What is a doctor's career worth? Or a person's life, particularly a child's? In the world of retail pharmacy the answer is about $1.50. That is the dispensing fee a pharmacist received after catching a 10-fold overdose of a potent medication, saving both the patient's life and the doctor's career.
Dosing errors are not uncommon occurrences, considering modern medication complexities. On one occasion I was told that my refusal to fill a prescription saved a man's life. My familiarity with his personal situation led to my decision not to dispense. Insights that mail-order pharmacy never has, I might add.
Obviously, there isn't a pharmacy in this country that could survive on dispensing fees alone. We depend on the margin between our actual cost and reimbursement. And without the volume in generic dispensing, there would not be enough margin for business survival. It has always been tough wrangling with insurance companies that virtually dictate contract terms. But now government, both state and federal, has discovered what an easy target retail pharmacy is. How much longer can pharmacy do more and more for less and less? What will the tipping point be, and what consequences will result?
We all understand the increasing frustration, mounting distractions, relentless pressures, and even law enforcement responsibilities we constantly deal with. These seem to go with the territory. But what really wears on me is the stark realization of the ever-increasing vulnerability and professional exposure we face with every single prescription we dispense! Besides the government oversight all business endures, pharmacies that contract with 50 or 60 insurance plans must follow their individual parameters and potentially face that many audits and recoupments. Even more unsettling is the consequence a pharmacist would face if, God forbid, he made a serious mistake or even missed catching a physician's error. Personal-injury attorneys would love to take everything we have worked a lifetime to earn.
So let me get this straight. We as "professionals" risk everything we have for a $1.50 dispensing fee. And it stings even more when you measure the amount of government waste against the valuable and cost-effective service we provide. We improve peoples' lives, and occasionally save them. But I, for one, am struggling with all the risks weighed against the meager rewards we earn.
All that said, it has been my privilege to serve my community honorably as a retail pharmacist for nearly 30 years. I don't know how much longer I want to do it or can do it for that $1.50 dispensing fee.
David P. Acconcia
Don't make a pharmacy degree harder
About your Nov. 6 article on whether pharmacy students should first have a bachelor's degree, no way! It's expensive and unnecessary. At a time when pharmacists are much needed, are you trying to discourage pharmacy as a career? Think also about how much time it would take to pay back a student loan. It was cheap when I graduated in 1971, and I feel sorry for those students having to do another year already for the Pharm.D. and to pay for it. The idea is absurd!
Rural Hall, N.C.
Chains' free offers a bad idea
Both Meijer and Giant Eagle are giving out antibiotics free with a valid doctor's prescription. Giant Eagle is also advertising free prescription cough and cold meds. Medicaid and insurance companies pick up on this, and it messes up reimbursements! We are already not reimbursed as much as we should be. Now chains are just giving away their products. Good one.
Dave and Sara Puterbaughdfirstname.lastname@example.org