Expand Pharmacist Roles to Reduce ER Visits

Photo: Alef Perez
Our ERs are vast improvement over this kind of
third world medicine illegals get in their own countries.

As I have recently experienced during a recent ER visit in northern Virginia, many cases presenting themselves are cases of sniffles of illegal aliens and their children who use the ER as their primary physician because ER visits are free to them, paid for by the U.S. taxpayers.  

A seven-year study just released on January 10, 2019, by the University of Waterloo in Canada found that pharmacists could dramatically reduce ER visits by “incorporating them with an expanded scope into the community or hospital emergency departments,” thus reducing the overcrowding of emergency rooms (ERs).

Wasem Alsabbagh and Sherilyn Houle found that “almost one-third of non-urgent Emergency Department (ED) visits in Ontario were for conditions that could potentially be managed by pharmacists with an expanded scope of practice – available in other jurisdictions in Canada.”

“Overcrowding in EDs is a concern most Canadians can relate to, and we know that it can lead to increased mortality and a higher rate of patients who leave without receiving treatment,” said Wasem Alsabbagh, a professor at the Waterloo School of Pharmacy.

He added, “Our findings support that we need to see more pharmacists working with expanded scope in community practice or based in the ED. This may reduce crowdedness and free more resources in EDs to care for more acute patients.”

After the researchers examined data from 2010-2017 of all Ontario hospital Emergency Department (ED) cases, they found that one in five patients who sought emergency care had non-urgent health concerns. Such unnecessary visits could have been potentially managed by a pharmacist.

To ascertain the percentage of non-urgent care, the authors of the study used standard scales that measured the severity of the patients’ symptoms and used statistics to determine which cases could have been managed by pharmacists “working with an expanded scope.”

In the last decade, various provinces in Canada have allowed pharmacists to write prescriptions for minor ailments. Such is the case of Alberta where, since 2007, pharmacists were allowed to write prescriptions for minor illness, to renew prescriptions, to administer injections, and to give vaccinations.

In Ontario, in 2012 and then in 2016 pharmacists’ roles expanded and they could renew prescriptions and administer flu vaccines and others.

“Our study included all expanded scope services in use across Canada when assessing which Emergency Department (ED) cases pharmacists could manage,” said Alsabbagh. “Over the seven years of the study period, we found that pharmacists with an expanded scope could potentially have managed nearly 1.5 million cases in Ontario.”

What conditions could a pharmacist with an expanded scope of practice treat? According to this study, skin-related problems like dermatitis, coughs, and inflammation of the ear canal, nasal passages, and throat were some of the cases that could have been managed by a pharmacist.

The Journal of Research in Social and Administrative Pharmacy published Wasem Alsabbagh and Sherilyn Houle’s study called “The Proportion, Conditions, and Predictors of Emergency Department Visits That Can Be Potentially Managed by Pharmacists with an Expanded Scope of Practice.”https://uwaterloo.ca/pharmacy/news/pharmacists-could-dramatically-reduce-er-visits

As more doctors retire in this country, less students study medicine due to its difficult, long, and expensive training, nurse practitioners’ and physician assistants’ roles expand, and more doctors are brought from third world countries and medical schools, could pharmacists’ roles fill the vacuum and expand beyond vaccinations in the United States where Emergency Rooms (ERs) are equally crowded by minor cases? How would they define minor cases? What would the medical licensing boards and medical schools do under such circumstances? Would pharmacist training and medical liability have to change?

 

 

 

"Free" Education With Strings Attached

If you think college tuition is expensive now, wait until it is free. Two years of “free” community college sounds wonderful, even though some students who just graduated felt cheated that they did not get it “free” and, in the name of fairness and justice, retroactive reimbursement was immediately demanded.

The President announced that two years of junior college will be free if “you are willing to work hard.” Was he referring to working hard to keep up stellar grades or doing community service in exchange for “free” or subsidized tuition? Surely even liberals must understand that nothing is free, somebody must pay for it, it is basic economics. There is an opportunity cost attached to any choice made. Not to mention that the government is going to dictate the curriculum taught in these junior colleges and there will be subliminal deliberate indoctrination.

Since liberals run education, it is really easy to search for ulterior motives. As Thomas Sowell said, “The real motives of liberals have nothing to do with the welfare of other people. Instead, they have two related goals – to establish themselves as morally and intellectually superior to the rather distasteful population of common people, and to gather as much power as possible to tell those distasteful common people how they must live their lives.”

How much is this generous “free” education going to cost U.S. taxpayers? The initial estimation is $60 billion, however, with everything that the government does, the price tag will escalate to much larger levels. The $10 billion the government lost on bailing out GM and Chrysler, not counting the forced loss to private investors, pales by comparison to how much taxpayers are going to lose with this “free” community college education.

Heritage Foundation’s Lindsey M. Burke reports that students with “C” average or better, will have three-quarters of the cost paid by our government with hopes that states will cover one-fourth, saving students $3,800 in tuition costs per year. This sounds like the Obamacare promise of saving families $2,500 a year in premiums. That worked out really well.

What’s going to keep junior colleges from increasing their tuitions, knowing that the government is paying the tab, Burke wonders. Federal subsidies should decrease, not increase. “According to the National Student Clearinghouse Research Center, only 20 percent of community college students transfer to four-year schools, and only 72 percent of those will have finished or remained enrolled four years later.” http://dailysignal.com/2015/01/09/free-community-college-anything-free/

Rush Limbaugh suggested on his show that perhaps President Obama is offering this “freebie” because he wants the young vote; maybe he wants to sweeten the financial pie after young people are going to have to fork over penalties for non-compliance with Obamacare, pay taxes on the subsidies, and lose potential W-2 tax refunds to IRS collection.

Who says that everybody is college material or is actually taking classes to learn? Some do it in order to defraud the government. One colleague mentioned 19 students who enrolled with a government grant through one of the community college programs, collecting over $20,000. By the end of the semester, the 19 students had passed a total of 12 semester hours even though the courses chosen were very easy. None returned. The following school year, the same people attempted to enroll in a community college 550 miles away with the same intent of fraud.  Because the two community colleges had academic ties, contact was made, and it was verified that the very same 19 were involved.

William Voegeli was quoted in the Blaze, “It sounds like what we’re saying is that…since the K-12 education system is doing such a questionable job on behalf of most of our students, what we’re really going to have now is a K-14 educational system. We’re going to have a fifth and sixth year of high school.” http://www.theblaze.com/blog/2015/01/12/is-president-obamas-free-community-college-plan-an-indictment-of-americas-education-system/?utm_source=facebook&utm_medium=story&utm_campaign=ShareButtons

There is a model of extended high school in Germany. The students who wish to pursue a college degree must attend a five-year high school. The rest either go to technical schools, apprentice schools, or are trained by various companies who foot the education bill.

Who says that a college degree is worth much anymore? Lately it’s like attending a bastion of liberal insanity. If you are interested in classes and degrees in studies of race, gender, environmental justice, social justice, and other non-sense degrees that will leave you unemployable after four years of expensive college tuition, and you don’t care that free speech is suppressed, then college is for you.

My education was theoretically free in Romania until, after two years of college, I decided to move to America. Why should capitalists benefit from my education, I was told? Suddenly my free education was no longer free. The communist party decided that I had to pay back the cost of everything, elementary, middle, high school, and two years of college.  Thank God I did not go to kindergarten and day care, my parents were too poor to afford it, it was only free to communist party elites’ children.

How much was it all worth, I asked? At subsidy rates, it was about $250 in 1978 dollars.  I got a good education, minus the socialist/communist indoctrination, so the price was more than reasonable even though we were dirt-poor. The college tuition in the U.S. at that time was about $600 per semester in a state university.