Who does the OPA really represent? billbrownblog.com January 24/2019

I recently watched the YouTube video which the OPA published entitled The Voice of Pharmacy.  Here is the link: https://youtu.be/IFd47I5udgA

It is over an hour long so you do have to invest some time.  Let me say at the outset that this piece is not meant to be a criticism of the video or the OPA.  In fact I was impressed with the sincerity and candor that was displayed by the three presenters, always in a frank and unscripted manner.  The video did reinforce a clear conclusion to me though.

For those who may be interested, here is a brief summary of the contents of the video from my perspective.  I believe the video clarifies who the OPA advocates for, though I am not sure if this was the intent of the video.

The video title is The Voice of Pharmacy, which surfaces the first question.  What is meant by ‘pharmacy’?

The presenters emphasize that the OPA represents the interests of both large corporations (non-pharmacist owned), and independent pharmacist owners. In fact the last several chairmen have all been independent owners from Small Town Canada.

The important Owners’ Council is made up of 24 members, 12 each from ‘corporate pharmacy’ & independent owners.  The emphasis is on representing the “pharmacy system” while it was not made totally clear what ‘system’ actually means.

There is also a clear message that the advocacy effort is with government and pretty well always involves economic issues that affect pharmacy owners.

Although the Owners” Council is self-sustaining, efforts to set up a Pharmacists’ Council made up of staff pharmacists have not been successful.  There was little uptake, and the whole effort is in hiatus at present.  Problem is that these unrepresented retail pharmacist employees apparently have little flexibility to attend meetings.  These individuals represent 80% of the 16 to 17 thousand licensed pharmacists in Ontario today.  It may also be that employers (BPR) are not that nuts about facilitating employee pharmacists attending meetings about issues like compensation & working conditions.

The OPA positions itself as representing the interests of owners, pharmacists, technicians and students.  Multiple approaches and diversity are what this is described as.

Not their fault, but the OPA admits it really has no negotiating power or authority to deal with government, or anyone else for that matter.  The government is just being nice in meeting with the OPA; it does not have to, and when it does, all discussion are covered by a non-disclosure agreement (NDA).  So no one really know what goes on behind the scene.

The video reveals that in original discussions with the government about the flu shot, the government initially wanted to reimburse zero for administering the flu shot.  The government’s argument being that the pharmacy would more than make up for any costs through increased store traffic and thereby sell more frozen pizzas, Cold-Fx, fat flushes, cough syrups, lamb chops, barbequed chickens etc.  The OPA prides itself in finally negotiating a begrudging $7.50 fee…it could have been zero.  Fact is, most pharmacists hate giving the flu shot (a technical act), but pharmacy owners, especially Big Pharmacy Retail (BPR) love them for the very reason government stated…increased store traffic, marginal no cost revenues & quotas to ensure targets are met.  Flu shots may be a small win for pharmacy owners, but the bane of employee pharmacists.  When government thinks of pharmacy it sees Big Pharmacy Retail, not individual healthcare professionals.

Then this zinger.  Apparently the two key initiatives which bind all pharmacy stakeholders together are: Preferred Provider Networks and Cannabis distribution from which pharmacists are presently excluded. What?

Some might have thought that compensation down 40-50%, ever increasing quotas, abysmal working conditions, 12 hour shifts, no breaks, random terminations/job security, no tech support, little or no respect from the employer, might have made the list of issues on the minds of at least some pharmacists today.  Nope.  None of these make the list of issues of concern to the OPA today.  The word ‘quotas’ never came up once in the over one hour video.

And therein lies the problem.  The OPA is a voluntary organization which depends on member fees for survival and credibility, but membership is probably less than 50%.  In an effort to represent the “Pharmacy System”, whatever this term means, the OPA fails to address the everyday issues which affect 80% of potential members.  In fact, these everyday issues are largely the result of the loss of control of the profession to non-pharmacist owned mega corporations…who sit on the very Owners Council in order to ensure their corporate interests are protected.

Really, one has to feel sorry for the OPA; it simply cannot win this game, and it’s not for lack of trying or hard work.  These are good people; they are just misguided.  Why not simply rename itself the Ontario Pharmacy Owners Association, charge $5,000 a year membership fees and then get on with it.

How can the OPA ever hope to garner the support of everyday working community pharmacists who suffer the consequences of issues and policies of other members (BPR) of the very same organization?

The lamb and the lion cannot sleep together

 

17 thoughts on “Who does the OPA really represent? billbrownblog.com January 24/2019

  1. Thanks for this blog, Bill.
    I too watched the video, and my assessment of it is fairly similar to yours.

    I chuckled when I read your proposed re-naming of the OPA, as I also think that the Canadian Pharmacists Association should rename themselves in the spirit of being honest about who they are truly advocating for – my alternative name for them is the Canadian Retail Association for Pharmacy (the acronym seems apropos).

    Like

  2. Pharmacists in Ontario do not bill the government directly, pharmacies do. Desire for change doesn’t change that for now.

    Pharmacists are paid by pharmacies, and anyone in hospital or FHT work has a salary that is affected by that arrangement.

    While advocating for changes in that arrangement, or advocating for better arrangements between pharmacies and pharmacists, it makes sense to advocate for better payments to pharmacies.

    As frustrating as that sounds, it is reality that we shouldn’t sink the whole ship while we are apparently still learning how to swim.

    Like

    • I agree with you Randy that what happens in community pharmacy has ripple effects on those of us who practice in hospital, FHT, CHC, NPLC and other sites. That is why I personally remain highly invested in the state of community pharmacy, even though I have not worked full-time in a traditional community pharmacy for over 12 years.

      I will also concede that, for better or for worse, government pays the pharmacy not the pharmacist. But let us be clear- pharmacy owners aren’t necessarily altruistic or magnanimous when it comes to looking out for the interests of front-line staff pharmacists. Pharmacy owners may indeed have self-interests that could be fuelling massive inertia when it comes to discussing remuneration reform- even when that remuneration reform is still anchored in the Ministry paying pharmacies, and not pharmacists.

      I agree with your sentiment that “we” need to advocate “for better arrangements between pharmacies and pharmacists” – but who exactly is the “we” doing this? This does not seem to be a priority for the OPA. This comes at the peril of working conditions and morale for community pharmacists, in my humble opinion.

      Like

    • Randy,
      Suzanne, in her comments above, has preempted me on this point. Nonetheless, I want to reinforce that I do not believe what you suggest will work.

      What you are talking about is what Ronald Reagan described as trickle down economics; the notion that as you build wealth at the top, it will trickle down to the masses below. If this was a sound concept, Donald Trump would not be the US president today.

      Th fact remains that pharmacy owners, especially BPR, consider pharmacists, along with the the rest of their retail employees as labour…cost of production. No business will ever voluntarily increase its cost of production. This is a fact of business 101.

      If, as a result of OPA’s efforts, one extra dollar ends up in the till of pharmacy owners, I assure you not one cent will ever reach staff pharmacists. All the extra money will go to the shareholders and everyone knows this.

      The fundamental problem is that there is no direct way that pharmacists can be paid by government. The second truism is that both government and the employer like it this way and will never lobby to change it.

      This puts OPA in the terrible position of being unable to add any value to 80% of its potential members. An awful situation indeed..

      Like

  3. Not arguing that pharmacies are treating pharmacists well, not at all. But when pharmacies suffer more economically, pharmacists are the first to feel it.

    Just saying that the current financial model rewards pharmacists economically only through pharmacies, and until that is changed, OPA shouldn’t be told that that particular advocacy is a bad thing. It just is what it is.

    Like

    • Randy,

      At the risk of belabouring the point, I am not saying that the kind of advocacy that OPA does is a “bad thing”; in fact it is a very good thing. As Allan states in the video, considering that OPA has no real negotiating power, it is amazing that the government even takes the time to meet with the OPA. And considering the government sees pharmacy as just another big business interest, it is remarkable that anything is achieved.

      Having stated this, then the OPA should be clarifying who they advocate for, and garnering much higher membership fees from those front line stakeholders…pharmacy owners.

      It is very difficult for working pharmacists, now working for low wages and terrible working conditions, to fork out $600 to support advocating for “the pharmacy system” as Mike states in the video. This is simply far too nebulous a concept when one is trying to put food on the table, pay off loans, and maybe get to the discounted gym to try and relieve the stress so eloquently described by many pharmacists today.

      Like

      • No, it is pretty simple actually. Putting aside the changes we need for a moment, many and complex, and thinking of what we have as a situation right now. The money flows to pharmacies, period. Pharmacists are paid by pharmacies period (or have incomes considerably influenced by such payments). If OPA advocates for the economic interests of pharmacies, it therefore advocates for pharmacists too. No connection, no pay.

        The rest, I agree is a great big mess.

        Like

  4. Bill:
    There is still hope. Those who have evidence to assist and direct the authorities have done well in getting the news release I heard today: “Ontario Government fines CWC (Costco) $7 million after Illegal Kickbacks.” The sheer magnitude of the fine alone tells you how deep this actually went; I’m sure it’s not recovery of all that was received by Costco. But hey…it’s a start, and it’s against PHARMACY, not pharmacists.

    OCP found the top pharmacists guilty a year ago, and levied a $20,000 fine each. Thank goodness for the government in this one.

    Other BPR (and individuals doing the same, such as has been reported regarding past presidents of OCP) should now start shaking a little bit, because the ball is rolling…

    https://ca.finance.yahoo.com/news/ontario-government-fines-costco-7-154849611.html

    Like

    • Yes, saw the announcement yesterday too. Ramifications could be huge here. Although if the practice is so wide spread, how will the government proceed after every individual pharmacy? Should be interesting.

      Like

      • I always caution against the tendency for some to say “everybody’s doing it.” There is no proof to that at all, yet it shows condemnation of us all, including those who are abiding by the rules. It’s one thing to claim as Costco did, “they didn’t know it was illegal” when their director of pharmacy sat on OCP Council and heard these topics as they arose…plus, he sat on critical committees of the College including Discipline. There was lots of notice given through public consultation on the regulatory changes, notices from the MOHLTC, notices from OCP, etc. That argument fails, but is consistent with what I would hear when someone was “caught”. The legal landscape, however, is that ignorance is never a defence before the law.

        Now, on to see what gets done about the past presidents who were implicated in similar actions back in late 2017. The silence on that topic has been deafening as well.

        Like

  5. You are of course correct. But I think of the highway speed limit by way of comparison. All the signs say 100 km/hr, but the vast majority of cars, trucks, & police cruisers do 120. All breaking the law. What happens when disregard for a law becomes somewhat ubiquitous? Just an observation, not a defence.

    Like

    • I love the comparison you use, because it is most often the one that anyone tries to use as justification against some other type of offence not being enforced (not saying that is you in this case, but only a comparison). Yet, the penalties for the two situations do not compare; speeding per se is not a CRIMINAL CODE offence, but a provincial offence under the HTA. One officer (based on conditions at the time) might consider 10% over the posted limit to be “ok” in his/her mind, another might not.

      At the end of the day, speeding is an “absolute liability” offence, not a “strict liability” offence. (One reference: https://www.bulwarklegal.ca/blog/strict-liability-vs-absolute-liabilty-which-is-your-offence/).

      That’s NOT the case with fraud.

      Said the pulled-over driver to the officer: “Those cars are all flying past us faster than I was going!”
      Officer: “But today, I caught you.”

      It will never be the case where all offenders will be dealt with under the law; it’s a roulette wheel and if your number comes up, be ready to accept the “winnings” (or, if you’re going to play the game, be ready to accept the outcomes). 😉

      Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s