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Why Do These Pharmacy Laws Exist?

While every industry has its unnecessary regulation, various government agencies (both Federal and state), standards agencies, payers, and middlemen have created a web of regulation in pharmacy so complex it's enough material for an entire website just to help pharmacies sort it out (ahem.....yours truly).


All of us would agree that some or even most of it is necessary, but others are the bane of my existence (yes I do still comply though). They are a waste of time, produce no meaningful information that cannot be obtained elsewhere, and they pull us all away from doing what we were trained to do.


To celebrate their faithful contributions to wasting our time, I'm presenting each of them with the PharmCompliance Medal of Stupidity!


GOLD MEDAL

CSOS Archiving

The enforcing agency: The DEA


It was a fierce competition for gold, with so much stupidity in the running, but at the last minute CSOS Archiving pulled through!


I was afraid with the DEA eliminating triplicate forms he might not make it, but he worked hard to prove just how idiotic he is.


Yes, Federal law requires that, in addition to:

  • The wholesaler reporting to ARCOS (the wholesaler's version of the PDMP);

  • The pharmacy electronically receiving the medications in the wholesaler's website;

  • The pharmacy printing a copy of their CSOS order, then signing and stapling it to their paper invoices and filing it for at least two years (or longer in many states . See our honorable mentions!);

  • 99%+ of pharmacies also logging the order into both a paper log and a computerized perpetual inventory,

Pharmacies must also save a .pdf copy of their CSOS order and upload it into their own electronic drive (again, for at least two years).


Who knows? Maybe one day the entire ARCOS system will go down, the wholesaler's site will crash, and the pharmacy will burn down (along with all that tinder called 'invoices') and the only thing left will be your hard drive that somehow survived the burn. And, after all that, the biggest thing we'll need to know is how many bottles of oxycodone you ordered a year and half ago.


PLEASE.....make it stop.


SILVER MEDAL

The "Daily Signature Log"

The enforcing agency: The DEA, and most state Boards.


"Mrs. DSL," as we'll lovingly refer to her in this post, put up a tough fight for the gold. Ultimately, though, she is easier to make a part of our opening and closing procedures than Mr. Archiving is (I think he got he got an honorable PhD, so maybe he's 'Dr. Archiving'?).


Still, though, she presents a completely worthless additional step in our day that also provides pointless fodder for inspectors. I personally really like our state inspector, who has just asked me to be sure going forward that everyone is signing it (we were missing a few signatures once out of 3-4 inspections we've had), but I can definitely see an inspector with a power trip going to town with this.


I guess the supposed point, though, is that you are 'attesting that everything is accurate,' whatever that means. I haven't personally met a pharmacist who would purposely make an error, and regardless attesting accuracy is completely meaningless and, in a court case, our liability would be judged through professional duty, not Mrs. DSL.


That leads me to think - maybe Mrs. DSL is there to keep track of who is working that day?


But how, might you ask, without our chicken scratch in a notebook could we ever know who was working that day?


In case someone is reading who can make Mrs. DSL go away, here are a few ideas:

  • Our electronic time cards

  • The security cameras

  • The workflow history in the pharmacy dispensing system

  • The other staff working that day

  • Patients

  • Our initials on the quantity part of the label on a C2 (99+% of pharmacies double-count and initial, and many only allow pharmacists to count C2's).

  • The printed initials on the back-tag of the prescription

  • The initials on the perpetual inventory log

  • The initials on the temperature log

  • The initials on the Vaccine Consent Forms

As with Dr. Archiving, though, you can never be too sure. We better keep signing that notebook in case all else fails!


Until this law can change, if you want Mrs. DSL to be as little of a hassle as possible, check out this one available for download. Print that sucker off and you're set for a year of fun.


BRONZE MEDAL

Printing and filing non-controlled electronic prescriptions

The enforcing agency: State Boards of Pharmacy


Notice the word 'electronic.' I should stop here, because that should be enough to know where I'm going with this, but I'm having too much fun, and plus it's my site anyway!


To all you BOP's out there - I know you all have pharmacists on them, don't you? Aren't many of you even still working in a pharmacy? Why are you making us all do this?


While it's true that, without printing an electronic prescription you wouldn't know if you have a complete book (i.e. are missing a paper prescription), let me propose to both you and the pharmacy IT industry how to fix this: