A Dose of Reality

      The volume based commodity model of community pharmacy is unsustainable.  That is the bottom line. 

      I could really stop here.  I’ve already written what I feel about the direction of community pharmacy.  We can’t continue down the path we are currently traveling. 

      A myriad of factors have all contributed to the current state of our profession.  We are in the midst of a total transformation of the role of pharmacists in the healthcare system. 

      Gone is the service and professional model that community pharmacy was founded on.  Pharmacists have allowed our own role in the healthcare system to be altered or even diminished over recent years. 

       We’ve relegated ourselves to non-professional activities in the fleeting hopes of saving our existence.  More often than not, pharmacists now manage dispensing and distribution functions rather than service or professional duties. 

       It’s not like we don’t have the potential for greatness.  Our clinical background and professional abilities far exceed our output.  The role of the pharmacist is what we need to re-define, not our abilities.

        Have we taken steps to change our responsibilities as pharmacists?  Absolutely.  Should much more be done to really harness our potential and fully utilize our clinical and professional training?  Definitely. 

       Instead of allowing our profession to grow and nurture under current conditions, we’ve been content to step back and watch the healthcare system evolve around us.  There doesn’t even seem to be a unified effort to properly organize ourselves under one representative group. 

       Pharmacy has always been an interesting professional field of study.  You have highly educated drug experts who have the knowledge to manage patient care and disease management in a way that will save money and improve outcomes. 

       But in modern healthcare, pharmacists are more likely to be described as delivery personnel or the healthcare equivalent of a fast food worker.  Pharmacists are simply losing our healthcare professional title in a sea of $4 generic lists and drive-thru windows. 

       Ask youself the following questions if you are primary employed as a pharmacist in the community or retail setting:

       1.  Am I more likely to counsel a patient on any sort of disease state information or medication counseling or will I be spending more of my efforts fielding insurance inquiries and/or rewards points or transfer coupon questions? 

       2.  Does immunization services help the profession of pharmacy by expanding our roles or does it simply overburden already understaffed community pharmacies?

        3. Will community pharmacies ever break free from the stranglehold being applied by the insurance industry? 

         4.  Are there any other healthcare professionals under any circumstances who are subjected to a working environment that includes a drive-thru window? 

         5.  How can any large pharmacy organization be blammed for a lack of leadership when they fail to receive the needed support from pharmacists?  Do we support them after they represent us or can they represent our interests only after we support them first?

          6.  What happens when prescription margins continue to deteriorate in this pro-insurance environment?  Will community pharmacies be able to survive with a near zero-profit business model? 

          7.  Independent pharmacies are dying out like dinosaurs.  What happens if they disappear completely from the retail landscape and all that is left are a handful of large chain drugstores? 

           8. Can pharmacists effectively do the job of checking prescriptions, screen for drug interactions, and properly counseling patients in an environment where we are given minimal time to devote to each individual prescription order?

       I could go on and on with more questions but I will stop there.  The point is that we’re all in the middle of a very critical period in the history of the profession of pharmacy. 

         No miracle cure for the profession of pharmacy exists just like there are no quick fixes for diabetes or obesity.  But a good start for all of us would be to take a big dose of reality.  That is the medicine the profession of pharmacy needs most!

The Redheaded Pharmacist

6 Comments to “A Dose of Reality”

  1. By Mark, October 4, 2012 @ 3:54 pm

    No offense, but I’ve heard this all before. All those questions but what do you suggest as a solution?

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  2. By RPh to the stars, October 4, 2012 @ 5:48 pm

    Preach on! Our problem is no one at the corporate level is listening. 30 flu shots by noon and 230 rx’s. No wonder I don’t tweet anymore I don’t have any down time.

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  3. By Pharmaciststeve, October 4, 2012 @ 11:13 pm

    You are correct… a professional association needs two things… members who pay dues and member who volunteer.. a person is not going to volunteer… they are definitely not a dues paying member… why would a RPH even ask “what have that association done for me”.. it is not about helping the individual.. it is about helping the profession – as a whole… which will help many/most of the members of the profession.

    There has been talk of unions/guilds since I was in college… my experience with the vast majority of the profession is that we are spineless, ball less, passive pleasers… many talk “unity” but few are willing to make the commitment – financial or personal…

    The vast majority will not even document when they are told to violate/bend/break numerous laws..

    the more the individuals in the profession continues to capitulate to the corporate bullies that employs them… as the surplus of RPH continues to grow… the corporate bullies will just become more brazen…

    IMO.. you will not be able to kiss enough ass … brown enough noses… stay low enough to remain in a safe harbor and asure keep your job. Every day you start with ZERO GOOD WILL with the company… everything that you have previously done well.. is water under the bridge… if is like trying to collect water in a sieve .

    There is little employment in the state of denial !

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  4. By Shazam, October 6, 2012 @ 10:44 am

    Like Mark said, heard this all before….nothing new here. Get the hell out of chain retail pharmacy is the real answer! 40hrs/week in that fish bowl is not healthy, I cringe when I walk by it while I am shopping.

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  5. By Bluetowelboy, October 7, 2012 @ 12:05 pm

    I hate to break it to you but economic realities will eventually break pharmacies. Certified Pharmacy Technicians will take over more responsibility until they are the ones doing the final check of the prescription. It won’t be long after that before it is asked why we even need a pharmacist in every store. Similar to the minute clinic where many Nurse Practitioners are overseen by one Physician, pharmacies will be run by technicians with one pharmacist overseeing many pharmacies. Will there be errors. Of course. There are errors now and no one seems to care in the general public. When was the last time you were asked how long will it take to fill this? Probably in the last 10 minutes if you are working retail. Have you ever been asked to make sure you take your time with a script? I never have. The public doesn’t care if there are errors as long as they don’t happen to them. Half the time my patients can’t tell who the pharmacist is in the pharmacy without looking at our name tags. The public won’t even blink a eye if we disappear. There may be a small story on 5 alive news when the governor signs the bill taking us out of the prescription filling realm but that may be it. There will be talk of cost cutting and reduction of pharmacy prices and that is it, the end.

    We have to admit we messed up when Nurses were working out how to be a bigger role in the health care system and they came up with the nurse practitioner we should have been right there looking for prescriptive privileges. I mean how hard is it to diagnose strep throat or an ear infection. We could be respected but I think at this time it is just too late.

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  6. By LDPlaceboeffect, October 13, 2012 @ 2:25 pm

    As pharmacists we have a specific role in society.

    In response to BlueTowelBoy, our professional duty as pharmacist is within the realm of expertise in understanding and promoting the proper place of drugs in society.

    We are not diagnosticians of individual illness, no matter how much we know and provide information to clients that enter our drugstores seeking knowledge that we can professionally provide.

    Nurse practitioners allow expansion of the role in properly directing treatment of common ailments. Insurance companies have pushed the role of less expensive diagnosticians under the guise of ‘working under’ license of a physician, and now there SHOULD be questions about the solo practice of nurse practitioners; in ‘solo’ practice NP SHOULD be working as nurses, with the liability of a nurse, not as a physician.

    If our work conditions limit or restrict our ability to perform our professional duty to society, we bring this situation to the societal legal regulators. If we are salesclerks, our regulatory bosses are in the retail industry.

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