Tuesday, June 1, 2010

Frustrated with pharmacy management

A couple months ago I came upon an advertisement in one of the pharmacy magazines that caught my eye. It was for an electronic unit that could be placed in the OTC aisle of a pharmacy. Basically the patient would input their symptoms and voila! the computer program would recommend the appropriate OTC product.

My first thought was what right-minded pharmacist would put that in their pharmacy? People already think that all we do is put pills on a bottle and slap a label on it. Now the clinical expertise for selecting the correct over-the-counter medication is being reduced to a few taps on a touch screen.

I can tell you which pharmacist decides to put that in the pharmacy. The one who hasn't actually practiced pharmacy in 15-plus years. The one who forgot about the profession as he/she advanced up the corporate ladder, striving for a more prestigious title/position within the corporate hierarchy. The type of pharmacist who decides that, rather than freeing up the pharmacist to counsel patients on OTC products over the weekend, the pharmacist (and pharmacist only) should be calling patients on Saturday afternoons to remind them that there are medications that they haven't picked up yet.

Basically the corporate yes-man who happens to have RPh after their name.

It saddens me that pharmacists who are promoted beyond the store level seem to forget how pharmacy actually operates. But that seems to be the norm for pharmacists who are not actually practicing pharmacy. They think of ideas that might have worked back when they were in a pharmacy, but have no chance of working now.

I recently filled in at a pharmacy in my chain that fills five or six hundred prescriptions per day. The pharmacy was attempting to counsel each and every new prescription that came through. My state only requires the pharmacy staff to offer counseling on new prescriptions. But this pharmacy was doing it for all of them in response to a directive from above. That means Mrs. Johnson was being detailed on the digoxin and furosemide that she has been on for the past seventeen years.

Now we did have three pharmacists working ten-hour shifts that day. That is about the only positive thing I can say. But on a day when there are 300 hundred new prescriptions going through the pharmacy, it's going to be hard to counsel each one.

In my experience, it takes four or five minutes to counsel a patient adequately. Using four minutes for the math, we would spend 1200 minutes counseling patients during the day. Twenty hours of counseling. That leaves ten hours for pharmacists to fill the 500-600 scripts. That works out to 20 scripts/hour/pharmacist. And that's not allowing time to consult on OTCs, call physicians, go to the restroom, etc... I think you get the picture.

Maybe in a pharmacy that fills 125 scripts per day. You know, the kind of volume the former-pharmacists-now-managers were filling 15 years ago before they abandoned the profession. But not in today's pharmacy where, thanks to poor third-party reimbursements and $4/free prescriptions, we are forced to crank out the script volume just to keep the pharmacy in the black.

I don't know.... I'm just getting extremely frustrated with the job. Non-pharmacists telling pharmacists how to practice pharmacy (I have a specific example in my local area that I might expand upon later... it will make your blood boil). State boards of pharmacy bowing to the pressure put on them by corporate entities. Pharmacist organizations totally ignoring the realities faced by the majority of pharmacists in the work force.

Maybe I need to change professions and take on something with a little less stress. Anybody know what it takes to be an air traffic controller?


Anonymous said...

It's been a little tricky defining the issues that really matter, and we've been going for the visceral complaints--that we'd hope the common man would understand, like no lunch, or having to wet one's pants, etc., this type has been more esoteric in quantifying but equally irritating to a pharmacist who's been used to 'sucking it up' in the area of ethical treatment.

The Redheaded Pharmacist said...

Personally I think that if you haven't filled a prescription since the Carter administration like some of these corporate heads you shouldn't be allowed to call yourself a pharmacist anymore. And with all of the idiotic decisions that they make it is obvious to everyone who actually works in pharmacy that they don't know what they are doing!

Unknown said...

don't frustated with pharmacy system, optimis think..

olga spathis said...

This is just another ploy by "monopoly chains" to ride the pharmacy coat. I think there is a song out there some rapper sings "riding me dirty". I am sick of it. We have allowed this to happen. I know one time- I had a patient that I was counseling and all of a sudden out of nowhere some woman jumps in and starts giving her advice. MOST pharmacists would have kept their mouth shut. All of a sudden "electra" jumped out of me and I said, " Excuse me are you a licensed health professional?" She answered NO- "Don't ever interupt a licensed health professional counseling a patient again, I will sue you for maligning my character in public and for undermining my authority and putting a patient at prospective risk for issues you know nothing about". She snickered at me and then went and complained to the MANAGER- the manager then came to me and I was lucky she was an african american woman. She says, the customer complained about you and said you talked bad to her- I said,"Listen, stop riding me dirty and riding my lab coat (I worked with a lot of inner city folks so I have since learned the rap jargon- which I have come to well....sort of use when dealing with certain socio-economic groups) that woman interferred with medical counseling and I won't have it.....No one ever bothered me again....no one ever questioned my authority and when I said something it got done....of course, the sweet side of me has been affected through the years. You have the right and it is your duty to take a hammer to such a machine because you can not control what type of edit specifications are on the computer, who maintains it, what company created it and if it is not fda approved in some manner (the edit specifications of the computer program must conform to electronic data capture approved by certain fda guidelines) THEREFORE what you can ensure to be 100% accurate is a liability and is detrimental to the health of the patient.......PR with the home office an corporate must stop. In one year you will be hearing my name- after I open my store there will be a pharmacists UNION and there will be a whole new group of pharmacy MARINES which I will get together to attack such infringement on our profession and the health of our American citizens. Enough is enough....I only ask you pass the word on and keep in contact with me.