Farewell to the druggist culture

August 10, 2014

When druggists morphed into pharmacists, an essential quality was lost. The need for speed has just about buried it. But you can bring it back.

Around 1995, pharmacists quit being druggists and started bowing to the commands of sophisticated prescription-filling computer programs. Today’s pharmacists need to stay grounded to serve patients and not be slaves to the prescription mill.

We are on the verge of losing something important. When it’s gone, we will never get it back. It’s a retail thing, but for over two centuries pharmacy was essentially a retail thing. Pharmacists were called druggists; patients called us Doc. Year after year, the general population said that we were the most trustworthy profession.

So what’s the deal with druggist? Isn’t pharmacist good enough?

I suppose it is, as long as you’re satisfied to camp out behind the counter and run the prescription mill just as fast as you can. Isn’t that what most chain pharmacists do?

My question is: How can we justify making profit more important than patient care?

A whole druggist skill set has been left behind. Start with OTC counseling. My goodness, for a couple hundred years, that was a vital part of our job. Now, you are likely to get something like this.

 

Counseling optional

I stood at the pharmacy counter at my neighborhood chain drugstore, hoping to have fun with the RPh. “What’s a good cough syrup?”I asked.

“What do you want?” she asked. She took a sip from her Vente Starbucks.“Well?”

“I want a good cough syrup.”

She pointed. “Over on aisle No. 3.” And she was gone.

“Why won’t she talk to me?” I asked the technician, who gave me an Are-You-For-Real? stare. “I need help.”

“Sir, she is filling prescriptions.”

I honestly believe that if she tried to really help her patients, she would run the risk of being written up for incompetence. It’s all about speed now.

 

Feed the prescription mill

Pharmacists have decided that running the prescription mill at breakneck speed is more important than to triage for the patient in need. That’s a shame. Often, the patient needing help is a poor person, holding out a twenty-dollar bill pinched from the grocery money. And the pharmacist is their only hope.

It was around 1995 when pharmacists quit being druggists and started bowing to the commands of sophisticated prescription-filling computer programs.

These programs are stool pigeons. When you walk away from the prescription mill and its insatiable need for speed, even for just five minutes, they’ve got you. They’re looking for you. A micro-notation is recorded under your name in the cloud. Too many of those, and they can replace you with a new graduate robo-dispenser.

A pharmacist with druggist muscles would not hesitate to help a mom choose what to do for her three-year-old son’s complaint.

Then a tattle-tale report is generated on the screen of another nonpharmacist Master of the Universe MBA. Too many like this and an everlasting not-a-team-player notation goes into your permanent record.

The computer is stupid. You were practicing patient-centered pharmacy, something all of us should aspire to, and the computer is going to punish you with a simplistic report stating that you were dead in the water for seven minutes and 18 seconds.

And you wonder why you got passed over for that brand-new store only three miles from your house.

 

Don’t forget the PharmD mills

They’re called pharmacy schools, and some of the new ones don’t even teach compounding. I worked with a newly minted RPh who was stymied by the rudimentary Tamiflu suspension using the content of capsules and Ora-Sweet. Her pharmacy school is in the business of churning out robo-dispensers who are NAPLEX-capable. Druggists were in the rear-view mirror. This is a critical mistake.

The centuries old druggist culture may die from lack of care. Looks to me like that probably has a lot to do with profits.

Every druggist is a pharmacist, but not every pharmacist is a druggist. There was a time, before Durham-Humphrey, when injured or sick patients chose between druggist and doctor.

When you youngsters get the chance to acquire druggist skills, do it eagerly. They may not want you to, but it is not their profession to run.

It’s yours, and don’t you forget it.  

Jim Plagakis lives in Sarasota, Fla. E-mail him at jpgakis@hotmail.com.