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Pharmacists need to believe in the basic skills that were once taught. We need to practice pharmacy in the traditional sense.
I work with several very talented people and most are either board-certified in a specialty or have completed a residency. Several have done both. They are all committed to the clinical aspect of phar
macy, which they see as the future of the profession.
I usually don’t disagree with that. In light of the current philosophy of both the professional organizations and academia, clinical pharmacy is the path we have decided to take. Right or wrong, we’re stuck with it. You can deviate from it and go your own way, but you’re on your own.
However, I’m starting to wonder if we need to take a different tack. Getting paid for medication therapy management (MTM) and patient counseling is currently not going anywhere, at least in a manner that many of us can access. Very few pharmacists get paid to do anything but dispense.
Maybe I should clarify that. Quite a few pharmacists who don’t dispense draw a paycheck, but the great majority of them are subsidized by a dispensing pharmacist - at least, that’s the case where I work. It’s kind of like watching a work crew where one person is working and the rest are leaning on their shovels.
I don’t mean to imply that not all are working, but I think you see my point.
Maybe it’s time to take a step back and evaluate who and what we are, and where the majority of us want to go. Perhaps we should change our educational requirements to return to a business-focused, problem-solving pharmacy practice instead of a clinical-oriented practice that is not financially viable or sustainable.
After all, the profession of pharmacy was just fine for hundreds of years, operating from a storefront where the druggist was a respected person who helped people with daily medical issues. Those who were competent had a steady clientele and were paid a fair wage and made a good living. Going to the drugstore to see the druggist was the first therapy choice for most people. Maladies were diagnosed, remedies were compounded, and money changed hands. It was a profitable business.
If you don’t think there is a need for this now, you aren’t paying attention to your clientele - your low-income, underinsured, or uninsured clientele.
No MD, PA, NP, or in-store clinic was needed or wanted. The druggist was a respected source for health care, as many people never saw a doctor. Get diagnosed by a nurse? You’ve gotta be kidding.
Talk to folks over the age of 70; I’m sure they will remember this very well, especially if they grew up in a small town without a physician.
Let’s just admit it - we don’t get the respect we used to receive. We are paid a good wage, but if you think that’s going to continue, talk to a recently graduated pharmacy student.
From a business standpoint, we have dumbed ourselves down to embrace clinical pharmacy. By doing this, we can’t really tell if we are needed or not. We don’t know what we pay for pharmaceuticals that we buy and we have no idea what we are paid for them by pharmacy benefit managers. Rebates and kickbacks rule the pharmacy world. Y
ou have no idea of the true profit you generate every time you fill a script. Some bean-counter in the home office does, though, and that knowledge will never be shared with the rank and file.
Back to basics
We need to believe in the basic skills that were once taught and insist that they be brought back in the pharmacy school curriculum.
We need transparency in pricing and what the actual cost is to fill a prescription.
We need to practice pharmacy in the traditional sense.
We need to quit waiting on someone else to represent us, define us, and rescue us.
We need to believe in ourselves and insist on control of our destiny.
It is time for all of us to start thinking. What do you truly believe in?
Jim "Goose" Rawlings is a senior pharmacist in central Indiana. E-mail him firstname.lastname@example.org.