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Should pharmacists evaluate the practices of physicians?

To the Editor.— The letter of Dr Taylor 1 introduces an issue that should be of concern to physicians, namely, the increasing evaluation of their practices by nonphysicians. Apparently this pharmacist initiated a review of antibiotic prescribing at his own instigation without any input from a physician. The major focus of the review was to detect whether "less expensive antibiotical alternatives" could have been selected. The author concluded that there were "preferred alternatives" based on culture and sensitivity reports. The selection of antibiotics is based on more than just a culture and sensitivity report. Often therapy must be initiated before such information is available. When the patient is seriously ill, the physician needs to be confident that he has provided broad-spectrum coverage against many potential pathogens. Failure to do so could result in the patient's death. When laboratory reports become available, the physician may not feel comfortable in changing to