strong>Jay Pee 9/2/09 All of your comments have been thoughtful. Some are “Can Do.” Some are hopeful. Some are “Doom & Gloom”. I have noticed that the majority of people want to be right more than anything. You who predict that robots, high school educated techs and cashiers will run us out of a job, I contend just want to be right. What the hell is the difference? It will be what it is. My take is that we better get our asses away from the “Prescription Mill” and do some counseling. You know what a “High Value Opportunity” looks like. That’s not Valtrex. That is zolpidem. “Be careful. You may sleepwalk. You may even sleepdrive. Please read this literature and call with questions.” The best way to continue earning $10,000.00 a month for a long time is to do your job properly. If you do not, CVS SHOULD finger you as the first to go.< Next thought. There is NO pharmacy organization with a large membership and therefore some clout that will assist us. The big ones are letting us twist in the wind. There is an organization that is geared up and ready to help. The officers and members are committed to making a difference FOR YOU. The problem is that the membership is still tiny. You guys are so frikkin cheap that you won’t shell out $110.00 for a membership. You are so institutionalized that you won’t even help. My friend Paul has you pegged. GALLEY SLAVES. $110.00 is 0.0009% of the average pharmacist’s annual wage. Dues for students and techs is cheaper than a good pizza and a few beers for you and your boy toy on Friday night.
It is my thought that we, pharmacists and our profession, have one chance to get pharmacy back for pharmacists. Everything is in place for it to happen. The conditions are perfect. Once the snowball starts rolling, there will be an avalanche.
APhA is not a practitioner’s organization. No matter what they say. I cannot see the APhA even noticing the opportunity. It is old. 1852. Feet in cement. APhA is too high minded. Improving Medication Use. Advancing Patient Care. It is interesting that the opportunity I see is a chance for this old organization to be to pharmacy what the AMA is to medicine. I’d certainly join back up if they took a strong and active position on this prospect.
NCPA is an organization in which only pharmacy owners and their managers can hold a voting membership. I can see NCPA helping a lot if they took a good look.
The entire pharmacy universe has its head in the sand. We have a duty to warn. Not warning is the rule. The road to a professional status that removes us from a profit on a product mentality is the fact that all 50 states (plus federal laws) require counseling.
I know. Here he goes again with an Airy Fairy Jay Pee vision. Just listen for awhile.
We do not counsel. We do not even think about counseling. My counseling is restricted to what I call “High Value Counseling Opportunities”. I was having lunch with a Dean of a college of pharmacy a couple months ago. Nice lunch in a fish restaurant in Houston. We talked about college football (his subject) and the awkward situation in the JOB of a pharmacist (my subject).
I told him that I rarely counseled. He gave me a look and took a sip of his iced tea. “Really?”
“Really,” I said, “I counsel only when there is a High Value opportunity.”
His eyes sort of glazed over. Too much information. He liked believing the myth passed around in the ivy covered halls. Counseling defines a pharmacist where he works.
My “High Value”, by the way, is not necessarily your “High Value Opportunity”.
Pharmacy state boards exist only to regulate the profession of pharmacy in order to protect the people of the state from dangerous pharmaceutical care. It is my contention that the common practice of pharmacists neglecting to counsel is dangerous.
The moment one pharmacy board decides that non-counseling is unsafe to the citizens and starts doing something about it is when things change.
I think it will take more than just a “write-up”. When a pharmacy board cites, suspends for one week and fines a pharmacist for non-counseling, that will be the crack in the dyke. The crack will widen when pharmacists find out that a citation means having to sit for the MPJE. The flood will be a deluge when the drug store has the pharmacy license suspended for one week, the game will change nationwide.
Can you imagine: A suspension of just one week for the pharmacist means a loss of pay. Close up the pharmacy for one whole week. How many patients will have to go through the inconvenience of getting their doctors to call in Rxs to a new pharmacy? When they find out the reason, most will never come back to the dangerous pharmacy. A game changer.
Every state would have to follow the precedent. Trust me. The state boards themselves could be sued. A patient harmed because they were not warned could ask a judge, “Why does not our state board MAKE them live up to the law?” A good attorney could take precedent from Wisconsin and use it in Kentucky if the pharmacist did not warn the patient of dangers in the Rx and the patient was damaged.
We have a duty to warn. We are really up a tree, aren’t we!
I do not know if pharmacists can bring enough pressure to bear, but I know that when citizens complain to a state board about getting Four Rxs filled and never seeing the pharmacist, the board will have to investigate. How about 100 complaints in Vermont and Wyoming. 1000 in California and New York.
There are millions of patients/customers/patrons who commonly say, “I trust the pharmacist more than I trust the doctor.” About drug therapy, that’s smart. They like pharmacists and they like it when the pharmacist comes and talks. Often, they make me a little uncomfortable with expressions of gratitude for my counseling.
Recently, I told a young woman, a second year medical student, that her ARNP was wrong about Midol being good for menstrual cramps. She bought the naproxen sodium I suggested and was back the next day gushing, “You were right. I have put up with unbearable cramps since I was twelve. Finally, I listened to the right person.”
What would happen if just 100,000 of them, even 10,000 of them, got a little pissed off when they find out that pharmacists are mandated to counsel and we don’t do it because we do not have the time?
What if just 1,000 of them complained to the board?
What if only 10 pharmacists were suspended for a week? What if only one chain pharmacy had to lock up the pharmacy for 7 full days and pay a hefty fine?
What if all the pharmacist middle managers of the chain in that state had to take the MPJE?
I’d like you to answer these questions. I know you guys. Many of you will find this scenario appealing, but will not comment. There are a few of you who always ask, “What is Jay Pee smoking?” There are others who will write a thoughtful comment. Come on, can this picture actually be worth putting juju into the ethers?
This can happen. Conditions are perfect. AARP could be dynamite in the dam. Citizens are becoming more sophisticated. They are educated medical consumers. Once they spot the wart on pharmacy’s nose, look out. This can happen, you guys.
All it will take is one pharmacy board to say, “Enough is enough”. I have practiced in five states. I’m looking at Washington State nailing this thing.