Pharmacist Access to Medical Notes – why all the excitement!

It often surprises me how pharmacists always wish that they had access to the medical notes.

I am one of those pharmacists who really doesn’t get excited about it.

I was a senior clinical pharmacist in a hospital and access to medical notes caused me grief every day. I had two main problems:

Stopping pharmacists looking in notes. Hours can be wasted looking through notes, checking and searching for something to pop out. Hours wasted when you could be talking to patients and nurses searching out medicines related problems, dispensing prescriptions, offering advice, providing services. It is when you ‘suspect’ that something might be wrong, that you might want to look in medical notes for ‘confirmation’.

Getting pharmacists to write in notes. Begin with ‘Pharmacist Assessment’, then write something that is pertinent to the care of the patient, write you name with the word ‘Pharmacist’ proudly underneath.  It sounds so simple, but it was really a struggle.

Don’t you professors in Universities teach pharmacists how to make an entry in a set of medical notes – or how to create a set of pharmacist notes? Most Pharmacists couldn’t SOAP notes!

At one point a consultant at the hospital asked if we should have a special page in the notes – you know like the physios who had yellow pages at the back. Hell no – pharmacists write in the main body of the notes, because our contribution to patient care is important. Not with silly green pens, but with bold black ink!

It is strange that when working in community pharmacy, I never really wanted to have access to the medical notes. I did not want to check whether electrolytes had been done for every patient on a diuretic or ACE inhibitor – didn’t really feel that it was my job to check everything. If I was worried and suspected something was wrong, I had the PMR and the patient to hand and a phone.

I don’t understand how some pharmacists think that access to medical notes is the Holy Grail – why they push constantly for it. They somehow believe that having access to the medical notes will make them better pharmacists. Personally I think it will be a nuisance and should something go wrong when we could have looked it up in the notes – then we will be jointly to blame for a prescribing error.

On the other hand, however – if the prescriber could only read ‘my entry’ in the notes then they might be much better prescribers. If they knew the symptoms and progress disclosed to me. If they knew what was purchased on top of what they prescribed. If they only knew what was actually taken. If they knew what was sold on the pavement outside the pharmacy.

My contention – pharmacists don’t need access to medical notes – prescribers need access to the pharmacist notes!


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