PHARMACY, TRUCKING & the OCP

Although not so obvious at the outset, there are a lot of similarities between the trucking industry and pharmacy.  The trucking industry (or the transportation industry) is all about moving stuff from one place to another, and big players in this industry focus on tonnage and distance; they mostly worry about their trucks.

The more trucks the better and keeping these big machines in top notch shape is paramount; regular servicing is the standard.

When it comes to the drivers’ concerns, the same level of care and investment falls far short.  Long shifts and great distances are standard fare for drivers, who are notoriously out of shape due to lack of exercise, fatigue and consumption of junk food.

Is this beginning to make some sense when comparison is made to pharmacy & pharmacists?  Replace pharmacy for truck and pharmacist for driver.

It was not that long ago that pharmacy regulatory bodies were obsessed with details about the actual ‘pharmacy’.  The number of square feet of counter space, beakers, scales, square footage etc. were critical issues.  These aspects have seen less emphasis lately as the notion of the pharmacist as a knowledge worker is promoted, and compounding becomes a specialty activity restricted to a small minority of pharmacies.   But still, regulatory bodies like the Ontario College of Pharmacists (OCP) see fit to charge pharmacy owners annual pharmacy accreditation fees in excess of $1,000 per year.

What are these fees for?  Maybe just a convenient revenue generator?  And still this is not enough.  This year the OCP has dictated that annual member fees will be going up 20% over the next couple of years in order to finance the increasing number of complaints and disciplinary issues the OCP has to deal with.  What a sad comment on the profession of pharmacy.  What has caused this degradation in the moral fabric of the profession, and this spiked increase in assorted misdemeanors involving (ever more frequently) members of OCP council and its very leadership?

This website has been inundated over the years, but much more so lately, with lamentations from pharmacists mostly working for Big Pharmacy Retail (BPR) re compensation decreases as much as 40% from five years ago ($32/hr is fairly common in Toronto today) and abysmal working conditions.  In the name of saving labour costs, it is common to witness pharmacists working alone (no technicians or assistants), trying to serve a dozen patients at a time, perform flu injections, and bag groceries all at the same time.  No bathroom breaks, no meal breaks.  And for this you need a PharmD?

To add insult to injury, while under these terrible conditions, retail pharmacists will now be subject to measurements for productivity and proficiency by both the insurance sector (who is looking to save money for their clients/employers), their direct employers (like SDM), and by the OCP whose stated sole interest is the safety and health of the public.

Back to the trucking analogy.  How can the regulatory system be so concerned about ‘pharmacies’, which are 90% owned by non-pharmacists, and be totally  unconcerned about the health and well being of pharmacists who have to deliver the goods?

When confronted with this issue, the OCP is resolute that its responsibility is solely the welfare of the public, and that business models and the inherent structures of such models are not its concern or responsibility.  In fact, new incoming council members are specifically directed that their personal opinions are not relevant when it comes to fulfilling the mandate of the College, and strict adherence to the edicts as set out in the college’s policies is to be the guiding principle at all times.  Just read & follow the rule book, innovation is neither requested nor welcomed.  In British Columbia the voting turnout for the last council election was something like 8%.  Wonder what the percentage was in Ontario.

The problem here is the narrow interpretation of what is in the public’s interest.  If the health & well being of the pharmacist fulfilling the professional act is of no importance, then how can the pharmacist be judged on his/her professional competency?  How can we have road safety if we have great trucks being driven by overtired amphetamine stoked drivers?

Such factors as the number of prescriptions filled per hour, level of technician support, flu shot injections, and the capability to perform so called therapeutic appropriateness, must all be of concern to the OCP if it is truly concerned about the public’s interest.

To state sole interest in the public, while having no interest in the pharmacist’s capability to do the work, makes no sense, and reflects an institution which is locked in its past.

It is really time to reconsider the efficacy of self-regulation in both pharmacy and medicine; it’s just not working.