Many of us who work in the community pharmacy practice setting are more than familiar with various quota systems and metrics. But are these metrics and a focus on numbers creating dangerous situations for patients?
A current News 3 story about a former CVS technician raises some questions related to the metrics and quota systems that are commonplace among the larger pharmacy chains. Is the current push towards volume pressuring stores to experiment with dangerous practices simply to keep the prescriptions flowing quickly?
According to the news report, a former CVS pharmacy technician in Las Vegas is making some serious allegations against CVS Caremark in an upcoming lawsuit. The former employee accuses the company of pressuring pharmacists into changing dosing strengths and quantities without the prescriber’s consent.
The technician also accuses the drugstore chain of instructing store level staff to automatically enrolling all birth control prescriptions into CVS’s auto-refill program without the patient’s consent. If the allogations are true CVS could be facing serious trouble.
My first instinct is to wonder if this was an isolated problem or if there is a wide-spread problem at CVS pharmacies. Did one district manager encourage the changing of dosages and strengths simply to boost their territory’s numbers or is there a broader problem?
If true, the allegations behind this pending lawsuit demonstrate just how far drugstore chains will push employees to boost their metrics. The games of speed and volume have replaced accuracy and patient care as primary goals.
The culture of numbers over people is simply dangerous and scary. Pharmacists can’t be expected to meet the demands of our job if we are forced to work in an environment where volume and metrics are the only measuring sticks for success.
The existence of quotas, and their influence on store level practices and policies, could create an environment where patients are at risk. What happens if company policies are in direct conflict to a pharmacist’s ability to complete our jobs? Who is at fault when these policies result in misfills or harm to patients?
To give CVS the benefit of the doubt, maybe this specific story is simply a disgruntled former employee taking out their personal frustrations on CVS? But what if the allogations are true? What would that say about the current state of community pharmacy?
I would never make assumptions about dosing changes or strengths on a prescription order simply to save time. Even if an “honest mistake” is made by a prescriber and I can predict with a good amount of certainty what a prescription should have been, I will still call the prescriber to confirm the order. That is my job as pharmacist!
Pharmacists must take care not to assume anything with a prescription order. And any company who even implies that it is OK to change aspects of a prescription without a prescriber’s consent is simply wrong.
Metrics aren’t necessarily bad. But when they become the sole driving force behind policy decisions, patient’s lives are put at risk. And when quotas are created to pressure pharmacies into meeting those metrics, safety is abandoned in the name of volume.
Take note CVS, people are watching. If what this former technician says is true, you will have a huge problem on your hands. Hopefully an investigation is forthcoming that will reveal the truth behind these allegations.
It’s one thing to encourage the growth of a business through efficiencies and good operating practices. But to push volume and speed at the expense of safety is simply wrong and dangerous.
What do you think? Could these allegations against CVS be true? If so is this an isolated incident or is there a widespread problem that needs to be addressed at CVS? I’m afraid if I found out the answers to these questions I’d be scared for the future of community pharmacy.
The Redheaded Pharmacist