What Type of Industry is Pharmacy?

Is pharmacy a product based industry or a service based industry?

Surprisingly there are many pharmacists that I have talked to that state we are a product based industry. Even more perplexing, they state that we need to become MORE product based and that programs like MTMs are worthless and will never do anything for the profession.

To me, that seems like a massively ill-conceived idea.

Part of the problem that what a pharmacist does is not accurately portrayed to the non-pharmacy public. I cannot even say the non-medical public because there are many medical professionals who do not know what a pharmacist can do. I covered this fact alone in a few months back.

If anything, we need to do more to be seen as a service based industry.

Sure we dispense a product that is sold and the surrounding areas of the store do the same. But that is not what a pharmacy is.

The classical definition of pharmacy is 'the art of preparing and dispensing medication'. I think a more accurate definition would be, 'the study and understanding of how medications react and treat disorders in the body.'

Or something of that nature.

The PBMs can justify the fact they pay us as a product based industry because that's how everyone else views us. No one cries wolf because no one sees anything wrong.

What would happen if doctors were reimbursed solely for the materials they use in an office visit? What would happen if a dentist was paid only for the cost of the filling used during a procedure?

There would be a nationwide outrage, would there not be?

Yet this is precisely what happens on a daily basis in a pharmacy and we are supposed to take it in stride.

What's more, it's not even PBMs that are shooting us in the foot. The four dollar generic program instituted by Walmart a few years ago was the biggest punch in the crotch the profession has endured. As if that wasn't bad enough, other organizations are resorting to giving away meds for free to 'compete'.


Low prices. Always.

Right.

So not only are we already viewed by the public just as someone who puts pills in a bottle, we also do so for free.

How can we function like this?

In truth, we can't. Simple economics state that we cannot continue to devalue our product without devaluing ourselves. We're already dangerously close to a point where the public views us on the same level as the cashier at McDonald's.

And then where we be? Everyone is trying to take the next step in the evolution of the profession, but no one is acknowledging the problems we currently have. Instead, most put on a happy face, throw around terms like 'MTMs' and 'Revolutionary Clinics' and assume all is well.

All is not well, and all will not be well until we start to resolve these problems.

The first step could be as simple as reaffirming to our patients that we provide a service to them. Obviously you can't say that point blank, but you can certainly start presenting yourself in ways that will lend credence to that idea.

Of course the first step is a baby one, as it's the next step that'll be the big one.

Until the majority of pharmacists in this country began to stand up for themselves and take a stand, we won't see this happen. No longer can we afford to sit idly by and be the quiet profession in the medical community.

We have been the whipping boy for far too long, and it's time to assert who we are and what we do.

What type of industry is pharmacy? An irreplaceable service that is being squandered by people ignorant of what the profession actually is.

And that is damned sad.

Weird Customer of the Day

Not a pharmacy customer, but still one of those head scratchers... no, one of those where you bash your head in the wall repeatedly.

Woman comes to the counter with a cart and four gift cards. She insists on putting ten bucks on each card and that I must ring them up separately.

Okay, whatever, I'll indulge you.

I then ring up the rest of her items for a total of thirty something bucks... when she gives me the gift cards I just rang up as payment.

Now what in the hell would possess someone to do that? It happened three days ago and I still cannot figure out even an illogical thinking process.

Any ideas?

Who doesn't like Bimbos?

Strollin' into the glorious Walmart in which I grace my presence today and I notice they redid the sales wall. This is good because there's usually cheap food. I like food... especially when it's cheap.

And then I see this:

My first question is who in the hell decided this would be a good name for a company? Can you imagine the conversation that lead up to that one?

D-Bag #1 - So what do you think we should call this new company? Super Duper Bread?

D-Bag #2 - That's not a bad idea, but it needs something more....

D-Bag #1 - How about 'Natural Super Duper Bread'?

D-Bag #2 - Hmmm I think it's missing something, but I can't quite put my finger on it

D-Bag #3 talking to D-Bag #4 in the background - Dude she was suchhhh a bimbo, I mean good lord man

D-Bag #2 - That's it! Bimbo!

D-Bag #1 - My god man, that's genius!

Then they give it a cute little bear mascot, because as we all know, the word bimbo causes us all to think of a pillsbury doughboy rip off and not of a stacked blond with the intelligence of a yak.

And then if that wasn't enough it has to be 'Soft, White, Family Bimbo' bread.

Really? A soft white family bimbo? That sounds like a show on Fox or the CW.

On this day, Bimbo Bread company, I salute you. Just not in the normal way I'd salute a bimbo.

Facebook, Twitter and a dog named Boo

Ok, maybe Boo is Old MD's dog, but the title sounded catchy in my head.

Since the countdown to school is getting progressively smaller, I've decided to do a bit of cleaning up around this place. I'm debating a full fledged redesign as I doubt I'll have time over the next few years once everything begins.

As of right now, there are small changes around the site.

On the left column you'll notice a new Facebook link. I took a page out of The Redheaded Pharmacist and started one up for this site. Whether or not it's a worthwhile endeavor I have no idea, but I thought it would be worth trying out at least, especially considering the emails I recieve.

Also if you jump into the specific URL link to a post, you'll now see icons for Twitter and Facebook for ease of sharing. Originally I wanted them on the main page as well for each post, but I've run into a bit of a programming hitch and I'll have to delay that.

I know you all are salivating in anticipation.

Here's A Way To Save Money on Healthcare

Every one is talking about different ways to reduce the cost of healthcare for individuals and the government. I, Phathead, have devised a simple solution that could save millions, if not billions, on a yearly basis.

Stop the copy cat drugs.

You're probably going, 'WHOAAAAAAAAAAAAA that's such a MIND BLOW." I know, right?

Seriously though, do we need an Aricept XR? Did we need a Coreg CR? Was there a legit need for Nexium to come out right as Prilosec was going off patent?*

Soon the ads will start and doctors will start prescribing because since it has XR (or CR or HD or whatever the hell else you want after it) it has to be better! And at 200% the price of the old product, that doubles it's effectiveness!

That's where the Lipitor HD post came from. There's no reason it exists except to make more money. It's not our fault Pfizer or Merck or whoever has few drugs in their pipeline. They should not, however, be allowed to take advantage of patients who can barely remember to take their medication, yet alone understand how it works.

If the APhA really wants to help patients, why not start a grassroots campaign to educate consumers of this fact? How much shelf space and inventory costs can you save if you no longer have to stock these useless items?

And it's simple. Truly, and utterly simple. But no one has the gonads to stand up and say stop.

Hell, maybe Lipitor HD isn't too far off the cuff after all...

*Note, I realize that there are some drugs that are more beneficial when Big Pharma pulls something like this. I also know that there are many that are not.

When You Don't Know an Answer, Just Make Up Something

Believe it or not, at one point in my life I was a rather shy and introverted individual. Actually, not just at one point, for the most of my life.

Through various means I have climbed out of that shell, so trust me when I say that when someone asks you a question that you don't know, one can have a tendency to panic or not want to take the steps needed to answer it.

Never once though did I make up a false answer just to pacify a customer.

A few nights ago I was kickin' ass at the register at Big Evil, like I usually do, when I overheard the conversation of the elderly couple I was checking out. They were both upset as she now needed a walker to get around, but they didn't have the money to spend on one.

I inquired what precisely they were looking for, and the husband informed me that they had just been to the pharmacy and asked if Medicare would cover it. Apparently two of the people behind the counter told them Medicare only covers drugs and in no way covers something like a walker.

Sigh.

They were both very upset for obvious reasons, even more so because they had already looked at the prices for various walkers.

Immediately I stopped scanning their items and whipped out a piece of paper. I told them the steps that they would need to take; getting a Rx from a doctor, what part they would have to pay for, how to get their supplemental to cover the rest of need be. I told them about the differences in basic walkers and the four-wheeled variety and how Medicare will pay much less of the four wheeled variety if they choose to go that route.

I also told them their best bet is probably to find one of the local medical supply companies in town as they are often more specially trained in that area and would be able to help them with any other problems they may have.

To say they both looked flabbergasted was an understatement. He asked how I knew all of this, and I explained my current situation.

To which he replied, "Well why the hell aren't you working back there with those numbskulls?"

As they were leaving I explained that if they had any more questions, I am found here most nights and would be more than happy to assist them further.

It was my first taste of pharmacy in two months and I relished it. Although I was left wondering just why in the hell they would tell them that sort of thing to believe with.

My guess is that either those people were vastly misinformed, they simply did not know the answer or they did not want to answer. That time of night there is only a tech and pharmacist on duty, so I know a RPh was involved at some point.

And that bothers me. Makes me wonder who else they shoo away when they don't want to answer something.

Now, I'm real excited to start working over there...