The Future Isn’t So Futuristic

I look at the calendar and some quick math confirms it. I have now been a practicing pharmacist for 25 years. And while I’m not usually one to mark every anniversary that comes down the pike, a quarter-century is long enough that I’ve realized I’m now living in the future my pharmacy school professors envisioned back in a time when people could see some new band called Nirvana for ten bucks.

Let’s see how that future turned out.

“This kind of thing, you won’t be doing it much longer,” my first boss once said to me. “The count, pour, lick-and-stick stuff will be history by the time you’re my age.” I was working for a grocery store company whose chain of command of the pharmacy department consisted of nothing but pharmacists right up to the top. The head of pharmacy was the only one of us who reported to a nonpharmacist, that being the CEO. The store manager was told he was never to come behind the counter unless there was an emergency. Doctors would call with questions and I would often consult the library of reference books I kept along the pharmacy wall and get back to them. For customers who had insurance, I often had a habit of chatting them up while the dial-up modem worked on filing their claims. In the days before mandatory counseling, I found more than one inappropriate prescription that way.

During my first year out in the “real world,” pharmacy organizations were continuing to trumpet the same tune I had heard in college. “A golden age of professionalism was on the way, and we must prepare by adding an extra year to the pharmacy curriculum and start calling ourselves doctors,” they said. A couple years later I got a memo congratulating me for topping the deli department in sales. I was insulted. Surely things like this wouldn’t happen in the future.

Well the PharmD is here, and today you could probably fill the concert hall that held one of those $10 Nirvana shows with “doctors” who have been berated by store managers or other nonpharmacists for making what was the correct professional decision.

Mandatory counseling is here, and when I left the chains to buy my own store I had less time to talk to patients than I ever did in the age of that dial up modem.

And what else is still here? The same count, pour, lick-and-stick tasks that my first boss was ready to write off, now all measured and evaluated down to minutiae by the very technology that was going to liberate us.

There has been one major change, which is the addition of a second “stick.” The stick into the arms of patients of flu shots and other immunizations. You better meet your quota, or you’ll probably hear from that store manager again.

So at the halfway point of my career, one thing is clear-those visionary leaders of pharmacy from the 90s failed. They got an extra year of school so graduates can start their career with more debt than I could have imagined when I started mine. They got flu shots, which are pushed much the same way the retailers that actually control our profession push the latest laundry soap.

One thing hasn’t changed though, and that’s the promises of the people who pretend to lead our profession.  Those promises of a future of professionalism are still coming, identical to what I heard the year I graduated, almost down to the word.

To the “visionaries” of this generation I say, if I want to hear some golden oldies, I’ll break out my Nirvana records. If you ever want to be taken seriously again, you’re going to have to change your tune.