I was going to keep my mouth shut on this – but there have been too many PO’d pharmacists for me to do so on social media (particularly LinkedIn groups–not to mention personal debates) about this article. Furthermore, the reporter was cool with me personally, so while I’m here to defend no one in particular, I did want to set the record straight. (And no, I didn’t see the article before it was published.)
Yes, that was me quoted in the article, as I previously posted on this very blog, under bullet #3. But – since I disagree or see how many of the bullets could be misinterpreted, let me go ahead and share my point of view on this article, bullet by bullet.
1. New doctor – Uhm, last time I checked, we were on track for a major shortage of general practice physicians in this country. So–someone has to pick up the space where the general practitioners can’t. That means clinics. That means immunizations. SO WHAT if drugstores are actually installing primary care in some shapes and forms? I think that is a good thing, because it makes healthcare more accessible, and keeps costs lower vs. everyone going to the most expensive spot to get care, the Emergency Department. As to the reimbursement by insurance companies – that, frankly, is between insurance companies and employers–not pharmacists. Next…
2. Death of the drugstore – I respectfully disagree with the entire premise of this bullet. ACA has really nothing to do with how busy pharmacies are these days. Guess what – because the average number of scripts per patient has gone up, people are living longer, AND people are pharmacy shopping across multiple pharmacies now to get the ‘best deal’ on prescriptions, we get to try to do drug utilization review without knowing every medication a patient is on (so it’s next to impossible to check for drug-drug interactions), battle with the insurance company online to get reimbursed for the claim, and MAKE SURE that patients are getting the right drug, in the right dose, and that the patient doesn’t have any allergies or contraindications to it. If that takes 45 minutes for my script, or any family member’s script, I’m FINE with coming back to pick it up. Prescription drugs are NOT lattes.
3. Raise – Here’s where I was quoted. And while pharmacists on average make great money, the physician salaries here are WAY TOO LOW. You can’t lump general practitioners with surgeons or specialty medicine doctors salaries either – it just doesn’t work–way too wide a standard deviation. And my point simply with my quote was this: We as pharmacists are happy to take on additional work–but we should get paid for it. That does NOT mean we are money grubbing self-serving people–that means that no other professionals give away their services, so why should we? (And think about that every time you get a $4 prescription filled.) Don’t get me wrong – I love my profession, but haven’t we in pharmacy kind of shot ourselves in the foot by giving away prescriptions BELOW cost?
4. Private secrets – Duh. What wasn’t really mentioned here is that we are bound both by HIPAA and HITECH Acts, not to mention professional ethics. Next…
5. Take your meds – Another duh. Medication adherence is the #1 problem in pharmaceutical care and pharmacy practice today. Furthermore, it is true – hospitals with readmissions will be penalized – so why shouldn’t community practice pharmacies team up with hospitals to try and make sure patients take their medications to AVOID returns to the hospital? It’s in EVERYONE’S best interest for patients to properly take their medication–not just pharmacists, not just doctors, and not just hospitals.
6. Magnet for dealers – Unfortunately, this is true. Indiana has the dubious honor of being #1 in the country for armed pharmacy robberies now. So–not only do we get to do everything I mentioned in bullet 2, but we also get to play detective/cops and robbers to try and supersleuth through forged prescriptions, legitimate prescriptions, etc. on top of drug utilization review (DUR) and patient med safety issues. I went to school to be a pharmacist – not Nancy Drew.
7. Pay out of pocket – See my comment about $4 prescriptions above. If you want to use pharmacy as a loss leader to get people into the store to buy other stuff, rock on…but personally, I don’t think pharmacy has anyone to blame but itself for competing on price alone. When we started selling prescriptions below cost (i.e. $4), we did it to ourselves.
8. Medicine to order that might kill? – To make a leap from Tamiflu all the way over to meningitis and generic compounded sterile injectables is WAY too oversimplistic a leap to make here. USP 797 alone is a diatribe. Pharmacists have entire classes on compounding and sterile compounding in pharmacy school. This leap on this bullet is way too breezy to be legit when it comes to the myriad of issues around compounding, sterile compounding, and inspection of pharmacies–foreign or in-state–by boards of pharmacy. Furthermore, I think a reason why we have generic injectable drug shortages is that manufacturers can’t afford to manufacture them anymore – and make a decent enough profit to continue making them drugs–so America, which is it that we want–cheap drugs or safe drugs? We can’t necessarily have both. Last–what about all the pharmacies out there that are playing by the rules, serving their customers, and serving unmet needs?
9. Food and nail salons in pharmacies – Who cares? Besides, if it is healthy food, I’m good with that – as pharmacies SHOULD be focused on both prevention and treatment and wellness!
10. Meth – it’s a problem. A HUGE problem, to the point where I personally think we need to make PSE a prescription-only drug, and maybe even a controlled substance. I also don’t dig that there is a specific, special process by which we have to sell PSE in pharmacies. Why are we creating an entirely DIFFERENT process to sell ONE drug in the pharmacy? We shouldn’t. If you really want to deter smurfing, just make the drug prescription-only, then let us do our original jobs. (See bullet #6 – I’m not in the cops and robbers business.)
And of course, whether or not we sell it for $4 is entirely another matter.
There. I’m certain there are pharmacists out there who may disagree with the reporter–I do in some aspects as outlined above. I’m just pumped there was an actual article on pharmacists, who often get left out of the conversation when it comes to healthcare (yeah, who was the last person you saw on national television talking about a drug – was it actually a pharmacist?) I’m sure there are pharmacists out there who disagree with me personally. Cool. That’s why we live in a free country. I believe I was the only pharmacist quoted in the article–I’m sure there are thousands of differing opinions out there.
Agree or disagree, do yourself a favor if you’re a pharmacist reading this, especially if you’re angry about it: write someone. Write about the truth in your blog. Write about how you feel in a letter to your Congressional reps. Talk to an actual reporter about what it is that you do. Write to anyone who will listen to set the record straight. WRITE SOMETHING TO SOMEONE. Otherwise–you’re just going to keep on waiting for someone else to write your story (if it is written at all)–and it may not turn out the way you want it.