Sunday, December 07, 2008

The cheapening of my profession

There are so many people in this world for whom the perfect career path is elusive. I'm not talking about individual jobs along the way, but rather, the broader, more encompassing career that those jobs help to make up. In my life, I've had regrets along the way (welcome to the human race, Dan!) but I am happy to say that becoming a pharmacist is not one of them. Whenever I get into conversations with people and the "what if" scenario of "would you choose the same career path if you had it all to do over again?" comes up, I don't even have to think twice. Even with all the debt it has saddled me with, even though my path to being a Pharm.D. was not the most direct in the world, I don't think I'd change it. Part of that is I believe that you don't mess with the path that your life has taken, for you never know what's going to get screwed up if you go back and mess with it. The other part of it is I am absolutely fucking fantastic at what I do. That is not meant to be immodest or full of myself, but being a pharmacist fits in well with a lot of my personality quirks. I cannot imagine being anything other than a hospital pharmacist, even though many days it is very trying and I come home tired. It's the job I'm meant to do (note: it's not all that I am meant to accomplish in my life, but it's the paying job I am meant to have. I am SO NOT one of those people defined completely by their job.)

So, when I read things like this, I feel very badly. A chain drugstore in California is now offering a "19 Minute Promise" - that is, if your (up to) 3 new prescriptions are not filled in 19 minutes or less, you get a $10 gift card and a free RedBox movie rental. I had heard rumblings of this at work, but someone had misattributed the program to Walgreens so I couldn't find anything about it. Then, U.S. Pharmacist arrived in the mail yesterday and the editor's page was devoted to it. The editor correctly compared this latest scheme as an attempt to equate drugs and prescriptions with pizza and DVD rentals. It is another move driven by the bottom line while paying no attention to the fact that pharmacists are highly trained health care professionals and the products they handle are not mere commodities like toothpaste or tube socks.

In addition to endangering the lives of people who get prescriptions filled, this kind of mindset cheapens the profession beyond where it had already let itself be cheapened. It started with drive-up windows in pharmacies and has just been in a downward spiral ever since. Drive-up pharmacies, while convenient for patients (especially parents of young children) diminish the amount of face-to-face time that the pharmacist has when counseling patients on their new meds. It is, in my mind, adding an element of "would you like to SuperSize your penicillin?" to something that is very serious! The upcoming addition of a drive through was one of (but not the only) reasons I took my first hospital job rather than stay on at the pharmacy where I was already employed part time.

The hardest part of this is the great big disconnect that exists in the education of pharmacists and the actual working conditions that are out there. Pharmacy education has changed a lot in the last 10 years, but the emphasis on the clinical aspects of the job have multiplied. When I graduated with my B.S., we did exactly a semester's worth of rotations. Now, Pharm.D. students do a whole year's worth. What comes out of pharmacy school are highly trained people that are aching to put their clinical skills to work. 90%+ of them end up in retail settings like Walgreens or Wal-Mart and the difference between the ivory tower and the real world becomes abundantly clear. I have my own opinions as to exactly what the place for clinical pharmacists are in the health care system and how that is kind of at odds with how students are being educated, but that's a whole other post!

I always say that there's no way I could work retail. I don't mean that with any disrespect to those hard-working pharmacists out there at the Walgreens and K-Marts and Targets because we need them to be doing the job they are doing - and I certainly am not the person to be doing that job. It's true, it would take a lot for me to be able to do it. A big part of the reason is I have been away from it so long that I would have to be re-educated in a serious way. Hospital pharmacy is it's own animal. I don't know how much things cost and things that you see only in community pharmacy are more and more foreign to me since I deal primarily with inpatients. I keep myself as current as I can with CEs and make sure that I do some that are not directly applicable to my line of work just so that I can keep up with the rapidly changing world of retail pharmacy.

I do know for a fact that if someone came to me and said that they were invoking a 19 minute rule and I worked for them, I would immediately commence a search for a new job. I care more about doing a thorough and accurate job than a fast one, although there is a balance between them. Successful pharmacists know where it is.


Yuяi said...

Wow, I'd tell them to kiss my ass if they imposed a 19-minute ANYTHING on me. That does reek of Pizza and DVD rentals. And God forbid you make a mistake in that 19 minutes and end up killing someone. That is a no-win situation.

That leads me to think of what I want to do "when I grow up". I don't think I ever set out to be a project manager or a supervisor or whatever I am at the moment. Sure it pays the bills, but it also stresses me out every couple years when they close worksites and lay people off. So, to answer my own question, I have no idea. I'm glad that you know and are happy with your profession.

nizonide 500 mg said...

Calutide 50 Tablet use in the therapy of cancer of the prostate gland. It could be helped to treat different conditions, as dictated by the specialist.