A pharmacist e-mailed that she took a sick day and felt guilty about it. I reminded her that she was so institutionalized that she couldn't even be off sick when she was sick. She answered, but I wasn't sick. The night before, at 10 p.m., after 14 hours on her feet, she had a pile of prescriptions that were not ready. One young woman needed Methergine and the usual accompaniments. She had a number of antibiotics that were promised earlier. Then a handful of hydrocodone/APAP, alprazolam, and carisoprodol. Why do they always show up at closing? "This happens every night," she went on. "There is a pile left from the night before every morning."
"You can stay until I'm ready to close," the nonpharmacist manager had said. "But the tech is hourly. She has to go."
So what did he get? A pharmacist calling in sick because she was feeling overwhelmed.
We are quickly moving in on a professional/business crisis point. Readers who have followed my thoughts know that I distinguish between the two. You also know that I believe that we can't have one without the other. We deal in a product, so we will always be engaged in a business, but the business has grown like Topsy. It has turned into this terrifying obesity that is crushing the profession.
It seems like many years ago a girl too young to be a mother stood at the counter. A toddler clutched her leg, crying. The girl's face was drawn. She looked terrified. The child's prescription was for prednisolone liquid, a graduated dose over a period of days. She had picked up the medication in the morning. It was midafternoon.
I had not counseled. I rarely counseled, back in the day. I said, "What's the problem?"
Her eyes widened. "I don't know what to do."
"Not that difficult," I said, "Just read the label."
Her eyes filled up and she began to cry. She couldn't read.
Professional failures like that happen every single day, all over the place. They happen because we are so invested in keeping the Prescription Mill running fast and smooth that we neglect our most important job. But we have to make a profit, don't we?
The business is very close to failing. Can't they see it coming? When we are not able to deliver the prescriptions that our culture demands, turn out the lights.
Approximately 10,000 Americans turn 65 every day. There are more than 330 million citizens who believe they are being cheated if they visit the doctor and don't leave with a prescription. The question is: What can you give me, doctor?
If we can't deliver, there will be no more retail pharmacies. Just dispensaries, many more of them mail order.