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A California pharmacy board task force tackles manpower issues and stirs controversy.
A task force created by the California pharmacy board to tackle pharmacist manpower issues stirred up a ton of controversy before it even met late last month.
Assuring public access to pharmacist care and prescription services was the driving force behind the creation of the manpower task force, according to California pharmacy board executive officer Patricia Harris. The 15-member task force includes representatives from pharmacy schools, unions, state pharmacy associations, a public health advocacy group, a health-plan association, and a retailer association. At least four task force meetings, open to the public, have been slated, with a scheduled Jan. 23 Los Angeles kickoff. A report will be presented next January.
Several groups have taken aim at the manpower task force, charging that the agenda has been set by the chain drugstore industry. Critics contend that the chains are trying to get the pharmacy board to loosen its regulations to permit unlimited technicians and clerks and make licensing easier by dropping the state exam in favor of NAPLEX. They are also opposed to license reciprocity with the other states, which they contend will lower professional standards in California.
The task force is not skewed toward chain pharmacy, countered David Fong, Pharm.D., senior v.p. of pharmacy for Longs Drug stores. As the task force member from the California Retailers Association, he's the lone member representing corporate pharmacy. He said that the chains did present seven talking points to the pharmacy board last October, but he added that all the other groups on the task force can put their own ideas on the table for discussion.
Adoption of the NAPLEX exam, license reciprocity, elimination of the R.Ph.-clerk/typist ratio, permitting central Rx processing, allowing one pharmacist-in-charge to serve multiple pharmacies, and a reevaluation of technician training and responsibilities are among the chain industry's key points, Fong said. Upping the R.Ph./ technician ratio might also come up, but it would be a long-term solution, he added, since it would require a time-consuming trip to the legislature.
"There's a real problem with ensuring pharmacy services in this state, and it's getting uglier," Fong said. "We all recognize there's a pharmacist shortage and the time for talk is over. We need to develop short-term and long-term solutions we can agree on and begin to develop a blueprint and a schedule of how quickly we can solve the problem."
The real problem is not a shortage of pharmacists but a shortage of R.Ph.s willing to work under intolerable conditions, contended Ralph Duff, the California Employee Pharmacist Association board member appointed to the task force. He thinks the pharmacy board should first conduct a survey of the state's 25,000 registered R.Ph.s to find out if they are working and where.
"From our vantage point," said Duff, "the problem is working conditions, but the board doesn't want to look at that, and the chains refuse to recognize it. I'll attend the first [task force] meeting to see where it's going. We don't want to rattle our sabers again, but we are opposed to reciprocity and raising the tech ratio."
The chains brought the current manpower problems on themselves by building too many outlets, keeping the pharmacy counter open too long, and creating workplace conditions that foster high staff turnover, contended Ralph Vogel, Pharm.D., president/executive director of the Guild for Professional Pharmacists, who's also on the task force. His union is opposed to upping the R.Ph./tech ratio and license reciprocity.
Despite the heat generated by the manpower task force, the pharmacy board's goal is to facilitate potential solutions by bringing all the players to the table, said Harris. She added that the board looks at switching to the NAPLEX exam and license reciprocity every five to 10 yearsa process unrelated to the manpower task force.
"Nothing is decided at this point," Harris told Drug Topics. "This is a very open, neutral process, and I don't have any preconceived ideas. Some assumptions are being made that aren't true. There may be some solutions dealing with the practice of pharmacy that the board may be able to or want to sponsor, but I would imagine that some of those changes are going to take legislation and I'm not sure the board is going to do that."
Carol Ukens. Manpower task force under attack in California.