The Angry Pharmacist wrote a great blog entry regarding the realities of retail pharmacy. I couldn't agree more with what he said, and I encourage everyone to check it out. I just had a few of my own thoughts that I'd like to add.
Since I started working as an intern during my second year in pharmacy school, I've been saying that pharmacy school teaches you everything except how to be a pharmacist. They overload you with pharmacology, therapeutics, medicinal chemistry, etc., etc., but they give you (at least they gave me) only ONE lecture over a 4 year professional program about the business side of pharmacy.
In retail, the business side of pharmacy is what keeps us having jobs. All those professors can lecture about patient care and medication therapy management all they want, but in the end, if pharmacies are not filling prescriptions, they're not getting paid.
By the way... Under the MTM model, just how many patients would we have to counsel an hour to make it profitable. A pharmacist is making almost a dollar a minute. How much are we looking to charge for these MTM sessions, and would we be able to have enough sessions to make up for a pharmacist's salary? I didn't even include the cost of all the time spent keeping records of our MTM sessions, nor did I include the cost of supplies (charts, storage bins, new computer software, etc.) to do so.
Moreover, does MTM mean that we stop providing medication counseling to everyone else? We used to do that shit for free, so under MTM if Mrs. Old Lady calls up with some questions about her medication, do we tell her she needs to make an appointment? I'm sure that will go over really well. One of the big reasons that the public looks so favorably upon pharmacists is that we're the most readily available source of health care information. With a simple phone call, anyone can speak to a drug expert within minutes. You start restricting what kind of information pharmacists can give out for free and suddenly, we're not any different from any other health care professional. However, if you want to set up MTM and don't put up any restrictions on free information, then what's to stop people from not setting up appointments and just demanding whatever info they can get over the phone or when they get their mandatory counseling upon picking up a new script? It's all very confusing.
Pharmacies fill prescriptions. That's how we get paid. That's the main service we provide to the public. We do our very best to make sure that every prescription that comes through the door is dispensed safely and accurately. In most cases, we are the last line of defense against medication errors. Every time we correct a prescriber's mistake or catch a potentially dangerous drug interaction, we are potentially saving someone from harm or (in the worst cases) death. In doing so, we save the health care industry probably billions of dollars per year by cutting down on serious adverse reactions and potential malpractice suits. That's the pharmacist's role in all of this.
Many people are worried that we'll be replaced by technicians or robots because it would save our employers money. Perhaps this is a real worry, but MTM isn't the answer to that either. If Walgreens or CVS wants to save money by taking pharmacists out of pharmacies, then why would they want to spend the extra money to have a pharmacist do MTM?
Furthermore, even the very best technicians cannot fill prescriptions as reliably as pharmacists. My store has a nationally certified technician that, by all accounts, is very very good at her job. Even still, I catch and correct a lot of mistakes she makes inputting scripts. Sure, technicians can type what they see on a script and fill it that way, but they can't ask the most important question, "Does it make sense?" A robot can't do that either. Only a pharmacist has the education and training do to so, and that's why we're vital to the success of the business as well as the safety of our patients. Our task is to make our employers understand this instead of trying to change the way we do business.