Pharmacy VS Optometry

[theillestill]

I'd love to see the issues with licensing on that. Or malpractice insurance. Or it standing up in a court of law when you misdiagnose someone.

 

[Hayden]

I'd love to see the issues with licensing on that. Or malpractice insurance. Or it standing up in a court of law when you misdiagnose someone.

That was one of my main concerns.

BTW, I don't know if it was obvious, but I am not talking about mild conditions (skin complaints, some sore throats etc.).

 

[thehairyfoot]

True, I am only basing my opinion on what my friends learned and they are graduates of only a few pharm courses, and not QUT.

But I absolutely do not believe that a pharmacy course gives a student enough training and clinical experience to be competent in diagnosing or managing any disease that walks through the door. Med students spend years in clinical placements getting the skills to do that, and even then they're not that good at it.

I'm not trying to disrespect the pharmacy profession, who I believe end up with a fountain of knowledge regarding drugs and patient care. I just logically don't see how pharmacists would be able to manage, for example, somebody who comes in keeled over in abdo pain besides sending them to their GP or ED. Where/why would they have learned the appropriate investigations, if they have no way of ordering them? What pharmacist would take a patient into the back room to check for Murphy's sign or rebound guarding? What pharmacist carries an ophthalmoscope handy? Or knows what to feel for on a DRE?

It just doesn't make sense to me. The same way I would never try and trump a pharmacist's knowledge in drug interactions, I don't see how a pharmacist attempting clinical diagnosis is a safe exercise. Not even triage nurses, with 20+ years experience in the ED seeing the initial presentation of all patients, actually try and diagnose them.

True. I don't even know what we were arguing about at the start.
I think this just bolsters my view that there being too many pharmacists is going to be a real problem soon. What else are they trained for :S Stupid guild

 

[crickethunger]

I don't understand the doctor's arguments about safety. My dad has to go to the doctor every month or so to get his coversil renewed but it takes ages at the doctors. It's at least a 2-3 hour wait. Plus the doctor usually doesn't check much, just writes up a new prescription. What a waste of time and money. Why not let the pharmacist do it?

Same as when I get a fever. I know what I need: antibiotics but I don't really feel like waiting at the doctor for hours in such discomfort waiting for the GP.

It has nothing to do with safety, doctors are just obsessed with protecting their turf. Wait till the Government gets more funding into nursing, then lots of nurse practitioners will start appearing that can basically do most of what GP's can. And GP's would have brought it on themselves. They are letting the massive doctor shortage stay as it is so they can earn half a million dollar salaries (and cry that they're getting underpaid- bullshit) and the Government will have to something. And if any Government in any election promises to increase/flood nurse numbers and increase NP training positions, I'm voting for them hands down. Anything that gets rid of this massive clog up is good.

And pharmacists seem like the obvious professional to go to for help. Sure there are dodgy pharmacists but there are some who are so brilliant, I trust them more than the doctor. As an example the Kapadia pharmacy in Glenroy is top rate. The pharmacists are very intelligent. I would happily agree to them giving medical advice, vaccines, prescriptions.

Oh one other thing. Recently I got stung by a bee. I went to the pharmacists and he gave me antihistamine. But he refused to take out the bee sting because if things go wrong he didn't want to get sued. I asked for antibiotics and he said I need to see a doctor. What bullshit. By the time i see the doctor I might have been infected and dead. It's ludirous. Let the pharmacist take care of little things like that. I didn't go to the doctor and don't even plan to go again unless I'm half dead. I'm sick of having to waste so much time for little things. I hope alternative medicine is at least allowed to expand. Anything to reduce waiting hours for doctors is good, even if safety is at some risk.

 

[crickethunger]

True. I don't even know what we were arguing about at the start.
I think this just bolsters my view that there being too many pharmacists is going to be a real problem soon. What else are they trained for :S Stupid guild

This oversupply of pharmacists isn't too much a problem. Our population is expanding and every time we dip into recession we will get sicker. The need for pharmacists will never die down. There salaries are still really good. Even if they are to reduce by say 10k, salaries are still good.

 

[Hayden]

Are you a troll?

I don't understand the doctor's arguments about safety. My dad has to go to the doctor every month or so to get his coversil renewed but it takes ages at the doctors. It's at least a 2-3 hour wait. Plus the doctor usually doesn't check much, just writes up a new prescription. What a waste of time and money. Why not let the pharmacist do it?

What on earth does this have to do with safety?

The pharmacist would not know your father's history, the fact that he may have been taking coversyl for some time with no problems, his past medical history, he might not want to add other medications even if he needs them... there are so many factors that come in to writing or continuing a prescription.

Same as when I get a fever. I know what I need: antibiotics but I don't really feel like waiting at the doctor for hours in such discomfort waiting for the GP.

And what on earth makes you think you need antibiotics every time you have a fever?

It has nothing to do with safety, doctors are just obsessed with protecting their turf.

I don't know any GPs or consultants that do not want more doctors in the workforce so that they can reduce their workload and stress.

Wait till the Government gets more funding into nursing, then lots of nurse practitioners will start appearing that can basically do most of what GP's can. And GP's would have brought it on themselves. They are letting the massive doctor shortage stay as it is so they can earn half a million dollar salaries (and cry that they're getting underpaid- bullshit) and the Government will have to something.

How the hell do GPs control the number of doctors in the workforce???

And pharmacists seem like the obvious professional to go to for help. Sure there are dodgy pharmacists but there are some who are so brilliant, I trust them more than the doctor. As an example the Kapadia pharmacy in Glenroy is top rate. The pharmacists are very intelligent. I would happily agree to them giving medical advice, vaccines, prescriptions.

People do go to pharmacists for help for those things.

Oh one other thing. Recently I got stung by a bee. I went to the pharmacists and he gave me antihistamine. But he refused to take out the bee sting because if things go wrong he didn't want to get sued. I asked for antibiotics and he said I need to see a doctor. What bullshit. By the time i see the doctor I might have been infected and dead. It's ludirous. Let the pharmacist take care of little things like that. I didn't go to the doctor and don't even plan to go again unless I'm half dead. I'm sick of having to waste so much time for little things. I hope alternative medicine is at least allowed to expand. Anything to reduce waiting hours for doctors is good, even if safety is at some risk.

It's probably not a good idea to comment on medical treatment when you have no understanding of it.

 

[theillestill]

I hope alternative medicine is at least allowed to expand. Anything to reduce waiting hours for doctors is good, even if safety is at some risk.

Love it. Even if safety is at some risk.

 

[theangelofdarkness]

If you have a serious medical problem, go to the emergency department. If you were really dying like you seem to think you are every time something goes wrong, they'll treat you quickly.

Nice to see you didn't need the antibiotics and are clearly still alive to post.

Hayden and theillestill have addressed the rest of your post, no point in repeating their points.

 

[thatguy]

This oversupply of pharmacists isn't too much a problem. Our population is expanding and every time we dip into recession we will get sicker. The need for pharmacists will never die down. There salaries are still really good. Even if they are to reduce by say 10k, salaries are still good.

You serious? That's gotta be a joke right?

 

[FishPharm]

True, I am only basing my opinion on what my friends learned and they are graduates of only a few pharm courses, and not QUT.

But I absolutely do not believe that a pharmacy course gives a student enough training and clinical experience to be competent in diagnosing or managing any disease that walks through the door. Med students spend years in clinical placements getting the skills to do that, and even then they're not that good at it.

I'm not trying to disrespect the pharmacy profession, who I believe end up with a fountain of knowledge regarding drugs and patient care. I just logically don't see how pharmacists would be able to manage, for example, somebody who comes in keeled over in abdo pain besides sending them to their GP or ED. Where/why would they have learned the appropriate investigations, if they have no way of ordering them? What pharmacist would take a patient into the back room to check for Murphy's sign or rebound guarding? What pharmacist carries an ophthalmoscope handy? Or knows what to feel for on a DRE?

It just doesn't make sense to me. The same way I would never try and trump a pharmacist's knowledge in drug interactions, I don't see how a pharmacist attempting clinical diagnosis is a safe exercise. Not even triage nurses, with 20+ years experience in the ED seeing the initial presentation of all patients, actually try and diagnose them.

For starters, I don't know many pharmacists wanting to make that level of diagnosis. In pharmacy school we learn way more than just pharmacology. Physicians come out of school an expert in diagnosing and pharmacist come out of school as experts in the best drug for that diagnosis. So to me, its equally as crazy to have a physician be the sole prescriber when that is not their area of expertise. The most ideal situation and what is best for a patient is for a physician to make a diagnosis and a pharmacist to do the prescribing. As far as pharmacists diagnosing goes, we do this every day in the retail setting when we recommend medications to patients ... the same medications that 6 months ago were prescription only in many circumstances. Me, personally, I don't want to diagnose to the level of what you mentioned above but I see nothing wrong with a pharmacist ordering routine tests and diagnosing patients in the setting of a Minute Clinic etc. (cough, cold, HTN, vaccinations etc) I would much rather have a phamacist be the one to prescribe than a physician who has very little pharmacology or a nurse who has even less....to me that is crazy .... no wonder antibiotics are being given out as placebo's and everyones addicted to Oxycontin. Eventually this is what will happen in healthcare.

 

[Ken2010]

From what I've read and heard, there also appears to be a "Pharmacy Student Tsunami", although it seems to be getting less press than the "Medical Student Tsunami". I imagine that Optometry would have greater job security in the coming years.

 

[vitualis]

So it's down to what you would enjoy most. For me I'm going down the path of optometry because I like the eye very much. And if I want to go into ophthalmology (yes I realise this is very very very tough) I can switch to medicine after the 3 year science degree (I'm talking about flinders optom which offers 3 years science+2 years master of optom) if I do good enough.

With regards to ophthalmology, I hope you realise that your plan is entirely unrealistic. There is absolutely no guarantee that you will get into Medicine. Even if you do, there is absolutely no guarantee that you will be accepted into the ophthalmology training program (we're talking about few positions per year than there are university medalists).

You should do optometry because you want to do optometry.

For starters, I don't know many pharmacists wanting to make that level of diagnosis. In pharmacy school we learn way more than just pharmacology. Physicians come out of school an expert in diagnosing and pharmacist come out of school as experts in the best drug for that diagnosis. So to me, its equally as crazy to have a physician be the sole prescriber when that is not their area of expertise.

Pharmacists however, have little knowledge of clinical medicine and proper assessment. Moreover, their treatment recommendations are heavily biases towards interventions that can be purchased from their store. This is a serious conflict of interest. Few pharmacists would suggest to a patient coming in with a sore throat due to a viral URTI that they don't actually need to buy anything from their store and advise on some simple home symptomatic remedies.

Me, personally, I don't want to diagnose to the level of what you mentioned above but I see nothing wrong with a pharmacist ordering routine tests and diagnosing patients in the setting of a Minute Clinic etc. (cough, cold, HTN, vaccinations etc).

So, what "test" are you going to use to determine that a patient with a cough and cold actually has a viral illness rather than community acquired pneumonia?

"Prescribing" is not a separate component to healthcare. It is an integral part of the systematic management of the patient. I have no doubt that many pharmacists have a better functional knowledge of pharmacology than many doctors. However, understand that it context: they are experts in drugs not experts in patient assessment, diagnosis and management.

Regards.

 

[Farmacist]

its funny because i just finished 1st year pharmacy .. and i was just offered a place at deakin to study optom
and in the end i really want to do medicine but honestly just using optom and pharm as a backup plan incase i dont get in ( i would like a job in a health profession anyway if i dont get into med)
but im not sure which one to do ... the deakin course is 3.5 years .
im not sure which will allow me to get a higher gpa

main problems
1. dont know which course is harder - allowing me to get higher GPA for postgrad med
2. not sure if i can get into non standard entry ., if this is the case i prob should stick with pharmacy as second year is easy ( as i love the subjects) and i could ace this and try to get in before i meet 3rd and 4th year where it becomes harder.
3.optom is 3 years , after 2 years i have bach vision science allowing me to apply for post grad 1 year earlier = doing the gamsat this
year too
4. Pharmacy would be more relevant to medicine and it would help me throughout med in comparison to optom.
5. with optom i may have to do physics and business subjects which i despise .. although i dont mind the pharmacy subjects and infact love some of them.
6. living at home would save 30k .... but at the same time the independence at on-campus by myself is amazing.

 

[bobby190]

@matt123 You seem to have a good passion for BPharm, one which I can totally understand, so I think anyone with these kinda reasons should stick to BPharm over optom.

https://pagingdr.net/forum/index.php?topic=4823.0 Huge thread from PD on same topic incase anyone else choosing between opto and pharm.

Physicians come out of school an expert in diagnosing and pharmacist come out of school as experts in the best drug for that diagnosis. So to me, its equally as crazy to have a physician be the sole prescriber when that is not their area of expertise.

To me this sounds about right. Im sure dentists also have less understanding of pharmacology than pharmacists aswell and dentists can prescribe (presumably because they are trained more in another aspect). Pharmacists being able to prescibe at some level to me sounds almost inevitable. I did 2 pharmacology papers and I must say just pharmacology goes a lot deeper than drug interactions or biochemical pathways and indulges in plenty of symptoms. Pharmacist must know this and much much more with dealing with people too.

It just doesn't make sense to me. The same way I would never try and trump a pharmacist's knowledge in drug interactions, I don't see how a pharmacist attempting clinical diagnosis is a safe exercise. Not even triage nurses, with 20+ years experience in the ED seeing the initial presentation of all patients, actually try and diagnose them.

I can understand this point and he is correct. BUT I think with a bit more training i.e. a masters degree as a follow up from BPharm I dont see why a pharmacist could not have ample knowledge to diagnose less severe/trivial/common cases and prescribing. Ofcourse it goes without saying for more serious cases one be trained to know when to refer to a doctor.

With regards to pharmacists prescribing...

It has nothing to do with safety, doctors are just obsessed with protecting their turf.

As outlined before there are reasons to think otherwise and infact the opposite. but could you blame someone for bring up the 'elephant in the room'? I wouldnt count it out completely & it is only natural, constructive and justified for doctors to protect their turf.

I hope alternative medicine is at least allowed to expand. Anything to reduce waiting hours for doctors is good, even if safety is at some risk.

Please be kidding...

Ok I perhaps have opened a can of worms here^^. But I have another question to anyone in the know...

How likely is it that optometrists and pharmacists etc would have more of their work replaced by machines and their jobs phased out more ( not entirely, just a major decrease)?
Visited optom few weeks ago and remember looking at that machine that checks the power of your eyes instantly and sparked this thought ^^.

 

[Farmacist]

yes i agree , i think this is why i will chose bpharm in the end.
and lol , That post is actually mine. !

 

[Nell]

Hmm. I suppose it depends.

Pharmacy is covered by an award wage, or an industry minimum, it might not seem like that much after 4 years of study and a year of internship, but it is something to let you know the bare bones of what you could earn; as of 2011 financial year I think it sat at about 21$ an hour minimum for a pharmacist, 23$ for an experienced (4+ years) pharmacist, and 24 and 27 for a pharmacist in charge and pharmacist manager, respectively. Generally, most places pay above the award wage (even Chemist Warehouse pays an average of 33$ an hour to a graduate pharmacist)

The national minimum wage is... Idk, about 15-17$ or something an hour for an adult, you can look it up, however as far as I last heard there is no award rate (industry minimum) for optometrists, and therefore theoretically I think you could be paid all the way down to the minimum wage.

However, this would never happen. I think there may be a graduate award wage which covers anyone working with a degree, so that's a start. Plus, supply and demand is at work - there is currently higher demand and lower supply of optometrists, so the pay stays high. They are in fact the second highest paid straight out of uni, following behind dentists. This starts at about 60-65k a year, which is good money for straight out of uni. This could go as high as 50$ an hour or about 100k a year, but would probably stagnate there, with few opportunities after that. Still, great money.

Pharmacy has a lot of supply that outweighs the increasing demand (esp. now) so that pushes wages down a little, you can still end up with about 60k after your pre-registration year, which has the potential over experience and promotions to again go up to 100k, so

Even though this thread is way way old, anyone who is looking at the two would probably be better off choosing which one interests them more, or which one they are best at, since the pays really balance out between the two after a few years.

 

[Nell]

How likely is it that optometrists and pharmacists etc would have more of their work replaced by machines and their jobs phased out more (not entirely, just a major decrease)?

Optometrists I am not sure, when I went a few weeks ago it seemed to be the non-optometrist lady doing the main start tests, and then the optometrist took me into the other room and did the 'number one, or number two?' thing for a few minutes before making some recommendations and so on. As far as diagnosis of eye conditions, this will always be up to the optometrist, however while I don't see their position as eye checkers being 'phased out' entirely, certainly machines will take away a seemingly large part of their position. They will always be required to make sure it runs smoothly however. Perhaps their training will being to focus more on disease diagnosis and treatment rather than the work they do with glasses in vision impairment. I could hardly say.

Pharmacists on the other hand, would never get replaced by machines. I worked in a Maloufs with a dispensing robot, which could probably be programed to be fully automated, but really all it does is speed up the process of dispensing a little bit by meaning the pharmacist doesn't have to keep walking from the computer around the dispensary to the relevant location of the medication they need to label. I suspect this mechanical assistance will probably result in a lower demand of dispense technicians and free up pharmacists to counsel a little more in busier stores, but the pharmacist will always have to be there to check the script. If you leave a machine to do the entire process you would have a number of problems:
1. a handwritten script could never be read by a machine because doctors have awful handwriting
2. if the script has a mistake the machine will not pick it up, it will copy it verbatim (I once had a doctor make a typo in the instructions which would have overdosed the patient - a machine would take this simply as is since it has no idea of what could or couldn't be, and would simply take the written instructions exactly)
3. if there is a drug interaction, how does the machine deal with it? if it's severe maybe the machine is programed to stop dispensing and tell the customer they cant have this medication. But the amount of times in reality that you get severe drug interaction warnings is ridiculous, but the pharmacist and the doctor are both aware of the possible risks and outcomes and have weighed these out against the benefits. A machine isn't capable of this by itself.
4. an error with the machine could put the pharmacy out of business for the day. If your pharmacist is sick you can always call in an emergency locum or try find someone to fill the shift on short notice. You aren't going to be able to get another half million dollar dispensing robot with a few phone calls.

there are many other issues but those would be the major ones. Also, dispense robots are very expensive, the cost:benefit ratio at the moment is typically not worth it. However, with the introduction of e-scripts, if it went nation wide, you could streamline pharmacy very efficiently. Cut costs by removing the dispense tech, have a pharmacist and assistant, the assistant takes in scripts, the pharmacists simply has to check it for validity, errors etc, scan it, the electronic script will fill itself in the dispensing program, the dispense robot will select the product and deliver it down to where the pharmacist stands, the pharmacist can then label it, check interactions and so on, and then take it out to the patient. The whole process could be very fast, efficient, and would be of great benefit to the patient since usually the pharmacist is stuck checking or filling scripts and has little time to counsel and so on.

Pharmacists are the health professionals that usually pick up new technology the fastest, so I see them working in the future more closely with such technology, rather than the technology ever negatively impacting the profession. To be honest, for most places I can't see it ever happening, not in retail or people related things. Everybody likes to deal with a person in the end.