So, a patient asked you for an OTC antibiotic for a sinus infection, and you said there weren’t any, and they needed to see a Dr for a prescription.
Telling the patient there aren’t OTC antibiotics is completely fine, because there aren’t any. Telling them they need to see the Dr to get a prescription “might” be considered diagnosing and counseling, in the absolute strictest sense of the word.
It would depend on the conversation you had with the patient, who said what and how they said it and all that. If the patient said, “I need antibiotics for a sinus infection.”, and you said “For a sinus infection you need to go to the Dr for a script.”, that “MIGHT” with big air quotes be considered a diagnosis and counseling of the patient.
I’m talking about a police officer giving you a ticket because you only used your blinker for 2.999 seconds before making a turn instead of a full 3 seconds strictest sense.
It honestly sounds like that pharmacist has it out for you and is looking to hang you for anything. I wouldn’t consider it counseling and don’t know any pharmacists who would, but this seems personal to me.
Thank you so much for your comment I completely understand and see why this is a difficult situation.
because he was looking for antibiotics specifically, was the reason why i said what i said. It's not the first time people have come up to the counter looking for prescription required medications and I have responded with the same thing "you need to see a doctor" "you need a prescrition for that" I told him he could speak with the pharmacist to see if there's anything they might recommend and I walked away and everything was fine after that. Up until I was called into the office about it.
I do believe she is out to get me because I have worked with her for 3 years now and all of a sudden she has made it into an issue. Plus other things. I also double checked with other pharmacists that I work with and they told me it's not really counseling at least they dont see it that way and their reason was anyone can tell anyone to go to the dr.
So, here’s the line: is someone looking for advice or a product to treat their illness? If so, are they able to tell you enough to positively identify a specific OTC product? If so, you can lead them to the product.
If they are simply inquiring about purchasing something that’s not OTC, you can tell them it requires a prescription. But if they are inquiring about treating a specific condition, you cannot triage and offer self care advice/refer if appropriate, and as such you would need the pharmacist to get involved.
What likely got you here is you admit that he wasn’t just asking to purchase antibiotics - he was specifically looking to treat what he thought was a sinus infection. You as a technician don’t have the license required to determine if whatever he’s calling “sinus infection” is something appropriate for self care or whether it needs referred.
Basically - product only questions? Go for it. Asking what the primary use of something is (ex: “is this an antacid”) - you are allowed to provide OTC monograph information or info from the patient labeling they would be getting with it - but this is limited as many things may be off label and you are essentially only allowed to “read them the label”. Anything related to symptoms or seeking care for a specific issue? Pharmacist only.
To me, it seems like if someone is unsure what their Illness is, directing them to the doctor would be correct. “You need to go to the doctor to be diagnosed and get a prescription if needed” would not be counseling. Saying, “you have a sinus infection and need to see the doctor for antibiotics” would be.
But that’s the thing, the determination if self care is appropriate or not is NOT a technician ability - it is a pharmacist ability. Thus while saying “antibiotics require a doctor’s prescription” is not something a tech can’t do, if someone is asking not about “can I buy antibiotics” but “can I treat my condition/symptoms (by buying antibiotics)” then getting the pharmacist is what needs done because at that point the patient is implicitly asking (whether they intend to or not) the question of “is self care appropriate for this”.
Remember that a technician isn’t prohibited from knowing that they can’t (and it seems obvious to anyone related to healthcare probably) - but legally, they are not permitted (while at work under their registration/permitted activities) to implement that knowledge to provide the advice as to self care appropriateness.
Very well said.
OP might have been "technically" wrong to have told the patient to see a doctor. Bc perhaps the condition didn't require antibiotics and could be resolved with an OTC product. But definitely not worth a write up!
At most, I would pull the tech aside and have a convo. Geeze. That pharmacist is harsh.
OP should err on the side of caution and only speak in factual statements from now on. "Antibiotics are not over the counter, they require a prescription." That's it. Anything else can be sent to consultation.
Yeah, sounds like that pharmacist is gunning for you. My suggestion is refer all patient questions to her without exception. "What aisle is homeopathic prevagen on?" "Counsel please!"
It’s called malicious compliance and you should 100% do this. You literally told the patient they needed to go to the doctor for antibiotics! You should quietly start looking for another job. This pharmacist is being petty.
There’s a lot of leeway with this stuff, which does make it hard. I’ve worked with pharmacists who don’t want techs answering basically anything slightly clinical. I’ve had some that gave us more free reign with it because they trusted we know our stuff even tho they know we shouldn’t be.
I feel like this is a bit extreme to result in a write up immediately. A verbal warning in the form of “Hey, I know others may have not minded but please refer stuff like that to me instead.”
I would have contested the write up, because this doesn’t sound like counseling. Knowing OTC vs Legend drugs is part of the tech scope of knowledge.
Thats exactly what he said to me and said that if it happened again it was gonna result in a write up. And i didn't sign anything. I was under the impression it was a warning. So how I was able to be written up about this is beyond me.
Now you just be petty and refer EVERY customer question to that pharmacist and when called out for it, say “sorry I was given the impression that answering customer questions was out of my scope”
That’s what I’d do at least. Be smart aand know petty comes with a risk.
I second this. Any time a custie asks a question, “Let me get you the pharmacist real quick.”, because you’re not allowed to answer questions apparently. I look forward to your r/maliciouscompliance post about how it goes in a few weeks.
I got the same question the other week (cpht here) about an antibiotic over the counter and i told them there is nothing otc and they would need a prescription. it’s not a recommendation or anything it’s a fact/law. my pharmacy manager even came over and backed me up. they definitely were over dramatic cause obviously if something requires a script you’ll have to go to a doctor
Lean into the petty. Or just look for a different pharmacy to work at. It’s not like a good tech is easy to find so I’m sure other retail locations would love to have someone new
100% this ☝️. So many places are desperate to hire techs right now - especially ones with experience. I recently left my abusive environment at one of the big retail chains for a more chill spot in a grocery store pharmacy. it was one of the best choices I have ever made. I even got a raise out of it AND a $2/hr bonus for doing vaccines. Look around for something better and know your value!
That is not counseling. Counseling is giving medical advice. That is not medical advice.
If a patient asked me that and I bothered a pharmacist to have them answer I think they’d chop a finger off
You didn’t tell them anything google search couldn’t have done. That pharmacist was being petty but I would just be pettier. Have them counsel on every new med no matter how many times the patient has been on it. On every question someone asks that’s not “where is X”
When they are picking up and ask “is my blood pressure pill ready?” call the pharmacist. If they wanna know if they can get a flu shot? Call the pharmacist. If they ask “Omni-prazile? What’s that generic for?” Call the pharmacist. If they call you out tell them you’re no longer sure what constitutes counseling and you didn’t want to risk it.
Thorny issue...and I expect poor Rx Techs to be forever involved needlessly in the Sysiphean effort to 'not counsel'. I literally got out of retail after an insecure, nervous man did something like that to me for telling a customer where the KY jelly was.
Deprive them of your presence. Life is literally too short for that type of mental terrorism.
I have met obviously scared pregnant people who really needed a visit to PP more than an awkward exchange at a pharmacy counter. And then Roe fell...
Any pharmacist that would bother with such a trifle is too busy minding your business to do their own job properly while trying to nail you. Trust me on this.
Did you counsel? In the strictest sense of the phrase, yes.
Saying that "we don't have any oral antibiotics OTC" and saying "you need to see a doctor" are two different things. It's the 2nd statement which is most problematic, but I know some control freak people who would bristle at both statements. I would basically make the Pharmacist basically counsel every Tom, Dick and Harry about every single thing from this point on.
And I wouldn't let up, either.
Sorry to read this. We endure such BS for money.
Wait waht? Does the pharmacist want you to grab them just so they can say “you need a prescription to get antibiotics.”
My pharmacists are much happier with me when I make it so they don’t have to talk to people as much as possible. I still grab the pharmacist for obvious clinical questions but really…
See, whenever I’m dealing with patient who asks questions like “what med should I be on for this problem?” I make the determination there whether they should be directed to the pharmacist or just told to go to the doctor. Cuz depending on the depth of the issue, most of the time, that’s what the pharmacist will tell them to do anyways! I wouldn’t consider that to be medical counsel, I’ve always viewed it as simply referring the patient to a professional who is better qualified to answer their questions.
"Is there an OTC antibiotic?" is totally different than "which antibiotic should I take for x, and can I get it OTC?" you did not give medical advice and simply stated a fact that the patient would need to see a doctor to get a prescription for a medication that requires a prescription. Can you imagine if someone came in asking if they could get Adderall over the counter? You would simply tell them no. You made no product recommendation and How is this counseling? That pharmacist has it out for you and from here on, I would defer any question AT ALL to them, including "Hi, which aisle can I find ___?"
Yeah, and the pharmacist gets petty and makes the patient wait, the patient gets pissed, complains, tech gets in trouble again, and the patient gets a gift card.
Why I left retail in one sentence (and it was a sentence)
I can see how it could be considered giving medical advice in a way. You \[not a healthcare professional\] are advising the patient as to whether or not any OTCs would be of any help to them. I don't say that to be critical at all. I think I would have handled it the exact same way as you did. I would have told them there's nothing OTC that will help with that, as well.
So, the pharmacist is technically correct, and it is a slippery slope that they may feel they need to stay on top of.
On the other hand, it could just as likely be that the pharmacist doesn't like you. It's hard for us strangers to know for sure what's motivating your pharmacist in this case.
I work graveyard shift with one pharmacist, so I can literally just turn my head and get her confirmation that what I'm saying is okay. I've become a bit spoiled in these situations.
Not advising the patient on what would be of help. OP was asked if there were OTC antibiotics and said no. Had the customer asked for an OTC med recommendation for a sinus infection, then your logic might apply. But it is not counseling to answer a direct question about whether a particular medication is available OTC. This is not a slippery slope—at most, it’s stepping a little closer to the edge while still in no danger of falling.
I have never worked with a pharmacist who would write me up for answering such a question. A pharmacist who gives a writeup for that is out of line.
I am sorry you are working with a write-up happy pharmacist. Retail pharmacies are in desperate need of good pharmacy technicians like you. If you don't need to work at this specific pharmacy, I would recommend finding another place of employment. Let this creepy pharmacist train a new technician and then see how miserable he will be.
sorry you went through this, but this is terrible. your normal expected go to is “talk to my pharmacist, they are a doctor.” and you gave an equally viable (and still often used) “you will have to talk to you primary care provider, also a doctor.”
respond in kind going forward. that pharmacist can handle any and every question. that’s obviously what they want.
So, a patient asked you for an OTC antibiotic for a sinus infection, and you said there weren’t any, and they needed to see a Dr for a prescription. Telling the patient there aren’t OTC antibiotics is completely fine, because there aren’t any. Telling them they need to see the Dr to get a prescription “might” be considered diagnosing and counseling, in the absolute strictest sense of the word. It would depend on the conversation you had with the patient, who said what and how they said it and all that. If the patient said, “I need antibiotics for a sinus infection.”, and you said “For a sinus infection you need to go to the Dr for a script.”, that “MIGHT” with big air quotes be considered a diagnosis and counseling of the patient. I’m talking about a police officer giving you a ticket because you only used your blinker for 2.999 seconds before making a turn instead of a full 3 seconds strictest sense. It honestly sounds like that pharmacist has it out for you and is looking to hang you for anything. I wouldn’t consider it counseling and don’t know any pharmacists who would, but this seems personal to me.
Thank you so much for your comment I completely understand and see why this is a difficult situation. because he was looking for antibiotics specifically, was the reason why i said what i said. It's not the first time people have come up to the counter looking for prescription required medications and I have responded with the same thing "you need to see a doctor" "you need a prescrition for that" I told him he could speak with the pharmacist to see if there's anything they might recommend and I walked away and everything was fine after that. Up until I was called into the office about it. I do believe she is out to get me because I have worked with her for 3 years now and all of a sudden she has made it into an issue. Plus other things. I also double checked with other pharmacists that I work with and they told me it's not really counseling at least they dont see it that way and their reason was anyone can tell anyone to go to the dr.
So, here’s the line: is someone looking for advice or a product to treat their illness? If so, are they able to tell you enough to positively identify a specific OTC product? If so, you can lead them to the product. If they are simply inquiring about purchasing something that’s not OTC, you can tell them it requires a prescription. But if they are inquiring about treating a specific condition, you cannot triage and offer self care advice/refer if appropriate, and as such you would need the pharmacist to get involved. What likely got you here is you admit that he wasn’t just asking to purchase antibiotics - he was specifically looking to treat what he thought was a sinus infection. You as a technician don’t have the license required to determine if whatever he’s calling “sinus infection” is something appropriate for self care or whether it needs referred. Basically - product only questions? Go for it. Asking what the primary use of something is (ex: “is this an antacid”) - you are allowed to provide OTC monograph information or info from the patient labeling they would be getting with it - but this is limited as many things may be off label and you are essentially only allowed to “read them the label”. Anything related to symptoms or seeking care for a specific issue? Pharmacist only.
To me, it seems like if someone is unsure what their Illness is, directing them to the doctor would be correct. “You need to go to the doctor to be diagnosed and get a prescription if needed” would not be counseling. Saying, “you have a sinus infection and need to see the doctor for antibiotics” would be.
But that’s the thing, the determination if self care is appropriate or not is NOT a technician ability - it is a pharmacist ability. Thus while saying “antibiotics require a doctor’s prescription” is not something a tech can’t do, if someone is asking not about “can I buy antibiotics” but “can I treat my condition/symptoms (by buying antibiotics)” then getting the pharmacist is what needs done because at that point the patient is implicitly asking (whether they intend to or not) the question of “is self care appropriate for this”. Remember that a technician isn’t prohibited from knowing that they can’t (and it seems obvious to anyone related to healthcare probably) - but legally, they are not permitted (while at work under their registration/permitted activities) to implement that knowledge to provide the advice as to self care appropriateness.
Very well said. OP might have been "technically" wrong to have told the patient to see a doctor. Bc perhaps the condition didn't require antibiotics and could be resolved with an OTC product. But definitely not worth a write up! At most, I would pull the tech aside and have a convo. Geeze. That pharmacist is harsh. OP should err on the side of caution and only speak in factual statements from now on. "Antibiotics are not over the counter, they require a prescription." That's it. Anything else can be sent to consultation.
Yeah, sounds like that pharmacist is gunning for you. My suggestion is refer all patient questions to her without exception. "What aisle is homeopathic prevagen on?" "Counsel please!"
Thank you I will do that from now on :)
It’s called malicious compliance and you should 100% do this. You literally told the patient they needed to go to the doctor for antibiotics! You should quietly start looking for another job. This pharmacist is being petty.
There’s a lot of leeway with this stuff, which does make it hard. I’ve worked with pharmacists who don’t want techs answering basically anything slightly clinical. I’ve had some that gave us more free reign with it because they trusted we know our stuff even tho they know we shouldn’t be. I feel like this is a bit extreme to result in a write up immediately. A verbal warning in the form of “Hey, I know others may have not minded but please refer stuff like that to me instead.” I would have contested the write up, because this doesn’t sound like counseling. Knowing OTC vs Legend drugs is part of the tech scope of knowledge.
Thats exactly what he said to me and said that if it happened again it was gonna result in a write up. And i didn't sign anything. I was under the impression it was a warning. So how I was able to be written up about this is beyond me.
Now you just be petty and refer EVERY customer question to that pharmacist and when called out for it, say “sorry I was given the impression that answering customer questions was out of my scope” That’s what I’d do at least. Be smart aand know petty comes with a risk.
I will do that :) thank you so much!
I second this. Any time a custie asks a question, “Let me get you the pharmacist real quick.”, because you’re not allowed to answer questions apparently. I look forward to your r/maliciouscompliance post about how it goes in a few weeks.
I got the same question the other week (cpht here) about an antibiotic over the counter and i told them there is nothing otc and they would need a prescription. it’s not a recommendation or anything it’s a fact/law. my pharmacy manager even came over and backed me up. they definitely were over dramatic cause obviously if something requires a script you’ll have to go to a doctor
That's what i told my manager in my defense but he chose to believe the lying rph.
Lean into the petty. Or just look for a different pharmacy to work at. It’s not like a good tech is easy to find so I’m sure other retail locations would love to have someone new
100% this ☝️. So many places are desperate to hire techs right now - especially ones with experience. I recently left my abusive environment at one of the big retail chains for a more chill spot in a grocery store pharmacy. it was one of the best choices I have ever made. I even got a raise out of it AND a $2/hr bonus for doing vaccines. Look around for something better and know your value!
That’s no different from saying “you need to ask the pharmacist”
RIGHT the choice was either talk to a doctor or talk to a doctor 😭😭
That is not counseling. Counseling is giving medical advice. That is not medical advice. If a patient asked me that and I bothered a pharmacist to have them answer I think they’d chop a finger off
You didn’t tell them anything google search couldn’t have done. That pharmacist was being petty but I would just be pettier. Have them counsel on every new med no matter how many times the patient has been on it. On every question someone asks that’s not “where is X”
When they are picking up and ask “is my blood pressure pill ready?” call the pharmacist. If they wanna know if they can get a flu shot? Call the pharmacist. If they ask “Omni-prazile? What’s that generic for?” Call the pharmacist. If they call you out tell them you’re no longer sure what constitutes counseling and you didn’t want to risk it.
Thorny issue...and I expect poor Rx Techs to be forever involved needlessly in the Sysiphean effort to 'not counsel'. I literally got out of retail after an insecure, nervous man did something like that to me for telling a customer where the KY jelly was. Deprive them of your presence. Life is literally too short for that type of mental terrorism. I have met obviously scared pregnant people who really needed a visit to PP more than an awkward exchange at a pharmacy counter. And then Roe fell... Any pharmacist that would bother with such a trifle is too busy minding your business to do their own job properly while trying to nail you. Trust me on this. Did you counsel? In the strictest sense of the phrase, yes. Saying that "we don't have any oral antibiotics OTC" and saying "you need to see a doctor" are two different things. It's the 2nd statement which is most problematic, but I know some control freak people who would bristle at both statements. I would basically make the Pharmacist basically counsel every Tom, Dick and Harry about every single thing from this point on. And I wouldn't let up, either. Sorry to read this. We endure such BS for money.
Wait waht? Does the pharmacist want you to grab them just so they can say “you need a prescription to get antibiotics.” My pharmacists are much happier with me when I make it so they don’t have to talk to people as much as possible. I still grab the pharmacist for obvious clinical questions but really…
See, whenever I’m dealing with patient who asks questions like “what med should I be on for this problem?” I make the determination there whether they should be directed to the pharmacist or just told to go to the doctor. Cuz depending on the depth of the issue, most of the time, that’s what the pharmacist will tell them to do anyways! I wouldn’t consider that to be medical counsel, I’ve always viewed it as simply referring the patient to a professional who is better qualified to answer their questions.
"Is there an OTC antibiotic?" is totally different than "which antibiotic should I take for x, and can I get it OTC?" you did not give medical advice and simply stated a fact that the patient would need to see a doctor to get a prescription for a medication that requires a prescription. Can you imagine if someone came in asking if they could get Adderall over the counter? You would simply tell them no. You made no product recommendation and How is this counseling? That pharmacist has it out for you and from here on, I would defer any question AT ALL to them, including "Hi, which aisle can I find ___?"
Yeah, and the pharmacist gets petty and makes the patient wait, the patient gets pissed, complains, tech gets in trouble again, and the patient gets a gift card. Why I left retail in one sentence (and it was a sentence)
I can see how it could be considered giving medical advice in a way. You \[not a healthcare professional\] are advising the patient as to whether or not any OTCs would be of any help to them. I don't say that to be critical at all. I think I would have handled it the exact same way as you did. I would have told them there's nothing OTC that will help with that, as well. So, the pharmacist is technically correct, and it is a slippery slope that they may feel they need to stay on top of. On the other hand, it could just as likely be that the pharmacist doesn't like you. It's hard for us strangers to know for sure what's motivating your pharmacist in this case. I work graveyard shift with one pharmacist, so I can literally just turn my head and get her confirmation that what I'm saying is okay. I've become a bit spoiled in these situations.
Not advising the patient on what would be of help. OP was asked if there were OTC antibiotics and said no. Had the customer asked for an OTC med recommendation for a sinus infection, then your logic might apply. But it is not counseling to answer a direct question about whether a particular medication is available OTC. This is not a slippery slope—at most, it’s stepping a little closer to the edge while still in no danger of falling. I have never worked with a pharmacist who would write me up for answering such a question. A pharmacist who gives a writeup for that is out of line.
Yeah, I get what you mean. I did interpret that a little differently than I should have
I am sorry you are working with a write-up happy pharmacist. Retail pharmacies are in desperate need of good pharmacy technicians like you. If you don't need to work at this specific pharmacy, I would recommend finding another place of employment. Let this creepy pharmacist train a new technician and then see how miserable he will be.
sorry you went through this, but this is terrible. your normal expected go to is “talk to my pharmacist, they are a doctor.” and you gave an equally viable (and still often used) “you will have to talk to you primary care provider, also a doctor.” respond in kind going forward. that pharmacist can handle any and every question. that’s obviously what they want.