Pharmacists are essential and often unappreciated members of medicine. When I had chemo I could not stop vomiting, I tried 8 different medications, smelling alcohol wipes, everything. The doctors said I was out of options. My retail pharmacist fixed it in under ten minutes. She spoke to me about what medicines I was taking together and wrote me a schedule of what to take when. I ever vomited again. She fixed the worst part of chemo when the doctors didn’t know how.
I have a very similar issue you did. I have Lupus meds that make me so violently sick, but my doctor kept saying that since the nausea meds didn’t work, I should just learn to deal with it. Luckily my pharmacist heard me complain about not being able to eat. She taught me what to eat first and how much water to drink and things to avoid. I still have a bit of nausea, but I’m so lucky to be able to eat again. The meds I’m on seriously saved my life and allow me to walk again so I can’t imagine having to live without them.
Just to clarify, PharmD requires four years of professional school with as little as two years of undergrad. Most obtain a PharmD after 7-8 years beyond high school. Most speciality pharmacy positions like the ones mentioned (onc, ED, peds) require a general inpatient PGY1 residency and then a second PGY2 residency in that specialized field.
Your channel sets the standard for medicine on RU-vid. Thanks for all the great content, Dr. Feinstein! If I had it all to do over again, I would have gone into medicine and anesthesiology. The ship has sailed for me but its great to see so many amazing young clinicians to take care of us all in the future!
Hi Max! Thank you so much for providing a behind the scenes look into the world of anesthesiology. Although, I'm from another country (Hungary) I can just hope that our hospitals and doctors have the same level of professionalism as you have. I had 7 surgeries so far, 3 knee surgeries (keyhole/laparoscopic) and 4 surgeries related to a ruptured appendix. My CRP level was 396 when I was admitted to the emergency room...I'm lucky to be alive. Huge thanks to the anesthesiologists and surgeons working on my cases. And please keep uploading new videos. :) Your sense of humor is phenomenal.
Great interview ! Spot on. I’m a pharmacist who works in an OR pharmacy. I can attest to the wonderful rapport we have with our anesthesiologists and anesthetists. We also looked at having machines for dispensing in each of our OR suites. You mentioned the inability to interact with someone for issues going on in the OR. Add to that the expense of the machines and medications needed to stock them. Also increase in workload to maintain and stock all those machines. I would definitely miss all the folks who come to the window to pick up their drugs.
I'm a hospital pharmacy tech and we have dispensing machines. I view them as a faster way to get medications to patients, and there is less of a need to jump back and forth to get meds. They are filled with a sufficient amount daily. Also, they make tracking controlled meds easier. You would not have to return them everyday. There isn't much workload if enough staff is in the pharmacy. They are usually stocked once daily.
@@rmccabe916 All you have said is true. When I consider our OR techs and all they do - they would not have time to tend to 27 machines - one in each OR and 4 more in Endo plus all they already do. Management is looking at taking one of our techs away from us. They are trying to get rid of FTE’s.
That sounds awful. Drug quantity in our machines is remotely monitored, which makes our job easier. Our pharmacy handles about 13 ORs and 150 patients, with about 30 Pyxis total (part outside ORs). OR machines are usually smaller, and the filling process is quicker than inpatient models. Pulling meds to fill is primarily the longest process, but you don't have to do it per patient, just each machine. And it makes charting a whole lot easier for doctors.
This is interesting to see how a different hospital does this. I am an inpatient pharmacy technician at another large hospital in a different city and we have pyxis in all of the ORs. The night shift are the only people that actually go there so we never really interact with anesthesiology unless they run out of something or need something particular to be brought up during the day.
Much respect for pharmacists, they do the quality control that sometimes your doctor might miss. It’s important to have a good relationship with your local pharmacist. It could be life or death.
Max, I absolutely LOVE your mindful approach to economics of medical practice. While that aspect is not as critical as efficacy from a purely medical standpoint, it does have a tremendous impact on patients after discharge. Thanks for caring!!
Thank you for spending some time going into the controls preventing abuse. Whenever I see Dr. Feinstein pull a tray... I always wondered what was preventing someone from just sneaking into the OR and pulling a vial from the tray. I'm a little surprised residency isn't required for licensure.
Wow! That was awesome! The OR pharmacy is very important! I learned a lot! I really wanted to be a anesthesiologist physician, I really enjoy donating to the anesthesiologist Foundation, since it was hard for me to go to college because of my cerebral palsy! You rock man
KONICA MINOLTA KONICA MINOLTA KONICA MINOLTA4217 PLASHETWARD LONDON 18th JANUARY 19th FEB PLASHET WARD LONDON 18th JANUARY 19th PLASHET WARD LONDON 18th JANUARY 19th PLASHET WARD LONDON 18th JANUARY 19th
Having learned a lot about behind the scenes stuff that goes on between my brother-in-law who’s a clinical engineer in charge of the mapping equipment during heart ablation surgeries and my sister who’s a clinical engineer in charge of equipment installations at hospitals I am always fascinated by learning about other behind the scenes aspects of things that go on in hospitals, so thanks for sharing this great information with us!
At 13:40, please note there was an error regarding qualifying to become a pharmacist in the US. Currently, there is a *four year* PharmD program, AFTER 2-4 years of undergraduate studies. After successfully completing the 4-year Doctor of Pharmacy degree, a comprehensive licensing examination must be completed in order for the graduate to be legally licensed to practice in their state.
You can’t forget about us pharmacy technicians we are the backbone of the inpatient hospital pharmacy on all levels. Specially speaking I am a hazardous compounding pharmacy technician at a cancer hospital (I make chemotherapy)
Love you, will be following and keeping up with you and your family. ❤ I'm so sorry, although I know that doesn't make it better. I always look forward to your videos, your voice comforts me and I love keeping up with your family
Drug abuse in hospital occurs more than you think. I was involved in two cases as a patient where 1 a nurse wasnt delivering the pain meds timely but the records showed another. I had video the clock for a 1/2 hour before and after the dose was due. The nursing director caught her. The second one was. Traveling nurse not providing the right dose. The prescribing notes were on the board in the room so i knew what i was supposed to get. She argued with me and i met with the director of the hospital in the morning. Don’t know what happened with that one. Great video.
Hospital pharmacy technician here. I completely understand the benefit to having a pharmacist to speak with in the OR if you have questions during operations. But it just would seem so ineffecient go in and out of the room for more meds at the pharmacy. Our central pharmacy staff is always available to help and is a call away. You have a good working rapport and experience with your coworkers, though. That is what really matters. Thanks for your service in the OR. 🙂
For nearly a decade, I provided IT support to a public R1 university's PharmD-based (2 years undergraduate, and then 4 years professional education) college of pharmacy, which included a research drug production facility. I had many great friends and colleagues among the faculty, staff, professional students and graduate (med chem/pharmacoeconomics, etc. ph.d.) students. Pharmacy is a truly fascinating field, I'm glad you were able to do a video with a pharmacist! 🖤💛🦅
I’m a pharmacy technician, and have enjoyed learning what the drugs do! I load them in the operating rooms all the time, but you’ve taught me how they’re used.
Geez gawd Dr Max makes one looking forward for a great trip under the spell of anesthesia drugs. Seriously he’s doing a wonderful job doing these videos. 👍
At the point you film the pharmacy's handout window, I noticed the presence of a drawer/box with phenylephrine (250ml bag, 80mcg/ml). Is That there for easy access during emergencies?
This is an excellent interview, providing good insight into quality operations of a pharmacy department at a hospital. Although I am not related to medicine, I work in an industry that is similarly "never-fail" -- or at least, that is the goal. Learning a bit about how an aspect of a quality hospital operation manages this is quite useful. Thank you.
I am an anesthesia and intensive care nurse in Germany. The dispensing of narcotics in anesthesia and intensive care medicine in Germany is the responsibility of the nursing staff. It's very interesting to see how different countries follow different laws! Thank you for this insight Mr. Feinstein. Best regards, Shimon
It’s frustrating how many people think pharmacists just count and push pills all day. As this interview shows, they do so much more. They’re an integral part of medicine!
What am interesting video. Even though I’m not a doctor myself, it’s quite clear to me everything you’re saying. This is such a good material to everyone from patients to health care professionals.
You have to do at least one more video with her!!! I'm wondering if she could talk about all the types of staff in the hospital pharmacy and how they work with pharmacists? I love your videos
Here in Atlanta sadly we find used up Fentanyl vials and they look to be licked clean inside and not that anyone cares but they must be getting stolen from a pharmacy or hospital by the box because there are lot #s and drug info on the ones we've seen. On a new home we are wiring right near old stadium every day we sweep up used syringes on sidewalk and ones stuck into lumber piles that may injure our workers even with gloves. I just happened to see your utube because I'm getting ready to have a 3 hour neck spine surgery and curious how much anesthesia will be pumped into me during procedure. Great info I was going to go to Med school but decided I'd make more as board licensed electrician and zero school loans. Now I'm regretting that feeling all the injuries I've had over the years. A+ channel.
It’s fascinating that pharmacists are so involved in the technical aspects of pharmacy in the US. RPhTs in Canada do everything, including managing & dispensing (including controlled drugs). Pharmacists are involved in clinical work on the units, they don’t even have to be in the pharmacy for the day-to-day work.
I am assuming this is just one area that is important to you---where their work allows you to do your job without having to be distracted by doing extra work. Everyday you grab meds you need---without having to do extra work to get them ready. Thanks for giving exposure to pharmacy and any other area you showcase at a later time.
My mom is a nurse and I have always thought that it would be cool to be a surgeon or and anesthesiologists, but there is no way that I could even come close to passing med school. lol
lmaoooo her reaction at the end re: pharmacist reacts to dr. glaucomflecken. "....we could." i chuckled. amazing video as always; always hoping that whenever i transfer a patient to the OR that i might meet max the youtuber! sinai pride
I recently learned that the rapper Tyga that was put under general anesthesia for an 8 hour tattoo session. As someone with tattoos, I think that's ridiculous to go under general anesthesia, myself and many others find that the pain and the process of receiving the tattoo is part of the whole experience and to "fast travel" through that seems ridiculous to me. Although to his credit, I will add I don't think I would have the patience for an 8 hour session, I'd have to break that up over at least a couple of days. But anyway, I know this is outside of your normal video type but if you got the chance to make a video just providing your point of view as an anesthesiologist, I would love to hear that. And I wouldn't ask you to attack him or anything, I just want to know, what are the medical risks of going into anaesthesia for a tattoo or is this an appropriate use for anesthesia from a professional perspective?
Not an anesthesiologist, however all anesthesia use comes with potential risks. Is the tattoo artist administering the anesthesia themselves or is there an actual anesthesiologist present? What level is being provided (local, regional, general)? Is the tattoo shop near a hospital in case things go south? How much will it cost? Numbing cream will be different to general anesthesia.
She has one of those most desirable pharmacy jobs out there. Creme of the crop literally AND in NYS. That is a tall order in the current climate for the pharmacy field.
You'd have to get through the safe first. Plus pharmacists and techs are known to be some of the biggest sticklers in the hospital. You'd have a hard time getting around us. 😠
Your videos have been really eye opening to me, thanks for these in depth discussions. I never gave much thought about anaesthesia before, however since they've made me worry about how they work. You mentioned before that the drugs that you use to induce anaesthesia are amnesiacs, however is there a chance that the patient is aware during the surgery but they simply don't remember after? It's a troubling thought I keep having, I wondered if you'd share your thoughts on this. Sorry if you've already mentioned this before on any other videos!
Just watching a video from a while ago about waking up during surgery. I had knee replacement surgery in 2009 and I remember stirring and hearing a very loud pinging sound like a hammer hitting metal. I can still hear it. I didn’t feel any pain but it was weird.
Hi Mr Feinstein, I have a question, lets say 1 of your anestrhesiologist takes pain medication namely dilaudid for back pain , and then he or she does their job and maybe the person has red eyes etc.. and dilaited eyes but its not from what they use during the procedure what would the pharmacist do then? Its not like the doctor is using the meds during the surgery but they are taking their own. Would they have to tell them they have a prescription of their own.? And how would something like that work?
My Fav Dr. on youtube, no annoying flashy editing with silly sounds, not overly produced and just the right amount of production value to feel authentic.
No wonder operations costs so much.. if each and every operation has its own tray with meds inkl every "shtf" option. Edit: if possible to figure out, how much does one tray cost :)
Part-timed it on a southeastern PA medic chase vehicle for almost 20 years, I had 2 C-II's; Pancuronium; and 3 C-IV's which required verification and recording at each shift change. That was a pain in the arse (nerve wracking responsibility) ; this??? I'd want an armed escort back to the O.R.!
Why can't we design a closed-loop security system for medication whereby access to, administration of, and disposal of exact quantities are measured? It could be done using NFC tokens built into syringes or an unremovable sleeve, in conjugation with modifications to the pump or administration device being used to detect and record the data. This would be a system that is very difficult for one individual to circumvent. I wonder why this hasn't been implemented yet.
@@MaxFeinsteinMD Ahh good ol’ reality check. Thank you for the video, I really learned a lot and became aware of challenges in medicine I didn’t even know existed. - first year med student here.
Dr. Feinstein, as a future CRNA, can you make a video regarding your professional relationships with CRNAs and the responsibilities they have within your healthcare facility? Thanks!
It’s 6 years all together, 4 undergraduate and 2 graduate. It depends on the state and the school. Some have accelerated programs, some have dual majors etc.
It’s 2 undergraduate and 4 graduate in the U.S. Current PharmD student here. (8 years all together for myself as I completed a BS in biochemistry prior to enrolling in pharmacy school.)
@@jaromirlatal177 Thank you. I framed my statement bad, It was more of an exclamation of wonder about those news than having doubts. I am used to having Midazolam standing in the medicine cupboard and not in the "drugs save".
@@FrozenFingers What country are you in? Benzodiazepines are very commonly abused drugs, and therefore are considered controlled substances in nearly all western countries, not just the US.
It’s 6 years altogether-4 undergraduate and 2 graduate. There are some accelerated programs, as well as dual majors depending on school. There are over 143 pharmacy schools in the US and you need to do your research. If I could do it again, I would chose dual majors over an accelerated program.
