Enslaved to the lure of wealth

Our profession was once again put in a bad light in one of the segments of the tv program "Imbestigador" when it featured in tonight's episode the 2 drugstores selling the unregistered drug misoprostol (Cytotec) in violation of the BFAD Advisory No. 02-02.

Nolee's Pharmacy in Calamba and Farmacia de Borja in Sta. Cruz (both in the province of Laguna) were positively found out selling the illegal drug.

The pharmacists in both drugstores were not present at the time when the "salesladies" were apprehended but it is more disappointing to learn from that segment that the owner of one of the drugstores is apparently a pharmacist.

If this is true, it seems that the guardian of the public health has gone enslaved to the lure of wealth.

Should empty vials of drugs be returned to the hospital pharmacy and destroyed by crushing prior to disposal?

On September 8, 1994, the Bureau of Food and Drugs (now the Food and Drug Administration) had issued Memorandum Circular No. 22 (Subject: Inventory, Proper Disposal and/or Destruction of Used Vials or Bottles) requesting the "conduct of a periodic inventory, proper disposal or destruction of used vials or bottles" by all concerned entities due to the "proliferation of adulterated, misbranded or counterfeit drugs" in the Philippines.

This was one of the measures taken by the Bureau to address the reports which reveal "that some unscrupulous persons are recycling used vials or bottles and fill it up with substances totally different in strength, quality, purity or potency from that previously contained in it."

On July 6, 1999, the Bureau of Food and Drugs amended BFAD Memorandum Circular No. 22 series of 1994 by the issuance of Bureau Circular No. 16 which defined "the responsibility of the Chief Pharmacists of government and private hospitals to conduct at least, a semestral inventory of the proper disposal and destruction of used vials or bottles, and to submit same to the Bureau within five (5) days fromt the date of inventory." The circular also directed the nurse administering the drugs to "be under strict instructions to return all empty vials to the hospital pharmacy for destruction on a quarterly basis" and that "all inventories and/or destruction shall be done under the supervision of a duly authorized representative of BFAD."

One of the accreditation standards of PhilHealth for health provider organizations (i.e. code 6.5.1.x.1) requires "the handling, collection, and disposal of waste [that] conform to relevant statutory requirements and codes of practice" and states the "presence of license/permits/clearances from pertinent regulatory agencies implementing among others the following: RA 9003, RA 6969, RA 9275, PD 1586, DOH Hospital waste management manual, RA 8749 (Clean Air Act)", as its core indicator.

This standard is consistent with the provision of the Joint DENR-DOH Administrative Order No. 02 series of 2005 (Subject: Policies and Guidelines on effective and proper handling, collection, transport, treatment, storage and disposal of health care wastes) which was also communicated, among others, to the president of the Philippine Health Insurance Corporation and directors of Bureaus under the Department of Health through the issuance of DOH Memorandum Circular No. 2005-0070.

The joint administrative order stipulates that the Department of Environment and Natural Resources-Environmental Management Bureau (DENR-EMB) "shall be the primary government agency responsible for implementing pertinent rules and regulations on the management of health care waste in the Philippines, particulary concerning the issuance of necessary permits and clearances for th Transport, Treatment, Storage, and Disposal of such wastes, as governed by RA 6969, RA 9275, RA 9003 and PD 1585." It also specifies that the "handling, collection, storage and transport of health care wastes shall be in accordance with the provisions of RA 8749, RA 6969, and RA 9003, and the DOH Health Care Waste Management Manual (Chapter 5)."

According to the DOH Health Care Waste Management Manual (2004), pharmaceutical waste "includes expired, unused, spilt, and contaminated pharmaceutical products, drugs, vaccines, and sera that are no longer required and need to be disposed of appropriately. This category also includes discarded items used in handling of pharmaceuticals such as bottles or boxes with residues, gloves, masks, connecting tubing and drug vials."

In this context, Chapter 5 of the Manual specifies that only "large quantities of obsolete or expired pharmaceuticals stored in hospital wards or departments should be returned to the pharmacy for disposal. Other pharmaceutical waste generated at this level, such as expired drugs or packaging containing drug residues should not be returned because of the risk of contaminating the pharmacy. It should be deposited in the specified container at the point of generation." It also states that "health care waste collection practices should be designed to achieve an efficient movement of waste from points of generation to storage or treatment while minimizing the risk to personnel."

Further, DENR Administrative Order No. 36 series of 2004, now requires waste generators to comply with the Waste Transport Record or Manifest System which include the declaration of the class, subclassification, and quantity of each hazardous waste, before it is allowed to store, recycle, reprocess, treat or dispose of hazardous waste at a facility outside its premises by contracting a DENR-accredited waste transporter and treater.

Therefore, policies and procedures on handling, collection, storage, transport and disposal of used pharmaceutical vials or bottles has to be aligned with the current regulatory and accreditation requirements. Ther repealing clause of the Joint DENR-DOH Administrative Order No. 02 series of 2005 which states that "all other issuances whose provisions of DENR and DOH Administrative Order, Memorandum Circulars or other issuances inconsistent [with it] are... repealed or modified accordingly", should also be considered.

Just an isolated case?

Two weeks ago I received a text message from my aunt asking me if I'll be interested in having my license rented by a doctor who owns a clinic somewhere in Cavite.

She told me that the doctor sells medicines in the clinic and to avoid being questioned by DOH surveyors during their inspections, he's offering Php 4,000 for the pharmacist's license. The pharmacist will just have to visit the clinic at least once a month and that's it!

I don't know if this scenario is rampant or just an isolated case, but the fact that it happened is something that pharmacists must not accept if the opportunity come their way.

We all know the reason why... some of us just pretend not to know. (You know!)

The grounds where sick people pass

She was half naked... face battered...
Her neck has hematoma... strangled... gang raped!


What kind of sickness had afflicted those who trampled upon your healing soul?
You've brought yourself to this remote land to cure.

And for what?


You ended up in the unwelcoming hands of some ungrateful brats.
They've even made witness to their crime the grounds where sick people pass.


Anger? Disgust? What's there to make you feel better?
What's left to get the rest of your kind to be out there?



______________
This post is dedicated to the volunteer nurse who was gang raped in South Upi, Maguindanao last September 25, 2010.

Amid dengue scourge

To hear news of ovepricing involving drugstores is no good news because it drags with it the pharmacist's name and reputation.

Such is the case of alleged overpricing in the sale of iv fluids "amid dengue scourge" in Cebu.

According to reports, those involved are pharmacies located outside Cebu City Medical Center and Vicente Sotto Memorial Medical Center.

I just hope that these reports are not true. Otherwise, those who were involved came short in "[helping] individuals protect themselves against diseases."




(Note: Posted first on the official website of the Philippine Pharmacists Association)

On ethics and self-regulation

Writing about the Medicines Transparency Alliance (MeTA) Philippines' series of round table discussions on the ethical promotion of pharmaceutical products, Dr. Alberto Romualdez in his article, "Finger-pointing on ethics" (Malaya, September 8, 2010), pointed out that "one of [the factors that influence the availability and accessibility of safe and effective medicines for sick Filipinos] is the continued misuse or overuse of ineffective, inappropriate, and often unsafe preparations for treatment of illnesses or enhancement of health."

According to him,"The irrational use of pharmaceutical products is a result of aggressive, often unethical, marketing and promotions practices of a highly competitive industry in a severely imbalanced market."

In his account of what has transpired in those round table discussions, he mentioned that "The health professional discussion group consisted of doctors and pharmacists who had the most extensive dealings with pharmaceutical marketing activities. These groups acknowledged that ethical problems existed but essentially laid blame on drug companies. The groups generally advocated for self-regulation in the form of existing or newly revised codes of ethical behavior. It was acknowledged however that mechanisms for monitoring compliance and imposing sanctions on violations were [woefully] inadequate."

In searching for any existing or newly revised codes of ethical behavior that may serve as basis for self-regulation, it is notable that the Code of Ethics of the Philippine Medical Association specifies the following:

"A physician is encouraged to report to the Philippine Medical Association or the Board of Medicine personal knowledge of any corrupt or dishonest conduct of the members of the profession." (Art. IV, Section 9)

"Generic names shall be used during the course of CME activities. However, after the lectures, the sponsoring entity may promote or indicate their branded products." (Art. IV,Section 15)

"Only gifts of reasonable value that primarily entail benefit to patient care or related to physicians' work may be accepted by a physician from a health product company." (Art. VI, Section 3)

On the other hand, the PPhA's code of ethics is more general in stating that "A pharmacist acts with honesty, integrity and professionalism in relationship with the patients and other health professionals."

Based on the above comparison, I hope that our code of ethics will be as specific as that of the PMA's. I also hope that this finger-pointing on ethics will stop soon. It's time we take the responsibility for our actions.

____________


(Note: Posted also in the official website of the Philippine Pharmaceutical Association.)

Something to look up to

I also consider myself an environmentalist, so I was pleased when I learned that the Department of Environment and Natural Resources, the Earth Day Network, mall owners and supermarket chains signed a memorandum of understanding last September 23 saying that plastic bags will not be provided anymore in malls and supermarkets on Wednesdays "to slowly shift public consciousness into using reusable totes."

Now, that, I think is something to look up to by pharmacy organizations in considering similar action to be implemented in drugstores and pharmacies to help protect the environment and also as part of their social responsibility.

State of hibernation

I guess I have already overdone the decision to lie dormant for a while to the extent that I've already forgotten how to open this account again. (It took a while for me to figure that out.)

Is it "busyness" or the pretense that I can just let the passing of days and years without being affected by the events and happenings in my professional life?

Is it lack of inspiration or the scarcity of topics to write about?

Whatever the reasons... enough is enough to this state of hibernation!

Thanks to those who gave their encouragement and support.

Quote of the Day

"I am hardly invited to talk shows to discuss the cheaper medicines bill... I would eventually learn that some television stations were told by the companies not to have me as a guest. Otherwise, they would pull out their advertisements."


- Iloilo Rep. Ferjenel Biron

Source:
"Drug makers using P1-B lobby fund vs cheaper medicine bill"
By Christian V. Esguerra
Inquirer
Last updated 07:28pm (Mla time) 07/29/2007

http://newsinfo.inquirer.net/breakingnews/nation/view_article.php?article_id=79364

Lately, I am seeing a TV commercial wherein the "Drugstore Owner" recommends a certain brand of paracetamol to the viewing public.

So I wrote the Bureau of Food and Drugs (licd@bfad.gov.ph) last week "to inquire whether this kind of TV commercial violated certain provision of A.O. 63 s. of 1989 since many drugstores are also owned by pharmacists. The Admnistrative Order says generic dispensing as 'dispensing the patient's/buyer's choice from among generic equivalents, i.e., finished pharmaceutical products having the same active ingredient(s), same dosage form and same strength as the prescribed drug' (Section 1, 1.2) and that 'Imposing a particular brand or product on the buyer' (Section 5, 5.1) is considered a violation".

Whether my inquiry gets a reply or not, I just would like to say that our responsibility under the Generics Act (to borrrow the words of former BFAD Secretary, Quintin L. Kintanar, MD, PhD) is that "of informing the consumer what are the available generically-equivalent drug products and their prices" and not to engage in favoring certain drug products over the others.

Assuming that drugstores purchase their stocks from legitimate and reputable suppliers, the only thing that I can think of why pharmacists (or their PAs) would "impose" certain brands to their customers is because of the promos that suppliers offer to them.

For example, discounts in the bulk purchase of the supplier's products are sometimes tempting to drugstore owners (whether they are pharmacists or not). So, if higher profits can be obtained by offering these drug products, the buyer who is not aware of his rights would just accept what the pharmacists or the PAs would recommend.

Have we really gone heartless?

Some members of the Sigma Rho fraternity are on hot seats nowadays for the alleged hazing of UP Public Administration student, Cris Mendez, that resulted to his untimely death.

This is not the first time that we hear of senseless deaths involving campus fraternities.

And to think that these fraternities are composed of supposedly educated individuals!

The truth is, I am now reminded of someone who had written, "I am a survivor of a concentration camp. My eyes saw what no person should witness. Gas chambers built by learned engineers. Children poisoned by educated physicians. Infants killed by trained nurses. Women and babies shot and killed by high school and college graduates. So I'm suspicious of education. My request is: help your students to be human. Your efforts must never produce learned monsters, skilled psychopaths, or educated Eichmanns. Reading and writing and spelling and history and arithmetic are only important if they serve to make our students human."

What about the pharmacist who irresponsibly dispenses prescription drugs nowadays like candies in sari-sari stores?

Or the one who is not bothered by the illegal selling of misoprostol which is used as abortifacient?

Or our inaction to the unethical practice of our profession?

Have we really gone heartless?

Surely, I want to hear more of Michael Jackson singing:

"Heal The World

Make It A Better Place

For You And For Me

And The Entire Human Race

There Are People Dying

If You Care Enough

For The Living

Make A Better Place

For You And For Me"

I really hope that would help...

More on "look-alike" and "sound-alike" dispensing errors

I'm beginning to notice that dispensing errors that have caught media attention or have landed in courtrooms were due to failure to observe dispensing rules and regulations under the Generics Act of 1988.

If, for example, "the lady at the counter" paid more attention to generics, she might have refused to fill the prescription for Methergin if the generic name was not written on it. Or, if the generic name was written, she might have thought it as an "impossible prescription" if she have interpreted the brand name as Melleril. [1]

A.O. 63 s. 1989 specifically states that "[v]iolative and impossible prescriptions as defined in A.O. 62 (Generic Prescribing) shall not be filled. The pharmacist shall advise the prescriber of the problem and/or instruct the customer to get the proper prescription..." (Section 4, 4.1)

The dermatologist who prescribed Thiamine had observed generic prescribing but the pharmacist's failure to practice what was required under the law had led to a dispensing error by filling the prescription with Thorazine. [2] (Oral doses of thiamine is being used as an mosquito repellant.) [3]

References:

1. "Wow mali" by Joy Gonzalez at http://www.manilastandardtoday.com/?page=goodLife02_sept_2003 [cited Aug.16, 2007]

2. http://ca.supremecourt.go/cardis/CV83632.pdf [cited Aug. 16, 2007]

3. "Avoiding Mosquito Bites" at http://www.infomediko.com.ph/past_episodes.html#061107avoiding [cited Aug. 26, 2007]

"Look-alike" and "sound-alike" dispensing error

Today, while browsing the internet, I came across an article in the May 29, 2007 issue of the Sunstar Manila* entitled “High court upholds damage suit v. drugstore chain”.

Here is part of that news article:

“… on Nov. 25, 1993, [Sebastian] Baking went to the clinic of Dr. Cesar Sy for a medical checkup. After undergoing an ECG, blood and hematology examinations, the doctor found that Baking's blood sugar and triglycerides were above normal levels, for which he gave two medical prescriptions -- Benalize tablets for his triglycerides and Diamicron for his blood sugar.

"Baking proceeded to Mercury Drug-Alabang branch to buy the prescribed medicines.

"However, the saleslady misread the prescription for Diamicron as a prescription for Dormicum, a potent sleeping tablet, and sold it to Baking, unaware that it was the wrong medicine.

"On the third day of taking Dormicum, Baking figured in a vehicular accident when he fell asleep while driving his car and it collided with another car. He said that he could not remember anything about the collision or felt its impact.

"Suspecting that the tablet he took may have a bearing on his physical and mental state at the time of the collision, Baking returned to Dr. Sy's clinic.”Upon being shown the medicine, the physician was shocked to find that what was sold to him was Dormicum, instead of Diamicron, prompting Baking to file a complaint for damages before the Quezon City RTC.”

Finally, this year, the Supreme Court has ordered Mercury to pay damages to Mr. Baking for the dispensing error “that caused him to fall asleep and figure in a vehicular accident.”

*****

Although the said article was way back in May 2007, I still decided to write the editor to comment:

Here’s what I wrote:

Dear Editor,

I just would like to comment on the article "High court upholds damage suit v. drugstore chain" (May 29, 2007 issue).

It is my opinion that the error in dispensing Dormicum instead of Diamicron is in the first place an error in prescribing the drug by its brand name.

Medication errors due to "sound-alike" and "look-alike drugs" happen and the article did not mention whether the doctor prescribed the drug by its generic name, because if he did, the drug will most likely be dispensed correctly.

This is because the generic name of Diamicron is gliclazide while midazolam is that of Dormicum. (Both generic names are not "sound-alike and "look-alike".)

Under the Generics Act of 1988, drugs prescribed by their brand names only should not be filled. So if, in this case, the drug was prescribed in its brand name (Diamicron) without the doctor writing the generic name (gliclazide), the drug store chain's employee indeed violated the law in the same manner that the doctor violated the same law.

Then I would say that if only the prescriber and drug store chain employee complied with the Generics Act, none of this thing would happen to the patient.

*****

I shared the above article to my colleagues and there were questions that came up in relation to the case:

1. How come the saleslady had access to a regulated drug, such as midazolam? (Pharmacists are the only ones authorized to have access to regulated and restricted drugs. These drugs are kept locked in their storage areas.)

2. Was there a pharmacist at that time? Should he/she be held liable?

3. Was there a dosage strength written on the prescription? If there was, how come she did not doubt the correctness of the drug that she dispensed? (Dormicum is available as 15 mg per tablet while Diamicron is available as 80 mg per tablet.; Diamicron MR is available as 30 mg per tablet)

*****

In the above case, the Supreme Court ruled that “ ’It is generally recognized that the drugstore business is imbued with public interest. The health and safety of the people will be put into jeopardy if drugstore employees will not exercise the highest degree of care and diligence in selling medicines’ ”.

I hope that every pharmacist who reads this learns that we have a social responsibility to guard the public health and by being negligent of our duty to properly dispense drugs, we certainly have a price to pay for our shortcomings. Pharmacy assistants or clerks should never be allowed to do the job that we are licensed to do. Let alone, to dispense a drug without regard to its classification as prescription or OTC drug.


*Source:
http://www.sunstar.com.ph/static/man/2007/05/29/news/high.court.upholds.damage.suit.v..drugstore.chain.html

Questionable promotional material

Section 6 (c) of the Generics Act of 1988 states that "Any organization or company involved in the manufacture, importation, repacking, marketing and/or distribution of drugs and medicines shall indicate prominently the generic name of the product. In any case of brand name products, the generic name shall appear prominently and immediately above the brand name in all product labels as well as in advertising and other promotional materials."

Last July 21, I wrote the Bureau of Food and Drugs inquiring whether drug companies are now allowed to advertise their drug products with the brand name above the boxed generic name.

My concern is regarding the 2 billboards of a popular cold preparation along the east service road of the South Super Highway. One is located near Sucat tollway and the other is located before the Skyway in Bicutan.

I was on my way today for work and while I was travelling the South Super Highway, I remember about this matter. So I checked and saw that the 2 billboards were already changed into a multivitamin product which complies with Section 6 (c) of the Generics Act of 1988.

I am not sure whether it was because of my inquiry that the 2 billboards were changed but if it was BFAD's action to my letter, I'm thankful that it was done accordingly.

Quote of the day

"We don’t want to be a critic of the Botica ng Bayan program but there are some unanswered questions about it. Firstly, why does the Philippine International Trading Corp. import generic medicines from India when we have a pharmaceutical industry which also manufactures generic drugs? Secondly, how come the drugstores of the Botica ng Bayan are not run by professional pharmacists? From a write-up on the Botica ng Bayan, it appears that even buy-and-sell entrepreneurs can get Botica franchises and sell medicine. Selling medicine like selling goods in a sari-sari store could be dangerous to the health of our medicine consumers."

- Jesus C. Sison in his article People's trust in courts boosted
Malaya (Opinion) , March 24, 2007

Source: http://www.malaya.com.ph/mar24/edjesus.htm

PPhA president promoting use of generics

I was watching Unang Hirit last Friday morning in a bus on my way to work. In one of the commercial breaks, a familiar face was shown on TV.

Guess what? It was none other than Ms. Normita D. Leyesa, President of the PPhA, in a TV commercial with PITC chairman Roberto Pagdanganan promoting the use of generic drugs!

This was the first time that I've seen this kind of commercial since the Generics Act was enacted in 1988.

True enough to the PPhA preamble, President Leyesa has shown that "A pharmacist, in coordination with the government and other health professional helps in the formulation and implementation of health care policies, standards and programs designed for the benefit of society."

Let's all hope that the members of the PPhA feels the same way.

Urging pharmacists to back lowering prices of drugs

Today I sent a feedback addressed to the editor of Sunstar Manila (1) that reads:


Dear editor,

This is a reaction to the article "Pharmacists urged to back lowering prices of drugs" wherein it was stated that Senator Mar Roxas "called on the Pharmaceutical [and] HealthCare Association of the Philippines (Phap) to join hands with the Department of Health (DOH) in expanding public access to quality medicines at more affordable prices rather than block the passage of legislation to lower the cost of medicines."

I just would like to say that the Pharmaceutical and Healthcare Association of the Philippines is NOT an association of pharmacists but "a business association representing the providers of most of the country's medicines" whose "members include the country's leading research-based companies of pharmaceuticals and medical services." It claims to have a membership of at least "64 Filipino and international companies." (2)

Although the association says that it is a "non-profit, non-stock organization", (2) it is pretty obvious that it has to protect the business interests of its members.

It is true that the "cost of medicines in the country is too high" and I believe that as a pharmacist, I should support every move of the government to lower its prices for the benefit of the majority of our countrymen.

Senator Mar Roxas might as well call on the Philippine Pharmaceutical Association (PPhA), the Philippine Society of Hospital Pharmacists (PSHP), the Community Pharmacists Association of the Philippines (CPAP) as well as the Drugstores Association of the Philippines (DSAP) regarding this matter.
________
References:
1. http://www.sunstar.com.ph/static/man/2007/02/26/bus/pharmacists.urged.to.back.lowering.prices.of.drugs.html

2. http://www.phap.org.ph/home.aspx

Interview with an applicant

I am a member of a committee that interviews applicants for vacancies in our department.

Just recently, we interviewed a pharmacist who was previously employed in another hospital. As I went over her resume, I learned that she had finished a sponsored clinical pharmacy course.

Knowing that the sponsored course aimed at assisting other hospitals to get started with their clinical pharmacy service, I asked why she resigned from the hospital pharmacy and got herself a job in a non-government agency involved in iradicating tuberculosis in the country.

As we listened to what she was saying, we got the impression that her former colleagues were not as interested and eager as she was in pursuing a clinical pharmacy practice in their hospital. She said that was one of the reasons why she resigned.

As I write this post, I still wonder if her former colleagues are among the members of the PSHP who can say that they "have led in blazing new paths in hospital pharmacy management and originated clinical pharmacy programs that are recognized in Asia."*

_______________
*http://www.pshp.org.ph/static.aspx?categID=10

Quote of the day: On educating consumers on Generics Law

"There must be continuing education on Generics Law. Our consumers have yet to fully appreciate the value for money offered by generic substitutes. Our doctors and public health institutions must not negate the spirit of this law by failing to live up to their duty to inform their patients, particularly the poor, about generic substitutes."


- Senator Mar Roxas, on his sponsorship speech on Senate Bill No. 2263 to make the laws on patents, trade names and trade marks more responsive to the health needs of the Filipino people delivered at the Senate session hall on August 16, 2006.

_________________________
pinoypharmacist's comment:


Former BFAD Director, Quintin L. Kintanar, M.D., Ph.D., in recognizing the role of pharmacists, said that "Under the Generics Act of 1988, the pharmacist is not only a dispenser of drugs. He is also a teacher; he has been given the responsibility of informing the consumer what are the available generically-equivalent drug products and their prices."

He also said that "To discharge this responsibility properly the pharmacist himself must be professionally competent and must also be well-informed on the provisions of the Generics Act and the current developments in the pharmaceutical field."

Further, A.O. No. 63 series of 1989 requires drugstores, botica and other drug outlets "To inform the patient/buyer of all available drug products generically equivalent to the one prescribed with their corresponding prices. In so doing, the drug outlet shall not favor or suggest any particular product so that the patient/buyer may fully and adequately exercise his option to choose." (Section 3)

So, you see how confident and ready the government was about the role of pharmacists when they drafted the implementing rules of the Generics Act. It seems, however that WE WERE THE ONES WHO ARE NOT READY.

But wait... Although Michael Tan (in his article, Generics again) observes that " drugstores don't always inform consumers about the possible choices", he admits that he "sees some hopeful signs around generics" based on his own experiences in buying medicines.

Reference:
http://news.inquirer.net/common/print.php?index=2&story-id=53269&site-id25&col=81

Labeling our patients' medications

In giving orientation to new interns, I always emphasize the importance of labeling "loose tablets and capsules" properly and in accordance with the requirements of A.O. 63 series of 1989 (Section 3, no. 3.2) not only for the sake of compliance but because it is the right thing to do to ensure the safety of medications for our patients.

My lecture on the subject matter includes powerpoint presentation of drug labels improperly (read unprofessionally) done that were collected from community drugstores and hospital pharmacies.

In one of this orientation lecture, an intern revealed to us that the pharmacist in a community drugstore where she had her internship reprimanded her for completing the information on the label simply because it took her longer to fill the prescription order.

What a disgusting way to train our interns!!!