Pharmacists have always had to deal with the perpetual conflict between our professional ethics and financial needs of running a business. Our roots are based on entrepreneurship, basically if you were a Pharmacist – or back then Druggist – you were self-employed. Even during the 20th century when many “Mom and Pop” pharmacists expanded into multiple location “chains”… most likely these regional chains maintained their “Mom & Pop” mindset… where the CEO and others in management were Pharmacists… where their professional ethics often strongly influenced their business decisions. “Metrics” were very simple… if business was more this year than last year… you were doing things right.
As we left the 80’s and entered the 90’s… things started to change.. the PBM’s were increases their share of the Rx business by some 2%-3%/yr, pharmacy computers were less a novelty and more a absolute necessity, store charge accounts became less important as the “plastic charge card” grew into nearly universally accepted by consumers, gross profit in the Rx dept continued to dwindle and yes the beginning of internet started to weave into our personal and business lives.
Also during this period, the number of independents at the beginning of the 80’s, were cut nearly in half by the end of the 90’s being cannibalized by the chains. Similar cannibalization was happening of those “Mom & Pop” regional pharmacy chains. Store expansion by the chains went into hyper-drive and the professions transition to a all PharmD program during the same time … created a huge and unheard of shortage of Pharmacists. There were reports of the shortage being in the 6000 range and reports of new chain stores opening and not being able to open the Rx dept because they could not find/hire Pharmacists to staff it.
What we did not stop to notice as the industry became dominated by three name plates… is that all those Pharmacists who had been in upper management where being replaced by MBA’s or others who have no concept or reference to what Pharmacists do and what Pharmacists are legally obligated to do. All they know is numbers.
Today we find ourselves with the BOP expecting/demanding that we live up to every sentence in our practice act and upper management demanding that we meet/exceed an every increasing number of metrics. Has anyone stopped to notice that no where in all those metrics management wants us to measure and meet/exceed… is any attempt to measure how/if we are improving the patients’ health that we provide services to? Isn’t that our primary function?
Filed under: General Problems
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