My last blog was an open letter to physicians attempting to explain how pharmacists perceive themselves within the healthcare delivery team, how their role is evolving, and to explain some of the real constraints which sit in the way of fulfilment of pharmacists’ professional aspirations.

There were many physician comments…quite good considering the subject matter which may or may not have been of interest to them.

Admittedly, I was pleasantly surprised by the degree of perception and understanding that these physicians have re the realities facing pharmacists today, as well as the frank questioning of some of the fundamental tenets on which pharmacists are basing their future hopes.

One physician drew a comparison between government oppression of physicians and Big Pharmacy Retail’s (BFR’s) oppression of pharmacists.  Governments are certainly largely affecting physician compensation, but there is no comparison to the impact that BPR has had on the profession of pharmacy.  BPR now owns pharmacy, controls the pharmacy associations and exercises a heavy influence over regulatory bodies.   Physicians still have it relatively good over pharmacists in terms of control over their day to day professional lives.  Not true with pharmacists.

A new pharmacist category was identified by one physician…”the grocery store pharmacist” aka referred to as “the employee of profit driven corporate owned machines” …ouch!  Physicians complain of receiving 30 faxes a day from grocery store techs because in this province pharmacists get $20 for every ‘physician interaction’.  This physician is not aware of the reality of ‘quotas’.   Every time a new billable professional service is approved by government, BPR seizes on the opportunity to generate more marginal revenue and profit with no additional cost; hence, ‘crank up the faxes’.

BTW, flu season is about to dawn upon us.  In spite of the dubious impact vaccines have had in reducing the incidence of the flu, BPR will be cranking up the advertising budget and generating new higher quotas for pharmacist injections on top of already stressed workloads.  Flu shots create more store traffic and enhance opportunities to sell junk food, homeopathy, TVs, and in some provinces, even tobacco.  One physician could not fathom tobacco still being sold in a pharmacy…but neither do pharmacists fathom it.

One physician points out that he receives maybe 10% of the actual medication reviews that are done on his patients.  Patients tell him that they are solicited at home to come in for “mandatory sessions” for which the government is then billed $280 each in his province.  The reviews he does see, he describes as “beyond useless”… double ouch!!

Once again physicians may not be aware of the despicable quotas situation being imposed on employee pharmacists by non-pharmacist owned corporations.  The majority of pharmacists are embarrassed by the poor quality of med reviews being done across the board, but feel largely helpless to change the situation when their employment security is determined by “performance metrics”.  One physician goes so far as to request for the ability to do paid medication reviews herself without any quota pressures.

Dear readers, are we beginning to see the drift of this piece; it seems that physicians have a pretty good idea of where “the rubber hits the road” as far as pharmacy service delivery is concerned.

It gets a little worse.  Physicians ask if medicine and pharmacy were separated long ago partly to remove the inherent conflict of interest of the prescriber benefiting from the product of the prescriber’s prescription,  how is it  that pharmacists now want to prescribe when they (as merchants) directly profit from the sale of the product that they recommend/prescribe?   Go to the nearest box store doctor, and see the massive end displays of Cold Fx for colds, fat flushes for obesity, homeopathy for treating everything from hair loss to cancer.  The evidence of this truism smacks you right in the face “like a big pizza pie” as Dean Martin put it.

Here is the last word from one physician which nails it down cold…”I am reluctant to advocate for ‘more professional services’ like (Medschecks) from pharmacists. I hope to see more guidance and leadership from their professional colleges”.   Don’t hold your breath doc.

The conclusion here is that pharmacists have a long way to go before they can expect to receive the proper level of respect from their medical colleagues.  With the pharmacy associations neutered from the get go, and the trembling regulatory bodies unwilling take on the dark forces which dominate pharmacy today, it is left in the hands of each and every individual pharmacist to just say NO.

When the quotas for injections are imposed upon you (on top of trying to fill 200 Rxs in eight hours or less, with no bathroom break or sustenance) just say NO. NO to Med Review quotas.  NO to all the retail driven performance metrics that compromise your professional integrity and dignity.

If pharmacists cannot say NO to the erosion of their profession by non-pharmacists, physicians will always treat them as second class citizens. And rightly so.





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