All wet: A pharmacy parable


Suppose a country were facing a flood of Biblical proportions but determined to focus on bringing in more tourism; what would you say about its priorities? Now suppose that country were a professional organization and ... well, read on.

Tuvalu, you see, is a country in crisis. At only 10 square miles and a highest elevation of just 15 feet above sea level, it has watched as the rising ocean waters have washed away more and more of its coastline every year, intruded into freshwater wells, and otherwise, bit by bit, made its islands a little less habitable every year. There is a very real chance that within our lifetimes, Tuvalu will literally be rinsed from the earth.

So a crisis is looming that everyone can see but most choose to ignore, as it gets just a little worse, day by day, year by year, threatening to end a way of life. Do you see the parallels to your profession?

"I am happy to report to you that we have constructed a new presidential headquarters during my last term," he says in his campaign kickoff speech. "We now have the space and infrastructure necessary to represent your interests to the world. I am also very excited to announce our new tourism 2025 project, which we expect will provide a much-needed boost to our economy by giving us world-class resort destinations to lure vacationers to our beautiful island. It is long past the time that we started to make use of our unique advantages to ensure our survival in the new global economy."

Meanwhile, your well has just started to pump saltwater and the crops you planted last month are starting to wither. The tides are coming a little closer to your front door this year than last. Can you see why a person might be less than enthusiastic about the upcoming election?

Now let's say Tuvalu is a one-party state, with no one else even pretending to represent the issues you care most about. It would be pretty easy to understand why people just might tune out politics altogether to focus on their day-to-day survival.

Closer to home

Perhaps not so easy to understand for the chief executive officer of APhA, though.

In a recent blog post on, Thomas E. Menighan says, "I can see how it must feel like a major disconnect when APhA is so focused on promoting consumer access to pharmacists' services while our own pharmacist members and nonmembers are struggling with workplace issues." He then spends the next paragraph explaining the importance of APhA's efforts to promote practice standards, extolling "the untapped potential that pharmacists have to offer to patients, and frankly to those who pay for care."

Yup. And Tuvalu has a lot of untapped potential as a tourist destination also.

But wait - there's more

APhA isn't ignoring your day-to-day struggles though.

"APhA is focused on gaining recognition for the value of our services, not only as providers in Medicare, but in all sectors of health care and with other provider groups," Menighan says. "If we had all 280,000 pharmacists as members, we could probably tackle workplace issues too."

You got that? The problem is you. You're not champing at the bit to give your money to an organization that admits it sees your day-to-day struggles, but chooses to put its primary focus on other issues. If only you would mail in a check and trust them when they say they would probably get around to addressing workplace issues, everything would be fine.

Words to live by

"We understand your problem, we're just going to work on other things, so vote for us!" probably won't be a winning campaign slogan for any candidate this November, and it is not an effective recruiting tool for you, APhA. You are not entitled to my dues money or anyone else's just because you claim to represent the profession. Complaining that no one is following you does not constitute leadership. Leadership comes from giving people a reason to enthusiastically line up so you can all get to where you need to go.

With 62,000 members (not all of whom are pharmacists) in a profession of 280,000, by this measure APhA is an unequivocal failure. Address the concerns of the people who actually fill prescriptions and deal with patients, and you will have so many members you will have to build another new headquarters.

Until then though, you'll have to excuse me; I have to go put some sandbags around the pharmacy. The floodwaters seem to have reached the door.

David Stanley is a pharmacist, blogger, and professional writer in Northern California. He can be reached at

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