Here's the shiny, happy vision of pharmacy's future, courtesy of The New York Times:
As the Walgreen Company pushes its army of pharmacists into the role of medical care provider, it is bringing them out from their decades-old post behind the pharmacy counter and onto the sales floor.
The pharmacy chain, based in Deerfield, Ill., and the nation’s largest, has renovated 20 stores in the Chicago area and is converting more than 40 in Indianapolis to get the pharmacist closer to patients. Pharmacists in the revamped stores are being kept away from the telephone, where dealing with insurance coverage questions and other administrative tasks occupy 25 percent of their time, Walgreen says.
“What we are seeing now is pharmacists should be using their knowledge to help consumers manage their medications appropriately,” said Nimesh Jhaveri, executive director of pharmacy and health care experience at Walgreen. “It’s not about the product but the care we give.”
Wow, that's almost enough to get me all choked up and misty eyed. Things are going to get better. Really. Walgreen's says so.
"I am a pharmacist who is under the most stress of my career trying to keep my position under this new program. We have 11 or less seconds to review an Rx for data accuracy ... and less than 8 seconds to review it clinically for interactions and dosings. They are actually riding us now to do clinical in 4 seconds [as of] our last meeting. Do you know how hard it is to look up a drug/dosing in 4 seconds? If we do not accomplish this timing, our 'metrics' are out the door ... We are put on level 1 discipline, then level 2, then we are given a 'life line' to find another position."
Huh? What? How did that get in here? Oh for the love of God, that's only an actual letter from an actual Walgreen's pharmacist that showed up in my mailbox awhile back. The "new program" he's talking about isn't the PR stunt that the Times wrote about, but a vision of Pharmacy's future Walgreen's is much further along in implementing it calls the POWER program. The idea is to move as much work away from the store level as possible, using things like off-site central fill centers to deliver refills to the store, call centers to take calls from patients, and splitting the prescription filling process into individual, repetitive tasks to be assingned to workers off site. The pharmacist above had the job of verifying the accuracy of prescription images sent to his home computer.
"The goal of the program is to relieve in-store pharmacists of certain tasks in order to give them more time to offer medication therapy management services." Walgreens told Drug Topics when POWER rolled out. Which sounds an awful lot like the bullshit they were sending the New York Times' way. Let's see how that's working out:
I just wanted to add a comment in regards to Walgreens POWER. I received my first average (usually always above average or exceeds expectations) performance evaluation because I was going against policy and checking hardcopies (that were typed and verified by POWER) before dispensing medications to patients. I was told not to double check hard copies and to only check product.
But.......but.......the future pf pharmacy isn't about the product. That's what Walgreens said.
By double-checking hard copies, I caught several mistakes a day. These mistakes I documented. At my high volume store, my near misses went from around 20 a month, to over 100 a month. One specific prescription that I discovered was incorrect due to my double checking of hard copies was a prescription for a child for morphine sulfate written as 20mg/5ml to dispense 1 teaspoonful every 6 hours as needed. The prescription was typed and verified as 20mg/1ml to dispense 1 teaspoonful every 6 hours as needed. In a child, this could have been deadly.
Even more deadly than the cigarettes Walgreens sued the city of San Francisco for the right to sell. Nothing says it's all about the care you give more than fighting for the right to profit from poison.
That quote was from a different pharmacist than the first by the way. I got quite a few:
I am writing to you in response to the letter you received from the Walgreens pharmacist who worked at POWER
I too was one of the pharmacists working in the stressful environment that he talks about...
...My "numbers" rarely came in where they were supposed to because I actually read the prescriptions, checked for interactions, looked at refill history, etc. So on my weekly phone call from my supervisor, who was a pharmacy technician, I would be reprimanded and told to go faster. I was verifying upwards of 1000 Rx's per 8 hour shift. The "fast" employees were verifying about 5000. (emphasis mine)
I'll stop here and point out that's 625 prescriptions per hour. Or ten a minute. Every minute. All day long.
The Andersonville neighborhood store includes a 50-square-foot room behind sliding doors where a pharmacist, James Wu, can sit and counsel patients, who sit on a padded bench that has enough room for the patient and a family member or two. Mr. Wu’s desk is steps to the right of the private room.
Wait. I'm sorry. I've got all my notes and papers mixed up here and I keep getting Walgreen's versions of Pharmacy's future mixed up. I think that was the bullshit one.
They were also going to enroll me in a class that taught me "what to skip over when verifying prescriptions"
Well they did say it wasn't about the product anymore.
Mr. Wu said he could now spend more time talking to patients or out in the store aisles, and rarely is distracted now by the orders being placed for prescriptions.
POWER pharmacists are stuck at a computer terminal situated between the Consultation Window and 2-3 cash registers (plus drive-thru). There's absolutely no peace or privacy; the potential distractions are incalculable, and their mere likelihood itself soon becomes a distraction in-lieu. RPh's no longer have their own personal terminal; they share the register computer with the Technicians, Interns, cross-trainers, Store Managers- basically, anyone who wanders through the pharmacy can enter data under the pretense of the RPh's initials.
Mr. Wu didn't say that second paragraph. A Walgreen's pharmacist actually working in the Walgreens of the future said that second paragraph. I could go on, but you get the picture. The reports I'm getting from the real world are nothing like the blowjob that New York Times reporter gave the nation's largest drug chain.
But wait my friends, because as they say in the advertising world, it gets better. One Walgreen's POWER pharmacist wrote me not long ago and gave me the complete scoop on what this program is like. The ups and downs, ins and outs, and all the dirty laundry of this initiative undertaken by the Pharmacy America Trusts™ to shape the profession's future. Those of you not in pharmacy will likely be shocked. Those of you in the profession most likely will just be saddened. You'll have to wait until I get the time to get the next post up, but I'll give you a hint: it doesn't involve a 50-square-foot room behind sliding doors where a pharmacist can sit and counsel patients.
Stay tuned.
