RESILIENCE…DO PHARMACISTS HAVE IT? billbrownblog.com May 27/19

Resilience sounds like such a positive word.  The word connotes ‘toughing it out’, not being a ‘quitter’, strength of mind & spirit, and all the characteristics associated with personal development, and leadership.

Recently there has been some urging from many circles to look for some positive stories in pharmacy, to look at the bright side, and to focus on solutions rather than the same old harping and complaining about the state of affairs.  Who could argue with this call for the positive rather than dwelling on the negative?

In a recent piece in the Globe & Mail,

https://www.theglobeandmail.com/opinion/article-put-down-the-self-help-books-resilience-is-not-a-diy-endeavour/

The argument is presented that research shows that resilience depends more on what we receive and interact with than what we have within us.  Surprise.

Extrapolating this to the pharmacy naysayers who write or comment on the present state of the pharmacy profession, there may be some downside to this urge to “make the best of things” and to looking for ways of finding solutions to the many problems pharmacy faces from within.

Looking for solutions solely within oneself is not going to cut it.  Eight five percent of pharmacy is now controlled by Big Pharmacy Retail (BPR), and not only in Canada.  Look to what CVS has done to the pharmacy profession in the US since Aetna purchased it.  Look at the situation in the UK with Boots since it was bought out by private equity firm Kohlberg Kravis Roberts.  Pharmacy is really BIG business.

Accepting what is dealt out in life, or love, or work, and then toughening it out through some association with this being a sign of strength of character is exactly what controlling parties wants.  The dynamics never change in such a scenario.  The oppressed party keeps on buying self help books, and things remain much the same.

The message here, and it is a positive one, is that all the will power, strength of character and resilience in the world are never going to help if one stays in the same place and accepts the environment presented.  It’s the people and the circumstances and the support systems around a person that will move that person from a cesspool of self pity and unhappiness, to a place where self fulfillment has a chance.  Without a change in environment, one may look tough, but one will remain on the losing side of the court.

Everyone knows what needs to be done to return pharmacy to the  profession it once was, but steps to get there appear steep, long & daunting

The pharmacy associations like the OPA do not appear to be heading in a new direction any time soon, and to representing the interests of everyday working pharmacists, despite ever-increasing pressure to do so.  If anything, recent political events in Ontario and Alberta would suggest that these powerless bodies continue to get caught flat footed by government.

The regulatory bodies like the OCP have zero interest in sustaining a professional working environment where pharmacy professionals can thrive and exercise their professional duties.  They continue to define their role in the narrowest of terms, even as the profession continues to slip ever further under the control of commercial vested interests.   Reminds you of the band on the Titanic

Hope.  Recently it appears that some International Pharmacy Graduates (IPGs) are beginning to look at opportunities back in their home countries, now that they have accepted that they were duped by BPR and the regulatory bodies into believing there was a pharmacist shortage in Canada.

More.  Career advisers are beginning to take a second look at suggesting pharmacy as a wise career choice.   Some of the news stories and comments have reached  young people and they are beginning to listen.  These comments are making a difference.   Saving even one student from a poor career choice is worth it.

It is acceptance, delusion and misdirected hope which have contributed to some of the worst catastrophes in human history.  So, it’s OK to get mad and to speak out.  Then to search for ways to change one’s environment to where talent, determination, strength of character, and yes resilience matter.

Be Careful What You Wish For May 8/19

It has been somewhat of a surprise that there has not been much more outrage/comment about recent proposed changes to the Ontario Drug Benefit Program coming out of the Ministry of Health & Long-Term Care.  These are pretty big changes.

First news, which came out of the OPA, was gushing with delight and self congratulating superlatives re the government’s decision to begin to allow pharmacists to prescribe and treat some 30 odd minor ailments.  On the surface this seems a very positive development.  Finally, pharmacists get to employ some of that knowledge which they garnered over years of university study.  So far though, only a tepid comment by government that it will pay for these services, but nothing about how much.  I am guessing a lot less that the $30 odd bucks a doc gets.  Same diagnosis, same outcome, but different remuneration levels?

Unfortunately, recognizing that 80% of all pharmacists toil as unrepresented retail employees of Big Pharmacy Retail (BPR), really clerks with not even minimum protection under the Employment Standards Act, what does this new era of professional privilege entail for the everyday working community pharmacist?

Here is a recent comment by a practicing pharmacist reacting to these new privileges which sums it up:

“Personally, as someone who has worked for years for a major retail chain, I feel absolutely no interest in this move towards diagnosing and treating minor ailments. We all already know what will happen is the Shoppers/Rexalls of our world.  They will require all of their pharmacists to take the courses and participate, then implement quotas requiring x number of billings per week, add no extra work hours thereby requiring you to squeeze even more into your workday, and share absolutely none of the extra profit the company may make with these billings. I will make no extra money with doing these services, but I will have the threat of losing my job if I am not interested in participating because they’ll fire me and hire someone who will. I will be taking on the additional liability for diagnosing and treating patients at no additional benefit to myself. Why should I be excited for this?”

A bit of a dispiriting  reaction, but then the truth always hurts.

Those bean counters at BPR are already cloistered in their subterranean chambers calculating how many UTI’s they can suck out of each of their employee pharmacists.  They work with algorithms not people.  They see big bucks here with no extra costs. Those lobotomized district managers will be marching up and down the aisles hunting for people coughing or scratching or whatever fits their dictated orders to set new quotas on.

So expanded scope is a great thing theoretically, but where the rubber hits the road, reality may tell another story.  More quotas, more work, less help, and maybe even less money.

And let’s not forget what the OCP is going to do with this one.  Although pharmacists may now hold a PharmD, it’s pretty well a foregone conclusion the OCP will mandate all manner of “mandatory” courses before allowing pharmacists to exercise any new practice privileges.  This kind of stuff is like honey to a bear to bureaucrats like the OCP; it just puffs them up.  Look to even more new hires at the OCP, and even higher annual fees  to pay for all this in the near future.

Then there is the small matter of $140 million that the Ontario government wants to take out of pharmacy, on top of the 700 Million already take out since 2015.  Is this after or before any compensation for minor ailments?

MedChecks are cooked. Done, Finished.  Pharmacists did this to themselves.  Some through sheer greed, but most through being forced trough BPR quotas to produce as many as possible with no attention to quality.  This golden goose has laid its last golden egg. The gravy is gone.

The so called “transaction fee” will cost another 17.4 million…minimum $1,000 a month right off the bottom line of the average pharmacy.  Bang.

The LTC game now goes under capitation.  Great idea for government but it may spell history to the business model of the big players in that game.

And to top it all, now that government has seen all those CBC/Global News programs on TV, there is going to be a whole heck of a lot more oversight over these pharmacy guys who appear to be crooks by inclination unless you watch them like a hawk.  Just watch those documentary reruns and see those pharmacists in their undershirts peeping through their front doors and complaining that it wasn’t their fault

Well at least the OPA is “disappointed”.

Hope some of those pharmacy undergrads are reading some of this stuff & may give them consideration for a mid course correction.  Just don’t tell the professors sipping coffee in the staff common room enjoying tenure and dreaming of retirement life at the cottage.