The
Arkansas
Pharmacist
Arkansas Pharmacists Association 2010 Summer Quarterly Edition
Mike Smets, P.D. President 2010 - 2011
Board of Directors 2010 - 2011 Officers
Area Representatives
President ..........................................................Mike Smets, P.D., Fort Smith President Elect ..........................................Gary Bass, Pharm.D., Little Rock Vice President ......................................Dennis Moore, Pharm.D., Batesville Past President ..............................................Jan Hastings, Pharm.D., Benton
Area 1 (Northwest) ..........Michael Butler, Pharm.D.., Hot Springs Village Area 2 (Northeast) ..........................Brandon Cooper, Pharm.D., Jonesboro Area 3 (Central) .............................Kenny Harrison, Pharm.D., Little Rock Area 4 (Southwest/Southeast) ......................Mike Stover, Pharm.D., Rison
Ex-Officio Members APA Executive Vice President ..............................................................................................................................................Mark Riley, Pharm.D., Little Rock Board of Health Member ................................................................................................................................................................John Page, P.D., Fayetteville Board of Pharmacy Representative ............................................................................................................................Charles Campbell, Pharm.D., Little Rock UAMS College of Pharmacy Representative (Dean) ....................................................................................Stephanie Gardner, Pharm.D., Ed.D., Little Rock Harding College of Pharmacy Representative (Dean) ......................................................................................Julie Hixson-Wallace, Pharm.D., Ed.D, Searcy UAMS College of Pharmacy Student Representative ........................................................................................................................Daniel Price, Little Rock Harding College of Pharmacy Student Representative........................................................................................................................Celia Proctor, Little Rock
District 1 Eddie Glover, P.D. U.S. Compounding 2515 College Ave. Conway, AR 72034
District 3 Danny Ponder, P.D. Ponder Economy Drug, Inc. 400 S College St, Mountain Home, AR 72653
District 5 Lynn Crouse, Pharm.D. Eudora Drug Store 140 S. Main St. Eudora, AR 71640
District 7 John Vinson, Pharm.D. Area Health Education Center 612 South 12th Street Fort Smith, Arkansas 72901
District 2 Brent Panneck, Pharm.D. St. Francis Pharmacy 210 Cobean Blvd. #10 Lake City, AR 72437
District 4 Laura Beth Martin, Pharm.D. Family Pharmacy 810 S. Main St. Hope, AR 71801
District 6 Stephen Carroll, Pharm.D. Allcare Pharmacy 517 Main St. Arkadelphia, AR 71923
District 8 Christy Campbell, P.D. Lowery Drug Mart #2 123 Central Ave. Searcy, AR 72143
APA’s Academy of Consultant Pharmacists
APA’s Academy of Compounding Pharmacists
President ................................................Larry McGinnis, Pharm.D., Searcy President Elect ........................................Muncy Zuber, P.D., Heber Springs
President ..................................................Mark Shinabery, P.D., Little Rock President Elect ..................................................................To Be Announced
Arkansas Association of Health System Pharmacists
Arkansas State Board of Pharmacy President..............................................................Benji Post, P.D., Pine Bluff Vice President ......................................................Marilyn Sitzes, P.D., Hope Secretary ........................................................Ronnie Norris, P.D., McGehee Member ..........................................................Steve Bryant, P.D., Batesville Member ..................................................Justin Boyd, Pharm.D., Fort Smith Sr. Citizen Public Member ..................................Ross Holiman, Little Rock Public Member............................................................Larry Ross, Sherwood
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President ....................................................Jason Derden, Pharm.D., Benton President Elect ..........................................Rayanne Story, Pharm.D., Searcy Past President ......................................Maggie Miller, Pharm.D., Batesville Executive Director ............................Susan Newton, Pharm.D., Russellville Treasurer ..............................................Sharon Vire, Pharm.D., Jacksonville Secretary ............................................Marsha Crader, Pharm.D., Jonesboro Member at Large ............................Jody Smotherman, Pharm.D., Batesville Member at Large ................................Jennifer Priest, Pharm.D., Little Rock Member at Large ........................Andrea Donaldson, Pharm.D., Little Rock
The Arkansas Pharmacist
Contents
Arkansas
Pharmacist The
Arkansas Pharmacists Association 417 South Victory Little Rock, AR 72201 501-372-5250 501-372-0546 Fax
The Arkansas Pharmacist (ISSN 0199-3763) is published quarterly by the Arkansas Pharmacists Association, Inc. It is distributed to members as a regular service paid for through allocation of membership dues ($5.00). Non-members subscription rate is $30.00 annually. Periodical rate postage paid at Little Rock, AR 72201. Current edition issue number 51. POSTMASTER: Send address changes to The Arkansas Pharmacist 417 South Victory Little Rock, AR 72201. EDITOR: Mark Riley, Pharm.D. Executive Vice President ART & DESIGN EDITOR: Helen Hooks Communications Specialist Opinions and statements made by contributors, cartoonists or columnists do not necessarily reflect the attitude of the Association, nor is it responsible for them. All advertisements placed in this publication are subject to the approval of the APA Executive Committee.
Features 2010 Convention Highlights ....................................................................12 2010 District Meeting Schedule ..............................................................23
Departments From the President......................................................................................4 The Executive’s Perspective ......................................................................5 Harding Report ..........................................................................................8 Member Classified Advertising..................................................................9 Medicaid Alert ..........................................................................................11 Safety Nets................................................................................................24 AAHP Report ..........................................................................................25 Compounding Report ..............................................................................27 In Memoriam ............................................................................................27 UAMS 2010 Salary Survey ......................................................................28 Calendar of Events ..................................................................................31 APA Board of Directors Minutes..............................................................32 Rx and the Law ........................................................................................36
Index to Advertisers Pace Alliance ............................................................................................6 EPIC Rx ....................................................................................................7 Pharmacists Mutual ................................................................................10 Arkansas Pharmacy Foundation Legacy ................................................26 Bio-Tech Pharmacal ................................................................................34 Arkansas Pharmacy Support Group ........................................................34 Cardinal Health........................................................................................35 Logix, Inc.................................................................................................37 Pharmacy Quality Commitment ..............................................................38
APA Staff Office E-mail Address apasupport@arpharmacists.org Mark S. Riley, Pharm.D. Executive Vice President mriley@arpharmacists.org
Scott Pace, Pharm.D. Associate Executive Vice President scott@arpharmacists.org
Helen Hooks Communications Specialist hhooks@arpharmacists.org
Barbara McMillan Director of Administrative Services & Meetings bmcmillan@arpharmacists.org
Debra Wolfe Director of Public Affairs dwolfe@arpharmacists.org
Celeste Reid Administrative Assistant creid@arpharmacists.org
The Arkansas Pharmacist
3
From the President National, State and Local Politics Some Common Misconceptions
Mike Smets, P.D. Coleman Pharmacy Fort Smith, AR
Healthcare reform is passed and in the books and is now out of our hands Well not exactly. Although pharmacy as a whole faired pretty well in the new legislation, there are challenges and opportunities to deal with in its implementation. In a recent visit to Washington DC we were told that we would experience “healthcare fatigue”, in that members of congress would not really want to talk anymore about healthcare and the new bill, but this was not the case. The real work is just now beginning, as politicians, agencies and bureaucrats interpret and begin to implement the new law. Continued contact with our elected representatives is more important than ever to make sure that the concerns for and value of our profession is understood. They can have just as much or more impact during the implementation phase of the new law as they did in the debate and the vote. I urge you to keep up with the initiatives and goals being pursued by NCPA and the other national Pharmacy organizations concerning the new healthcare law. With the departure of Marion Berry and Vic Snyder, and either Blanche Lincoln or John Boozman, the Arkansas delegation will have some new faces for next year. It is very important that we establish relationships and maintain the credibility that we now enjoy with these new folks – and that starts with you and me
– their constituents. Its summer – no need to talk to state representatives Summer is really a good time to get to know these folks. With the term limit situation in Arkansas, each year brings a bunch of new faces to Little Rock in the fall and I think its just good manners to meet and introduce yourself to a state representative before you start asking for their help. Maybe even talk about other non-pharmacy issues which are important to you or see if you can help them out on something or just say “Hi, thanks for taking on the job”. They will be busy during the session and if they recognize a name they will be more likely to stop and listen on a hectic day. APA will have some legislative initiatives and we will really need your help contacting and talking to your representatives at that time. On the APA web site there are all the tools needed to be communicate effectively during the upcoming session. Under “site updates” there is a great little list of 10 rules for talking to a legislator. Now is a good time to update your e-mail and contact lists of your state local and national representatives. Local politics don’t really affect our profession. Do you fill any prescriptions for city or county employees? Do you want your city to be attractive to new business and growth? Do you think its wrong for a city to endorse mail order prescriptions? Do you want your customers and their families to stay in the community and thrive? If you answered yes to any of these questions then local politics does matter. Get to know your councilmen and mayor. These people are really the most accessible elected representatives we have and mostly they really to like to hear from us. City meetings are always posted and open to the public and just by being there occasional, you send a message that you care and need to be listened to when the time comes. I don’t know enough to talk to a CEO and HR person about how the choose and evaluate their PBM Yes you do. You probably know more than they do about the truth and how pharmacy is reimbursed for our services. How about a couple simple questions, such as “What does your PBM do with its rebate money?” or “How much if any do you really save by using mail order?” Always remember that our Executive Vice Presi4
The Arkansas Pharmacist
Continued on pg. 7
The Executive’s Perspective
Summer has officially started, and while that means days off of school for kids all across the state, there is no summer break from dealing with the myriad of issues that affect the profession of pharmacy. Two key items that the APA will be working on over the summer are e-prescribing of controlled substances and healthcare reform. On June 1st, an Interim Final Rule went into effect that allows controlled substances to be written and transmitted through electronic prescriptions. It has taken industry groups upwards of five years to get the DEA to promulgate rules that allow the electronic transmission of controlled substances. While it is now legal for prescribers to write e-prescriptions for controlled substances and for pharmacists to receive them, this rule is still an Interim Final Rule. This simply means that groups, like the APA will continue to look for ways to improve the rule and make it more efficient for providers and their software vendors.
Scott Pace, Pharm.D. Associate Executive Vice President
Healthcare reform continues to be a hot topic. The President signed reform into law this Spring, but many of the changes do not take effect until 2014. In the meantime, regulatory agencies will be promulgating rules and regulations that will add more specifics to the new law. APA will be watching this process closely to ensure that pharmacists in all practice settings are not adversely affected by the regulations. Moving forward, I encourage all of you to keep an eye on your state and local elections in November. As the candidates come to your cities and towns, make sure you take the time to visit with them. Let them know that you are a pharmacist and that you will support candidates who support our profession and our patients. We will have at least three new Congressmen for the first time in decades next year and now is a great time to build a relationship with the candidates. It will pay dividends for years to come. On a personal note, I want to sincerely thank everyone who helped me during my campaign for the Arkansas House of Representatives. We ran a very strong campaign, emerging from a crowded four-way field to make the runoff election. We narrowly lost the runoff by 313 votes. It was a great experience, and I am proud of the campaign we ran and I look forward to finding an opportunity down the road to give it another shot.
The Arkansas Pharmacist
5
President - Continued from pg. 4
dent, Mark Riley, will help in any way he can, including coming to your town to meet with those companies along with you. I’m just a staff pharmacist so I don’t need to do this stuff. If you like your job and want you company to stay in business and you want the best for your patients then you really do need to do this stuff. If you go to church with a state representative or a councilman or your kids/grandkids play little league with the mayor's kids/grandkids let them know that you are available to help them on pharmacy or healthcare issues with you expertise. You can establish a relationship just a well as an owner can – and maybe even better since you won’t be seen as having such a vested interest in legislation. At the very least make sure your contact file is up to date so you can weigh in on issues with our legislators as they come up this session as APA notifies you. As we have demonstrated in the past, just the sheer number of calls on an important issue does greatly count with these folks. APA presidents enter their term full of dread and trepidation Actually I am very excited and honored to start the job. I can’t wait to hit the road in September and meet more Arkansas pharmacists and see more of our beautiful state. As usual there are great challenges and opportunities, (some yet to even appear – did mention that this is an Arkansas Legislative session year?) APA will of course be trying to accomplish some things in this year’s session and I will need you help and ideas.
The Arkansas Pharmacist
7
Harding Report Summer may be upon us, but things are still quite busy at the college of pharmacy at Harding! While we do not offer any didactic courses during the summer for pharmacy students, our pharmacy practice faculty continue through the summer teaching pharmacology for the physician assistant (PA) program at Harding. Both pharmacy practice and pharmaceutical sciences faculty also devote more time to their ongoing scholarship and research activities during the summer months. This includes working with students, both pharmacy and undergraduate, to continue or complete projects. Additionally, several of our rising second and third year pharmacy students are out completing their introductory pharmacy practice experiences (IPPEs) in hospital and ambulatory care sites, respectively. About 50 percent of the class chooses to complete their IPPEs during the summer months, with about three-fourths of these doing so in Arkansas and the other fourth participating at sites in other states. Finally, the college’s service activities keep going strong throughout the summer with faculty practicing at their clinical sites and students participating in pharmacy service-learning activities, such as volunteer work at charitable clinics, throughout the state. A small group of students has chosen to participate in the School on Alcoholism and Other Drug Dependencies at the University of Utah being held June 20-25, 2010. The school occurs annually and teaches students of various disciplines the most up-to-date techniques for working with individuals with alcoholism and other drug dependencies. This is the second year Harding students have attended the University of Utah school. Students who attended last year shared what they learned with their fellow pharmacy and PA students during chapel sessions in 2009-2010 and felt it was a “life-changing” experience. Four new faculty members will be joining the college over the summer; two in the department of pharmacy practice and two in the department of pharmaceutical sciences. Dr. Ashley Earley is a 2002 graduate of the UAMS College of Pharmacy who comes to us after completing a pharmacy practice residency at the Central Arkansas Veterans Healthcare System this past year. Dr. Todd Brackins received his B.S. in pharmacy from the University of Louisiana at Monroe and his Pharm.D. from the UAMS College of Pharmacy and comes to us after spending the last 20 years working for Eli Lilly. Dr. Josh Brown received his B.S. in chemistry from UCA and has just completed his Ph.D. in pharmaceutical sciences with an emphasis in medicinal chemistry at the University of Tennessee in conjunction with St. Jude Children’s Research Hospital. Dr. Landry Kamdem received his Pharm.D. from State’s Academy of Chemistry and Pharmacy in St. Petersburg, Russia and his Ph.D. in life sciences, with a focus in biochemical and clinical pharmacology, from Georg-August University in Goettingen, Germany and comes to us following four years of post-doctoral fellowship at St. Jude Children’s Research Hospital and Indiana University. We are very pleased to have these four, very talented individuals joining our faculty and know they will further contribute to the excellent group of faculty we have already assembled. Another exciting development for the college is the first pharmacy practice resident associated with Harding who will be starting this summer. Dr. Marty Lute, a 2010 graduate of the UAMS College of Pharmacy, will be completing a newly established residency program with White River Rural Health Center (WRRHC). Dr. Lute will rotate her time between various ones of the 20 clinics within the WRRHC system as well as at the college engaging in academic pursuits. Much is happening in the college of pharmacy at Harding and we’re excited about the strides our faculty and students are making in advancing the profession of pharmacy in Arkansas and beyond! ~ Julie Hixson-Wallace, Pharm.D., BCPS 8
The Arkansas Pharmacist
Member Classified Advertising Looking For Work Looking for work, full time preferred, in North Central Arkansas. Contact: Paul Scott, PD , 870-449-6692, Yellville. Pharmacist In Charge Wanted Immediate Opening Kroger in Blytheville AR is looking for a Pharmacist in Charge. Excellent pay, bonus potential, and benefits. If interested please contact Jamie Shoemaker at 501-516-2301 or Jamie.shoemaker@kroger.com. For Sale Four sections of metal wall shelving 8 ft. height 4 ft. width Call Will (870) 836 8176 Best Relief Pharmacist In Arkansas Available I am available to do relief work Mondays through Thursdays. I will of course work an occasional Friday and Saturday on special request and will of course work vacations. Would prefer Little Rock metropolitan area and as far south as my license is legal. If your customers and staff don't tell you the next day that I was the best relief pharmacist that ever worked for you, the day is FREE. You can reach me at 870-543-0841 or by e-mail at frankwill2@hotmail.com - Frank Williams Relief Pharmacist Pharmacist available for relief for vacations or occasional day off. I have over 40 years retail experience with 25 years as the owner of an independent compounding pharmacy. Can cover the River Valley and Ouachita areas. Call John Csiha; cell number: 479-355-0371 Pharmacist Needed Looking for part time pharmacist for an independently owned pharmacy in Searcy, Arkansas. Please contact Scott Stanley, Pharm.D. at the following contact information; 501-281-1374, Stanley Pharmacy P.O. Box 2039 Searcy, AR 72145, or stanleycorporate@centurytel.net. Pharmacist Needed We are looking for a full-time or part-time pharmacist for an independently owned pharmacy in Paris, AR. Please call Elizabeth at 479-963-1555. For Sale All items located in Rison, AR Lighted wall fixtures - 70 total feet 5 ft gondolas - 10 total lexmark T640 printer - 1 total credit card terminal - 1 total Contact: Roth E. Rabb, P.D. @ 870-718-9482 or after 6:00 p.m. 870-325-6836
Independent Pharmacies Wanted Independent pharmacist interested in purchasing independent pharmacies in Arkansas. Pharmacies will remain independent after purchase. Purchaser has solid independent pharmacy background. If interested in selling your pharmacy, please contact Vance at 870-897-1204 or via e-mail at VanPark@aol.com. Volunteer Pharmacists Needed Shepherd’s Hope Neighborhood Health Clinic is a ministry of Fellowship Bible Church and Oak Forrest United Methodist Church serving uninsured and indigent patients in the South Midtown area of Little Rock. The Clinic is located at 2404 Tyler Street (behind Oak Forrest). The hours of operation are 6:00pm to 8:30pm every Tuesday and Thursday night. Current needs are pharmacists willing to volunteer every 4 weeks. If you are available to volunteer and help with this ministry, please contact Bren May at 501-993-0729. Thank you! IVANRX4U, Inc., Pharmacist Relief Services, Career Placements. Relief pharmacists needed - FT or PT. Based in Springfield, MO and now in Arkansas. Staffing in Missouri, Arkansas, Eastern Kansas and Oklahoma. We provide relief pharmacists for an occasional day off, vacations, emergencies -- ALL your staffing needs. Also seeking pharmacists for full or part-time situations. Please contact Tracy Byrd, Marketing and Recruiting Director, or Mike Geeslin, President for information regarding current openings throughout Arkansas - temporary as well as permanent placements. Let IvanRx4u help staff your pharmacy, call 417-888-5166. We welcome your email inquiries, please feel free to contact us at: Ivanrx4u@aol.com or Ivanrx4u-tracy@hotmail.com. Pharmacist in Charge Wanted Competitive salary with up to 3 weeks paid vacation and major medical coverage plus 401K plan. Great schedule - Monday thru Friday, hours 9:00 a.m. to 6:00 p.m. Contact Alan Tweddell at 870-931-2881 or send resume to: Country Mart Pharmacy, 208 Lincoln Dr., Fredericktown, MO 63645 Positions to be filled in S.E. Missouri. Relief staffing available through Staff RPh, Inc. We provide quality pharmacists and technicians that you can trust for all your staffing needs. Our current service area includes AR, TX, OK and TN. For more information call Rick Van Zandt at 501-847-5010 or email staffrph@comcast.net. Pharmacy for Sale In beautiful North Arkansas. Established in 1974. Family owned with exceptional reputation in dynamic community. Excellent schools, recreational & retirement center, golf courses, lakes, rivers, 2.5 hours from Little Rock, AR; Memphis, TN; and Springfield, MO. Pharmacy is ideally located: a) across from doctor’s complex and new treatment, diagnostic, and emergency facility, b) next door to ophthalmologist and optometrist. Contact Mike Sprague at 512-799-5265.
The Arkansas Pharmacist
9
Meicaid Alert Division of Medical Services Program Development & Quality Assurance P.O. Box 1437, Slot S-295 路 Little Rock, AR 72203-1437 501-682-8368 路 Fax: 501-682-2480 路
OFFICIAL NOTICE TO:
Health Care Providers - Pharmacy DMEPOS Suppliers
DATE:
June 1, 2010
SUBJECT:
Extension for Pharmacy DMEPOS Supplier Accreditation Requirements
Per federal regulations, pharmacy providers of durable medical equipment, prosthetics, orthotics and suppliers (DMEPOS) have received an extension of time to acquire Medicare accreditation. The new date for accreditation or exemption is January 1, 2011. As such, for pharmacies only, Arkansas Medicaid has extended the deadline for submission of the required information to February 1, 2011. All Arkansas Medicaid Pharmacy DMEPOS providers must provide a copy of their Medicare accreditation, surety bond or reason for exemption to Arkansas Medicaid Provider Enrollment by February 1, 2011. If the requested information is not received by February 1, 2011, the Arkansas Medicaid provider number will be canceled. Please mail or fax to: Medicaid Provider Enrollment Unit HP Enterprise Services P.O. Box 8105 Little Rock, AR 72203-8105 Fax Number: (501) 374-0746 Thank you for your participation in the Arkansas Medicaid Program. If you need this material in an alternative format, such as large print, please contact our Americans with Disabilities Act Coordinator at 501-682-8323 (Local); 1-800-482-5850, extension 2-8323 (TollFree) or to obtain access to these numbers through voice relay, 1-800-877-8973 (TTY Hearing Impaired). If you have questions regarding this notice, please contact the HP Enterprise Services Provider at In-State WATS 1-800-457-4454, or locally and Out-of-State at 501-376-2211. Arkansas Medicaid provider manuals, official notices and remittance advice (RA) messages are available for downloading from the Arkansas Medicaid website: www.medicaid.state.ar.us.
Eugene I. Gessow, Director The Arkansas Pharmacist
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Convention Highlights
Thanks to Our Convention Sponsors
12
AAHP
Healthcare Computer Corporation
AmerisourceBergen
NASPA and Proctor & Gamble
APA Consultant Academy
Pace Alliance
East End Pharmacy
Pharmacy Compounding Accreditation Board
Epic Pharmacies
Rx Systems
Fort Smith Convention & Visitors Bureau
UAMS Alumni Association
GlaxoSmithKline
UAMS College of Pharmacy The Arkansas Pharmacist
Convention Golf Tournament
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The Arkansas Pharmacist
Convention Exhibitors 2010 Exhibitors Harding College of Pharmacy QS/1 Smith Drug EPIC Pharmacies, Inc. Scott Specialties PBA Health Manchac Technologies Rx Solutions Bio-Tech Pharmacal, Inc. Rx Master Pharmacy Systems Robert P. Potts & Associates Merck Takeda Pharmaceuticals H.D. Smith Regina’s Gifts IVANRx4U, Inc. Berry Plastics Corporation Santarus Cardinal Health Novo Nordisk, Inc. AAHP Astellas Pharma US Liberty Computer Service McKesson Corporation Arkansas Healthcare Access Foundation Harding University Students Hospira Gilead Sciences Sanofi Aventis Rx Systems Langermania TOP Rx, Inc. MEDA Pharmaceuticals PharMEDium Services, LLC Genentech Windsor Health AmerisourceBergen Retail Designs Morris & Dickson Pharmacists Mutual Companies Custom Country Candles UAMS College of Pharmacy GlaxoSmithKline Data Rx Management, Inc.
The Arkansas Pharmacist
15
Karaoke Party
In appreciation of APA’s Wholesale Partners AmerisourceBergen McKesson Morris & Dickson Smith Drug
Karaoke Party
CE Sessions Pharmacists from all over Arkansas earned as many as 18 hours of continuing education credit at the 128th Annual APA Convention at the Fort Smith Convention Center, June 24th – 26th. Convention attendees participated in educational sessions that covered a wide range of topics, such as: hyperglycemic crisis, antibiotic resistance, hypertension guidelines, Arkansas pharmacy law update, immunization update, and collaborative practice credentialing. In addition, Dan Weston from GlaxoSmithKline gave a great keynote address entitled “The Value of Medicines: A Triple Solution for a Healthier America.” APA would like to extend our thanks to all of the speakers who helped to make this year’s convention CE so successful.
The Arkansas Pharmacist
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An Evening with the Presidents
below: Dr. Richard Hanry wins a “nights stay” at Miss Laura’s
Miss Laura’s Players perform at “An Evening with the Presidents”
Ray Baker, Mayor of Fort Smith, presents a Key to the City to both Dr. Jan Hastings and her husband Leiutenant Terry Hastings
right: left: Dr. Mike Smets Dr. Jan Hastings places the “Past passes the President’s Gavel to President’s Pin” on Immediate Dr. Mike Smets as Past President, he becomes the Dr. Jan Hastings. 2010 - 2011 APA President
Dr. Mike Smets presents Dr. Jan Hastings with the “Outgoing President’s Plaque.” 18
Mayor Ray Baker officially proclaims June 23rd through June 26th, 2010 Arkansas Pharmacists Association Convention Days. The Arkansas Pharmacist
Dr. Mike Smets presents Dr. Jan Hastings with the “Outgoing Presidents Award.”
Friday Night Party
This years Friday Night Party was truly a blast. Immediately following the banquet, attendees were shuttled by street cars to “2nd Street Live� for desserts and musical performance by the Drugstore Cowboys. Everyone seemed to have a great time.
The Arkansas Pharmacist
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Award Winners
2010 Award Winners Pharmacist of the Year
Distinguished Young Pharmacist Bowl of Hygeia
Dr. Richard Hanry Medic Pharmacy El Dorado, AR
Dr. Rob Christian Baptist Health Medical Center North Little Rock, AR Dr. Ronnie Norris Drug Mart Pharmacy McGehee, AR
Innovative Pharmacy Practice Award Charles M. West Leadership Award
Arkansas State Board of Pharmacy 50 Year Gold Certificate
Dr. Maggie Miller White River Medical Center Batesville, AR Bryna McKenna P-4 Pharmacy Student UAMS College of Pharmacy 20
Dr. Baker Coulter Baker’s Pharmacy Crossett, AR The Arkansas Pharmacist
Incoming APA Board Members
2010 Incoming Board Members President
President Elect
Vice President
Dr. Mike Smets Fort Smith
Dr. Gary Bass Little Rock
Dr. Dennis Moore Batesville
Area 1 Representative
Area 2 Representative
Dr. Brandon Cooper Jonesboro
Dr. Michael Butler Hot Springs Village
District 6 President
Compounding Academy President
Dr. Stephen Carroll Arkadelphia
Dr. Mark Shinabery Little Rock The Arkansas Pharmacist
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AP-PAC Luncheon
Approximately 60 people attended Saturday’s Arkansas Pharmacists Political Action Committee (AP-PAC) luncheon as part of the 128th APA Annual Convention. This luncheon is not only a fundraiser for our PAC, but also serves as a venue to dissiminate information about the political landscape to APA members who are dedicated to making APA successful in the political arena. We were thriled to have the Honorable John Boozman as our featured speaker this year. Congressman Boozman addressed political concerns effecting pharmacy in the upcoming elections in November. After speaking, he answered questions for several minutes. 22
The Arkansas Pharmacist
2010 District Meetings Schedule DATE
DISTRICT
TIME
LOCATION
PRESIDENT
PHONE NO.
Sept. 7 Tuesday
5
7:00pm
Pine Bluff Pine Bluff Country Club
Lynn Crouse
870-355-2046
Sept. 8 Wednesday
6
7:00pm
Hot Springs Clarion Resort on the Lake
Stephen Carroll
870-403-9400
Sept. 9 Thursday
6
Russellville 7:00pm Arkansas Tech University (East Banquet Room)
Stephen Carroll
870-403-9400
Sept. 14 Tuesday
6
7:00pm
Monticello Monticello Country Club
Lynn Crouse
870-355-2046
Sept. 15 Wednesday
4
7:00pm
Camden Camden Country Club
Laura Beth Martin
870-777-2263
Sept. 16 Thursday
4
7:00pm
Texarkana Park Place Restaurant
Laura Beth Martin
870-777-2263
Sept. 21 Tuesday
2
7:00pm
Forrest City Forrest City Country Club
Brent Panneck
870-237-8215
Sept. 22 Wednesday
2
7:00pm
Jonesboro St. Bernard’s Auditorium
Brent Panneck
870-237-8215
Sept. 23 Thursday
1
7:00pm
Little Rock Chenal Country Club
Eddie Glover
501-327-1222
Sept. 27 Monday
8
7:00pm
Batesville Lyon College Ed. Dining Hall
Christy Campbell
501-268-1900
Sept. 28 Tuesday
3
7:00pm
Flippin Sodies @ Flippin Pharmacy
Danny Ponder
870-425-5145
Sept. 29 Wednesday
3
7:00pm
Bentonville DoubleTree Hotel
Danny Ponder
870-425-5145
Sept. 30 Thursday
7
7:00pm
Fort Smith Hardscrabble Country Club
John Vinson
479-424-3166
Safety Nets
Safety Nets A patient presented the original prescription illustrated in Figure One to a pharmacy technician. The technician entered the prescription information as Lamictal® (lamotrigine) 150 mg, quanFigure One tity 30, with directions to the patient of “take one tablet every morning”. The same technician filled the prescription and placed it in line for pharmacist verification and counseling. The pharmacist on duty had developed a particular interest in look-alike, sound-alike medication names and the potential hazards they posed to patients. As this pharmacist began examining the filled prescription for accuracy, the possibility of a look-alike, sound-alike mix-up between Lamictal® and Lamisil® (terbinafine) immediately came to mind. After remembering that Lamisil® tablets are only available in a 250 mg strength, the pharmacist decided that this order had been correctly filled for Lamictal® 150 mg tablets.
patient why she had gone to the physician. The patient replied that she was being treated for a toenail fungus. At the point, the pharmacist realized the prescribed medication was, in fact, the antifungal Lamisil®, not the anticonvulsant Lamictal®. After physician verification, the prescription was correctly filled for Lamisil® 250 mg tablets and the patient appropriately counseled. Not only was the patient started on the way to recovering from a persistent fungal infection, she was shielded from needless exposure to adverse effects associated with Lamictal®.
"Newly marketed medication names may cause confusion"
The pharmacist who sent this report to Safety Nets then took an extra stop to protect the patient. Before counseling about Lamictal®, the pharmacist asked the 24
Numerous issues of Safety Nets have focused on the problems associated with medication names that look and/or sound alike. With every newly marketed medication, the possibility exists that a health care professional will misinterpret the new name for a medication with an older more established name. This is especially true if the medications have other common elements such as strengths, dosage forms and dosing intervals. The pharmacist in this case is to be commended. His diligence in comparing newly marketed medication names with existing names created a valuable safety net for his patients. Even though this pharmacist was
The Arkansas Pharmacist
AAHP Report aware of the potential for confusion between Lamictal® and Lamisil®, this knowledge did not prevent the error from occurring. The root cause of the error was the incorrectly written strength for Lamisil® (i.e. 150 mg instead of 250 mg). The incorrect strength initially caused the pharmacist to misinterpret the prescribed medication. This case demonstrates how easily lookalike, sound-alike errors may occur.
practiced required Board of Pharmacy patient counseling. It was here the error was finally detected. Pharmacists who do not practice counseling are not acting in the best interest of their patients. Counseling remains the last – and best – safety net for our patients.
Fortunately for this patient in this case, the pharmacist
AAHP Report Jason Derden, President
AAHP 2010 Annual Fall Seminar The Arkansas Association of Health-System Pharmacists (AAHP) will host its 44th Annual Fall Seminar on October 7th and 8th, 2010 at the Holiday Inn Airport Conference Center in Little Rock, Arkansas. AAHP will offer over 10 hours of live ACPE accredited continuing education. The program will include an exhibitor session, pharmacy technician and student sessions, poster presentations, awards luncheon and more. The American Society of Health-System Pharmacists (ASHP) will have representatives at the fall seminar including a visit by the ASHP President. Please mark your calendar for the AAHP 44th Annual Fall Seminar to be held on October 7th and 8th, 2010 at the Holiday Inn Airport Conference Center in Little Rock, Arkansas. Visit our website at www.aahponline.org for future program details. AAHP Technician Initiative AAHP is currently hosting Technician Town Hall Meetings at institutions around the state to educate and gain vital information regarding technician training, education, and certification. The information provided by pharmacists and technicians will be used to promote the role of the technician as well as define the direction of the profession. For more information regarding the Town Hall Meetings or to schedule a meeting please contact Janet Liles at jliles@searcy.asub.edu or Jason Derden at jsw3derden@sbcglobal.net. Listserve of AAHP Members AAHP in conjugation with ASHP is offering a Listserve for AAHP members. Many pharmacists are already taking advantage of this key resource. The majority of challenges we face within our individual organizations are the same across the state. The Listserve can be your lifeline to connect with other pharmacist and share your experiences. To join the Listserve, visit our website at www.aahponline.org.
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Compounding Report Counting by “Fives� I am pleased to be your Academy president for the next two years. As you are well aware, compounding is being threatened by the FDA on two fronts - human prescribing and for veterinary purposes. I know many of you believe compounding is our sacred right, but we must always fight to keep this. We are the experts of our profession, not bureaucrats in Washington. Several pharmacists from around the state met with the board this spring to discuss issues in veterinary compounding. Nothing was set in writing, but stay tuned for future announcements. I cannot tell you how many of my patients come into the store and comment how they appreciate what I do. Compounding services are unique and reserved for pharmacists. We must be diligent in our efforts to protect our profession. After all, did we go to school all those years to learn to count by five? We are respected and paid for our knowledge, not by counting pills! I hope to see many of you at the district meeting this fall. Feel free to contact me with any issues that you may have at (501) 217-0000 or email at doxymws@aol.com. ~ Mark Shinabery
In Memorium Dr. David Baker, Conway, AR
Dr. Gene Pynes, Maumelle, AR
Dr. Rodger Foust Morrilton, AR
Dr. Lloyd Woodard Glenwood, AR
Dr. Debra McMaster Hope, AR
Dr. William Vondron Johnson City, TN
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2010 Salary Survey
UAMS College of Pharmacy 2010 Salary Survey Results Paul O. Gubbins, Pharm.D. Professor, UAMS College of Pharmacy
It’s hard to believe that the years pass so quickly. During the month of May, I enjoyed graduation for the 18th time at UAMS. The commencement ceremonies were a wonderful celebration for our students, their families, and friends. Prior to the Honors Convocation, we surveyed the graduating seniors regarding job opportunities as we have done in the past. Dr. Paul Gubbins tabulated the data and the following report reflects their responses. Even in the midst of one of our toughest economic times in history, I am impressed again by the strength of the job market for our graduates. I congratulate our new pharmacists and hope that their professional journey is marked with the core values that we stress during their time at UAMS: respect for others, integrity, creativity, excellence, and teamwork. Warm Regards, Stephanie
Summary • • • • • • • •
•
• • •
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104 UAMS COP P4 students completed the survey 90% have accepted a position 31 % believe the position opportunities available were excellent or good 60% have accepted a position in a community/retail setting 15 students have accepted a residency/fellowship position 12% will receive a sign-on bonus Approximately 51% will practice pharmacy in central Arkansas 18% of the students accepting positions will practice pharmacy or do a residency out-of state, excluding residencies, 10.6% of the students accepting positions will practice pharmacy out-of state Top benefits include: paid vacation, health insurance, retirement, and paid holidays which are the same as in 2009; 5% of graduates will receive APA membership dues paid by their employer Average salary for a pharmacist (excluding residency) position is $113,977; an increase of $5,081 (4.7% increase) from 2009. Approximately 26% plan to own a pharmacy in the future Approximately 89% have student loans, with an average amount of $74,633
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Table 1: Demographics Variable Ages 18-21 22-25 years old 26-30 years old 31-35 years old 36 or greater Gender Male Female Marital Status Single-no children Single, with children Married-no children Married-with children
No. Students (%) 0 (0%) 43 (40%) 46 (44%) 12 (12%) 3 (3%) 36 (35%) 68 (65%) 52 (50%) 1 (1%) 38 (37%) 13 (13%)
Plan to Own Pharmacy in Future Yes No
27 (26%) 77 (74%)
Table 2: Position Information Accepted a position Yes No
94 (90%) 10 (10%)
Position requires moving to different city/state Yes No
36 (38%) 58 (62%)
Previous employment with employer (n=93) Yes, as intern Yes, during rotations No, have no working relationship Ranking of Position Opportunities (n=101) Excellent-found exact position wanted Good-satisfied with opportunities Fair-wish there were more opportunities Poor-few opportunities Very poor-trouble finding position
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36 (39%) 14 (15%) 43 (45%) 11 (11%) 20 (20%) 38 (38%) 27 (26%) 5 (5%)
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Table 3: Salary Information by Position Environment Mean Number of Hours Worked Salary Range Per Week $110,000-$120,640 38 $92,000 - $125,840 40 $111,200 - $124,800 40 $115,000-$125,000 41
# Students n=931 8 23 20 5
Mean Salary Per Year $113,314 2 $116,024 $116,677 2 $121,064
15
$106,000 2
$92,000 - $122,720
1
-
-
Residency/Fellowship Graduate School (e.g., MS or PhD program) Sales
15
$40,182
$35,000 - $50,000
-
-
-
-
-
-
-
Home Health
4
$112,850
$107,000-$125,000
-
Other For all students except those completing residencies
2
106,600
-
-
76
$113,977
$92,000- $125,840
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Position Environment Independent Chain (e.g., USA Drug) Mass Market (e.g., Wal-Mart) SuperMarket (e.g., Kroger) Hospital Pharmacy (includes outpatient pharmacies in institutions, VA system) Nuclear Pharmacy
1 2
One respondent did not provide a practice setting One respondent did not provide a salary
Table 4: Salary Information by Location in State*
Location Northwest AR (Fayetteville) North Central AR (Mountain Home) Northeast AR (Jonesboro) West Central AR (Russellville) Western Arkansas (Fort Smith) Central AR (Little Rock) East Central AR (Forrest City) Southeast AR (Monticello area) Southwest AR (Hope) Out of State *does not include residency positions 30
Number of Students Locating in the Area (n=75) 10 1 5 2 4 38 1 4 0 10
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Mean Salary Per Year $119,192 $114,408 $113,930 $111,056 $120,790 $117,140
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Calendar of Events
Table 5: Benefits Rank 1 2
Benefit Paid Vacation (mean number of days = 13) Health Insurance Retirement Plan Paid Holidays (mean number of paid holidays = 5) Profit Sharing Paid Liability Insurance CE Expenses Paid by Employer Paid License Fees Shift Differential Sign on Bonus (n=11; mean bonus = $12,938) Other Bonuses (e.g., tuition, bonus based on profit) Moving Expenses Arkansas Pharmacist Association Dues Paid by Employer Other*
T3 5 6 T7 9 10 T11 13 14
*other includes 401K, payment for NABPLEX, Store Discounts, Dental & Life Insurance, Travel expenses for meetings
Calendar of Events AUGUST August 12 - 14, 2010 APA Board of Directors Retreat Rockwall, TX
SEPTEMBER September 7 - 30, 2010 APA Annual District Meetings
August 24, 2010 Student Picnic Sherwood Forrest Preceptors Invited
OCTOBER October 7 - 8, 2010 AAHP Annual Fall Seminar Holiday Inn Airport Little Rock, AR October 23 - 27, 2010 NCPA Annual Convention Pennsylvania Convention Center Philadelphia, PA
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APA Board of Directors Minutes Minutes Arkansas Pharmacists Association Board of Directors March 21, 2010 Hosto Center Little Rock, Arkansas Members Dr. Jan Hastings – presiding Dr. Mike Smets Dr. Paul Holifield Dr. Kenny Harrison Dr. John Vinson Ms. Celia Proctor Ms. Colin Ward Dr. Jason Derden Dr. Mike Stover
Dr. Gary Bass Dr. Brent Pannick Dr. Michael Butler Dr. Danny Ponder Dr. Mark Riley Dr. Lynn Crouse Dr. Buzz Garner Dr. Dennis Moore
Guests and Staff Dr. Cindy Stowe Harold Simpson – legal counsel Barbara McMillan Dr. Scott Pace Debra Wolfe Dr. Richard Hanry - treasurer
CONSENT ITEMS President Jan Hastings called the meeting to order at 9:35 a.m. President Hastings requested Dr. Gary Bass to lead the invocation. President Hastings asked the APA Board to review the minutes from the December 2009 meeting. A motion was made and seconded to approve the minutes as amended. The motion passed. DISCUSSION ITEMS Meeting Updates Barbara McMillan reported that convention will be held in Fort Smith in June 23-26, 2010. The convention will be held at the new convention center. The Board meeting will be held at the Marriott. The convention will be western theme. There will be 18 hours of CE at the convention, including the new collaborative practice credentialing program. Ms. McMillan also reported that the 2010 APA Board retreat will be August 12th-14th at the Hilton Resort in Rockwall, TX, just outside of Dallas. Harding College of Pharmacy Report Dr. Julie Hixson-Wallace reported that ACPE was on campus on March 3rd and 4th and the visit went well. The College is currently recruiting for 3 pharmacy practice faculty and 2 pharmaceutical science positions. The College has filled its 2010-2011 incoming class. UAMS College of Pharmacy Report Dr. Cindy Stowe reported that the College took 75 students to the national APhA meeting in D.C. The chapter won multiple awards and Dr. Eddie Dunn was awarded faculty advisor of the year. Ms. Collin Ward received a national student leadership award. Dr. Stowe reported 300 applicants for the 2010-2011 school year, and the College will be admitting the class within the next month. 32
The Arkansas Pharmacist
Arkansas Association of Health-System Pharmacists Report Dr. Dearden reported that AAHP is working on the 2010 Fall Seminar, October 7th & 8th at the Little Rock Holiday Inn Airport. AAHP is also working on ASHP’s technician initiative. Dr. Lynita Shaver is working on the residency taskforce. Arkansas State Board of Pharmacy Report Dr. Mark Riley reported in place of Dr. Charlie Campbell. Dr. Riley gave an update on an issue involving the DEA. The DEA has enforced a provision in federal rules that prevents employees of long term care facilities from being agents of a physician for the purpose of calling in controlled substances. Dr. Kirtley also noted the collaborative practice regulation changes have gone into effect and the first certification program will be held in January at the UAMS College of Pharmacy. The Board has formed a committee to look at how narcotic loss reporting is currently being handled. The committee will convene in early 2010 to investigate this issue. Healthcare Reform/DME Accreditation Dr. Scott Pace reported that the House of Representatives is voting on Healthcare Reform legislation today. The bill includes several pharmacy friendly provisions, including a DME certification exemption, grant programs for MTM, PBM transparency, and changes to the definition of AMP. Special Committee on Medicaid Dr. Mark Riley reported that the APA convened a special committee on Medicaid funding to address the $400M shortfall in the Arkansas Medicaid program. The committee held multiple meetings in person and on conference calls and made a recommendation to the Arkansas Department of Human Services as a way to help control Medicaid prescription drug costs. AR-BCBS Dr. Riley reported that the APA and AR-BCBS have entered into discussions to see how the pharmacists of Arkansas and BCBS can partner together to improve pharmacy benefits in Arkansas. Discussions will be ongoing over the next year. Employer’s Health Coalition Dr. Riley reported that the Employer’s Health Coalition will be evaluating data with RxResults to see the impact of the exclusive deals that they have made with Walmart and Walgreens. State Worker’s Comp Dr. Riley reported that the APA continues to work with the Arkansas Insurance Department to optimize processes and expenses within the program. Miscellaneous Dr. Pace reported on the four congressional races, the United State Senate race, and the myriad of state races for the 2010 election year. Dr. Riley reported that the APF Golf Tournament will be held at Tannenbaum Golf Course on Thursday, April 22nd. Dr. Riley also reported that the APA will host a fundraiser for Governor Beebe’s re-election campaign on ThursThe Arkansas Pharmacist
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day, March 25th at LaVada’s in North Little Rock. ACTION ITEMS Financial Report Dr. Richard Hanry reported on the financials of the APA. He reported that the APA is working within the budget and all the financials are looking on target. Dr. Hanry submited the financials for acceptance. There was a motion and a second. The motion carried. Adjournment A motion was made and seconded to adjourn the meeting at 11:45am. The motion passed.
APA Foundation Board March 21, 2010 Dr. Jan Hastings convened the Foundation Board at 12:00 p.m. on March 21, 2010. The Board made a motion to accept the actions of the Foundation Board. The motion was passed. A motion was made to adjourn the meeting at 12:15 p.m., motion passed.
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The Arkansas Pharmacist
Rx and the Law
PHARMACY MARKETING GROUP, INC
AND THE LAW By Don. R. McGuire Jr., R.Ph., J.D.
This series, Pharmacy and the Law, is presented by Pharmacists Mutual Insurance Company and your State Pharmacy Association through Pharmacy Marketing Group, Inc., a company dedicated to providing quality products and services to the pharmacy community.
SPOLIATION OF EVIDENCE As a pharmacist, you are aware that if you dispense an incorrect medication, you must take care of the patient. This normally includes apologizing for the error, correcting the mistake, and contacting the patient’s physician. These are all important, but you may forget that you also need to take care of yourself. If a patient receives an incorrect medication, there is always a chance they could sue you. That is why it is so important to gather and preserve all relevant information about that incident. The best thing you can do after a dispensing error has occurred is to thoroughly document the situation. It is recommended that you record the following: how the error occurred, the date the error occurred, the date the error was discovered by the patient, the date the error was brought to the pharmacy’s attention, the amount of doses the patient believes they ingested, the amount of doses returned to the pharmacy, and the names of anyone you spoke to while resolving the issue. Document all conversations with the patient or the caregiver. Don’t use an abbreviated form of documentation. Use complete words and sentences. It may be easy for you to recall all of the details now, but it could be a year or more before a lawsuit is filed. After filling thousands of prescriptions and handling other problems, it may be impossible for you to remember anything about that specific incident. To be safe, all documentation should allow a party who was not involved to fully understand the situation. It is worth mentioning a second time to document the amount of doses the patient brought back to the pharmacy and preserve the physical evidence. Too often a 36
pharmacist will verify the patient received the incorrect prescription and then dispose of the medication. They have just disposed of a valuable piece of evidence. The number of doses returned to the pharmacy can help establish the maximum number of doses the patient could have ingested. At any time in the future, if the patient claims they took a specific quantity of capsules/tablets, you will be able to confirm or deny this claim with your documentation and the returned prescription vial. Count the tablets and save the bottle. Treat this as evidence by placing it in an envelope and sealing it with your initials on the closure. The production of evidence in litigation is governed by the Rules of Civil Procedure. The rules require a party to preserve evidence in a number of situations. It could be in situations of actual pending litigation or when a party is put on notice of a potential claim. It is also a requirement to keep evidence if a party reasonably anticipates that the information might be needed for future reference. As you can see, the requirement to preserve evidence is broad. It can be argued that a patient returning to the pharmacy with incorrect medication that resulted in an injury creates a situation where litigation is reasonably foreseeable. The best practice is to assume this is true and preserve the evidence. Spoliation is the destruction or significant alteration of evidence in a case. What happens if you don’t preserve evidence? The rules also provide the sanctions available when spoliation occurs. These sanctions run the gamut from reprimands, findings of contempt, up to dismissal of a case. Generally, it will take an egre-
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gious violation for a court to dismiss or default a case, so it is not very common. However, it is more common for the court to allow the jury to make a negative inference from the spoliation of evidence. That is, the jury is allowed to presume that the evidence destroyed was more likely injurious to the destroying party’s case than it was likely beneficial to their case. This is really a common sense application. People are not likely to destroy things that will be helpful to them. This, of course, is not true in all cases, but what is a jury to do if the evidence is destroyed? The returned prescription might have proven your case, but if you disposed of it, the court will give the jury the spoliation instruction. This instruction can be very damaging to your case and may result in a significant verdict against the destroying party. The bottom line is you should be able to reproduce or recall details in the future that you would have been able to answer the day the patient presented with the error. If you destroy, dispose of, or do not record some piece of evidence, it could have severe consequences. All of this documentation and preservation is in your best interest. Protect yourself, be complete.
Š Don R. McGuire Jr., R.Ph., J.D., is General Counsel at Pharmacists Mutual Insurance Company. This article discusses general principles of law and risk management. It is not intended as legal advice. Pharmacists should consult their own attorneys and insurance companies for specific advice. Pharmacists should be familiar with policies and procedures of their employers and insurance companies, and act accordingly.
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