The
Wayne County Pharmacist Association (WCPA) presented a four-hour class plus
lunch, to recent graduate pharmacists from all Michigan Colleges of Pharmacy
and elsewhere, to prepare them to pass the MPJE—a test of relevant federal and
Michigan pharmacy law.
I
taught that class on Saturday, June 2, 2012.
I am honored that the WCPA asked me.
Yes, I actually talked for at least three hours and the amount of
information to be covered was such, that three hours of talking went by rapidly
for me.
Preparing
to teach this course, I examined an April 16, 2012 table on the NABP website
that covers the MPJE passing rates for first time candidates by Colleges of
Pharmacy, from 2007 through 2011. Ferris
State, U of M and Wayne State University show a decline in the passing
rate. I have also
noticed that practicing pharmacists, who have been out of the university for
some period of time, could benefit
greatly from more effective teaching on the subject of pharmacy law.
Obviously,
if a pharmacist does not know what the law is, that pharmacist may unintentionally
fail to comply with it. Further,
pharmacy law is not a stationary target but a moving one. Laws change frequently and there are always
new ones. Articles on the internet and continuing education courses exacerbate
the problem by confusing and frightening
pharmacists with proposed laws and the author’s misunderstanding of the laws
and cases that they purport to be qualified to opine on. Journal articles are written poorly from a
grammatical and clarity standpoint. If
you are going to paraphrase a law for students, make it understandable, certain
and clear. Poor writing skills
leave readers bewildered and frustrated.
If you are unable to present a statute, regulation or common law (case
law or “judge-made law”) clearly and simply, you are not an expert.
Do
not equate a photographic memory of rules and regulations to be the same as
understanding and applying them. It is
unnecessary for a pharmacist to be able to recite from memory those provisions
of the pharmacy law that he or she does not deal with on a frequent basis
because that pharmacist can read those regulations when they become an
issue. You must however know they
exist. That is why pharmacies are
required to keep current copies of the Statutes and Rules on the premises.
Regarding the MPJE and the Decline in First Time
Passing Rate
Based
upon my interaction with the pharmacy students at the MPJE preparation, the
pharmacy students of today are every bit as intelligent, motivated and capable
as any who came before them. I would
rule out the students themselves as a factor in the decline.
There
are at least three other areas to examine in regard to the decrease in the
pass/fail rate on the MPJE:
1. Can
the method, procedure and content of pharmacy law classes at our colleges of
pharmacy be improved? All respect and
deference must be given to our three excellent colleges of pharmacy, their
deans, their professors, and in particular, their pharmacy law professors. That said, virtually anything can be improved
and I have a unique perspective by virtue of being a pharmacist and attorney
who has decades of experience in the trenches in every venue where pharmacy and
law intersect. Many pharmacist clients
have rightly acknowledged that there is a substantial difference between the
practice of pharmacy and the collegiate perspective.
There is a huge difference between being the
trial attorney for a pharmacist in a criminal case involving allegations of
diversion of narcotics through illegitimate prescriptions and, reading a
synopsis of the results of that trial to a classroom. Please note that this writer is in no way
criticizing any professor but just pointing out some crucial distinctions.
2. Is
the present MPJE the best tool for assessing an applicant’s competence in the
core areas of pharmacy law that practicing pharmacists require? Have suppositions surrounding CAT and the
questions been proven by disinterested
experts?
3. Are
there simply too many laws and too much complexity in the vast world of
pharmacy law? Yes and the problems will
only get worse. I have some innovative
ideas for efficiently learning, organizing and applying pharmacy laws.
Helping Practicing Pharmacists Learn the Law
The
problem of effectively learning pharmacy law is not limited to students in the
university. Perhaps the greatest need is
found in actively practicing pharmacists.
The
Board of Pharmacy currently requires one hour of CE units (of the 30) to be in
the area of pain control. That is a good
thing but couldn’t there be at least one if not two hours devoted to pharmacy
law continuing education? I am a
pharmacist and I do my continuing education.
Pharmacology and disease states are well covered and readily available
in live and written CE’s. In my opinion,
the pharmacy law CE’s are poorly presented to practicing pharmacists. I must state that it is painful for me to
read some pharmacy law articles in journals, online, etc., the material is
poorly written and raise more questions than the materials solve. Sometimes the authors are quite simply wrong
about the law. The author relies upon
secondary or even tertiary law sources instead of primary ones. That means they are relying upon the person
who did an abstract or synopsis of a statute or case law and if that person
drew the wrong conclusions then the person scanning that abstract will be even
more misinformed.
That
brings us to an important question, who should present pharmacy law to
pharmacists and pharmacy students?
What that should that person’s qualifications be?
I
attended a live continuing education seminar for my own pharmacy CE credit requirement that incorporated an MD from
another state, whose practice is devoted to treatment of pain. This physician opined from her research of
law on the internet, that if a pharmacist calls on the telephone and verifies
with a pain control specialist that the prescription was written for this
patient and that is what the doctor intends, that the pharmacist is free to
dispense those opioids without fear of further accountability to the Board of
Pharmacy or the DEA. If any of the
practicing pharmacists in the audience followed that advice literally, it would
not be very long before they would be calling me to defend them in an action by
the DEA and Michigan Board of Pharmacy.
This physician was in my judgment learned and skilled in her profession but should reserve
her opinion to her specialty.
After
these experiences, I have been inspired to want to inject my perspective of
pharmacy law into the university courses and continuing education for
pharmacists – if the universities and practicing pharmacists want me. A soldier who fights and thrives in deadly
combat has valuable insights for soldiers headed to first-time combat that
cannot be found in books.
Conclusion
I
am not saying that pharmacy law should only
be taught by a person who is a pharmacist and an attorney. It takes more
than that to teach and inspire. It
takes expert knowledge and actual experience combined with
excellent communication skills and respectful rapport with students.
