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How not to run a pharmacy

Posted Oct 23 2008 1:20pm
I've determined that I'm an independent at heart. Not politically, but in the practice of pharmacy.

Over the course of my career (including internship), I've worked for an independent, a teaching hospital (in a clinical role), two regional hospitals (strictly as data-entry and cart check), a nation-wide retail chain, an international mega-retailer, and a small regional grocery chain.

The clinical job at the teaching facility utilized my pharmaceutical knowledge the most, but since I don't possess the almighty PharmD, I can't land a job like that now (plus there would be a major pay cut involved). The other two hospital jobs were mind-numbing, mostly because the respective directors of pharmacy lacked the "boys" to approach administration as to how to effectively utilize the pharmacists' skills.

As for my time with the big-boy chains, all that mattered was profits. I can say that some of my district managers actually cared about pharmacist working conditions, but everybody from the regional level and up only cared about dollars in the bank. Forget about patient safety. Forget about pharmacist quality of life issues. I received a directive one day to eliminate two technician positions simply because sales did not meet the projected sales for the previous four weeks. Forget that sales and prescription volume were up over the previous year. Don't take into consideration that the largest employer in the town of 15,000 just laid off over half of it's work force 6 weeks prior. The fact that sales did not reached the budgeted levels was all it took to warrant the elimination of those two positions.

When I started my current position at the regional grocery chain, our director of operations told me to run the pharmacy as if it were my own. Which I have done. It has been a very rewarding experience. I'm able to use a lot of the information that I picked up as an intern at the independent and put it into practice. I've tried a few things that I thought might work. Some have, some haven't. But at least I've had the opportunity to succeed or fail on my ventures.

Much like how it is with independent pharmacy. You give things a try. Some work, some don't. But it's fun coming up with the ideas and putting them into practice.

So a couple months ago an independent pharmacy called me about taking over their operations. I interviewed and was offered the position. The job sounded almost too good to be true. I've been looking for something like this for years.

But something told me not to leave my current job.

I talked with the pharmacy and we came to an agreement. I would work there on my regular job's off-days, and after 4 weeks I would let them know if I wanted to take the position full-time. To let you know how good this job was.... pay was better, insurance was better, hours were better (9-5:30 M-F, 9-1 Sat, closed Sun). Volume was low. A chance to get to know the patients. Looked like the ideal job.

My first day did not go too good. I had a cashier and a technician working with me, but the cashier was on the phone dealing with personal issues and the technician didn't know how to operate the computer. That's helpful.

Anyhow, I figured out how to operate the computer and survived the day. I went back a few days later for back-to-back days. Things went a lot better. Even though the technician still did absolutely nothing in the pharmacy (I'm talking even little things, like restocking vials), it went pretty good.

Except that the pharmacy had not received a drug order since the first day that I worked. They had an "owe" box that included owes from the week between Christmas and New Year's Day, and this was in late January. I pulled one of the VP's aside and questioned him about the drug order situation (at this point I should let you know that the retail pharmacy was part of a must larger specialty pharmacy operation that serves multiple states, so you know that the retail wasn't the money-making part of the operation). I handed him a list of drugs that needed ordered ASAP, if not sooner. He went over to one of the computers in the store and appeared to be placing the order. Why the actual retail pharmacy staff didn't write the order I have no idea.

I took a week off from the new place and returned this past Monday. I looked on the shelves. None of the items on my list were on the shelf. They were down to 10 Lipitor 10s, 15 Lipitor 40s, and zero Lipitor 20s & 80s. On a Monday at the start of the month. Other notable items that were missing included the generics for the following: Coreg, Lotrel, Biaxin XL, DuoNeb, Claritin. There was no Advair 250/50 to be found. And the staff had no idea when the next order would come in. It's one thing to be careful with ordering and having tight inventory control, but this place had over 4000 generic Apresoline 25s and only 3 simvastatin 20s.

And this place was so well organized that a second pharmacist came in at 9:30. The VP who faked writing a drug order came over and we had a quick but pointed talk. I let him know that patient care was being compromised by their lack of concern about the retail side of their operation. We talked a few minutes longer and I exited the pharmacy for the last time at 9:45.

It's about dignity, self-respect, and integrity. This employer apparently doesn't want its employees to have any of these basic rights. And thus they will not have Pharmacy God.

And it's sad because this was an old-time, mom-and-pop pharmacy. Complete with a soda fountain. It's been open for over 70 years, but the current management has destroyed it over the past 8 months.
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