This may sound a little weird to you, but last month I spent an afternoon pondering whether my closet had become the sort of time-travel apparatus implied by Einstein's theory of relativity. Actually, that probably sounds a lot weird, and I should probably explain before you turn the page.
Last month I was able to collect my reward for nine months of pharmacy action: my first paid vacation of the year. I decided to make clutter clearing the main goal of my time off and dove into a collection of boxes at the back of my closet to see what could be thrown away, sold off, recycled, or otherwise shown the exit from my life. A copy of a pharmacy trade magazine caught my eye and I took a little break from my cleaning to browse through the articles.
"The chain drug industry continues to break new ground in its nationwide campaign to deliver a broader spectrum of reimbursed healthcare services to patients, managed care payers and integrated health networks," the lead article said.
I put that issue down, grabbed another, and saw this: "There's a great opportunity to work across the whole spectrum of the healthcare channel...We can cooperate with other healthcare providers and academic institutions to support research to evaluate the impact of patient care initiatives."
This is when I became concerned. Because one of those articles was written in 1997, the other exactly one month ago. Can you tell which is which?
Let's try another:
"An integrated wellness approach to diabetes care can help patients not only improve their condition, but also lower their prescription costs" vs. "New legislation authorizing payment to pharmacists for diabetes care services has sailed through the state senate."
Again, one of those quotes is 15 years older than the other. Any clue which came first?
The payment for services legislation. Are you being paid for diabetes care services? Didn't think so.
Einstein's theory of relativity predicted that time travel is indeed possible. Long story short, he concluded that if you could manage to move faster than the speed of light, your perception of time would change. That a month in your fast-moving rocket ship might seem like 15 years to those moving slower than light.
I remembered this as I continued to read and slowly began to suspect my closet had become a time portal.
"We are going to move away from the old practice of pharmacy, which was primarily transactional, to more of a personal relationship...This is a completely new pharmacy, health, and wellness experience with a focus on health outcomes."
And this, about an organization that had "taken the wraps off its long-awaited 'Pharmacy of the Future,' a radically redesigned pharmacy that unites new concepts...The new format affirms in dramatic fashion the company's intention to evolve its pharmacy practice beyond simple drug dispensing into the realm of integrated patient care and disease management."
One of those quotes is 14 years old. I'm not telling you which. Either these magazines have indeed mastered time travel, being published last month while bearing dates from the '90's, or, despite almost a generation of promises heralding a "pharmacy of the future," from the perspective of the retail pharmacist, very little has changed.
Sadly, I realized eventually that it wasn't the time travel.
I wonder whether the "pharmacy of the future" manager who said in 1998, "We're doing this for one reason, to help us free up time so we can spend more with the patients," is actually spending more time with patients in 2012?
I'd be confident in betting the answer is an emphatic "no."
The "pharmacy of the future" has turned out to be about more prescriptions, fewer resources, metrics that measure not time with patients but prescriptions out the door, and flu shot quotas.
The most dramatic change in the profession has not been the elimination of "count, pour, lick, and stick," it has been the addition of one more stick — that of an arm or two between an ever-increasing number of prescriptions. I don't remember reading anything about that in 1997.
Of course there's always next year, or the year after that. I'll put this magazine on a closet shelf and report back to you next time I feel like a little decluttering. Things will surely be better by 2027, right?