A dose of pharmacy truth: Report from the front lines

An outstanding quality of many of the opinion columns written by Drug Topics readers is their ring of truth. “Who will stand up for pharmacy?,” Kim Ankenbruck’s first blog post (February 10, 2014), triggered an outpouring of e-mails from readers who appeared to identify with every word. Kim has a real gift for expressing what so many readers are thinking and feeling, so we asked her for an update. She sent us a doozy.

My DT Blog post flowed so easily, it almost wrote itself. I wrote it initially as a response to Robert Mabee’s piece “The Political- Medical Complex” (Drug Topics, December 10, 2013). I wanted to let people know that, hey, this guy knows what he is talking about. Read his article.

My letter to the editor turned into my usual long-winded way of getting my point across, and I was asked if it could be put it in the DT Blog. I was surprised and flattered, but I didn’t see that what I was saying was all that unique.

In spite of all the kind comments and feedback I received once the article was published, I can’t help but wonder how many pharmacists saw the title and thought, “Sure, YOU stand up. I’m just trying to keep my household running and take care of my family. I don’t have the luxury of making a stand. If I lose this job, my whole life will have to change. OUR whole life will have to change. Not to mention what getting fired or pushed out would do to my self-esteem, my standing in the community. I have never failed at anything - at least, not at anything this big. I pride myself on my accomplishments and my work ethic. I excelled in school, I excelled in my job, I created the American Dream. Now you are telling me that we need to band together and stand up for pharmacy? I’m just trying to survive and keep what I have.”

How bad things happen to good pharmacists

We pharmacists like stability. Our anal-retentive selves like things in nice neat little compartments, organized (we know where things are, even though it may be a challenge for someone else!), clean, and safe. We hate conflict, drama, confrontation, emotional displays, and negotiation.

We go out of our way to keep things on an even keel, even denying ourselves basic human comforts such as food, bathroom breaks, and time off. 

We have trouble delegating and holding people accountable.  “If you want something done right, do it yourself” is our unspoken motto.

Enter the district manager, the store manager, and the emotionally needy technician.

The duck-plucker and his tools

The DM. To a narcissist like the DM, we are sitting ducks, ripe for the plucking. He knows what makes us tick, and he presses all the right buttons. He knows that for us, approval and job security are No. 1.

Talk about serving patients and being a professional all you want. The bottom line is, you would never do this for free. Fact is, you probably wouldn’t do it for the measly $10 an hour your techs get, either.

The store manager. The DM recruits the store manager to keep track of us and report any activity or talk that runs counter to our mission, and oh, what an important mission it is. Only the store manager can be trusted. The pharmacist is a prima donna, a renegade. He must be brought into line, and the store manager is just the person to help management accomplish this.

The store manager already despises us. He/she is constantly under the gun, and since pharmacy is the biggest profit center in the store, ours is the department he focuses on. 

We are a thorn in his side, not only because he cannot do our job, but because he sees us as arrogant know-it-alls. He would love to take us down a few pegs.  After all, he had to work his way up, he has paid his dues, and no uppity pharmacist is going to put one over on him.

His mission is all the sweeter to him, since he knows he has the absolute backing of the DM. He is now in charge of the store AND the pharmacy.

 The huge difference in our salaries makes him hungry to demean us and remind us at every turn that we are no longer in charge and there will be grave consequences to resistance.

The technician. The store manager finds a technician, a mole, if you will, to become his informer and do his bidding. This person is usually the tech who wants to be in charge of the pharmacy and in his mind could be, were it not for that pesky 6-year, $250,000 degree he could never commit to.

On the surface, this is your hardest-working tech, but in his heart, he would love to see you fall. The DM and store manager tell the tech how important he is to the company. They say that as “head technician” the tech is in charge of the other technicians, and they instruct him to report to them any violations of “company policy” he may detect in the actions of the pharmacists.

Watch your back

Some of you think you can hold on, straddle the fence, maintain your professional integrity, and make it through long enough to get your kids through high school or college, or till you retire.

That’s what we all think, until the company decides it’s time to get rid of us.

Make no mistake, they will make it look like your fault, and you will have no recourse.

If you become a marked pharmacist, you are just as good as out the door. Clean out your locker and move your license down on the wall so you can grab it on the way out.

The deceit and cruelty of these people know no bounds. Pharmacists have been accused of picking pills up off the floor and taking them, stealing, selling drugs, drinking on the job, insubordination, incompetence, being too slow, being impaired.

The suits will call you into the office and bait you, hoping to get a rise out of you so they can say you were insubordinate.

They will falsify drug tests and accuse you of things you didn’t do. They will make innuendos and snide comments about your character, your personal life, your attitude, and your job performance. They will destroy your life, and then tell you to have a nice day on their way out the door.

If you jump through their hoops, they will let you stay long enough for them to completely destroy your self-esteem and self-worth, and then they will kick you out the door anyway, smirking all the while.

These people enjoy this job. They revel in it. It comes easily to them. They relish the opportunity. It’s all part of the narcissism embodied by the DM.

As defined by Psychology Today:

Narcissistic Personality Disorder involves arrogant behavior, a lack of empathy for other people, and a need for admiration - all of which must be consistently evident at work and in relationships. People who are narcissistic are frequently described as cocky, self-centered, manipulative, and demanding. Narcissists may concentrate on unlikely personal outcomes (e.g., fame) and may be convinced that they deserve special treatment.

This is the mess we find ourselves in, and no one is safe - not for long.

What can be done?

The e-mails I have received made it clear that I was preaching to the choir, but then they asked me what could be done.

I DON’T KNOW.

 The whole “healthcare” system has become so complex and so interwoven with politics and social policies that it will take an army of dedicated, multitalented people to sort it all out and turn it around, if indeed that can be accomplished at this point.

Some of you don’t think the profession can be saved.

You are right. It can’t be saved in its present form.

You and I don’t have the expertise, the energy, or the inclination to take this on.

However, there are people who are making this their cause, people who understand the process and who are not beholden to the powers that be for their livelihoods.

What we can do

What we can do is provide documentation, our stories, our input, and our ideas.

At this stage of the game, it is not necessary to put your name to anything. Tell your story. It’s good therapy. Make some connections, so you have some support. Don’t stay isolated in your little corner of hell.

A simple internet search will provide you with a starting point. I will not provide a list, since that would make it easier for the people who monitor the internet for the corporations (oh yes, they search and read the same things we do), but the websites and resources are easy enough to find.

I (almost) never met a pharmacist I didn’t like. We all have our foibles, quirks, prejudices, and faults, but we also share a common bond, forged in pharmacy school and maintained throughout our careers, despite the efforts of our individual employers to severe them and divide us.

We are good people. We have to be to do this job. We still make sure to keep our patients safe, even if it means that we are not.

Starting now

Start planning and covering your bases now. Proceed as if you will be terminated tomorrow, however sad and sickening that may sound, because that is what is happening to us.

Document, document, document. Back up your hard drive. Know that even this may not save you, as an individual. Do it anyway.

Find out who the leaders are and send them your stories. We’re going to need your help.

Keep your head up. You deserve better.

Kim Ankenbruckis a pharmacist in Indianapolis, Indiana. Contact her at kim.ankenbruck@yahoo.com.

[Editor's note: For another suggestion about what you can do, watch for David Stanley's "View from the Zoo," coming in the May issue of Drug Topics. Until it publishes at drugtopics.com on May 10, take a look at these two pieces of his: "Stand up and make yourself heard" and "Now hear this."]