Free Diabetes Medication
All across the pharmacy blogosphere, pharmacists and technicians have complained that these developments in retail pharmacy are steps on the road to the end of the profession as we know it. Pharmacists are being devalued by giving away product and professional services for free, and it seems like there's nothing we can do to stand in the way of our corporate masters instilling these plans.
I'm going to just lay it out there as I see it, and you can agree, disagree, discuss it, whatever. The retail pharmacist is on the way out. I don't know how much longer it will be before it happens, but I truly feel that it will eventually happen and probably within my working lifetime.
Let's just take a step back and look at how retail pharmacy started.
Back in the day, retail pharmacists possessed one special skill that no other professional had. Pharmacists could compound medication. A physician would write a prescription for a specific ointment, solution, or other dosage form that needed to be specially prepared before dispensing to a patient. Pharmacists filled that role. They were needed. No one else had the training to make complicated compounds. It was all up to the pharmacist.
As the years passed, drug manufacturers started to make their own pre-packaged dosage forms. Slowly, the need for specialized dosage forms for patients decreased as most patients could be treated using the manufactured products. Compounding started to go away, but the convention of a retail pharmacist remained. Doctors still wrote prescriptions, and pharmacists still filled those prescriptions. However, instead of using their specialized skills, they simply pulled a product off the shelf and stuck a label on it.
To make themselves feel more useful and professional, the notion of counseling on medication came along. Pharmacists felt they really should be doing more than sticking a label on a bottle, so they decided that their new professional role would be medication counseling. However, medication counseling isn't something that is unique to the profession of pharmacy. Doctors can counsel patients on medications. So can APRNs, physicians assistants, nurses, and pretty much any health care professional. You might be able to make an argument that a pharmacist undergoes more intensive schooling about drugs than any other health care professional, and therefore, they are best fitted to provide counseling. Regardless, unlike compounding, counseling is not a skill unique to pharmacists.
It shows too. Feel free to disagree with me, but from my perspective, I do not think that most retail pharmacists are presently capable of providing medication counseling to patients above and beyond any other health care provider. Some retail pharmacists take an active role in learning as much as they can about medications out of either curiosity or a feeling of professional obligation. Most others are just happy to count by five all day, and for the most part, their employers will let them. I think reading pharmacy blogs gives us a skewed perspective of the sense of professional responsibility and enthusiasm that most pharmacists have.
In my experience, most just want a paycheck. They got into pharmacy because they liked the idea of getting paid big bucks to count out pills all day. I'll admit that's the reason I went to pharmacy school. It looked like a really easy job that didn't have a whole lot of responsibilities except to not kill someone. Obviously, I wasn't quite correct, but my point stands. Most retail pharmacists do not choose the profession for the same reason that people choose to become doctors or nurses. Most retail pharmacists didn't choose retail pharmacy because they thought they were providing health care. They chose it because it was a science profession that got paid well and was on the outskirts of health care without actually being health care.
Again, I'm generalizing. This isn't why ALL retail pharmacists chose the profession, but in my experience, it really seems to be why the majority did.
Most pharmacists would rather not counsel. Now, if a law came out and forced pharmacists to counsel, I'm sure most of them would do so out of fear of losing their jobs. However, I think most pharmacists are just hoping that every customer that comes to pick up medication checks that little counseling denied box.
Since retail pharmacy is run by giant corporations like CVS, Walgreens, and Walmart, you can bet that unless there's some money involved in counseling, no corporation will truly start an initiative to promote counseling on all medications. Since giant corporations rule health insurance in this country, you can bet that they'll do very little to help pharmacies get reimbursed for standard counseling on all prescriptions. Unless some kind of law gets passed that absolutely demands counseling on all new prescriptions (and that law will be fought tooth and nail by the big corporations), you won't see big chain pharmacies really forcing their pharmacists to counsel. They'll pay lip service to the public, but their corporate policies will actually discourage services that don't provide monetary benefit.
If pharmacists are not compounding, and they're not really counseling, what purpose do we really have? Why do we get paid so much when essentially all we get paid for is to fill prescriptions? The answer is that we don't have a true purpose in the current pharmacy model. We're superfluous, unnecessary. Our 6 figure salaries are the biggest thing standing in the way of those giant corporations making more money. Since we no longer offer a service no other health care professional can provide, we can be phased out in favor of less expensive labor in the form of trained pharmacy technicians and increased use of robotics.
Is the elimination of the retail pharmacist the best thing for the public? Absolutely not. Mistakes will increase, and even if we are not using our clinical knowledge all that much, the fact that anyone who has gone through as much difficult schooling as a pharmacist has to have a certain degree of intelligence and responsibility that would serve well in any job. However, what's in the best interests of big corporations is rarely what's in the best interest of the general public. The corporations will try to make more money in any way they can, and customers will adjust to whatever future changes are made to the current retail pharmacy format. For all the talk about how the United States is the land of the free, the vast majority of the general public seems to simply adjust and accept whatever choices are taken away from them. If the corporations change and offer no other choice, the American people will go along for the ride. They might complain a little. They might say they liked things better the old way, but in the end, they'll just roll with the punches. Therefore, don't expect the public to put up much of a fight if retail pharmacists are greatly reduced or eliminated altogether.
I feel like I'm in a race against time. I truly think the days of the retail pharmacist as we know them are numbered. However, I don't know how much more time we have. Therefore, I'm hoping that my job will last just long enough for me to figure out what else I can do with my life that would provide some kind of service or benefit to the general public. I'll admit that if I thought the job would last forever, even as much as I don't believe in what I'm doing, I'd probably continue doing it simply because it pays well enough for me to live a nice, comfortable life. I don't think it will last forever though. I'm not even sure if it'll last another 5 years (for a variety of factors not just corporate elimination of pharmacists). There has to be something else I can offer that few others can. I think that's the secret to job security.