Hacker News new | past | comments | ask | show | jobs | submit login

1) Did they believe that the medicine would harm the patient & why would they believe that? If there were any evidence it could, surely that would have been bought up loudly.

2) Is there a secret handshake or QR code we should be using to separate this new sort of "good doctor" whos prescriptions are good from these "bad but qualified doctors" whos prescriptions are bad? I have naively gone all these years believing that qualified doctors could prescribe treatments but it seems that there is some uncertainty on that point. How would you separate the two without relying on your own opinion?

3) If we are relying on our own opinion anyway and doctors can't agree, why is it the case that patients with the prescription can't make their own decisions based on their own risk tolerances?

4) Doesn't the prescribing doctor have a better understanding of the patients needs and situation than a pharmacist? The pharmacist isn't exactly doing an in-depth interview to make their decision, they stand at a counter and hand out drugs.

I'd put it to you that the behaviour of this hypothetical pharmacist refusing to fill a prescription ... is pretty poor. Verging on outrageous.




1) "The FDA and CDC are explicitly saying not to take this for COVID" is a fairly significant form of evidence.

2) Who said anything about picking good/bad doctors? The prescription and the patient are what's being evaluated. A good doctor can make mistakes; a bad doctor can write plenty of reasonable prescriptions worth filling.

3) Because we've tried that as a society. It's where the term "snake oil salesman" originated. We decided correctly that it was a sucky setup.

4) My pharmacist has caught a drug interaction my doctor didn't. They likely have a more accurate record of what I'm currently taking, as well. You seem to be mixing up pharmacists and pharmacy techs; perhaps a visit to https://en.wikipedia.org/wiki/Pharmacist would be appropriate.


1. Well, ok, but that is a different argument. You said that a pharmacist could refuse a customer in cases such as when the medicine caused harm. Is there any evidence that this medicine caused harm? We all know a bunch of people said not to take it, that is not something anyone is going to argue about.

3. So why are pharmacists immune to being snake oil salesmen but perfectly qualified doctors giving out prescriptions can be snake oil salesman? Is there something wrong with the system that qualifies ordinary doctors?

4. Are you suggesting that the reason the pharmacists were overriding this prescription is because there is an interaction with Ivermectin? I feel pretty confident you'd come off the worse if we check, but I'll admit I haven't.


1. A pharmacist might justifiably believe giving a medication to someone when the FDA and CDC have explicitly said not to is a form of doing harm; that they've got good reason to make the recommendation. They, like medical doctors, are empowered to make judgement calls.

3. Strawman. I don't doubt that there are ivermectin-flogging pharmacists just like there are ivermectin-flogging doctors. Your question was "why is it the case that patients with the prescription can't make their own decisions based on their own risk tolerances?"

4. Your question was "Doesn't the prescribing doctor have a better understanding of the patients needs and situation than a pharmacist?" I answered that; they do not always, no; this fact is part of the reason they exist.

This goes a lot smoother if you follow the chain of the questions you asked through to my answers to them, rather than mixing up the context with a blender.


1. They certainly might, that is why I'm typing all these questionmarks. What is the justification for why it might cause harm?

Overruling a doctor's prescribed treatment is a pretty extreme action. Drawing a rough parallel to abortion, I can see how they might choose not to carry Ivermectin and call it a day. But if they are selectively not filling prescriptions for political reasons, that is outrageous. There is no evidence that Ivermectin will cause patients harm. If they then took horse paste, there is evidence that the pharmacists stubbornness is causing more harm. It is better for people to take drugs under the supervision of a doctor.

3. You've had 2 goes at answering the question and you are struggling to even take a credible guess at how the prescription might have caused harm. And we know a doctor might think it is a fine thing to prescribe speculatively. But I think you have more problems than just that - it looks a lot like you're comfortable with the idea that a pharmacist can overrule a doctor and a patient based on gut feel and no evidence. Literally no evidence, given your responses so far. Are you really comfortable with that crazy stance? You don't think it is reasonable that patients trust and follow their doctors advice?

4. So in this specific case, do you think that the pharmacist suspected an interaction? Because I feel pretty confident you'd come off the worse if we check, but I'll admit I still haven't. The filling of Ivermectin scripts somehow became a political rather than a medical issue and this pharmacist is probably acting politically.




Join us for AI Startup School this June 16-17 in San Francisco!

Guidelines | FAQ | Lists | API | Security | Legal | Apply to YC | Contact

Search: