Make Pharmacy A Better Profession
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Do you have any ideas or suggestions that would make your Pharmacy Organization, eg., Alberta College of Pharmacy, or any Jurisdiction's Association better?
What would improve the Association(s)? How could they better serve Pharmacy, Pharmacists, and Public Safety?
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Essay23 - written by carpediem2100
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May 20/2006
There is a potential conflict of interest in retail Pharmacy. The company profits according to the volume of medicine/drugs sold. The other point similarly is efficiency. That is, the more units sold in the least amount of time contributes to maximizing profit. The dilemma(s) may be: a) improving the health of customers and reducing their drug use/dependency will also reduce the profits of the business. AND
b) With less time to clinically review a customers medication profile, this clinical task may not be done thoroughly or possibly not done at all. The current business/marketing model may therefore not be the best for the patient's health.
Fortunately, Pharmacists are professionals and do not exploit this conflict.
The bottom line is there appears to be no financial or market incentive for drugstores to do a good job. The Pharmacist by moral and ethical contraints must overcome these lack of incentives to look after his/her customers/patients. For their huge responsiblility, their control is limited. Legally they are responsible. The Pharmacy colleges have endowed them with this duty and yet no-one knows how to fix this situation. If anyone knows I am "all ears".
Essay 25
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written by carpediem2100 June08/2006
An alternative market model may be the solution for improving the profession
of retail Pharmacy. As discussed in a previous essay, Essay 23, the current model
consists of profit tied to prescription volume. This leads to a disincentive to
remove customers off medicines. It also results in no motivation for the pharmacist
to spend time to review customers' drug-history. For instance, allocating time towards
selling more prescriptions, (or widgets), results in more money; whereas spending time
checking for drug-related problems or drug-interactions adds no money to the "bottom line".
Here is a draft of the model
----------------------------
Step1: Sell drugs at little or no profit. Drugs should be sold to the customer at
the same cost as the drugstore gets from the supplier. It would not be unreasonable
to factor in a small mark-up in price to offset carrying charges. Perhaps 3% - 5%
should be added on? (I haven't worked out the math to what the percentage should be.
Maybe, the percentage should be 0%, if the model allows it).
Step2: Associate a clinical fee for the service of a clinical review. Each time a
review of the drug-history/drug-profile is performed, the pharmacist shall charge a
fee. To take this concept to a further extreme, a fee shall only be incurred if the
result of a clinical review results in catching a problem which benefits the customer
(this may not favor the "cash-register" of the drugstore though).
Step3: Make the clinical review service optional. Customers who wish a review will
request it and be obligated for the costs. Customers are not forced to have this
clinical service against their will. To illustrate this: Mrs. Jane Doe has been
taking blood pressure "pill X" for 9 months. The last time she had her prescription
filled was 2 months ago, when at that time she requested a drug-profile review and
she paid for it and the pills. She now comes into the pharmacy for a refill of "pills X"
and has no medical complaints or questions. Nothing in her life/lifestyle has changed
and she says her recent discussion with the doctor was reassuring. Jane indicates she
does not wish a review done and thus is only charged the cost of the drugs with
little or no financial markup. In this instance, Mrs. Doe saves money.
- The financial transaction aspect of selling drugs to the customer, whether it be by cash,
credit card or drug insurance can be handled by pharmacy assistants or technicians.
- The distribution aspect of selling drugs to the customer can be handled by
pharmacy technicians or robots.
- The clinical review of the drug-profile, or other clinical related questions should
be handled by pharmacists.
Ideally a working model will favor the customers' health, and finances. The pharmacy
would not lose money. The pharmacy would make a reasonable profit but not an absurdly
high profit considered to be highway robbery.
The problem is just that. The "value" is tied to the cost of purchasing medicine. The pharmacist is obliged to perform value-added services, in reality, for free! These services can be commercial based i.e., free delivery, open-house clinics etc... or they are professional based ones. For example, reviewing for medication conflicts, checking dosing ranges etc. The professional services are legal requirements. But it seems each year they just keep getting added on. In the end, success is still measured by the number of widgets sold and not by the amount of work/services performed.
We laugh at Albertans. They are running around telling the public they can prescribe medicines. What a falsehood. Most pharmacists there are entitled to supply non-addictive medications only in the context of a diminished supply. This is what most if not all northAmerican pharmacists do anyways. To call this service prescribing is misleading. It is the rare pharmacist who is actually qualified to competently prescribe a medicine from scratch. What a big public-relations nightmare they have in that province. Ha. Double Ha.
It's a tough profession, for certain. Insurance doesn't want to pay for the medications. A significant lot of time and effort is needed to process the claims with a common less than perfect success rate. You get the wonderful pseudo-environment of a fast-food paced workday but with tons of responsibility.
this guy Jim Plagakis is honest
http://drugtopics.modernmedicine.com/drugtopics/article/articleDetail.jsp?id=109779
he has this and other topics published the web.
http://drugtopics.modernmedicine.com/drugtopics/article/articleDetail.jsp?id=109779
http://www.theangriestpharmacist.com/category/hate-mail/
http://www.theangrypharmacist.com/archives/2007/09/pharmacist_hate_1.html
parents' frustrations
yup, please make drugs cheaper
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