Recently, in BC, positive steps have been taken to put some degree of control over the ownership of pharmacies, be it direct or indirect control.  One would think that such a move was long overdue considering that 90% of pharmacies are now owned and/or controlled by non-pharmacists.

Taking this absurd situation of pharmacy ownership even further, regulatory bodies like the Ontario College of Pharmacists (OCP), are always zealous in going after pharmacists for any transgression deemed unprofessional or illegal, but these same bodies appear helpless in pursuing those entities which own the pharmacies involved, even if the transgressions are in fact policies or marketing strategies (like loyalty points or fee discounting) of the pharmacy owners, mostly Big Pharmacy Retail (BPR).

Pharmacies were once important; they are not important now, and in fact are the single largest determinant contributing towards the downfall of the profession of pharmacy as a whole.

When pharmacies were primarily compounding centres, the physical plant and all of the necessary paraphernalia to manufacture medications were critical.  Sterile technique and galencical skills represented the primary value proposition of pharmacists. This was half a century ago, but still the regulatory bodies dwell on ‘pharmacies’ with all the concomitant bureaucratic processes this involves…like accreditation and standards and metrics which make little sense today.

These outdated and harmful bureaucratic policies have played right into the hands of BPR.  The purchase of pre-1954 charters, allowing for non-pharmacist ownership of pharmacies has left pharmacists with the present pharmacy environment which all pharmacists sadly suffer under today; an environment dominated by commercial interests, selling all manner of useless (or even harmful) “remedies” marketed on television, with a dedicated focus to shareholders’ interests to the detriment of the interests of patients.

If pharmacists are indeed knowledge workers (like physicians, lawyers, and accountants), what importance is there to the physical space occupied by pharmacists in the delivery of their services?  Pharmacies are indeed redundant, and act to imprison pharmacists to an outdated model.  Pharmacists’ main role, in a BPR environment, is to act as a prop, or a draw to lure customers into the physical plant in order to be sell them all of the junk, fast food, and lawn chairs they can carry to their cars.

Having stated this reality, what are the chances that there will be any change any time soon?  Slim, maybe.

Think of the vested interests in the status quo.  First the regulatory bodies.  Fat from the extra fees they now collect from pharmacy technicians (largely underutilized), they would be horrified at the notion of losing those annual accreditation fees.  How would they support those lavish offices, and those trips to conferences to discuss all the lofty subjects they deem important?

But even more so, think about BPR.  How would BPR feel about having billions of dollars wiped off its balance sheets as the value of a pharmacy entity evaporates to zero?    Not to mention the control over pharmacists which BPR now has and cherishes.  The uproar and legal challenges would be a wonder to behold.

Suddenly, a “pharmacy” would just become a building with a pile of inventory in it, much more like a warehouse really.  An asset would become a liability.  Such a location would become a ‘pharmacy’ only when a licensed pharmacist steps in through the door, and ceases to be a ‘pharmacy’ when the pharmacist goes home for the day.  Think about the transfer of power such a development would create.  Respect would return to the pharmacist, who today is regarded as another of BPR’s retail employees, wedge into a cubicle between the deli and the fresh produce.

Well all this may seem like pie in the sky except for one guy.  His name is Jeff Bezos…aka the CEO of Amazon, who recently passed Bill Gates as the wealthiest man on earth.

Bezos understands that most customers just want stuff cheap and fast and with little effort, including drugs.  Bezos doesn’t care about owning pharmacies or investing in retail locations in increasingly bankrupt shopping centres.  Bezos sees the future, and by diminishing the power and leverage of BPR, may indirectly & unwittingly become the messiah for the profession of pharmacy.  Bring it on Jeff.  Who would have thunk it?


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