Sometimes an incident occurs in life which crystallizes all that is wrong or all that is right about a given situation.   A recent ruling by the Complaints Committee of the Ontario College of Pharmacists (OCP), and subsequently upheld by the Health Profession Appeal & Review Board (HPARB), against an Ontario pharmacist is one of these crystallizing moments.  In this case this ruling could not better exemplify all that is wrong with the OCP (and with HPARB).  It’s a classic.

http://www.canadianhealthcarenetwork.ca/pharmacists/news/professional/pharmacist-who-didnt-fetch-canada-post-package-faces-college-complaint-44140?utm_source=EmailMarketing&utm_medium=email&utm_campaign=Pharmacy_Newsletter

The piece, published on the Canadian Healthcare Network (CHN), garnered 109 reader comments, maybe a record.  All comments were highly critical of the ruling and came from incensed pharmacists right across the country.

In law, “Justice must not only be done, it must seem to be done”.  In this case not only was justice not done, but a great injustice was perpetrated, not only on the unfortunate pharmacist involved, but on the pharmacy profession as a whole, and indeed all pharmacists across the country.

First, the incident involved an individual who was neither a patient of the pharmacy nor a customer of the pharmacy involved; the individual was a post office customer.  Under what jurisdiction did the OCP exercise its duty?  Why did the irate customer complain to the OCP in the first place?  The incident whereby the pharmacist did not “fetch” the parcel on demand did not involve a patient/ pharmacist encounter.  The irate customer could have complained that she was not satisfied with the retail service she received from an employee to the owner of the store, a retail service matter, not a professional misconduct matter.  The pharmacist’s reaction or behaviour had nothing to do with his professional duties as a pharmacist.  Maybe if he wasn’t wearing the ubiquitous white coat, she might not have known he was a pharmacist.  The white coat and the pharmacy setting made him the target for her misplaced and rude behaviour and subsequent complaint.

What if the incident occurred in a parking lot, or between disputing neighbours, or between spouses?  Where does the jurisdiction of the OCP to meddle in the lives and personalities of pharmacists’ end?  What did this incident have to do with the pharmacist’s lack of knowledge of jurisprudence?  This was not a statutory or legal issue, it was behavioural on both the part of an irate customer and a store employee.

The OCP could have simply indicated that this incident did not fall under the definition of a pharmacy activity and was therefore not within its purview.  But no, in its over zealousness to appear to always be “acting in the interest of the public”, the OCP did not hesitate to take down the pharmacist and apply ridiculous punishments which went far beyond what was justified under the circumstances.

The compulsion for the pharmacist to attend a ‘Managing Conflict when People are Angry Course” borders on imposing mind-bending central state tyranny.  The course happens to be given by a company which one of the HPARB panel members was once a VP of.  Conflict of interest anyone?

What business does the OCP have trying to alter the behavioural characteristics of its members, most of whom are less than perfect.  This ruling could not reveal more how far off track the OCP is in exercising its mandate.  The OCP does nothing to attempt to impact on the total loss of control of the profession to big business interests but chooses to focus on hammering a frustrated pharmacist trying to deal with an unreasonable angry retail customer.

He probably does not have the money or the time, but if this unjustly persecuted pharmacist took this matter to civil court, the outcome would likely be very different.  Wouldn’t this be a neat thing for the OPA to support and drive?  Just dreaming in technicolour of course.

The other aspect of why this whole incident sparks such an angry reaction from the pharmacist community has nothing to do with the OCP.  It has to do with what pharmacy has become, largely a retail business with employee pharmacists required to suck up to customers lest they take their business elsewhere, or to the internet.

Professionals are supposed to be frank, and sometimes firm, with their patients.  Ask any physician or nurse how often they need to be less that smiley and effusive when dealing with patients in the patients’ own self interest.

This philosophy does not apply to lowly retail clerks who are expected to ‘run and fetch’ whatever is demanded of a retail customer.  Anything short of grovelling could cost a clerk his/her job, or in this case the intervention of his regulatory body’s unjust and self-fulfilling judgement, and it did cost him his job too.  Time for the notion of pharmacy self regulation to be reviewed for this, and for so many other reasons.

The reality is that customers are always right, but patients are not.  Too bad this poor guy had everything stacked against him, and not a single person or entity came to his aid.

Wonder if they will review this case in pharmacy schools as an example of what graduates can look forward to.

March has arrived and once again we get to celebrate Pharmacist Awareness Month; some believe it’s a bit over the top that we need a whole month?

“March is Pharmacist Awareness Month (PAM) — the perfect time to celebrate pharmacists’ expertise and the important role they play in delivering quality care to patients!”

The quotation above is taken straight from the OPA web site.  Pharmacists and patients are encouraged to “rethink pharmacy”.  The message emphasizes that pharmacists play an “invaluable role”, an “important role” in quality healthcare delivery.  If pharmacists play such an important role, how come we have to keep telling people about it?  Over and over again pharmacy appears to be proselytising its own importance to an indifferent audience.  Certainly there appears to be a reluctance to actually pay real money for these “important services” by governments or by patients themselves.

What an irony then that, almost timed by design, the Toronto Star and Global News should publish the results of an extensive investigation into widespread fraud by pharmacists in the Greater Toronto Area.  And we are not talking pennies here, we are talking hundreds of thousands of dollars and in some cases millions.  The journalism piece names names and shows pictures of the pharmacists involved.  We can see their faces and see where they live, in the mansions that they presumably bought with the stolen money.

On three successive evenings, Global News methodically reviewed the intricate ways that “crooked pharmacists” and “pharmacist fraudsters” have stolen money from the Ministry of Health, Ontario Drug Benefit Program with wanton abandon.  Often with little shame, these individuals’ defense is “depression” or “it wasn’t me, it was the hired help” or “my husband wasn’t working, and I had four kids at home”

This stuff is excruciating to watch. The clear suggestion by the investigation is that this is just the tip of the iceberg.  The ODB is not set up as a forensic agency, it is set up as a payer for goods and services, largely based on an honour system.  This means it is wide open to abuse by “unscrupulous pharmacists”.  Where are the often quoted “most trusted, most accessible” professionals?

The other message/suggestion in the investigation is that the Ontario regulatory body, the OCP, is real soft on these individuals, and although they are found guilty of professional misconduct, these bad apples are largely fined and lose their licenses for a year or so.  Eventually they all get their licences back and presumably go back to their criminal ways.  No one goes to jail.

How come a punk who robs a convenience store for $100 to buy drugs spends six months in prison, but a “healthcare professional” can rob the public purse of a million or two and gets only a slap on the wrist?

Interestingly the OCP was never interviewed for this investigation.  As usual, the solemn OCP brown stone mansion on Huron Street in Toronto is shown, front door shut but not a person in sight.  Likely privacy is sighted as the reason for silence.  Yet it is this body that licensed these individuals in the first place, and it is this same body that allows them to return to practice and own a pharmacy after a relatively short period of atonement.  What assurances does the OCP have that these individuals will not re offend?  Why are they not barred from the profession for life… right across the country?  How come some of these perpetrators once actually sat on OCP council?

Pharmacy has been around for a long time.  This ‘problem’ appears to have reared its ugly head to this degree in more recent times.  Where’s the variable and where’s the constant?  The OCP is now raising pharmacist annual registration fees by 20% to help cover costs of more intensive investigations into professional misconduct?  So the ‘good guys’ have to pay for the sins of ‘the bad guys’.

Unfortunately, the faces of these people become the faces of pharmacy.  This may not be fair or even accurate, but these are the faces that millions of viewers see and lay judgement on.  The power the media has to make a specific statement is considerable.  Those that don’t like the message sometimes call this “fake news”.

The fact is that the story is not about pharmacists, it’s about pharmacy owners, who in the cases of the examples given, happened to be pharmacists.   So were they crooks who became pharmacists, or pharmacists who became crooks?  The distinction is an important one.

But it is hard to deny the ‘truth’ when you can see the guy standing in the doorway of his house, in his underwear, and you can look him straight in the face.

Pharmacy certainly has an image problem.  How unfair for all the regular pharmacists who toil in the trenches day after day for reduced compensation and under terrible working conditions, not to mention the new innocent grads about to enter the meat grinder.

Too bad it’s all happening during Pharmacist Awareness Month.   How about we shorten it to a week?