Updated August, 2007
My thoughts on this subject have changed quite a bit since I first wrote this series in March of 2005. Then I was not a fan of hospices that use the large “mail order” hospice pharmacies, now I believe that those pharmacies may be the best option for many hospices.
Your hospice is in charge of providing all medications that are needed to control the symptoms associated with your hospice diagnosis. With that charge comes a lot of responsibility. Your goal is to have your pain controlled. The hospices goal is to control your pain in a cost effective manner. I used to think that a hospice that was willing to hire an out of state pharmacy was a sign that the hospice was more focused on the cost control side of medication than the pain control side. While that instinct may not be 100% wrong, I am sure it is also not 100% right. What I have learned in the past year and a half is that there is one thing that is much more important than where your hospice purchases the drugs.
The thing you need to find out about a hospice and its pharmacy is how good the pharmacist is. The national mail order hospice pharmacies pride themselves at having pharmacists who specalize in hospice type drugs. They spend time and money studying the types of problems hospices face and the drugs that can best solve the problems. It is this type of drug knowledge that you want for the hospice you choose.
No, this does not mean that you should choose a hospice just because it uses a mail order pharmacy. (I’m still not convinced that they are a great option for hospices. What it does mean is that a great hospice is going to have a real relationship with its pharmacist. You are looking for a pharmacy/hospice relationship that entails much more than just filling perscriptions. No matter how good a hospice’s nursing staff may be, there are times when they are going to need some serious research help. Being able to call your pharmisist, whether he is around the corner or in another state, and get well educated answers to serious questions is a key to good hospice care. Not every patient is going to need that kind of research or knowledge, but some patients require all the brainpower a hospice can find. Having real access to a pharmicist with some serious brainpower is one thing that really allows a hospice to care for its patients.
There are four more parts to this series. Next, find out why size matters