking and sticking" tasks that take up more than a third of most pharmacists' time. The pharmacist would still bear ultimate responsibility for ensuring that the prescriptions are correctly filled.
Any pharmacist employing such a technician would be required to consult with patients about their prescriptions and maintain medication records for each individual to prevent problems that might result when a patient is being treated by several doctors, he said.
Need for Consultation
"I filled 190 prescriptions yesterday," said San Bernardino pharmacist Bill Pearson, who testified at Wednesday's hearing. "I could use some help in the pharmacy so I could consult with patients. I'm self-employed and I have to do more than I feel safe about."
The proposal is supported by the California Pharmacists Assn. and the California Society of Hospital Pharmacists, but opposed by unionized pharmacists who have joined forces in a group calling itself Californians for Safe Prescriptions, by consumer groups such as the Southern California Gray Panthers (advocates for the elderly), and some law enforcement agencies.
Opponents say that besides the possibility of more medication errors, the changes would displace licensed pharmacists and result in narcotics being diverted for street use when placed in the hands of unlicensed people not subject to background checks. They also point to a state survey by the Guild for Professional Pharmacists in which 87% of pharmacist respondents said they would expect to see an increase in the prescription error rate if the proposal is implemented.
Union representatives said no other state permits technicians to dispense medications.
But Robert Johnson, executive vice president of the California Pharmacists Assn. in Sacramento, said his group supports the proposed regulations because they "would make it possible to use support personnel and place restrictions on them."