Miracle in the Pharmacy

There is a scene in the movie "The Miracle on 34th Street" where Santa Claus is in Macy's, having children come up to visit with him and share what they would like for Christmas.  One such child requests a particular toy and when Santa says that he is sure the young man will have it under his tree Christmas morning, the child's mother makes a cross face because that particular toy is sold out at Macy's.  She is frustrated that Santa would promise something to the young child that she knows she will not be in a position to provide.

Much to Mr. Macy's dismay, Santa promptly directs the mother to Gimbal's Department Store, down the street, where he is sure they have an ample supply of this particular toy.  Mr. Macy is sure that this behavior is bound to drive away all of the Christmas shoppers; however, quite the contrary happens.  As it goes, the customers are so taken with the fantastic customer service that Santa has provided them that they continue to shop at Macy's more than ever before.

Perhaps this is a theory that crosses the border of all types of business.  Today I had a father walk into the pharmacy with his 10 year old daughter.  They had been to see one of the physicians up stairs and rather than go across town to their usual big box pharmacy, they opted to stop into our clinic pharmacy for their prescription.   We had never filled prescriptions for this particular family before, so we gathered the demographic information and said we would get going on it as soon as the doctor sent down the prescription.

Ten minutes later we had not yet received the prescription so I gave a call upstairs to see if I could get the process moving forward.  Come to find out, the prescription had already been electronically sent to the other pharmacy, so after a bit of a discussion, I took a verbal order and agreed to call the other pharmacy and let them know we were filling the order.

As I was taking the order I became slightly concerned because the prescription was for an antibiotic liquid that is not to commonly prescribed in our area.  Fortunately, we had enough of the medication on the shelf for half of the course of therapy; however, the father would need to return in 4 or 5 days to pick up the remainder of the medication. 

I went out front and explained this situation to the father, asking if he would be in a position to come back next week for the remainder.  Unfortunately, his daughter was with him for this week; however, tomorrow morning he was taking her back to her mother's house which is about 50 miles away.  I understood and said I would call a couple local pharmacies to see if anyone had the medication on hand.
After 15 minutes of phone calls searching for an uncommon antibiotic liquid we came to the conclusion that we were the only ones who had any of this medication in stock.  I explained this to the father and offered to call his daughters physician to see if any of the other antibiotics may be appropriate in this particular situation.  

The father had been acutely observing this entire process over the past 20-30 minutes.  He was so enamored with gratitude for our effort to find this medication for his daughter that he asked us to just take care of it.  He stated he would be happy to take what we had today and he would come back in a few days, pick up the rest of the medication, and drive it to his daughter's house. 

Going through the process of traveling to a clinic, waiting in the doctor's office and then being seen as a patient can be an event that takes up the greater part of a day for many individuals.  When the patient leaves the office and arrives at the pharmacy, providing a sincere and authentic customer experience may make the difference between this particular patient using your pharmacy, or another pharmacy, the next time they have a prescription to fill.


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Cancer Pain

More often than not, an individual does not realize they have cancer until it has spread far enough along to be causing some sort of physical issue.  At this point, the person sees their doctor, is referred to another doctor, is eventually diagnosed with some type of cancer, and then begins the long and complicated process of treatment.

Along with chemotherapy, radiation and possible surgery, patients are regularly faced with an ever increasing level of acute pain.  Pain control, in the level sometimes required to treat metastasizing cancer, may bring with it a series of emotional and social implications that leave patients struggling for appropriate understanding.

Please click on the link below and read the article I posted at RxEconsult describing one such patient working through the struggles of cancer pain.


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Future of Pharmacy

In 1979, when I was a junior in high school, I was faced with the task of deciding which way I wanted my future career to go.  Like any practical pre-college student, I did an analysis of my options.  What career can I go into where I can choose what city I want to live in, start out at the top of my pay grade, work reasonable hours, graduate with an advanced degree within 5 or 6 years, and always have a job waiting for me?  After looking at law, medicine, engineering, advertising, and politics; I saw that pharmacy filtered to the top of the list in all of the categories.  I really had no idea what pharmacy involved; however, my plan was set that I would go to pharmacy school, graduate in an advanced Pharm.D. program within 5 or 6 years, and work wherever I chose.

In 1987 I graduated with my Doctorate in Pharmacy, bypassing any undergraduate degrees, and proceeded to choose from the myriad of offers available to graduating pharmacists.  Over the next 15 years it felt like every other day I would receive an offer in the mail from a corporate pharmacy chain, offering an exceedingly large sign on bonus and moving expenses, if I was willing to move to whichever city and take a job working with them.

The days of students graduating pharmacy school and immediately being offered a large sign on bonus to work for a chain pharmacy in the city of their choice has passed; however, this passing has coincided with the country slowly coming to understand the immense intrinsic value of a pharmacist.  Pharmacists may need to continue their post-grad education by specializing in one of the many specializations; however, now is an exciting time with so many new areas of specialization being recognized by institutions and providers.

I recently read an article that painted a dismal picture of the Future of Pharmacy.  The article, titled "Who Will Stand Up for Pharmacy?" describes the pharmaceutical corporate takeover of pharmacy schools, insurance companies, and state boards of pharmacy.  I feel the author was not just describing the frustrating state of affairs that the United States pharmacy system has become; moreover, she was calling all pharmacists to take a stand, find your passion, and move your profession forward.

I forwarded this article to quite a few of my pharmacy contacts in order to get some feedback on their opinion about the Future of Pharmacy.  Following are the opinions of five pharmacists or students who responded.  Please, add your comments below in the comment section!

Barry (outpatient hospital pharmacy manager with years of retail and management experience)
"I have practiced Pharmacy for 40 years.  I have seen the profession move through various phases, often fraught with gloom and doom.  First were the insult of low reimbursement from the PBM's, then the threat of mail order pharmacy and the invasion of the pill mill retail outlets.  Somehow retail pharmacy still survives.  I am encouraged when strangers find out I am a pharmacist, how they relate what a special relationship they have with their pharmacist, both chain and independent, but never mail order."

"What makes me come to work every day is knowing I can and will make a difference in people's lives helping them with their medicines and health care.  Pharmacy as a profession can be rewarding or mundane, it all depends on what you want to make of it.  What encourages me is that it appears that most pharmacists share my enthusiasm about helping their patients."

Carl (retired hospital pharmacy director who still works retail pharmacy to keep his skills)
"I feel the article by , Kimberly A. Ankenburk, RPh, was too negative.  My simple response to her question is that pharmacists need to "Stand for Pharmacy".  The situation she believes exist has existed in other professions past and present; it is nothing new.  Change produces doubt and fear that we are losing "something".  In reality, we are gaining an opportunity to create something new.  I have practiced pharmacy for 46 years.  Occasionally it has been "easy" but most often it has been a difficult career finding your place in the health care environment.  It has, and still is, a rewarding job, especially when we focus on our patients' needs.  To the question, "Who Stands for Pharmacy?"  Pharmacists must stand for pharmacy."

Jason (outpatient hospital pharmacy director with years of management and insurance company/formulary experience)
"There is a greater variety of opportunities now than ever before.  However, the oversupply issue won’t go away anytime soon.  Just over 9 months ago I decided it was time for a change in my own career.  It was then that I came face to face with the challenges of the job market here in MA." 

"I thought the drug topics article was too negative and maybe a bit too narrowly focused on retail, probably since she is a Walgreens pharmacist.  But that being said, I think she does point out some real problems.  I have personally spoken to a dean at one of our schools of pharmacy who admitted they send out flyers to prospective students claiming there is a pharmacist “shortage” right now (I got one in the mail and called him out on it).  So, basically, they lie to fill their seats (and their pockets).  Also, our board of pharmacy and the whole department of health are corrupt.  In our state they siphon away most of the money from pharmacist license renewals that SHOULD be used to help strengthen the board and use it for other state needs.  In the meantime, the board is filled with those who conveniently “look the other way” which is what happened with the whole New England Compounding Center tragedy.  Steve, it is just a mess.  Corruption, lying…I could go on.  And at least in Massachusetts, the association that is supposed to represent us really just represents the schools of pharmacy.  You will never see a dispensing pharmacist from a chain get a position of leadership…unless they have drank the Kool Aid.  LOL.  It’s almost comical." 

"All that being said I still love the profession.  I feel bad for pharmacists who feel stuck.  I feel bad for pharmacists who are older and are experiencing age discrimination.  I’m currently working on creating tools for pharmacists who want to change career paths.  I’m persuaded that most pharmacists need to do more to diversify their opportunities.  But for as hard as things can sometimes be, very few pharmacists could start their own pharmacy and pay themselves as well (with benefits) as they are making for a chain.  Sometimes we have to make hard choices."

Ome (experience in academia, clinical practice, online content development, pharmaceutical industry, and founder of RxEconsult Healthcare Network)
"Here are my thoughts about the future of pharmacy. I actually forgot about this article. Thanks for reminding me."  http://www.rxeconsult.com/healthcare-articles/Why-Pharmacy-is-a-Great-Healthcare-Career--287/

Anonymous (Graduating Pharm.D. Student, Class of 2014)
"The future of pharmacy is a concern for those who have been in the profession for years as well as those entering, like myself.  The concern from my perspective stems mostly from fear of finding employment and saturation of the profession.  I think many of these changes are occurring because of the influx of pharmacy schools and new graduates.  On the other hand, I think that our career is expanding in a multitude of directions and we may be forced to be more creative in the career path we take.  Unfortunately, those who have been in the profession are forced to comply with the dominating retail chains or the countless new graduates will happily swoop in for their job." 

"I do think, however, that advancements in the scope of pharmacy practice address the rapid growth the profession.  Pharmacist recognition a healthcare provider in states like California expands the roles and responsibilities of pharmacists increasing the demand.  In addition, accelerated advancements in technology have remarkably affected pharmacists and the entire healthcare community.  It causes frustration among many pharmacists who have been practicing for years and for those of us who chose this career path thinking there would be more job security. Nevertheless, the profession will only move forward and we can chose to stay current and move with it fall or behind and risk losing jobs.  Those who evolve with pharmacy and stand up for the profession will have jobs and those who sit back and complain will not."  

"It will be important for pharmacists to dictate the direction in which it takes to maintain the quality and respect in which it has always deserved."

Luka (Foreign Pharmacy Student in Slovenia)
"Yes the times have changed and we as a colleagues, friends, must step together and demand changes. It should not be some individuals only; it should be all or nothing for the effect to be [potentially] seen. I am aware that the US is a big country and there is many Colleges of Pharmacy and the market has become over saturated. I get why are people afraid for their jobs because there will always be potentially 10 other pharmacists waiting for the position. It should not be like that!  Maybe all wouldn’t t follow at first but I’m sure the number of pharmacists demanding changes would soon increase. Maybe the other pharmacists in the foreign countries would become encouraged and inspired by the actions of their colleagues in the States and maybe, just maybe they would start demand changes too (if they felt the need them)."

Please, add your own comments below in the comment section; keep the converstation going!


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