John Lemberger gives his point of view about a failure to counsel citation from the Wisconsin Board of Pharmacy
I have recently been officially cited by the Wisconsin Board of Pharmacy for a "failure to counsel" event that occurred nearly two years ago. This citation means an automatic fine of $250 plus $400 in court costs.
What was my reaction after the inspector introduced herself the day of this so-called violation? I felt like I was caught in an ambush. I had to calm myself down before calling the prosecuting attorney, so that I would be polite when I informed her that I was considering seeking legal counsel to fight these charges.
All this time, I was verifying my tech's accuracy in filling Rxs. When the scripts were completed and verified, I would take them to the customers and counsel them. I was sometimes ringing the scripts at the cash register myself so that the tech could keep filling drugs. I was working with one tech only that day.
All this time I was listening to the extremely upset customer complaining about why it was taking so long to fill his Rxs. While I was checking more new prescriptions, a customer came to the counter and stated that she was picking up a refill. I asked her if she had any questions. She said "No". I handed her prescription to the tech to ring up, while I attempted to finish filling the last of the Rxs.
In the State of Wisconsin, the pharmacist is required to hand ALL prescriptions to the patient and counsel them, even on refills. Then the technician can ring up the sale. In this supersonic fast-food pharmacy era, requiring the pharmacist to hand every prescription to every customer, as the board expects, is an impossibility!
As soon as this transaction unfolded, the inspector came into the pharmacy filling area and introduced herself. She told me that I had failed to counsel. I politely pointed out the long line and the presence of the very loud and profane patient and that she (the inspector) was there at the time and witnessed this. I stated that with only one pharmacist and one technician on hand, if I had to hand every prescription to every customer, I would not be able to fill and/or check the scripts behind the counter.
I was given a citation which describes my violation, fine, court costs, and a date when the fine must be received. As you can imagine, I am really upset over this citation. Pharmacists are often so far behind in filling prescriptions that we have to fight hunger pangs and our urge to go to the bathroom even though our bodies are screaming for relief.
On top of that, there are so many time-consuming duties we must fulfill, such as pseudoephedrine requirements. In this state, the pharmacist is required to obtain a photo ID to determine if the customer is old enough to purchase psuedoephedrine. Then you have to enter the product into a log book, have the patient sign the log book, and then the product must be rung up at the pharmacy cash register. If the customer is new, and needs to be entered into the system, this process can take 15 minutes.
I know a pharmacy manager who was cited even though he was not on duty when his staff R.Ph. was cited for failure to counsel. This 'bullying' of good pharmacists by boards of pharmacy outrages me. I may spend more money trying to fight my case than the amount of the fine, but I feel it is time for someone to stand up and protest the board's tactics. The Lemberger name is well known in this state and I don't want it sullied in this manner. If there are practicing pharmacists on the Wisconsin board of pharmacy, I'd love to observe them for a day in a busy store and see how well they carry out the mandatory counseling provisions. I'd like to see how they react when I slap them with a citation.
It is my hope that other pharmacists will join me and contact their own state board members and let them know what pharmacy is like in the real world.
THE AUTHOR practices community pharmacy in Wisconsin. Feel free to contact him at firstname.lastname@example.org