You Are Losing Skills, Perhaps Never Learned.

We are on the verge of losing something important. When it is gone we will never get it back.  It is a retail thing, but for over two centuries pharmacy was essentially a retail thing and pharmacists were called Druggists. Patients called us Doc and the general population year after year said that we were the most trustworthy profession.

So, Plagakis, what is the deal with Druggist? Isn’t Pharmacist good enough?  I suppose it is as long as you are satisfied to camp out behind the counter and run the Prescription Mill just as fast as you can.  Isn’t that what most chain pharmacists do?  After all, the for-profit pharmacy schools are just very expensive NAPLEX study courses.  Compounding? Gimme a break. My question is:  How can we justify making profit more important than patient care? I contend that there is a whole Druggist skill set that has been left behind.

Start with OTC counseling.  My goodness, for a couple hundred years, that was a vital part of our job.  Now, you are likely to get this:

I had stood at the pharmacy counter at my neighborhood CVS.  I was going to have fun with the R.Ph.  “What’s a good  cough syrup?”

“What do you want?”  She took a sip from her Vente Starbucks.  “Well?”

“I want a good cough syrup.”

She pointed, “Over on aisle number three.”  And she was gone.

I raised my arms, palms up. “Why won’t she talk to me?”

The technician gave me an Are-You-For-Real? stare.

“I need help”.

“Sir, she is filling prescriptions.”

I honestly believe that if she tried to really help her patients she would be running the risk of being written up for incompetence.  It is all about speed.

An old Druggist wants to know when did OTC medications have all of the therapeutic drugs with side effects, contraindications and dangers removed from the formulas?  Pharmacists have decided that running the Prescription Mill at breakneck speed is more important than to triage for the patient in need and that is a shame.  Often it is a poor patient with a pinched twenty dollar bill from the grocery money. You are their only hope.

Around 1995, pharmacists quit being Druggists and started bowing to the commands of sophisticated prescription-filling computer programs.   These programs are stool pigeons.  When you walk away from the Prescription Mill and its insatiable need for speed for just five minutes they got you.  They are looking for you.  A micro-notation is recorded under your name in the cloud. Too many and they can replace you with a new graduate robo-dispenser.

A pharmacist with Druggist muscles will not hesitate to help this mom choose what to do for her three year old son’s complaint.

A tattle-tale report is generated on the desk of another non-pharmacist MBA Master of the Universe.  Too many like this and an everlasting not-a-team-player notation goes into your permanent record.  The computer is stupid.  You were practicing patient-centric pharmacy, what all of us should aspire to, and the computer is going to punish you with a simplistic report that you were dead in the water for seven minutes and eighteen seconds.  And you wonder why you got passed over for that brand new store only three miles from your house.

They are called Pharmacy schools and some of the new ones do not even teach compounding.  I worked with a newly minted R.Ph. who was stymied by the rudimentary Tamiflu suspension using the content of capsules and Ora-Sweet.  Her pharmacy school is in the business of churning out robo-dispensers who are NAPLEX-capable. Druggists were in the rear-view mirror.  This is a critical mistake that was made worse when the National Association of Retail Druggists changed the name to the National Community Pharmacists Association. Did Druggist shame them?

            The centuries old Druggist culture may die from lack of care.  It probably has a lot to do with Profits.  That is how it looks to me.

Every Druggist is a pharmacist, but not every pharmacist is a Druggist.  There was a time, before Durham-Humphrey, when injured or sick patients chose between Druggist and doctor.  It was a simple question.  Why go to the guy who is likely to hurt you?  The Druggist will give you a pill.  It is called Counter-Prescribing. The patient describes the symptoms.  You prescribe an OTC that hits the spot.

When you youngsters get the chance to acquire Druggist skills, do it eagerly.  Your companies do not want you to, will hurt the metrics.  Fuck the metrics, it is not their profession to run.  It’s yours and don’t you forget it.



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