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Friday, April 8, 2011

The 15-Minute Guarantee

It is official.  The profession of pharmacy has finally succeeded in minimizing the profession part of our jobs in exchange for rebranding ourselves as an oil change place.  It's like trying to outdo the 9-minute ab workout by creating an 8-minute ab workout.  At an oil change place, all they do is pull a plug, let it drain, then fill it with new oil.  This is exactly like pharmacy; you bring us something empty and we just put pills in a bottle, right?

The way the system is supposed to work is the prescription is entered immediately at drop-off.  With usually one computer located here, this means everyone will now be waiting in line to drop off instead of waiting for it to be filled (and the clock doesn't start while you still hold your Rx).  It's like a shell game where you move something without the audience catching you.  Like everything else, the devil lurks in the details--only 3 Rx's, excludes Rx's needing ordered, prior authorizations, contacting your doctor, calling insurances, etc.  Hell, anymore I have to contact doctors because they still haven't learned how to write a correct prescription.  (I just had two separate doctors send in scripts with a control and non-control on the same blank in two hours and one was clearly marked "not for controls".)  Anyway, I cannot wait for people to come into my pharmacy and say they want it in 15 minutes.  We usually average 20-25 minutes during even peak busy times, but I also have to deal with technician call-offs, peak business before and after holidays, the full moon syndrome, big storms, and radiation fears, etc.  On top of all of this, what happens when we catch a mistake or serious interaction?  The same thing that happened when, despite being on the market for nearly 20 years and always prescribed as 5ml BID, I received a Tussionex script written TID-QID.  Called the doctor and got yelled at by the patient that he had to wait because my job was just to fill whatever his doctor wrote.  Yep, and now I have to do it in 15 minutes if I work at that Harrisburg-based company?  NO thanks.  Now would this then nullify the guarantee?  Do you think in this relatively minor case the patient would understand or care?  Do you think he'll bitch enough about the inconvenience and the only reason he went there was for the "guarantee" and he'll end up getting a gift card anyway?

With all the work we have to do, do we really need to add a layer of stress over every Rx we fill that if we don't meet the guarantee it'll cost me $5?  What happened to us?  What's next, pharmacy staff getting docked pay/raises/bonuses because they had too many waits over 15 minutes and had to give too many $5 gift cards?  Trust me, they can and do track that sort of thing over there.  I believe in a better solution, pharmacy world.  I believe we can hire a fairly qualified technician at $10 an hour.  This would keep us going faster and provide the assistance needed to get everything done that we need.  That's the equivalent of only two(2) missed "guarantees" an hour.  I think most pharmacists I know would much rather have an extra body in the pharmacy to lower stress than to have to meet a guarantee with fewer people and much higher stress.

The funny thing is, in the promotional ads for the guarantee, they explicitly say "we care about your health and wellness".  Really?  How can you claim that?  That's like saying I care about your weight, go sit in my waiting area and enjoy the free Diet Coke and donuts I set out for you.  Just like McDonald's is a health food store, right?

If they really cared about these things, they'd hire better tech help, make it easier to hire and fire based on job performance, pay them better, and just give pharmacists the help they need.  They, like many other competitors, issue coupons for gift cards with the transfer of a script.  This brings in a short-term bump in business, but not a long-term growth solution.  Inconceivably, they of course do not schedule accordingly for these bumps.  Add these coupons to understaffing and a guarantee and it's simply a recipe for disaster.  And with the high cost of health care to work there, the least they could do is provide free blood pressure medications to its staff.

Simply put, we are just whores.  The oldest profession in the world.  When we stopped respecting ourselves, we stopped being respected.

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