A study published 2012; 28(4):546 in the Journal of General Internal Medicine had some very disturbing results.
21% (nearly 1.3 million) of senior citizens picked up a prescription that had the potential to cause harm. Those Rx’s referred to it as “high-risk medication.” Another 5% (300,000) of these patients received 2 high-risk medications. This study was done using the records of pharmacies that served the Medicare Advantage prescription plans. The central regions (southeastern part) of the U.S. had the highest risks for these problems. The observed population consisted of 6 million elderly patients. So there was total of almost 1.6 million chances of significant harm to these 6 million patients.
Darker The Color, The Higher The Risk Of Harm
Map above is from Danya Qato/Brown University
MD And RPh Collaboration “Perfect” Scenario
Pharmacists need more interaction with physicians and other healthcare professionals. This means we need to work as partners in medical practices. That brings me to where pharmacy stands now and what the future holds for a prescribing pharmacist.
Got A Pretty SpongeBob Band-Aid, Interested?
Pharmacy has gone through so many changes in the last 20 years. Recently, the profession has taken over a major role of nurses by immunizing patients. Change is sometimes good. The question remains if this is really a good thing for pharmacists? All the marketing about servicing the community and all the hype about being available at moment’s notice is pure marketing to increase the bottom line of the employer. The pharmacist needs to instantly drop what she is doing and take care of whoever interrupts her. There is truly no professional privacy. Renovating Your Mind calls this serious occupational fragmentation which may significantly increase job liability.
It Sometimes Gets Worse Than This, Seriously
Thank you zeebar.com for this cartoon.
Commercials about pharmacists jumping over counters to complete overwhelming tasks are not funny, but actually very sad. I remember hearing an ad on a local Top-40 radio station whose sponsor was one of the most prestigious pharmacy schools in the country. Their bottom line was if you become a pharmacist then you could make $100,000 or more every year. The school had to use money as an incentive. It was having such difficulty getting students that could fill the seats to pay for 6 years of college. How unprofessional that even colleges have to use marketing to reach their financial objectives. Even pharmacist employment has dropped precipitously throughout the country. Try to find a good full-time pharmacist position with benefits and you may be surprised at the results of your query. My advice is to intern at the desired place of employment early in your collegiate years for a better chance at a permanent position after graduation.
How Much Is Enough? Greed Chokes Quality
The reason for the immunization frenzy that pharmacists must inject is all about the money. Prescription net profit margins were in the low teens but may now be heading towards the single digits. That means after all expenses, an item for every $100 could net $9 in profit or less depending on if it’s a brand or generic. What profession works on a 9% profit margin. What the profession has done was unify forces with corporate American to make every graduating pharmacist certified to give an injection. Why? The profit margins are much higher with immunizations than filling prescriptions.
Everyone needs to make money to survive which is understandable. All pharmacists should be looking for a win-win proposition. We need our pharmacy organizations to lobby for a mandate that pharmacists work within physician’s offices. Our goal is practice what we know best, prescribing medication. So why is it that everyone else is prescribing instead of us? Besides doctors, the prescribing professional landscape includes nurse practitioners, physician assistants and optometrists. Let’s push legislation that completely revamp pharmacy school education. A graduating student class that is ready to practice in various sub-specialties depending on their preference in pharmacy school. The physician and pharmacist come together to form a team with the best of both worlds. One side would focus on diagnostics and diagnosis. The other side on prescribing with consultation. The meeting of the minds would bring both professions onto a high level of patient care.
Pharmacists have the most training about drugs, diseases and the body of any healthcare professional. The only thing stopping us is us. Our associations have succeeded in the push for paid consulting which is mainly done online, by fax and phone. We have positively influenced drug therapy by connecting with doctors, patients and insurance companies. But we need to be right in the center of things at the medical practice. The graduating class of 2020 could be ready to enter a new era of pharmacist prescribing. This would be a win-win for patients and health care professionals in the United States.
Counting By 5’s Is A Turn On, Not
Stop having CNN, MSNBC, CBS, ABC and Fox continue to show pharmacists as counting out pills on Abbott blue-green trays. We were all proficient in that talent in grade school. We already do so much for the public behind the scenes to help increase the quality of their lives. We need to renovate the playing field and hit the ball out of the medical park with pharmacist prescribing. Spread the word!!!!!