Close the pharmacy

You did not misread that. You misinterpreted it. Pharmacies used to be hidden. Pharmacists were accessible if they walked out to you, which we often did, and we were more valued as a result. You could no more stare at us over the tops of the shelves than you could hear us whispering on the phone in a corner.

Times have changed. While the whole open floor plan concept works great if you’re building a house, it does not suit the pharmacy. I say, close it.

See also: Electronic prescriptions: Return to sender

Not a zoo

We are truly just a few metal bars and a coin-operated food dispenser away from being animals in a zoo. People stare at us. They yell at us from anywhere in the store. They throw stuff at us. They put their kids on our counters. I swear someone took my picture at my last store too. Seriously. What other profession allows its professionals to be treated like this?

I say, close it. If the "centralized pharmacist" concept is going to work, arrange for the rest of it happen behind the scenes. That way, when I have three techs, each on a phone line, and I am checking something, no one can smart off by saying, "There's four people back there not helping me." Bugger off. Now you see me, now you don't.

I want the pharmacist to be the focal point. I want to perform my professional duties. You just don't need to know what else goes on. If anything, put us back on our elevated platforms.

Stay tuned: Part 2 from The Cynical Pharmacist will appear Saturday, September 19 in your Community Pharmacists' Special Report from Drug Topics

Put up a wall

Close the pharmacy. Put up a wall. Put a pharmacist out front in a consultation room or at the counter in a chair. Give her an iPad to assist patients while their medications are being filled. Slow down the whole process.

We need to focus on the professional aspect of our jobs. We need to focus on our knowledge, on why we spent so much time and money at school. If we stop trying to squeeze blood from a desiccated idea (profit margin on pills?), then we can look at new ways of highlighting our place in the healthcare world and getting paid for it.

Doctors enjoy an insular experience, hiding behind layers of staff and walls. They visit with patients one-on-one, privately reviewing medical history, diagnoses, and treatments. Pharmacy needs to examine this concept.

The Apple model

My first thought came from a visit to an Apple Store. After spending some quality time there recently, I realized what an amazing concept Apple has for its retail outlets. I think I want to work with Apple on designing a pharmacy. Here’s how I see it:

A technician will greet you as you enter the store. She will ask the reason for your visit and then direct you to the appropriate person/area of the store, while entering your personal and insurance information on an iPad and alerting that person to your needs.

The second person will instantly know why you are in the pharmacy: to pick up a prescription, to drop off a prescription, to have us check your insurance, to get a flu shot, to seek counseling, etc. She will guide you to the appropriate table/counter/area, where a technician will answer all your questions and assist you with your needs.

The pharmacists will be behind a counter/wall, checking your prescriptions as the orders appear; then they will walk them out and review them with you. A technician/cashier with another iPad will scan your credit card for payment and have you sign with your finger right on this device and your transaction will be complete.

The physician model

My second epiphany came while sitting in a doctor’s office, waiting well beyond my appointed time to be called into the secret chambers. That’s when it occurred to me that pharmacies have no business being in retail.

What if we set up pharmacies like doctors' offices?

Picture this: The receptionist sitting behind a glass window who greets you is your only access point to the pharmacy. She will ask you to fill out forms verifying that all your information is correct, and you will sign a permission slip allowing us to bill your insurance and "treat" you today.

You will also confirm in writing that, should any issues with billing occur, you will be notified/paged/texted and asked to contact the payer directly. We would offer free wi-fi and some courtesy phones, in case you want to contact the payer right away.

Upon the successful billing and filling of your prescriptions, a pharmacist would be waiting for you at a counseling window. She would take the time to go over everything with you. Upon completion of this fully billable service, you would proceed to the checkout window where you pay your copays before exiting our office.

It gets better

We could set up different offices within the suite so that our pharmacists could perform different tasks throughout the day, including medication verifications, DUR checks, taking doctor calls, making doctor calls, prior authorizations, immunizations, etc.

We would have an office of specialists at your disposal. Once you enter a room, you are being billed for their knowledge and services. We would eliminate the fast-food mentality and retail experience from the sullied reputation of our profession and get back to what we really are supposed to be: professional pharmacists.

We can do it

As a profession, pharmacists need to dictate how our profession is sold to the public. There’s an additional benefit, as well: increased safety and security for the staff. But that’s part two of this post. Stay tuned.

For more from The Cynical Pharmacist, see "Electronic prescriptions: Return to Sender" and follow him at www.facebook.com/thecynicalpharmacistand at www.thecynicalpharmacist.blogspot.com.