Nowhere in the Pharmacist's Oath is there a discussion of units-of-service.
Regularly I need to take pause and contemplate the evolution of our pharmacy profession. Recently I experienced a situation in our clinic pharmacy that caused me to question the meaning of units-of-service.
Late in the afternoon this young lady presented to our pharmacy with a couple of prescriptions from the local community hospital emergency room. This particular patient was from another county, so, when she was discharged from the emergency room earlier in the day she thought it would be reasonable to go to one of the familiar chain store pharmacies.
Throughout her afternoon she visited 2 of these stores, both times being turned away without her medications because her insurance was not currently active in this county. She was sick, needed medication, so she headed back to the hospital and found her way to our outpatient clinic pharmacy.
As expected, after processing the prescriptions, we also received a message that her insurance was inactive. At this point, we took a moment to ask the patient about her living status. She explained that she had just moved into this county and her insurance had not yet been transferred.
This sounded like a perfectly reasonable scenario so I asked my technician to make a phone call to the patients insurance and see if anything could be worked out. After a few minutes on the phone, the insurance had granted a one time override to cover the patient until her insurance could be transferred from the prior county to her new county of residence.
This was not a big deal for us. The entire process took 10 minutes and did not interfere with our normal workflow. Why had she gone to 2 other pharmacies and no one had offered to help her resolve her insurance situation?
It is my opinion that the pharmacies were just too busy to try and help her. This is certainly not the fault of the hard working pharmacists or technicians. As pharmacists we are all aware of pharmacy-metrics or units-of-service. During any given time frame we have work flow metrics that need to be met. We all have a que of prescriptions that need to be typed, verified, filled and dispensed.
Who has the time to help a patient who has just relocated into a new county and is having insurance difficulties? Any effort that takes the pharmacist and the technician away from performing the necessary functions of a well-run pharmacy will lessen the overall productivity and decrease the units-of-service for the day.
As a pharmacist in his 30th year of practice, I understand the pressure we face on a daily basis. Workloads are increasing, regulations never end, and it feels like a new medication enters the market place every single day. This is the time we need to remember the first sentence from the Pharmacist’s Oath we took on the day we graduated pharmacy school.
I promise to devote myself to a lifetime of service to others through the profession of pharmacy.
In July of 2007 the American Association of Colleges of Pharmacy adopted the new Pharmacist’s Oath. Reading through this document, there is mention of the welfare of humanity, optimal patient outcomes, ethical and legal standards, continuing knowledge, and a host of other excellent measures.
Nowhere in the Pharmacist’s Oath is there a discussion of units-of-service or pharmacy-metrics. Tomorrow when you go to work, give yourself a moment to pause before walking into the pharmacy. Reflect on what it might look like to practice in a world without metrics. Then, walk in the door and allow yourself the opportunity to be available.