Opinion: Staffing, Phone Lines, and Drive-Throughs

The profession of community pharmacy presents an interesting dichotomy, one that requires business skills as well as clinical skills. Not much infuriates me more when I hear dispensing pharmacists say, “I don’t get involved in that clinical stuff. I focus on the business side.”

I’d like to tell them to go sell shoes. Pharmacy is a healthcare profession and clinical skills are of paramount importance. Someone decided a very long time ago that dispensing pharmacists needed a college degree to run a drug store as a pharmacist. Dispensing information is as important as dispensing product.

I’ve been doing this amazing profession for 38 years, and one thing I am always working to improve is management of workflow. I always say, “There are too many bottles and too many sheets of paper for a pharmacy to be disorganized.” Organization is critical to operate a pharmacy. Nothing disrupts workflow more than “looking for stuff.” 

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The most important job of any pharmacist is verifying the accuracy of prescriptions. I wrote a column about my technique of using the red pen, to provide me a physical way of checking prescriptions and “pull the trigger” so I can efficiently move to the next.

Unless he or she is an owner, there are three parameters in a pharmacy that are out of the managing pharmacists’ control: staffing, phone lines, and the drive-through window.

I’ve written several articles about staffing, and the different formulas chains use to determine staffing. I’m waiting for the day that state boards of pharmacy or the pharmacy organizations take a stand on inadequate staffing, the No. 1 gripe for most pharmacists. 

The number of phone lines is another challenge. When a pharmacy has three phone lines and only two busy techs to answer them, the pharmacist gets interrupted. Pharmacists answering the phone and answering the questions like “What time do you close?” or “Do you have chocolate milk up front?” is utter nonsense, but often with both techs on the phone, line No. 3 rings and only the pharmacist is available. The number of phone lines should never exceed the number of technicians available to answer it.

Of all the customer conveniences that frustrate the pharmacist, the drive-through window is the most challenging. Most drive-throughs are attached directly to the pharmacy space. Patients can gawk in and observe the staff answering phones, and processing orders. I remember when the small chain I worked for in the 1980s installed the first drive-through in our area. A seasoned pharmacist and I were talking, and he said “Buddy, when you have a drive-through, one clerk should be assigned to that spot, and that should be their only responsibility.” Most drive-throughs in the pharmacy world do not have such luxury, and often the pharmacist is the one to walk over and tend to the window. I’ve seen patients want to buy lottery tickets, soda, and stamps, while interrupting pharmacy staff from their life-saving work. 

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I counsel patients on every new prescription by flagging the bag with a fluorescent green sticker. I bring them to the small private area and discuss the use, side effects, directions, and any other information I may have. My opioid patients get special counseling for appropriate use, security, constipation concerns, and are handed a drug disposal bag to properly destroy any unused meds. This can’t possibly be done over the intercom system in a drive-through. Patients standing in the parking lot can hear every discussion with the patient in the drive-through. What ever happened to privacy and HIPAA? That certainly went out the (drive-through) window.