Monday, September 15, 2014

The Return of Respect Starts with Us

There's no one person to blame. It just kind of happened. Maybe it happened when we stuck a pharmacy inside a grocery store. Or maybe it happened when they opened the first pharmacy with a drive through window. I don't know when it happened exactly. Neither do you. What we do know is that our profession changed somewhere along the way.

Yes, we're one of the most trusted professions, but we're treated with much less respect now than we used to be. When people come into Goofmart Pharmacy, do the script push across the counter, and tell me they're going to be back for their prescription in five minutes (without having any idea of the current situation or how many people are ahead of them in line), it shows the lack of respect people have for our profession. When people tell me that all I have to do is "slap a label on it," it shows the lack of respect people have for our profession. When people come in after having seen the doctor ten minutes ago expect their prescription to be filled and ready to pick up, it shows the lack of respect people have for our profession.

In some cases it might just be a matter of having had enough of waiting. When people go to their doctor, wait fifteen minutes to get taken to an exam room, wait another ten minutes to actually see the doctor, then get only five minutes with the doctor and given a handful of scripts, they've had enough. They don't want to wait anymore, and I can't blame them. But a patient can't go through this routine and then expect things to magically accelerate at the pharmacy. Yes, your doctor did see you and prescribed a medication. BUT we're not only filling your prescription, we're ALSO making sure it is safe for you, is appropriate for you, and making sure you're getting the right medication. That's our job and whether you like it or not, this part takes time too.

The e-Script system reduces a little of the workload in the process. By eliminating some of the issues doctors have with writing clearly (there's so many of them you can't possibly imagine) the e-Script system has introduced a new set of issues. Office staff that are untrained with the system or don't know the medications that well (such as the difference between immediate release and extended release) gum up the process quickly. Unfortunately, because of the way the doctor office works, getting it fixed rapidly is almost impossible. For a patient that thinks we have a magic phone line which instantly connects us to the prescriber, any additional wait time seems ridiculous to him or her.

My biggest complaint with the e-Script system is not the system itself, but the way patients perceive it. In some cases, this perception is created by the doctor. I have had patients tell me, patients who actually know better, that their doctor will fiddle on the computer with their prescription and announce to them, "Ok, I sent it over. It's ready. Go get it." In other cases, patients themselves think that once the doctor hits the SEND button a label prints out on our end and a team of technicians instantly fills the prescriptions. I have had to tell too many people that sometimes it can take up to an hour before we ever see it on our end. "But I saw my doctor send it" they say, not knowing that it's not like email. Even if it was like email, who checks their email every 30 seconds? (Yes, I know there's some people that do check their email every 30 seconds. I'm talking about NORMAL people).

If we're going to return some respect to our profession, we as pharmacists need to stop these incorrect perceptions. I have patients who are also doctors for other patients. I do my part by gently telling them how our side of the process works. If you're a pharmacist, I encourage you to do the same. When you get a patient that runs in expecting a prescription to be ready for them when they walk in and you determine that the doctor has given them the idea that it would be ready for them immediately, take some time to call the office and again, GENTLY tell them how it works. Tell them how much you appreciate the fact that they care for our patients, BUT that you're not running a fast food operation. If you're nice, you'll get a message across eventually.

As for patients, do your part to train them as well. Decide on a wait time with your staff depending on various situations and stick to it. Exceptions can and should be made for crying babies, but don't push yourself and risk patient safety just because they're in a hurry. Patient safety is paramount, and it is what we're all about as pharmacists. Don't let your company bully you. Don't let metrics pressure you. Don't let whiny patients coerce you. Do what is right for the patient by carefully checking each and every prescription. 

Only then will the respect for our profession return. 


Unknown said...

As you mentioned, the doctor's office is frequently to blame here. I have had several procedures w/ local anesthetic where I can drive after. The doc sends me off to "fill this at the pharmacy on your way home, then stay off your feet for the next x days, taking the pills every 8 hours blah blah blah." So I'm working in that small window until the local wears off hoping my pharmacist can "fill it while I wait." If the doc knows that they are going to prescribe this pain med after my procedure, why can't they give me the script beforehand to fill beforehand so I don't have to wait, post procedure and annoy my pharmacist. I'm guessing if it is a controlled med, they don't want to prescribe it until after the procedure to cover their butt.

I just had a doc tell me to pick up a numbing cream for a procedure that he swore was over the counter. Every pharmacy I went to said I need a prescription. So, after calling my doc to say I couldn't get it, he ends up phoning in a prescription just 3 hours before the procedure when I need to use the stuff an hour before the procedure. This results in me having to harass my poor pharmacist again basically at my doctor's instruction.

bcmigal said...

It's not only the patients. Our employers do not respect us for a nanosecond. We must meet the "expectations" i.e. waiters filled in 15 minutes or less, wait time/promised time above 90% , quotas for immunizations, adherence calls, and "scores" for every task imaginable. There is no mention of patient care. But you can bet if the "metrics" are not met, there will be counseling and coaching. When safety is compromised due to stress and threats, the pharmacists will be thrown under the bus.

Anonymous said...

It's not just pharmacists, and I suspect it's more a symptom of the public in generals "me first, nothing is ever my fault/responsibility, and if I'm not satisfied someone must pay" attitude. Veterinarians get it too - absolutely no respect for our time, skills or efforts.

Clients blow off appointments without even a call, yet blow up when you ask them to pre-pay (it's a 3 strikes system for us, so repeat offenders only). I mean, it's just OUR time, it's not actually *valuable* at all. They show up with 3 animals when scheduled for 1, they show up to recheck a test performed at another vet and flip out when expected to pay for the doctor's exam (this happened last week) because clearly the time of a professional should be comped for no reason.

The worst part - there's no way to change these things and stay in business. If you crack down on disrespectful morons, they go on Facebook/Yelp/Google reviews and trash you. One idiot screamed at me last week that she KNOWS how flea medications work (she figured it was a force field around that banished fleas from the area), she could "almost be a vet" because she had a pet with fleas before, there are NO FLEAS in her house, they MUST be coming from outside... and what was I going to do to "make it right" when a single dose of preventive didn't fix it? And the office manager's response was: free medication to make it right, because the idiot might run to Facebook and say mean things. We cannot win, and we won't at this rate.

Gonzo95211 said...

Look, the World isn't in the 1890's, and people have places to be and things to do. So of course, folks expectations as to wait times are sky high- there's other folks breathing down their necks, just as they are seemingly breathing down yours. Having said that, wait times are a function of how long it takes. Put simply, it is what it is, and it takes as long as it does. However long it takes to do the job correctly, and check all the required boxes is the right amount of wait time. I don't see much sense in making any one wait simply to make them feel some sort of "respect" for out profession.

Anonymous said...

I've only really gotten impatient one time with my beloved pharmacist.

In my defense, I had a temp of 103 and was in danger of coughing up a lung.

When they told me the doc hadn't sent anything over for the raging infection in my lungs and could I come back later, I told them hells no, and if you like I'll stand here and cough all over you until we get this taken care of. Magically, five minutes later I had my scripts. I went home, collapsed, and don't remember much about the next several days as my body tried to fight off the illness.

I did tell "Jack" I was sorry the next time I saw him, and he just smiled. I'm certain his smile translated to 'screw you, lady' but I didn't care. I still meant it.

There are two sides to these stories. I think that sometimes the pharmacist's view of the world is a bit jaded.

bcmigal said...

To Gonzo and one is saying to make a person wait out of spite. We know what it is like to be sick and have to wait at the doctor's office. We know what is is like to have to wait at the pharmacy with a toothache or a crying baby. Most of us have been there. If your multiple prescriptions were magically done in five minutes and billed and filled correctly, you have a great pharmacist. But when our worth as pharmacists is judged by how fast we can type, count and label then we do become jaded and cynical.

Anonymous said...

The problem is we don't respect anyone, these days. Not anyone. Not really. Sometimes we're polite, but we think we're right, always, so contradiction makes everything.... iffy.

...I wonder how much difference a nice sign might make... sort of a "here's how your prescription is filled!" or a "here is what we're doing!" sign.

Anonymous said...

I'm in my 34th year as a pharmacist and when I am in the vicinity of a pharmacy department as a customer and can overhear the conversation between a tech and a patient it quite often causes ME anxiety and I am not even involved. The general public should have to work in retail for a period of time before they are allowed to shop in stores. It would give them an appreciation of what the world is like on the OTHER side of the counter/transaction.

Anonymous said...

The excuse you use for behaving like a bitch is part of the problem. There is no excuse for that behavior. The problem you were having was YOUR problem. Call the doctor office and ask whats up. And yes, Jack was smiling just to keep you quiet so he can get on with his day. Unfortunately your behavior was rewarded with success. Congrats.

Gonzo95211 said...

There now, you see? If "Anonymous" (how very brave) above, feels that it's fine to abuse someone so viciously just because you dont like what they said, I really dont see how this is a mature line to take. Highly unpleasant. And even sadder that the comment has been approved.

Unknown said...

So Gonzo and Awesome..would you rather your prescriptions be filled as fast as possible or filled correctly which means being checked and sometimes double checked for errors and checked against your medication profile to make sure what you're getting isn't foing to interfere with your other medications. Your choice folks. And let me point out since it is MY license and livelihood on the line, im going to choose filling it correctly and so you will have ro wait a little longer. Tell me do you also treat you doctor and his staff the way you treat your pharmacy staff when you have to wait or show your new insurance card or update your info? We are NOT McDonalds!

Anonymous said...

Right on, Anonymous! I couldn't have said it anymore succinctly.

Oh, and *Gonzo95211*, your hipocrisy is showing: it's much more brave to use a weird screen name than "anonymous".

From another ANONYMOUS poster (aka gobbledygook8553)