The upside of efficiency


One pharmacist asks, what else will the profession of pharmacy find wrong with chain drugstores? He asks that the industry put aside its differences and look at what is best for pharmacy.

I just finished reading Dennis Miller's Viewpoint article [“When efficiency is all that matters”] in the February 2011 issue of Drug Topics.

I have been a community chain-store pharmacist for the last 17 years. I couldn't do my job without automation. And I'm not talking about the filling/checking aspects of my job. The advancements in noting drug interactions and disease states are part of this efficiency. This does lead to better patient care. These advances in computer systems and technology allow me to fill more prescriptions accurately and efficiently. (Now, let's not roll our eyes over this one.)

The reality is that most patients do not want to spend a lot of time in a pharmacy, especially if they have a migraine or the flu, or they’ve just been released from ambulatory surgery. It is my belief that many technical advances that all pharmacies - independent, ambulatory, smaller chain - benefit from began as efficiencies started in chain pharmacies with the financial resources to develop such programs.

Efficiency allows me to perform other functions that I might not otherwise have time to perform.

Dennis states, "...the foundation of the independent drugstore is customer service." The foundation of any successful business is customer service, whether it's hospital pharmacy, nuclear pharmacy, home care, or chain. It's just your customer base that is different.

Dennis further states,"Our entire healthcare system is based on quantity rather than quality." Any and every aspect of healthcare is a business. It's the only way it can survive. And this is more critical if you look at providing national healthcare; take a look at reimbursement rates for services and prescriptions from state programs.

Even our pharmacy educators have to publish papers and receive grants to maintain their academic positions.

Just because a pharmacy practice is a business, that does not automatically equate with having to be impersonal or removing the human element from your job.

I wonder what else the profession of pharmacy will find wrong with chain drugstores. But the question should be “What else will the profession of pharmacy find wrong with pharmacy?” For whatever reason, pharmacists are extremely territorial (e.g., I work at an independent pharmacy, or I'm a clinical pharmacist, or I work home care, etc). How about we put aside our differences and look at what is best for pharmacy?

Remember, baby steps. Let's start with deciding what is the primary organization that will represent all pharmacists. Then let's work on things that will make our work days more efficient and less stressful. Start with basic operating procedure that has logical rules and regulations, followed by a uniform insurance card that DOES have the patient ID, Bin and PCN number, and Rx group number clearly listed on the card.

While we’re working on this, pharmacy can continue to develop MTM models that can be easily adapted by all pharmacists. Then let’s continue to work with pharmacy schools to fine-tune the education process, developing better practitioners and not just increasing the number of pharmacy schools to meet perceived demand. And let’s have our professional organizations at both national and state levels take a stand against developments that decidedly hurt pharmacy, such as $4 prescriptions, zero patient cost for pediatric antibiotics, unattainable long-term job demands in any job scenario, proliferation of more pharmacy schools, etc.

The one thing I've noticed during my 28 years of pharmacy practice is that pharmacy is pharmacy's worst enemy. How about we stop this aspect of pharmacy?

Maybe the title of the Viewpoint article should have been "When pharmacy is all that matters."

Norb Salamonskiis a community chain-store pharmacist in Marshfield, Wisconsin. He can be reached by e-mail at

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