WHAT DO YOU DO WHEN THE DECK IS STACKED AGAINST YOU?

In a recent blog by Brandon Tenebaum, on the Canadian Healthcare Network, re the qualifications of the next CEO of the Ontario Pharmacists Association, there was a high degree of heated reaction.  The issue began with whether the CEO necessarily needs to be a pharmacist or not, but inevitably became a debate as to the validity of the OPA as an association and whether it is dedicated to the interests of pharmacists, or those of Big Pharmacy Retail (BPR).

Over and over again the OPA is held to task for what it does, or does not do.  I am sure the departure of Dennis Darby, who was a well-intentioned individual, was somewhat precipitated by a good degree of frustration on his part as well as those around him.

Nevertheless it can probably be stated with some validity that the OPA is having problems.  Membership is either static or dropping, and actual pharmacists (not technicians) may represent somewhere close to 50% of potential.  If BPR did not pay for its employee pharmacists’ OPA fees, membership would likely plummet.

It can also be generally stated, that there is a great deal of dissatisfaction on the part of pharmacists with the direction that their profession has taken, especially over the past decade or so. Things seem to be going from bad to worse.

At a time when physicians are burning down the castle because they are not getting huger increases in remuneration (pity the poor physicians struggling on $300,000 per year), pharmacists have had average wage decreases somewhere close to 50%, now at par with hospital technicians.  And pharmacists like to consider themselves professional colleagues with physicians?  More like very distant poor cousins, maybe.

At the same time that pharmacists continue to complain about poor remuneration, abysmal working conditions, and lack of respect from the public and/or their non-pharmacists owned employers, their frustration continues to grow because there does not seem to be any way out.  Weak leadership together with powerful vested interests in place to protect the commercial business model are the prevailing realities.

Institutions like the OPA, the universities/academia, and even worse, the regulatory bodies like the OCP who continue to abandon their obligations, just bury their heads in the sand and hope to survive intact for another day.  They are always busy creating new committees, new programs like PharmDs, regulating technicians, and expanding endless regulations…all mostly designed to ensure self-preservation.

This is a bleak picture and manifests itself through an endless “weeping and gnashing of teeth”.  Cries for unionization never stop, though the reality of this ever happening is close to zero.  “Join the OPA and help rebuild the association”…might make you feel better, but not likely going to change anything.  The dark forces are just too powerful.

Whether it is BPR, the government, or any of the other vested interests, a confused and dissipated profession works in their favour.  Does the government really want to deal with a powerful united OPA?  Does the government really want another headache like the one it currently has going on with the OMA?  I don’t think so.

At times like this it may be helpful to take a little inspiration from a historic figure, who in the face of overwhelming odds, revolutionized a nation…Gandhi.  And Gandhi did it by peaceful means, not one bullet fired by him or his followers.  There are others like Gandhi:  Nelson Mandela, and Martin Luther King Jr., who utilized similar strategies and changed the faces of their nations.

Perhaps the path to change will not come from a new pharmacy association, or a new leader (a messiah) who never comes, or from a sudden change of heart by the powerful vested interests.  Perhaps this change will come through the individual small decisions pharmacists make every day in their practice settings, even if that setting is a 12 by 24 foot cubicle in a discount grocery store.

When given a quota for professional services, don’t meet it.  Do just a couple less.  When asked about the efficacy of Cold-FX, tell the truth is spite of the fact there are 1,000 boxes on the end of the aisle you are standing in.  When the district manager wants to talk to you about some new policy or complaint, keep him/her waiting.  When there’s a line up for injections, keep attending to pharmacy duties until you are free.  Avoid rushing in an attempt to meet so called “performance standards”.  You may not be covered by employment standards legislation, but you are protected by statutory law.

It will be through the thousand small acts of disobedience by thousands of pharmacists simultaneously that control of the profession may slowly begin to slip back from the firm grip of BPR and the other vested interests.  If nothing else, such actions will give you back some self-respect, and may just brighten your day a little.

Remember, prison bars do not a prison make.

 

4 thoughts on “WHAT DO YOU DO WHEN THE DECK IS STACKED AGAINST YOU?

  1. Quote: “Institutions like the OPA, the universities/academia, and even worse, the regulatory bodies like the OCP who continue to abandon their obligations, just bury their heads in the sand and hope to survive intact for another day. They are always busy creating new committees, new programs like PharmDs, regulating technicians, and expanding endless regulations…all mostly designed to ensure self-preservation.”
    This!! A thousand times this!!! Substitute the equivalent organizations in my home province of Nova Scotia, and you have things in a nutshell. The regulatory bodies quake in their boots to take a stand against any of the BPR crowd for any reason and content themselves with creating new positions and fiefdoms like any other navel-gazing bureaucracy, and the professional organization has become mostly co-opted by the minions of the same gang.The young folks coming out of University are honed to a fine clinical edge that leaves poor old 1970’s-trained me in awe, only to be buried in regulatory busy-work and/or sales/Rx quotas. What a bloody waste! The government and insurance companies are concerned only with making sure that we (especially the few independents left) make as little profit as possible while providing as many services as possible on whatever crumbs they choose to let fall from the table . I think that without some unimaginable upheaval, the profession as we knew it is doomed. I wish I could believe that ANYTHING can be done, but I don’t, which is why I left a profession I once loved after 40 years. I must applaud you for crying in the wilderness, but I fear it is too little, too late. Keep the faith, brother.

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  2. Here’s some other suggestions for Pharmacists wanting to maintain some semblance of “some self-respect” & also uphold the philosophy and health outcome goals of SMOKING CESSATION that the Pharmacy Profession used to hold dear:

    1) Don’t take that CE course on dispensing (so-called) medical marijuana, especially if it includes the smoking of cigarettes as a dosage form.

    2) Don’t encourage the use of the smoking of marijuana cigarettes for (so-called) medical purposes, if the day ever comes that these are available as a dosage form in Canadian Pharmacies.

    3) Contact your elected representative & let them know that regardless of the eventual direction on “recreational” marijuana, it is NOT in the best interests of the Pharmacy Profession to be dispensing or encouraging the smoking of marijuana cigarettes as a dosage form for (so-called) “medical” purposes.

    Liked by 1 person

    • Hi madukr,

      I think its reasonable to say that botanical marijuana will never be allowed to be sold through pharmacies for the same reasons as why cigarettes are not. The recent task force report on marijuana legalization stated that alternative dosage forms must be made available, such as oils, capsules, transdermal patches, beverages, and etc. And the current leading medical marijuana companies in canada have a lot of money invested into R&D for alternative dosage forms.
      So in short, smoking marijuana is but a short phase until alternative dosage forms are made available, and I do not think that any pharmacists need to worry about selling botanical marijuana because it would go against public health policies.

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  3. Actually, Big Pharma Retail doesn’t pay for its employee membership with the OPA (so you are wrong about that). I know the inner workings (at least recently). They used to pay for employee membership but havent in the last two years.

    OPA committees and board members are pharmacists like yourself. Many of them own small retail pharmacies, and they sanction the direction of OPA. It is easy to be a critic. It perhaps the laziest thing you can do as populate the discourse with misinformation. It is far more prudent to put your money where you mouth is and step with ideas that could strength the association and pharmacy in the province.

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