THE CONTINUING SCOURGE OF PROFESSIONAL SERVICES QUOTAS

Almost everybody hates professional services quotas…pharmacists, the governments that pay for services, the public who receives poor quality care…almost everybody, the big exception being Big Pharmacy Retail (BPR).  The chains/grocery stores just see quotas as yet another great way of generating extra revenues at no cost except the wellbeing of pharmacist employees.

The prestigious CPJ (Canadian Pharmacists Journal) recently published an article (Nov. 25/16) entitled:

Factors associated with pharmacists’ perceptions of their working conditions and safety and effectiveness of patient care

The gist of the article (from which I will borrow heavily) is that the role of pharmacists has changed rapidly in recent years through legislation, allowing pharmacists to provide various new patient orientated (versus product oriented) services.  Retailers don’t like this.  Retailers like to sell stuff, any stuff.

Along with this change, concern is constantly growing that the pharmacy workplace environment is not evolving alongside these changes in practice.

In a recent survey conducted by the BC College of Pharmacists, pharmacists in the community setting (58% chain, 19% Independent) were asked various questions including perceptions of working place conditions.  Result:

 

“Pharmacists mostly disagreed with the statements that they had enough time for breaks or lunches or to do their jobs, as well as enough staffing support. Pharmacists’ perceptions of their workplace environment were negatively associated with workplace-imposed advanced service quotas (for medication reviews, immunizations and prescription adaptations); being employed at chain store pharmacies, compared to independent pharmacies or hospitals/long-term care settings; and higher prescription volume.”

Now here is the kicker.  Please focus on the last four words of the conclusion.

“Pharmacists working in chain community pharmacies who are required to meet monthly quotas for expanded services reported a substantial negative impact on their working conditions and perceived safety of patient care.“

Nothing new here.  We have all known for some time that quotas are bad except for those who set them solely for the objective of grinding one more dollar out of pharmacists. We do not need any more surveys.

We could understand why The Neighbourhood Pharmacy Association of Canada (up until recently better known as The Chain Drugstore Association of Canada) might offer no comment to these conclusions.

The burning question remains, why do the regulatory bodies not respond?  This is about patient safety for damn sake; this is what regulatory bodies are supposed to be defending, and for which these colleges exist.

Why do the pharmacy associations not offer a scintilla of redemption by declaring a positon on professional service quotas?

For the third time in this forum I will ask the following question.  I would like to know why the OPA cannot come out with this simple statement and then publish it in every major newspaper in Ontario.

“We are the Ontario Pharmacist Association (OPA). We represent the 14,000 pharmacists of Ontario and we stand for excellence in the profession of pharmacy. Through continuing learning and diligence towards the ethics and quality standards of practice, we strive to provide the citizens of Ontario the highest quality pharmaceutical services possible. We are committed to this goal. With this in mind, the OPA takes the official position that quotas for professional pharmacy services are not acceptable, and not in patients’ interests, nor those of the governments that fund these services. We will do everything within our power to see quotas end, and to ensure that the pharmacists of Ontario be given the opportunity to remain patient focused throughout their professional lives.”

Why will the OPA and the OCP not take a stand against something as oppressive as quotas?

Why are pharmacists left hanging in the wind? …forced to choose between compromising their professional duties/ code of ethics and their employment security?  What a travesty.