Take your best shot

August 15, 2011

Very soon the pharmacist will be the primary care provider for all colds, stuffy noses, sore throats, and coughs. This is your chance. Take it or leave it.

The way he started off bothered me. He took my right hand in both his hands and squeezed. His deeply lined face was luminous. He began to tell me how wonderful I am.

"You helped me out with my problem," he said. "I couldn't have done it without you. Thank you, sir. Thank you very much."

This seemed to satisfy him. After thanking me again, he released my hand with a smile and walked away. I looked down at my hand. There were 2 $100 bills in it.

I know that we pharmacists have been trying to figure out how to get paid for our knowledge and experience, but this was ridiculous.

A golden opportunity

We have an opportunity coming up that will benefit the profession and will enable us to enhance our personal reputations without any of the drudgery entailed by APhA initiatives. Each of us will have the chance to go for it or let it slip through our fingers. This time, don't screw the goose.

It's so simple. The days of seeing a doctor for a common cold are over. Doctors don't have time or inclination to treat patients for something so trivial. Colds get better in all cases. The patient who feels like he's going to die will be lucky to see a PA or an ARNP. They're busy too. Three weeks for an appointment?

If patients are lucky enough to see a PA, the disappointment will crush them. "What do you mean, you can't write a prescription that my insurance will cover?" It's not because PAs can't write prescriptions. They have that power now. There just won't be any prescription-only drugs left on the market.

On Wednesday, March 2, 2011, FDA ordered about 500 prescription drugs used to treat colds, coughs, and allergies off the market. The drugs had never been approved for safety or efficacy.

So there will be no prescription-only cold medicines left.

No Rx and no doc

Pharmacists have known for decades that these grossly expensive products (and you know the ones I'm talking about) are nothing special. The manufacturers were given 90 days to stop manufacturing and 180 days to stop distributing. On September 2, 2011, you can turn out the lights; the party will be over - and I say good riddance.

The average patient is smart. She will soon ask, "Why should I pay $100 or more for an office visit to have the PA prescribe an over-the-counter medicine when the pharmacist, the expert, will do it for nothing?"

Very soon the pharmacist will be the primary care provider for all colds, stuffy noses, sore throats, and coughs. This is your chance. Take it or leave it. For you captives of the Prescription Mill, OTC counseling is real pharmacy.

Don't let this one get away

I know - you're going to whine that you don't have time. Well, there will be pharmacists who will make the time, and a rising superstar just might be working right beside you.

Chain companies might not manage to find a way to free up time. Some are hopelessly top-heavy (you know the ones) and out of touch.

On the other hand, the independent who puts a big sign in the window that says "Cough, Cold, Allergy Medicine Advice Here" will take this business - and trust me, the head of household of a family of 5 is likely to move all the family prescriptions just because the pharmacist at Willow Drug Store made her feel better. The copay is the same.

The guy who loved me so much was an Alzheimer's patient. I returned the money to his son.

Our services will continue to be free until we figure this one out. But for now, we can grab the business that drops in our laps. If we let it slip away, we have no one to blame but ourselves.

Jim Plagakis is a community pharmacist in Galveston, Texas. You can e-mail him at and cc us at http://jimplagakis.com/, jpgakis@hotmail.com