Technology: It is Here to Stay

As the last millennium drew to a close there was a lot of apprehension about the year 2000. Everyone was worried about Y2K and whether our computers, both personal and pharmacy dispensing software, would be able to handle the “flip of the calendar.” My biggest apprehension of the year 2000 was that my first-born child, Gretchen, would be 16 years old and learning to drive the car!

So as any dutiful parents did at the time, we bought a cell phone. This cell phone was to be used only in case of emergency. If Gretchen were to have an accident, get a flat tire, or run out of gas, the trusty phone would be engaged to seek assistance from her father. What a marvelous idea-at least we parents thought. By the time our third kid had graduated, every family member had a cell phone!

I often say I hate technology. Me being the hard-headed 59-year-old that I am, I still carry a flip phone. I absolutely refuse to be held hostage by such an electronic device. When I’m on a college campus whether at St. Francis where I teach, or at Pitt or West Virginia University where I frequently visit, everyone in the halls, cafes, or lounges all has their cell phones. Yes, even at work my staff can’t seem to part with these addictive devices! I jokingly say, “those smart phones must have a toilet paper app since you can’t even go to the bathroom without them!

Back in the early 1990s when electronic processing of prescription claims was in its infancy, an old seasoned pharmacist named Dick Treese told me, “Young man, when you let those black boxes into your drug store, you will kiss your profession good-bye.” Dick was referring to the modems that provided real time connectivity to the insurance companies. We always disliked filling out the carbon paper claim forms, but with all the hassles we experience every day with prior authorizations, nonformulary issues and cost and copays, I think Mr. Treese was right. Technology certainly changed our profession.

We seasoned pharmacists remember a day when price was the determining factor of where your patient shopped. When I started as an intern, one of my personal icons in pharmacy, Louis Rinovato, told me when I inquired about calculating prices, “I charge a 40% markup, and deserve every penny of it.” Mr. Rinovato was compassionate toward his patients, but realized that the light bill needed to be paid, too. If a prescription cost $6.00, he sold it for $10.00. Some of the more aggressive pharmacists marked up “one third.” If the prescription cost $6.00, they would charge $9.00. Could you imagine those margins today, especially with the hepatitis C drugs costing $60K?  A margin of $30K to $40K per prescription?

I cringe when I see my pharmacy students reach for their phone anytime I ask a question about therapeutics. I tell them a physician will never ask a question they can find the answer to on Epocrates or Micromedex; the physician has already looked there. I even struggle teaching my physician assistant students, because they often say, “it’s on my phone.” Go ahead and pull up the package insert for “conjugated estrogens.” It says it is for indication #6: prevention of postmenopausal osteoporosis. I don’t think most clinicians would today consider using long-term conjugated estrogens for that indication. Pharmacist knowledge of disease states and drug therapy can never be replaced by an electronic device.

I hate technology.

Wait, my wife’s iPad is ringing and my grandson Luke wants to Facetime. Man, I love this technology, what did we ever do before it!