Garth Rattray | Please update Pharmacy Act
A few years ago, while I was staying in Oracabessa one Sunday, a pharmacist (in Ocho Rios) refused to accept a call-in prescription from my colleague (in St Andrew), meant for relief of my unexpected, extreme pain.
He said that pharmacy regulations state that all phone-in prescriptions must be followed up with a signed, hard copy within 24 hours and that pharmacies are audited by the Pharmacy Council and health-insurance companies.
Missing hard copies would bring serious problems. Therefore, he only accepted call-in prescriptions from nearby doctors who he knew personally.
Interestingly, later that week, a pharmacist from Florida, United States (US), called to ask me what medication I wanted to prescribe for a patient of mine with Parkinson’s disease. The original script was lost and, although she didn’t know me and I’m not registered to work in the US, she said, “Let me see how we can help her.” This stood in stark contrast to the treatment from the local pharmacy.
Although I work in St Andrew, I have had to call in prescriptions to as far as Negril and had no problems. Somehow, in order to temporarily assist ailing patients in urgent need of their essential medications, some pharmacists find a way because it would be impossible for me to get the original prescription to them in a day or so.
The Pharmacy Act refers to the need for (original) prescriptions given by “… a registered medical practitioner or a registered dentist or a registered veterinary surgeon or veterinary practitioner”.
The Pharmacy Council inspectors are sometimes flexible regarding accepting faxed and emailed prescriptions because they can be easily printed. Their position is that they will treat the fax or email the same as an original IF, in accepting the fax or email, the pharmacist was able to ascertain conclusively that it was from that particular doctor.
However, inspectors from the National Health Fund adhere strictly to the need for the original prescriptions. These must be submitted within 36 hours (not 24 hours, as stated by that pharmacy in Ocho Rios).
Prescription regulations are an attempt to protect against fraud and duplication. Therefore, even if a prescription is faxed or emailed, the original still exists and can, possibly, be picked up and used. In so doing, it’s duplicated.
I believe that a simple solution to that concern is to require that once the prescription is sent electronically, the doctor must write ‘faxed’ or ‘emailed’ across the prescription and sign it again. Additionally, since WhatsApp pictures can be printed, these should also be accepted.
Flexibility in system
I know that the system allows for flexibility because prescriptions from government pharmacies can be uploaded to a telephone app or deposited in Quick Prescript kiosks. The original must be submitted upon collection of the meds, but there is a three-day (72-hour) window once the app is accessed. Obviously, this arrangement breaches the 36-hour deadline regulation.
Due to the prime minister’s Legacy road projects, many faxes can no longer be sent or received. So, recently, because of the increased auditing and enforcement of pharmacy rules and regulations, a prominent pharmacy near Half-Way Tree could not accept my call-in script and another pharmacy, in St Andrew, stipulated that for them to accept my call-in prescription, I would have to promise to take it to them in person. Another problem is the requirement that itinerant pharmacists need to travel with their certificates of registration. Issuing annual identification cards that can be displayed on their person would solve that problem.
In light of modern technology (digitalisation/communication/transportation advances) and the long-distance care that they afford; for the sake of good patient care, I hope that the Pharmacy Act will be updated/amended soon.
Garth A. Rattray is a medical doctor with a family practice. Email feedback to firstname.lastname@example.org and email@example.com