COMMUNITY PRACTICE

Pharmacy boards of two minds about R.Ph. breaks

Pharmacy boards that have tackled the issue of lunch breaks for pharmacists have generally adopted two different approaches to the dining dilemma. One camp allows the pharmacy to remain open when the pharmacist grabs a bite, while the other favors locking up.

California, Delaware, Maine, New Hampshire, North Carolina, and Texas are among the states that permit the pharmacy department to remain open as long as the pharmacist is available on the premises. Colorado, Hawaii, Minnesota, Nebraska, New Jersey, New Mexico, North Dakota, West Virginia, Wisconsin, and Wyoming are among the states that require the pharmacy to be closed if the pharmacist is absent. However, some boards allow the rest of the store to remain open as long as the pharmacy department is closed and locked.

Allowing the pharmacy to stay open while a lone R.Ph. is on break generally comes with several caveats. For example, the New Hampshire board's new protocol permits only technicians to remain in the pharmacy during the absence of the R.Ph., who must be available somewhere on site to handle emergencies. Techs can continue to perform nondiscretionary tasks as determined by the pharmacist. New orders or refill Rxs can be accepted and processed, but they must be held for a final check by the pharmacist. New Rxs phoned in cannot be accepted.

The North Carolina pharmacy board hasn't had any complaints from consumers about pharmacies being allowed to remain open while the R.Ph. is on break, according to executive director David Work, R.Ph., J.D. "Our policy has worked fine," he told Drug Topics. "We've had no complaints from consumers or pharmacists. Occasionally, we get a complaint from a supervisor that a pharmacist won't take a break, but I'm not so sure I believe that. I guess there could be some who would say that when they come back, they're just as far behind. For our board, it's a safety issue going back to working conditions."

Montana is in the process of updating its pharmacy practice regulations, but, for now, the old rules require that the store has to be locked if a pharmacist is not present, said Rebecca Deschamps, R.Ph., executive director of the pharmacy board. The board also stipulates that a technician can't perform any task unless a pharmacist is physically present in the pharmacy. Compliance officers won't cite a pharmacy as long as the R.Ph. on break remains somewhere in the store and no Rxs are released without the pharmacist's sign-off.

"Montana has many towns with only one pharmacy, staffed by one pharmacist," Deschamps said. "This seems to be a workable approach that does not compromise patient safety."

Brooks Pharmacy, a Rhode Island-based chain with 248 pharmacies, consulted with the seven Northeastern pharmacy boards to explain its plans to structure pharmacist breaks, said Daniel Haron, R.Ph., v.p.-pharmacy and professional affairs. "We were extremely pleased by the support of the boards of pharmacy," he said. "Some states took longer than others, but, in every case, they looked for a way to be part of the solution."

The Brooks solution was a 30-minute break from 12:30 p.m. to 1:00 p.m., which was the time slot pharmacists voted to adopt. The R.Ph. must remain on the premises while the technicians process incoming Rxs as much as possible by law and ring up any refills that are ready.

"We didn't want to start something with good intentions for the pharmacists that became a nightmare when they came back from break and got toasted," Haron said. "The pharmacist feedback has been fantastic, and they have been floored by the number of patients who didn't know they weren't getting a lunch break all along. We think we have been successful in helping the pharmacist with a little quality of life without challenging our patient care or alienating our relationship with the physician."

Keeping the pharmacy open while the R.Ph. is on break somewhere in the building just doesn't cut it with some pharmacists on an Internet message board. "We are either on lunch or on the clock," said one message. "We need the break for the public's safety as well as our own sanity and health. If the pharmacist can be called away from lunch for any business reason, then that time is not a lunch break."

Having to stick around in the store doesn't bother Michael Saija, R.Ph., who works at a Brooks Pharmacy in Dedham, Mass. "I have a little place over by the microwave where I eat," he said. "The break lets me rest and catch my breath. The telephones stop ringing through, and doctors can leave a voice mail. It's a great success that has met with nothing but praise from the customers."

Carol Ukens

Carol Ukens. Pharmacy boards of two minds about R.Ph. breaks.

Drug Topics

2001;4:20.