If we can pull components of a combo meal by assembly line, why can't we do the same with simple pharmacy orders?
If we can pull components of a combo meal by assembly line, why can’t we do the same with simple pharmacy orders?
What if the technician took a prescription order and then, after transcribing it on the computer and printing the labels, finds the medication bottles and, just like French fries, transfers what looks like 30 tablets into a vial and affixes the label. Trusting that what the prescriber wrote was appropriate for the patient, the pharmacist simply verifies that the correct medication was filled by the technician and then gets it out to the patient as quickly as possible. Seems easy enough, right?
If you work at a retail pharmacy, you know the technician and pharmacist do more than just transfer pills from a bottle into a vial and label it.
First, patients rely on insurance to cover most if not all the cost of their medications, and dealing with insurance issues takes time. Some of the medications prescribed aren’t always in the insurance’s formulary, so the pharmacy team members attempt to reach out to the prescribers and, when successful, work with them to switch to an alternative so patients don’t have to pay as much.
Second, medications run out and sometimes aren’t available until the next day. Medications are expensive, and from a business perspective, it’s unwise for the pharmacy to order a lot of medications that aren’t prescribed as often because the non—fast-movers sit on the shelf, expire, and have to be discarded.
Last but not least, all medication comes with safety precautions. It’s not like soda where patients consume it in one sitting and can get a refill right away. To ensure medications are taken as prescribed, patients must wait until they’re almost out of the supply before their insurance allows them to get another refill. When the refills are up, patients rely on the pharmacy to reach out to their prescribers to request additional refills so they won’t have to schedule another physician visit. This can take some time because some prescribers are difficult to reach by phone and don’t always respond promptly to faxed refill requests.
A lot could go wrong if retail pharmacies ran like fast food restaurants. If the technician doesn’t take the time to count the number of tablets, the patient could receive less medication than prescribed. If the patient receives more than prescribed, the pharmacy loses money.
If the pharmacist doesn’t take time to evaluate whether what was prescribed is appropriate, in the off chance that the prescriber made a mistake in the medication, strength, or directions, the patient could be ineffectively treated or harmed. The patient could overdose if no frequency is specified other than “as needed.” The patient could be under-dosed daily if the prescribed calcium supplement isn’t divided into smaller doses that can be maximally absorbed.
If the pharmacist doesn’t take time to counsel, and it’s the first time the patient has received the medication, the patient may not fully understand how to take it, where to store it, what to expect, and when to follow-up. Certain common adverse effects have quick fixes and some shouldn’t be of great concern. But, if patients aren’t made aware of these things, they can experience more distress and end up paying for unnecessary physician visits.
So, the next time you wonder whether things could be streamlined and whether the pharmacy would benefit from an assembly line, just remember all the personal attention that goes into evaluating and filling a single prescription. And remember that it’s someone’s health, not just lunch, that’s being ordered.