What’s Causing the Change at the Pharmacy?

What’s Causing the Change at the Pharmacy?

The National Pain Report has received a number of reader comments recently about problems in dealing with their pharmacists. It prompted a thought that maybe how pharmacists are being prepared in school is causing some of this tension. We asked Steve Ariens, a retired pharmacist who writes extensively on chronic pain issues, what he thought. His perspective, as always, is interesting.

Steve Ariens

Steve Ariens

I don’t think that the problem is so much with what is taught as to what the selection process is to allow those in pharmacy school. Right now it is highly influenced by academic scores (GPA). Until the recent acknowledged Pharmacist surplus-we had 5-6 applicants for every academic slot. Rumors have it we are now only 1.5 applicants per slot. When I applied to pharmacy school, there was no problem getting in, rather the problem was reaching graduation. There was 39 in my graduating class and just 13 were out of the original 85 freshman declared pharmacy majors.

At the special committee meeting of the Florida  Board of Pharmacy in June, they were talking about “educating” Pharmacists - basically educating them in “common sense.” In my experience all too often those who have high academic scores tend have low common sense scores. It is difficult to “teach” common sense. That position, demonstrates to me just how disconnected state Boards of Pharmacies are.

Some of us see a large influx of students, over the last decade, that are being more influenced by the sizeable paycheck, and the perceived job security. We have went from 80 odd pharmacy schools to 120+ schools in the last decade or so and most of the new ones are for profit schools and have went from a 4 yr. program to a 3 yr. – 36 months straight degree and some believe that they are more focused on “teaching to the test.” Pharmacy is a highly scientific based degree and these new grads are all about the data - the black/white of medical care. They know little/nothing about ADA, labor laws. They are well versed on DEA regulationss and the state laws and practice act. Many are $100,000+ in school debt… and that “cocktail” makes them very pliable to the corporation. They are eager to please and not question when they are asked/told to do something that may be unethical, illegal, immoral.

The fact that their mindset is data based means that subjective disease like chronic pain, just throws them. They have no data to make a decision and go into “shutdown mode” because they can’t relate to the medical needs of patients like those who suffer chronic pain.

I once saw a quote from a Pharmacist complaining about having to get vaccination that she “became a Pharmacist… so that she would be a DOCTOR and not have to deal with patients …”

Now, back to the Board of Pharmacy dilemma - a real can of worms. Most are stacked with non-practicing corporate Pharmacists… they will recuse themselves if something comes before the BOP concerning their employer but collectively they will not do anything that will harm the chain store industry.  They will take an independent Pharmacist out and because of the surplus - they are imposing tougher fines/suspensions on individual pharmacists because they no longer have to protect the labor pool to make sure their employers have a warm body and license to keep the Rx dept. open.

Only time that I see a BOP act is when controlled meds are involved and/or some sort of immoral issue is involved - other than that they are basically catatonic.

A couple of us just started a new blog www.mederrorsdepot.com/blog  we are trying to get pharmacists to come forward with how many errors are happening and being buried and “paid off” and that the numbers are exploding… It has been reported that CVS is having further Rx staff reductions as of the first of the year.. this is the fourth or fifth year in a row of staffing cuts… while their Rx volume continues to grow. With the CVS/Target & WAGS/Rite Aid merger.. that represents about 60% of all the chain store outlets… and they are talking about up to 3000 WAGS/Rite Aid store closures and I look for 600 Target Rx dept. closing. That is another 7000 +/- RPH’s unemployed by the end of 2016-2017 on top of the 3000 +/- of excessive grads that are coming into the market place each year.

The colleges of pharmacy are only a very small part of a larger problem.

Steve Ariens writes on pharmacy and chronic pain issues. His blog can be seen here.

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Jeremy Goodwin, MS, MD

So much of what is written here applied to physicians too. Just as racism begins at home do too do the non empathetic physician attitudes ( and lack of critical thinking skills) begin in the classroom with the selection process. Several courses in psychology and social studies should be as important a requirement as the usual sciences.


We have a School of Pharmacy at a 4 year college close to where I live and I noticed many years ago that around certain times of the year when pharmacists that are working for the first time at local pharmacys it isn’t a good time to take in certain prescriptions. They have the book learning, but how to deal with people and apply some of what they have learned that requires thinking on their own, they are at a loss to do. Most of this does get better as they get use to being in the real world.

I have always dealt with only one or two pharmacys. When it comes to Schedule II meds that may need to be ordered, I deal with only one pharmacist. The frst time I went in the store after talking with her over the phone, I went out of my way to introduce mysef and thank her for ordering the meds that I needed. I learned a long time ago that it is always best for a pharmacist to be able to put a face with a name and certain meds. And I still make it a point to thank her for ordering the meds. Some people may say that is their job, which it is. But, most employees will go out of their way for a customer if they know that they and their efforts are appreciated, not just pharmacists. In todays climate when pharmacists can be treated rudely by many customers, it helps when they remember you for the right reasons.

I also believe that we have a responsibility to check the prescriptions that we get to be sure they are for the right meds and the right dosages. If we get a prescription and it is for the wrong thing and we take it, we can’t blame the pharmacist for it because everyone makes mistakes. Pharmacists and physicians should not be put on pedestal because they are all human and they all make mistakes. If you do have a problem with a particular pharmacist, you can ask to speak to the Pharmacy Manager. The chain pharmacys use to also have pharmacists that were over area pharmacys, I think they called them District Pharmacy Managers. I’m pretty sure they still have them. If a problem isn’t taken care of by a Pharmacy Manager and it is a chain store ask for the District Pharmacy Managers contact info. BUT, you have to be reasonable. And if you are told that something is law, look it up yourself before you ask a pharmacist to do something that they can’t legally do.