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

• 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?

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

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

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

• How can any large pharmacy organization be blamed 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?

• 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?

• 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?

• 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!