Letters to the editor: August 20, 2007

August 20, 2007

Chains should not have been the only ones contacted about the issue of drug errors. Pharmacists should also have been consulted about ways to error proof pharmacies.

We should have been consulted

Make no mistake about it. Your July 9 article about chain pharmacies finding innovative ways to combat medication errors revealed the many different ways that the chains, the industry, the associations, and companies are trying to do my job. Nowhere in your discussion were the chain pharmacists themselves consulted to provide solutions to medication errors. The professionals on the front lines are forever having the professionals on the outside tell us what they think we need to know and do to prevent errors.

As a chain pharmacist for 22 years, I feel it's the same story: Give us the tools we need, then cut our staffing because payroll is too high. Give us more staffing when our script volume reaches a certain level, but in the meantime handle the insurance problems, patient consultations, doctor phone calls, drug ordering, and paperwork with what you have. Pay someone to "babysit" a robot that needs constant feeding of drugs and containers just to get at most of the top 200 drugs filled.

In my 27 years of practice, nothing has replaced the triple checking system that we long established and that many pharmacists have come to rely on: checking the prescription itself; checking the medication with the prescription; checking the label with the prescription, medication, and receipt.

All the technology and system innovations will not replace the dedication, concern, and attention that I provide to filling a prescription and taking care of my patients. All the technology and innovations will do is further complicate my ability to do my job, help the chains keep stores open that employ anyone with a license, and possibly help avoid one more error and lawsuit. Until the chain pharmacies realize that opening more pharmacies only increases the shortage of pharmacists in this country, then no amount of innovation will solve the growing concern about medication errors. In the meantime, I will try my best to deal with the outside forces that keep trying to do my job while suggesting that they spend a week or two side-by-side with me and really see how to prevent medication errors.

Gregg Levitan, R.Ph.
Baltimore, Md.
runfastbanjo@comcast.net

I enjoyed the article "Make No Mistake About It." As a pharmacy owner who has invested heavily in technology in years past, I cannot put a price on patient quality control. Having installed Innovations work flow as well as their robot, we have eliminated any chance of error. Moreover, we have in place additional quality control practices.

I provided my clients with quality control and the best equipment on the market through the profits I made and reinvested in my business. Today, these profits are gone. How can any individual, organization, or the government expect pharmacy, whether a chain or independent, to make any type of investment when there is no profit?

We need to stop kidding ourselves and wake up to the reality that without a reasonable profit, there will be no future for pharmacy. Pharmacy owners are entitled to a fair return of profit. What we have now is price controls, at the expense of pharmacy.

On a separate matter, with regard to the June 18 letter by John G. Fisher III, I do not totally disagree with the content of his letter about drug disposal and the environment, but I believe that any amount disposed, including a trace, does make a difference.

I have been involved with the board of the Okeechobee Utility Authority water and waste water system since 1995. The sewer/waste water system is dependent upon a unique balance of bacteria/microbials to help digest the waste. Any upset to this balance, even trace amounts, can cause serious problems.

Steven D. Nelson, R.Ph.
Consultant Pharmacist
Okeechobee Discount Drugs
Okeechobee, Fla.
stevenrx@okeechobee.com