The Des Moines Register from Des Moines, Iowa • Page 13

LETTERS Sl April It, 1913 THE DtS MOINES RFCISTFR IJA Doctors vs. pharmacists Do government regulations create baby-sitting problem? KAIIILCtiJ RICIUWDSOIL By BRUCE POWELL MAJORS details of running a rural health clinic. The logical conclusion of this should be considered aides who are competent to follow physicians' written orders for a 7-day supply are then competent to follow orders for) a 30- or 60-day supply. Thomas R. Wolf, Richland.

Regarding) The Register's well- written editorial concerning the drug-dispensing legislation which now stands before the Iowa House: The editorial served a useful purpose In clarifying some of the misinformation which surrounds this issue. I'd like to dispel several other I AM AN avid reader of classified ads Not only the kind found in newspapers. Outside of the Personals column, newspaper want ads are sane, serviceable, serious filled with 1973 Chevies, air conditioners and German shepherds. The real connoisseur of classifieds reads the ads huddled in the backs of magazines. Newspaper want ads are in the business of selling things: ideals, crazy schemes and bizarre Ways of life.

The big, color spreads for Scotch and underwear that grace the fronts of magazines are designed by the advertising establishment, the movers and shakers in the mezzanine of capitalism. The classifieds, on the other hand, are run by the guys in the cheap seats. Magazine classifieds are a keyhole through which you can spy on a whole weird, whimsical underground world. I started out by reading the ads in the "women's" publications. The magazine articles discuss the intricacies of combining marriage, motherhood and nuclear physics; the classifieds are in touch with what women really want to know: how to increase your bust size, whiten your teeth and spark up your sex life with skimpy myths.

First, this bill does not represent "special-interest legislation." Iowa currently lacks a well-defined drug-dispensing law that can be uniformly applied to govern the distribution of potent, complex and potentially dangerous drugs to our citizens. Attorney General Thomas Miller in fact, urged the Legislature to enact legislation to resolve the current state of confusion relative to Iowa's drug-dispensing law. Second, contrary to statements made by representatives of the Iowa Medical Society, this legislation would not prohibit physicians from delegating non-judgmental dispensing functions to their assistants, nor would it require physicians to provide "over-the-sboulder" supervision of these non-judgmental tasks. To the ALU contrary, the bill specifically allows the delegation of non-judgmental dis I am a family practitioner In a small Iowa community and I would like to respond to your editorial In the April 6 Register, "Doctors v. Pharmacists." Insofar as the "72-hour emergency rule" Is concerned, I do not feel that this clause would provide a workable compromise for this issue.

For the elderly who must usually depend on family and friends to provide transportation, it would simply mean that after 72 hours, they would again have to beg transportation in order to obtain a larger supply of medication. The same is true of working parents with young children, for example. During my 32 years of family practice in this community, there has never been an error more grave than the miscounting of a few pills as a result of dispensing medication from this office. On the other hand, I could cite a number of errors of considerably greater magnitude made by pharmacists in filling my prescriptions. My office staff uses the same care and dedication in carrying out my orders as any doctor has the right to expect from nurses in a hospital.

Pharmacists usually do not elect to locate in small towns. The primary reason for this may well be that small towns with one doctor, or no doctor, usually cannot provide an adequate livelihood for a pharmacist Kenneth N. Andersen, M.D., 121 Summit Center Point. I I wholeheartedly agree with the I'Doctors vs. Pharmacists" editorial on April 6 about the dispensing bill in the Legislature.

One issue that was not stressed, however, was that prescription drugs are often dispensed by physicians or their assistants without being properly labeled with the name of the drug or directions for taking it and probably all other pharmacists, have from time to time had someone come to us, show us a tablet or capsule they had received at their doctor's office, and ask what it was and how often should they take It They had been given neither written nor oral directions. Dispensing physicians should make Sure their prescriptions are adequately labeled and patients are counseled as to their use, just as pharmacists are required to do. This bill should not be construed as an effort to promote pharmacists' economic gains or as an attempt to impose an additional burden upon physicians. It should be supported by all of us in the interest of the public's health and safety. Stephanie Hig-by-Baker, pharmacist; 3000 University, Apt.

1 69, Des Moines. There will be changes in medical care in rural Iowa if the proposed restrictions on drug dispensing by physicians becomes law. Let's not have rural Iowans ask, 10 years from now, what happened to our small-town doctor? If these unnecessary restrictions are placed on him, he will vanish from the scene. If this scenario happens, the blame can be placed squarely on the shoulders of a majority of our legislators. The House committee action require her to replace her four smoke detectors with a five-unit integrated fire-detecting system, at a cost of pensing functions.

HER CONTINUING lament that funding of the welfare state is not expanding at as high a rate as it once did, syndicated columnist Ellen Goodman $2,000. The Iowa Medical Society has taken the position that physicians lingerie. They offer to help you become a mode! (or just look like one), choose a "fat camp" or learn shorthand by mail. The Puritan work ethic is alive and thriving in the ranks of the classifieds. If the ads in fashion magazines are paeans to self-improvement, the classifieds in food mags preach the joys of self-indulgence.

Pamper yourself with rare spices and exotic vinegars, order nuts from Morocco and whale blubber from Alaska. Take cooking lessons from "Lorenzo the Magnificent," who will teach you to do marvelous things with mozzarella. Needless to say, magazine classifieds generally do not deal in the necessities of life no apartments for JLLrecently discussed the issue of government funding should be granted the legal authority of day-care centers: "It's the poor, especially the working poor, who face an to delegate the total drug-dispensing function to anyone they deem appropriate, even when the physician is These are not isolated cases. According to Kathleen Murray, a lawyer at the Child Care Law Center in San Francisco, regulations effectively barring entry to the home day-care field are common. In California, for example, one must comply with the building codes issued for schools.

Among other things, this would mean having increasingly grim picture. In the past year, between cuts In federal funding and state budgets, families have lost subsidies and centers have lost funds. The single largest day-care program, Title XX, was cut $3.1 billion to $2.4 billion." absent from the site of dispensing. In the interest of public health and safety, the pharmacists of Iowa cannot accept the wholesale dispens separate bathrooms for boys and girls, both of which would have to be accessible to wheelchairs. Goodman's liberal perspective is not the only perspec ing of potentially dangerous drugs by As a result of these restrictive features of child-care-center regulation, many working parents complain that people with little or no pharmaceuti cal education whether they're as tive on this and other feminist issues: In freedom, Feminism, and the State," an anthology of libertarian feminist writing, recently published by the Cato Institute, feminists Lynn Kinsky and Sharon Presley argue that convenient, reasonably priced child care is not available.

How does the bureaucracy respond to this need? Kinsky sistants of physicians or of pharma and Presley point out in their essay that when the gov cists Thomas R. Temple, government regulations have created the child-care executive director, Iowa Pharmacists Association, 8515 Douglas, Des ernment sees the lack of child-care facilities (caused by government restrictions), it steps in to fill the void at costs far in excess of what perfectly adequate private Moines. crisis. Zoning laws, unnecessary and pointless 'health and safety' restrictions, required licensing that is difficult to obtain all combine to assure that people will not be able to get together to provide low-cost child care on their own." child-care could be provided for. Typically a large portion of the cost gf child-care centers goes to line the pockets of The letter from pharmacist J.C.

the bureaucratic administrators or to pay rent on unneces Thompson (April 7 Register) reveals In the Washington area alone, a number of private sarily expensive buildings. A movement is under way to end this regulatory burden They offer to help you become a model (or just look like one), choose a 'fat camp' or learn shorthand by mail. The Puritan work ethic is alive and thriving in the ranks of the classifieds. how little he, and perhaps other phar macists, understands the role of other day-care facilities have been closed recently because of the inability of the women running the facilities to comply with burdensome government regulations. Anne Bersinger, deputy director of the California Department of Social Services, says she may even propose that allied health-care professionals.

Judith Heintz had run a very successful center, The her state institute total deregulation. People who wanted He describes the pharmacists' role as being more important than "processing blood for analysis," ap Shoe, in her home, for several years. A neighbor had to establish private day-care centers could register with private certification programs, if they wished, and Heintz center closed under a 1925 ordinance forbidding businesses in residences. parently not realizing that if blood is In Damascus, Susan Suddath had kept children in her home for more than 17 years sometimes as many not processed and analyzed correctly, the resulting information given to the physician could be erroneous and lead to the wrong prescription being written. This will harm the patient no as 20 when she could employ neighbors or relatives as assistants.

The children in her care entered the public" schools at competence levels up to two years ahead of other children. She was recently put out of business, matter who dispenses the drug or how much patient education occurs at the parents who valued a particular certification program could look for the centers endorsed by it. Perhaps liberal feminists like Goodman should pay more attention to the ways in which government intervention in the economy reduces opportunities for women, instead of automatically asking for more intervention when past government programs do not produce the desired results. A growing body of economic literature suggests that the burdens involved in raising children contribute to the problem of lower average-wage rates for women. A greater supply of day-care services would obviously be part of a solution to this problem, but that may happen only when liberal feminists realize that government is not the answer.

however, by regulations limiting the number of children that can be cared for in a private home to four in the day, time. or six after school hours. The health-care system in our state works well because each of the many professionals involved does his or her In Potomac, Sylvia Thorpe, another home day-care entrepreneur, was faced with regulations that would part conscientiously and expertly. rent or used pickups for sale. We're talking conspicuous consumption here.

For example, my token home-decorating magazine, House and Garden, has gone even more upscale on me; where they once ran ads for( gingham curtains, they're now hawking crystal frogs delightful little frog to collect and Yugoslavian patio furniture and discount 18th-century French armoires. But by far the most entertaining of Bruce Powell Majors, who writes frequently on feminist None can function optimally without issues, wrote this article for the Cato Institute. the contribution of the others Thomas J. Persoon, laboratory supervisor, 1012 Twentieth Coral- modifying! the proposed legislation allowing physicians' assistants to give out a 7-day supply of prescription drugs to patients reflects Insufficient understanding of the operational ville. (Letter also signed by four The gentleman strikes it rich others.) classifieds are found in such "coun Teaclters and productivity terculture" magazines as Rolling Stone and Mother Jones.

Here is where you'll find satellite insurance By PHIL GAILEY and WARREN WEAVER JR. (whether to protect your satellite or yourself, I cannot say). classes. Parents of children learning the skill of reading would prefer that their children be in classes of 20 rather than 30. A teacher has a better chance to produce readers if shehe For sale are tips on how to "garden UNTIL RECENTLY, the only gambling Patrick Leahy had ever done was to run for the Senate as a 0 Js? without "negative ionizers" to has a reasonable class size.

cure your allergies; plans for setting up "non-sexist, non-racist, gentle cultures based on cooperation. During the past several decades, the workplace for teachers has not equality and environmental concern" (God could have used these folks on Democrat in Republican-leaning Vermont. Leahy was in Las Vegas recently for a speaking engagement with a Republican colleague, Senator Charles Mathias Jr. of Maryland. At the airport, where they were waiting for their flight back to Washington, Mathias asked Leahy if he had played the slot machines.

No, Leahy replied, the sixth day). You can buy a kit to build your own geodesic dome (it is earthquake-resistant, energy-efficient and mows its own lawn). Use Astro-Carto-Gra-phy to chart your own geographical he was not a gambling man. Mathias set in on him, finally persuading him to invest a quarter in a low-rolling fling with a one-arm bandit. power points (it guaranteed), and get in shape by summer (that's guaranteed, too).

Or buy a pocket Geiger The gentleman from Vermont dropped a quarter into one of the Ian Binnie, in a recent commentary, accused educators of being drags on productivity. As an educator, I do not consider myself an expert on productivity. However, I do know enough to realize that Binnie omitted several basic facts relating to productivity. Binnie stated, apart from farmers, who are drowning in the results of their productivity, there is no real evidence that Iowans as a whole are more productive than residents of many other states." Binnie might have pointed out that the nation's farmers are the most productive workers in the whole world. However, each American farmer is supported by 152,000 worth of productivity-enhancing equipment.

Each American farmer has modern technical support that is superior to any other worker in the world. In addition, each blue-collar worker in this country is supported by nearly $26,000 in production-enhancing equipment Economists correctly point out that American industry is falling behind in productivity because it has not kept pace in automation and will have to be retooled if it is to be competitive. Meanwhile, the average classroom teacher has support of less than $500 tvorth of production-enhancing equipment. In the building where I counsel, 35 teachers share the services of one part-time clerk. The clerk has one typewriter, one ditto machine, one mimeograph machine, and one copier.

All 35 teachers share one telephone. The building is without a computer terminal. Binnie also equated teacher-pupil ratio with productivity. He suggested that increased productivity could be generated through larger elementary airport slot machines, pulled the lever and turned away to say, "See, I never win." Before he got his words out, the bells went off and $50 in quarters poured out of the machine. Leahy fell on his knees and began stuffing coins in his pockets.

changed substantially, but it must. Considering the differences in productivity-enhancing equipment, could it be said that Iowa teachers are the most successful workers in the state? I think so! Miles A. Browne, president, Des Moines Education Association, Ingersoll Des Moines. Jepsen meeting Many of us who attended the lobbying effort in support of the nuclear freeze in Washington, D.C., last month were disappointed that Senator Roger Jepsen would not or could not meet with our delegation for any reasonable amount of time. Now I believe it was could not, rather than would not, which prevented our meeting with Senator Jepsen.

On April 8, Senator Jepsen Invited me and five others) to meet with him in his office in Davenport to discuss the nuclear-freeze proposal. The senator alloted 45 minutes of his time to discuss this issue with us. We had a lively and informative dialogue with him Senator Jepsen and our group did not reach a consensus, nor did we persuade him to vote in favor of the nuclear freeze. However, we appreciated the time he spent with us, the dialogue we had with him, and the attention he gave to his constituents. Paul Koupp, 402 Cass KeoMaqoa.

A few minutes later, the senator set off an airport metal detector. Advised by security personnel to put his pocket change in a plastic tray and walk through again, Leahy filled nine counter to help you keep tabs on the radiation levels in your back yard. You can buy natural clothing, natural shoes, natural vitamins and natural highs. Your T-shirt can be politically blunt is a head or artistically evocative (sport Camus or Kafka or Moby Dick). And when you just have to get away from your non sexist commune and your radioactive back yard, take a politically aware vacation.

Talk to the peace people of England; visit the centers of resistance to the deployment of Pershing II. Maybe, if you're lucky, they'll let you into East Germany. (Whatever happened to Father Pat and his trip to the Vatican?) Every so often, I'm tempted to order some of these crazy things say, a thimble with a geopolitical map of the world on it, or a T-shirt with Jean-Paul Sartre's picture. But thus far, I have restrained myself. 'Some dreams are better left trays with quarters.

Inside the boarding lounge, the senator was explaining his luck to some of the other waiting passengers. Deciding to show them just how it had happened, he walked over to a nickel slot machine, put in a coin and pulled the lever. The bells went off again and $20 worth of nickels came spilling out. With that kind of luck, some of his colleagues are saying, perhaps Leahy should run for president. Phil Galley and Warren Weaver Jr.

REGISTER ILLUSTRATION BY TOM WEINMAN write for The New York Times..