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Friday, February 7, 2014

Dear State Board of Pharmacy...

I would like to introduce myself. I Am The Cynical Pharmacist. I have had a blog for a couple years and moved it to Facebook a little over a year ago. I started with the tenet that everyone is out for themselves when it comes to pharmacy. A while later I discovered it is mostly true among patients, doctors, and corporate pharmacies. For now I would like to focus on my unofficial, but highly conclusive, results from my time on FB.

First, pharmacists need a "return to sender" button for electronic prescriptions. We receive more errors on these prescriptions and this results in a majority of wasted time trying to figure out what the doctor intended. From hold times with office staff to waiting for them to call us back, electronic prescribing is not the savior it was expected to be. I believe we as pharmacists should be allowed to charge the offices a fee for repetition of the same mistakes. Eventually one of these will not get caught and the pharmacist will get in trouble. The prescribers refuse to learn how to fix the problems on their end. (See FB post dated 10/7/13.)

Second, corporations do not care about prescription errors. Of course they have workflow designs in place to minimize them. What I am talking about is the additional work we are supposed to incorporate into our days while working with minimal tech support. Pharmacists need a study to be done to define a minimum pharmacist-to-technician ratio. Corporations should be required, by State Law, to obey these. There should be studies done for stores with drive-thrus, for those that perform MTMs, and during flu shot season. If you wish to run a pharmacy in our state, you must obey these rules.

Third, coupons or other incentives for pharmacy-to-pharmacy transfers should be immediately outlawed. Many states already do this and some even limit the number of times a prescription can be transferred to a single transfer. Inconvenience to the patient? I am sorry, but if this is what the law says, then that is the law. People will adapt. They'll get over it.

Fourth, I am tired of being told how to do my job by the AMA and prescribers. Many offices post signs or have outgoing messages that say "call your pharmacy and they will request refills on your behalf". Wrong. I never agreed to that. It used to be a courtesy. I want to know how and why we allowed ourselves to be taken advantage of in this manner.

If we truly care about our profession, it is about time we as a profession stand up and fight for our rights and our patients' rights. We are tired of getting yelled at by customers who turn around and cry to corporations who reward them with gift cards. This has to stop. We are tired of being the whipping post for prescribers and the AMA. We are tired of calling offices to verify error-filled prescriptions only to be told "it's a glitch, oh well" and being responsible for bailing out the prescriber when she picked the wrong drug/strength combination from the drop-down menu or she didn't erase the default directions only to have them act as if this happens all the time. Their flippant attitude could mean serious consequences if the pharmacy is not on the ball. The only way for us to ensure acuity is to minimize distractions. For this to happen we need a group to have a backbone to tell patients and prescribers and corporations "this is how it has to be!".

If you truly wish to see what a day-in-the-life is like for retail pharmacy, I invite you to check out my FB Page. I have over 66k people across the country and around the world who are all telling the same stories. We all know the issues. The chief complaint I receive is "nothing is going to change as long as we just sit here and complain". We need to act. We need to take our profession back. I am constantly asked when I am going to do something about it. Today. Today is the day I write to all of you and beg for a meeting, a conversation, a meeting of the minds to radically change the direction of pharmacy.


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