On the record with APhA

David Stanley“You don't get to complain until you've at least tried to do what was suggested.” That’s been an unwritten rule in my work life for many years now, and one that seems to get used more and more as we grow into an increasingly impatient society. We've all had patients who ask about the next step in their therapy before they even fill a prescription. Worse yet is the patient convinced that the doctor got it wrong, who doesn’t even want to try the recommended solution to the problem. Some of these people, I've said more than once, seem to be more interested in complaining than in following the correct procedure to get better.

It wasn't until I saw the email from APhA, though, that I thought maybe I suffered from the same problem.

See also: All wet: A pharmacy parable

That guy in the basement

I've been more than willing to criticize the American Pharmacists Association over the years, comparing it at times to a useless brother-in-law who sleeps all day on the couch in your basement and then asks you for money. While the organization seems very interested in signing pharmacists up for membership and collecting a not insignificant amount of money in dues, it does not seem nearly so interested in addressing the problems actual pharmacists encounter while trying to do their jobs.

There before me, though, on the computer screen that morning, was a “Call for Policy Topic Ideas,” soliciting suggestions for issues to be addressed at the organization's next House of Delegates.

I had always assumed that anyone with any exposure to the pharmacy profession was well aware of the crisis at the prescription counter, which includes, for example, the never-ending cycle of staff cuts, metrics impositions, “productivity goals,” and immunization quotas, which have made it all but impossible for the average retail pharmacist to deliver adequate pharmaceutical care.

You know what they say about the word “assume,” though. Maybe no one had ever formally brought the issue to the attention of the organization that claims to represent us. Maybe, we've all been like those patients with so little faith in their doctors that they never give them a chance. Well, no more.

See also: You talkin' for me?

The word goes forth

From this day forward I can officially say that an appeal has been made to APhA to address the problem of pharmacist's working conditions. Herewith is APhA’s “Call for Ideas,” along with the responses I sent, in full:

What problem(s) would this proposed policy topic address? 


“All too often, it is impossible for patients to receive proper pharmacy care at locations operated by the major chains. This is not the fault of the individual practitioners employed there, but rather, a result of the employment practices of the corporations that for all practical purposes, now control community pharmacy.”



What factors have contributed to the problem(s)?


“The desire for ever-expanding profits from the chains. The excuse of declining reimbursements from PBMs rings hollow when compared to the billions of dollars of profit made by each of the large pharmacy players in the industry.”

Why is this proposed policy topic necessary for the profession? 


“Quite simply, the short staffing that is the new normal in today's pharmacy world is the biggest barrier to the necessary change required to bring pharmacy into the 21st century. APhA and other pharmacy organizations have articulated a vision of what modern pharmacy practice should be like, but the profession will never get there until we end such practices as unrealistic productivity metrics, 15-minute prescription guarantees, and flu shot quotas.”



What specific issues should this proposed policy topic address? What specific areas should the Board of Trustees and Policy Committee consider in crafting language related to this topic?


“The issue of access to adequate pharmacy care and required compliance with things such as OBRA counseling. A position needs to be taken that, far too often, community pharmacies are not given the resources required to accomplish this, and that needs to change.”



Who are the target audiences for the proposed policy topic (the public, pharmacists, other health professionals, etc.)? 
“Every stakeholder in the profession. Pharmacists, doctors, nurses, patients, the insurance industry, corporate employers - I could go on and on ...”

And if APhA continues to be silent, going on and on is exactly what I plan to do. Because that useless brother-in-law no longer has any excuse for crashing on our couch.

The ball's in your court, APhA, and we’re all watching.