Change has become the mantra of the day on many societal levels…or perhaps it’s the perceived need for change.  The US election, just days away, is to some degree pivoting on the electorate’s demand for change.  Both candidates are promising change.  The implication is that change will lead to a better place, not just a different place.  This need for change extends globally as we witness massive political shifts (Brexit, human migration, left/right political swings etc.).  To say the least, we live in interesting and uncertain times.  Change is truly a constant.

Now to the more immediate level, it can be said that there exists both a real, and a perceived, need for change in the landscape described as the profession of pharmacy.  In reality pharmacy has, over the last couple of decades or more, gone through tremendous change.  Unfortunately the prevailing conclusion appears to be that this change has not been so good for the profession of pharmacy in general, but even worse for practicing pharmacists.  So now pharmacists are looking for more change, perhaps back to a time when there was little doubt as to a pharmacist’s independence and professional values within the healthcare equation.

Ratcheting things backwards is usually very difficult, if not impossible.  In the case of the pharmacy landscape as it exists today, taking things back to “better times” is a pipe dream.  So the challenge becomes adapting to this new reality, and taking back some degree of control.

I have been writing about this subject for almost three years, and indeed the essence of this blog is all about pharmacists taking back control of their profession from Big Pharmacy Retail (BPR) / Big Business.  The pendulum of control has swung way too far in BPR’s direction and it is now time for pharmacists to yank back some of that control.

To repeat emphatically, BPR are not “the bad guys”.  Businesses, including big pharmacy businesses, adhere to a strict set of rules…in a nutshell, towards creating and increasing shareholder value.  If BPR waivers from this mission, management is replaced, or in the worst case scenario the business fails.  Don’t blame BPR for the present situation that pharmacists find themselves in; pharmacists must blame themselves.

And this is the first step towards recovery.  Pharmacists must hold themselves accountable for their present unfortunate state.   Loss of control did not happen overnight.  This was not a coup.  Loss of control occurred over time, gradually, step by step, incrementally, while pharmacists aided and abetted this process through a passive attitude and a tendency to “not make waves”.  It is a documented fact that pharmacists are by nature (and this is a general statement) more passive than other healthcare professionals.  Nobody would call the physicians of Ontario a passive lot.  Heck, they even took on their own association (the OMA) when they did not agree with what was happening.

You name it:  the scourge of professional services quotas, forced injections, performance metrics, lack of technical assistance, drastic compensation decreases of 40%, 12 hour shifts without a break, sale of homeopathic products etc. etc. all came about in stages with the full cooperation of the employee pharmacists who worked in these organizations and acquiesced to demand after demand.  These are all retail imperatives, and all serve the purpose of maximizing profit, and accordingly increasing shareholder value.  These imperatives also all serve the retail customer, but they do not necessarily serve the patient’s best interests.

Where was the leadership (the pharmacy associations, the regulatory bodies, academia) when all this was happening?  Unfortunately no one was looking at the big picture; all were looking at their feet and demurring within the silos that they habited.  Maybe attitudes are changing a bit now, but professional control will never happen without the active participation of all pharmacists in their everyday workplaces.  We are not talking about working to rule here, or confrontational approaches; we are talking about having an attitude…a proper attitude centred on patient care, professionalism, and pride in what pharmacists do and say.  If pharmacists are having trouble sleeping at night because of the compromises they have had to make during the day, they have a problem.

Start today by taking back control of your professional life.  Step by step, as more get on board eventually a sea change will occur; it will not be fast or easy; it begins with a focussed attitude.  Taking the right attitude is a personal and powerful decision. The present is the point of power.

All healthcare professionals are healthcare workers, but not all healthcare workers are healthcare professionals.  If pharmacists want to retain their identity as healthcare professionals, they must act like professionals, and begin by not sacrificing their professional integrity at the altar of commerce.

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  1. Great post Bill. I couldn’t agree more. Pharms need to get past complaining about their situation and take control of their practice. It’s gotten to the point that pharmacists don’t even refer to their “practice”, just their “job”. Many choosing to leave the profession rather than fight for what it should be.


  2. Nicely put. The scale has tipped to commerce of late, out of balance with patient interest. It’s unfortunate to see some big players ignoring the primary interest of pharmacy: patient health.


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