Board Certification After Awhile

Was it worth it? I know many wonder this same question, and I believe it is. It is expensive to keep current. There is a yearly fee due to BPS every year. The required approved continuing education is pricey and complicated. 

The reason I continue to believe it is worth it is because prior to obtaining this, I feel like I had something to prove. Many newer grads felt or assumed I was a BS Pharm even though I was a PharmD. Many assume that because I have been out of school over 15 years, I am behind the times. Experience is sometimes not as valued in every job culture no matter what field it is. Bright and eager new graduates come out feeling as though we are behind the times, and sometimes they are right. 

Prior to obtaining my BCPS, I had no residency to point to. Yes, we had residencies back then, but my debt load didn't endorse another year of the same at half the price. The return on investment didn't seem good enough. If I was graduating today, I would definitely do a residency. 

What happened to me after the board certification is that I quit trying to prove myself to peers. I refocused my efforts on the patients by doing a better job in going the extra mile and also by noticing the system issues that aren't being exposed. I also have stopped trying to make my career the thing I work on the most and have let it fall to a healthier place behind God and family. What will be will be.  

Should a job in pharmacy open up where I can do more of the things I enjoy: clinical decision making, brainstorming, patient advocacy, and writing, I will be moved. Until then I credit certification to validating competiveness with newer pharmacists while also solidifying my belief that experience is king. I am glad I invested in myself and hope you will too! 

Depakote and Abbott's $1.6 Billion Mistake

Abbott never had FDA approval to promote Depakote for aggression and agitation in the elderly or schizophrenia. The total includes a criminal fine of $700 million and civil settlements with the states and federal government totaling $800 million. Abbott pleaded guilty to a criminal misdemeanor for misbranding the medication. Abbott is also going to pay 45 states $100 million to resolve liability with consumer protective laws. Luckily the Justice Department found no deaths due to this crime.

The company admitted that from 1998 through 2006, it "maintained a specialized sales force trained to market Depakote in nursing homes for the control of agitation and aggression in elderly dementia patients, despite the absence of credible scientific evidence that Depakote was safe and effective for that use," the Justice Department said in a news release.

"In addition, from 2001 through 2006, the company marketed Depakote in combination with atypical antipsychotic drugs to treat schizophrenia, even after its clinical trials failed to demonstrate that adding Depakote was any more effective than an atypical antipsychotic alone for that use."

Heaphy said Abbott earned about $13 billion from Depakote sales during the period investigated, but he said it was difficult to determine how much of that was the result of sales for illegal purposes. He expressed confidence that, once the fines are factored in, Abbott will not have profited from the improper practices.

Um... Ok. $13 billion minus $1.6 billion equals a profit.

No wonder this will keep happening.

Are You Kidding Me?

My mouth just dropped open.  It's obvious to me that physicians do NOT read medication reconciliation forms for home meds at all.  The ones that do, kudos, but the ones that don't make my job more interesting and at times really get to me. Case-in-point:  50-something presenting to the hospital with lower GI bleed.

The doctor signed off to CONTINUE HER HOME MED OF PHENTERMINE FOR WEIGHT LOSS.  Are you kidding me?

I guess the nurse could have written "Purina Dog Chow - take one cup by mouth daily" and the physician would have signed off on it.

Way to go Joint Commission on putting in a requirement with no means of adhering to any sort of THINKING for anyone involved.

Except for the pharmacist of course to wade through the BS and find what is really needed.

I really like the one where the physician wanted to continue the patient's viagra while in the hospital.  THAT should keep the nurses on the floor on their toes running from a man who is looking for some fun.  Not good.

Medication reconciliation forms.  The bane of my existence.

Baxter Recalls Heparin Products

Baxter International recently announced a voluntary recall of all remaining lots and doses of its heparin sodium injection multidose and single-dose vials and HEP-LOCK heparin flush products.

The FDA has received 448 reports of adverse events associated with heparin products, but some of these may be duplicate reports. In 389 of these cases, Baxter was named as the source of the product. The reports included 215 “events of interest” and 21 deaths. Most of the events occurred last year.

The FDA has launched a “far-reaching investigation” of a Chinese firm, Changzhou SPL, which made the active pharmaceutical ingredient (API) for Baxter, Michael Rogers, director of the FDA’s Division of Field Investigations, said. Two FDA inspectors were sent to China to carry out that investigation and related investigations of two “consolidators” associated with the API manufacturer. They also may inspect workshops and farms associated with the manufacture of the product, which uses pig intestines.

The agency has posted on its website a redacted version of the Form 483 observations that its investigators issued after inspecting the API plant. It can be accessed at www.fda.gov/ora/frequent/483s/Changzhouspl_heparin_20080226_483.html.

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It's the backdoor method of the Chinese trying to kill us.  Just kidding.  Seriously though this recall does affect the hospitals where I work pretty severely.  When do you think we'll stop relying on foreign countries to make a medicine that can be trusted?