I've been a Pharmacist for a long time. Almost 30 years right now. The profession has changed a lot in that time and I'm nearing retirement as I'm thinking 30 years is enough.
However, while the profession has changed people's viewpoint of us hasn't. People think we take the prescriptions handed to us, count the medication from a large bottle, put it in a small bottle, put a label on the bottle and charge them way too much money for it.
In some cases they might be right
Some pharmacies are just designed to churn out the maximum number of prescriptions as quickly as possible. I've heard rumors of some chain pharmacies which penalize Pharmacists if they don't get the prescriptions out fast enough.
In reality though getting the medication into a bottle is something the technicians in the Pharmacy do. Pharmacists try to avoid that task
Some people might know that Pharmacists do more
Often times people will ask Pharmacists questions about their health and medication. Giving advice on medication and what medication might treat certain conditions is certainly a more fulfilling part of the job. Indeed virtually all of my University education was about medication, how it works, what it does, what it interacts with and waht to expect from it.
Some people think we know more than we really do
Of course some people think we are a Doctor in disguise. Or maybe a nurse in disguise. I have gotten questions about how to treat and dress wounds, post surgical wound care, dressing changes and more. Nurses do that ... Pharmacists are trained in medication with little training in wound care. I've been asked to look at rashes, wounds, listen to symptoms or ask to give a second opinion on a Doctor's diagnosis. Again, I'm not trained to diagnose illnesses as that's a Doctor's perogative.
Sure, I know a little about wound care. Sure, I know enough about diseases to rule out the obvious or give an informed opinion on some very obvious things. However, I'm not a nurse, doctor, physiotherapist, psychiatrist, etc. I'm trained in medication.
Regarding the misconception of charging a lot for medication
Medications are expensive. I understand that people don't want to pay for them as they are an additional unwanted expense. However, where I live I do not believe that we overcharge for medication. Why do I think that? Because where I live there is a normal way of billing for medication:
The patient pays our costs to get the medication into the Pharmacy (no markup). Then they pay a "dispensing fee" to cover our expenses (our markup). The "dispensing fee" is a flat rate for each medication we fill and doesn't depend on the cost of a medication. On an extremely expensive medication like Harvoni : Our Cost = $23,400/month. Our Markukp = $11.25 which means a profit of 0.05%. Sure some medications are cheap like Hydrochlorothiazide : Our Cost $0.75/month. Our Markup = $11.25. In that case we make a much better profit.
However, in general the Pharmacy makes the same amount of profit on any sale. There is no financial gain for us to recommend an expensive medication. Indeed, we try very hard to keep costs down for both our inventory and our customers.
The Hidden job of a Pharmacist
One thing that I've learned over the years is that there is a hidden part of the job that the public DOESN'T tend to know and that most new graduates also DON"T tend to know.
It is out job to advocate and stand up for our patients
Many of my patients have been coming to our pharmacy for years. For them it is comforting to deal with the same Pharmacist they have grown to trust over the decades (our Pharmacy has been in the same location since 1970. I've been there for 14 years and my boss for 27). They know that we look out for them and their best interests. We are their voice with other health professionals and their guide to wellness.
When they don't know how to approach their Doctors or IF they should talk to their Doctors they ask us and we can guide them on how to best talk to their Doctor.
When they don't know how to deal with their insurance company--we take the time to show them how to fill the forms, or get the contact numbers, of explain the letter they got. Most people are a little clueless when it comes to speaking the language of insurance companies. Sometimes the insurance companies are obstinate about paying and in those instances it is not uncommon for me to call the insurance company, figure out how to get things covered or how to navigate their treatment protocols.
Sometimes I help out the patients with government red tape in getting coverage. Vacation supplies. Residence requirements. Subsidies. Prior Authorization requests and income thresholds for coverage. There is coverage for people's medication throught the government but often times people don't know what is available or how to access it. Often times I step up to help my patients deal with faceless government entities to get them coverage.
Other times I just help patients navigate the overall health system. It can be confusing with all the different health professionals and agencies out there. Where do they get an X-Ray? Where do they get an MRI? How do they get psychiatric help? How do they get addiction help? How do they get housing support? How do they find a new family doctor? Where are walk-in clinics or the emergency room?
Accessing healthcare can be confusing!
A big part of my job is being available.
Confused people walk into my Pharmacy all the time. They know they need help but don't know where to start. I'm a medical guy in a white jacket they can walk up to and ask questions. Helping a confused and nervous person deal with the intricacies of the healthcare system is something I do all day, everyday.
Standing up for others
The #hiveleaners prompt this week is standing up for others. When I was first thinking about responding to that prompt two people came to mind. I could have talked about helping Salim a refugee from Afghanistan. He was confused about how to get a drivers license, his food was running out and he didn't know how to track down his aid cheque from the government. I helped him get food, get his license, and find help to deal with the government. I also thought about Gary. He was kicked out by his wife, forced to be homeless, and then fought a legal battle he was innocent of. We gave him food to eat and a place to stay while he tried to sort things out
In the end thought I decided that my job as a Pharmacist was how I stand up for others.
I stand up for them if the Doctor isn't paying attention to their illness.
I stand up for them if they need help but don't know where to turn
I stand up for them if the insurance is presenting them with hurdles they do not know how to overcome.
As I reflect though I prefer to Stand With those who enter my Pharmacy. In the old days it was very much Pharmacist in charge, patient does what is told. The newer model is more of a Pharmacist standing beside the patient helping them to make informed decisions about their health and wellbeing.
What's my real, hidden job as a Pharamacist.
It's not counting medications from a big bottle to a little one
It's not looking for interations with medication
It's not counselling patients on the medication and side effects.
..... It's Standing up for or Standing in unison with my patients. Helping them access options for their health and wellbeing.
Sure my expertise is in medication and its use. However, decades of helping customers has helped me understand medication is important but having a sympathetic ear and heart to help is the more important part.
I also know I'm at best a mediocre Pharmacist. I try hard but I've seen my boss navigate patient interactions and he is a true master. Then again, I've also seen some Pharmacists who don't seem to have a heart at all....I'm glad I'm not one of them.
Thanks for reading
As always, questions are welcome :)