PHARMACIST STEVE

For  those of you who believe that everything must be PC (POLITICAL CORRECT) .. PLEASE STOP READING NOW !

When I was a kid, a long time ago – can’t hide that one with thinning gray hair – Western movies were big on the small screen. Back then it was all about Cowboys and Indians (Native Americans today)… Seemingly every movie had a “battle” between the “Redman” and the “Whiteman”… The whiteman would “circle the wagons” to defend themselves against the attacking Indians. The Indians seem to always be the aggressors.

The normal scene before the “Indian attack” was a lot dealing with a traditional “war dance” and the ever present “war drums rhythms” that preceded “the attack”

And why did these Indians keep attacking the whiteman?… could it be that the whiteman was perceived of interfering with the Indian’s way of life and telling the Indians how and where they should live. Basically trying to interject their foreign life style on those their ancient native life styles that had served them so well.

First of all… in the pharmacy world/profession.. I am hearing faint “war drum rhythms”.. are the natives becoming restless?

Let’s look for comparisons to what our Native American brother had to deal with in the early days of our country… and what we – pharmacy profession – are having to put up with today.

During the early part of the 20th century, pharmacy and healthcare was a pretty simple environment… the basic interaction was relegated to a very workable Pharmacist -Physician- Patient triad.  Most Pharmacists were self employed and in the early part of the century… the vast majority of medications were compounded.

The first “attack” on this simple system was  The Durham-Humphrey Amendment of 1951 .. which divided medications into Rx only and OTC. The original triad was altered.

The next two decades, the Pharma’s took over with their standardized medications. “Detailmen” were the rule of the day, brand name drugs ruled our world.  Some statements were made back then that the Pharmacist is there just to fill the Rx for what the doctor ordered.  It was heresy to put the drug name on the label , discuss side effects or even counsel the patient about their medications….

As we entered the 70’s… and here comes the next tsunami of change.. the DRUG CARD,  Medicaid and generics… how insidious this new process was going to end up being on our profession… no one really knew or understood at the time.

The 80’s brought on computers, restricted PBM network, mail order pharmacies and a every increasing Rx volume and reduced profit margins.

The 90’s saw more of  the same… around 50% of the independent pharmacies disappear from landscape and chain stores start popping up on every corner… regional chains started to be “gobbled up” by the consolidation of every growing “mega chains”

The 2000’s .. we saw Medicare Part D.. and how the PBM’s played games with some of the insurers.. confusing seniors by putting a particular chain store logos on their new Medicare drug card.. causing these seniors to believed that they were required to get their prescriptions filled at the particular chain.. it was also reported the PBM’s took their own sweet time to make payments.. especially to independent pharmacies… and within months of Part D implementation… 5% of the independent pharmacy landscape was GONE.

The practice of  pharmacy became the BUSINESS OF PHARMACY.. with a influx a MBA’s in all the levels of healthcare… healthcare soon became “all about the money”.. it is now all about growing market share, gross revenues, and profits.  Patients and good patient care was relegated to measuring “metrics”… arbitrary process measurements that is suppose to prove that numbers on a spreadsheet is some evidence that good patient care is being provided.

We on the front line knows.. the only metric that means anything is the current Rx count ( week/month/quarter) is higher than the previous year’s time frame… you are doing the right thing.. it is pretty simple… doesn’t take a MBA .. to crunch many numbers to arrive at that conclusion.

Back to the whiteman and the redman…. are we pharmacists been relegated to the “reservation” and being told what/how to live by the whiteman?

The one major difference is .. we are LEARNED HEALTHCARE PROFESSIONALS who have and are legally responsible for people’s lives. Those doing the “pushing” have neither the legal authority to push nor the possibility of  suffering legal/financial consequences for what the pushing causes.

Do you hear those distant “war drums”? Are the “natives” getting restless? Is the “reservation ”  and its limits/boundaries just a mirage?

 

 

 

Filed under: General Problems