It is interesting to note that the some of the same insurance companies are driving the changes in Canada.
The question remains are we going to follow the crowd (other provinces) who have been heavily lobbied by brand drug companies, insurance companies, and chain drugstores?
This is not the model we need for an aging population - we need more of the services offered by independent stores - not less.
We need to make sure that Newfoundland and Labrador keeps the best network of pharmacies and professionals found anywhere. We need to make sure that all our neighbourhoods and communities have reasonable access to equitable services.
Ontario is the province driving these negative and regressive pharmacy remuneration models and the rest of the provinces are following.
The American system is about 5 years ahead of Ontario - look at the results.
If the stock market is going to be the driver of your health outcomes - then what should you expect?
Workloads, chain stores add to safety risks, Oregon pharmacist survey says
Published: Sunday, February 12, 2012, 10:15 PM Updated: Monday, February 13, 2012, 12:13 PM
View full sizePatrick
Bowman opened Tualatin Pharmacy 11 months ago and says his business is
building. Pharmacy runs in Bowman's family; his father, sister and he
once operated seven stores. Before opening his store in Tualatin, Bowman
worked in large chain stores. The experience, he says, was not good. A pharmacy technician in Hillsboro sells an Ativan prescription to the wrong man, who gets pulled over for driving erratically.
An Astoria woman suffers a cardiac arrest, and later learns her pharmacy for months had overdosed her with thyroid medication.
These are among the estimated hundreds of pharmacy errors reported in the last few years, either to state agencies or in lawsuits. And some pharmacists say errors are happening more than ever.
A recent survey by the Oregon Board of Pharmacy reported that more than 350 chain pharmacists — more than half of those responding — said their working conditions don’t promote safe and effective patient care.
Many complained it is getting worse. “I feel that we are operating on the edge of disaster,” wrote one. “It is a danger zone for us and our patients.”
Last summer, the state board hosted an online survey for roughly 5,700 licensed pharmacists licensed in Oregon. The results were gratifying and disturbing, says board member Ann Zweber. She hadn’t expected so many to respond — more than 1,300; unfortunately, many responded by reporting safety concerns.
“People had a lot to say,” she says. “It concerns me greatly.”
The survey results describe a profession in transition. Independent pharmacies, which once dominated Oregon, now number just 214 out of about 750 retail pharmacies, according to state records. As independents give way to large chains and mail-order operations, increased competition is inserting a bottom-line mentality into the way people get their pills.
Only 25.9 percent of chain store pharmacists agreed working conditions promoted safe and effective patient care — compared to 76 percent of pharmacists at independent pharmacies.
Not only that, more than 200 hundred chain pharmacists commented about workload and safety.
The survey data isn’t perfect. It’s anonymous and pharmacists were allowed to self-report their type of workplace. But the board believes the survey is credible, Zweber said.
Many complained of having to fill more prescriptions each day with fewer staff; of 12-hour shifts with scant breaks; and constant distractions, such as administering immunization shots to augment profits.
One reported quitting a chain job because of feeling “like I’m going to jeopardize the patients every time I stepped into that pharmacy.” Another said because of lack of staff, “we have seen a huge increase in errors. We used to have a couple per month, now we have a couple per week and sometimes more than one in a day!”
Blake Rice, a pharmacist who used to sit on the state board, thinks many errors are caught internally by improved safety procedures. But he agrees chain stores don’t protect the public, giving drugs “the same lack of oversight as the sale of bread and milk or canned beans.”
Several chain store representatives disagreed.
Chrissy Kopple, spokeswoman for the National Association of Chain Drug Stores, said the survey does not reflect chains’ commitment to quality. “NACDS and individual chains will continue to work with the Oregon Board of Pharmacy to maximize patient safety and health.”
“We have a strong safety record because of our on-going education and training for pharmacy associates as well as our continued investment in technology for our pharmacies to maximize accuracy and patient safety,” said Rite Aid spokeswoman Ashley Flower.
There is no data to definitively show more pharmacy errors are occurring, or that they happen more often in chains. Pharmacies do not have to report errors to any public agency. The pharmacy board considers roughly 80 cases a year involving reporting errors. The Oregon Patient Safety Commission encourages voluntary reporting, but only 94 pharmacies have signed up.
The Institute for Safe Medication Practices solicits confidential reports of pharmacy errors from consumers and pharmacists. The group is seeing a steady increase in such reports nationwide, said Michael Cohen, a pharmacist who heads the group.
He said the group is sending its own survey. “It’s hard for the pharmacists who work at these chains to complain too loudly to their manager or go public because they work there and they don’t want to undergo any type of job issue,” Cohen said.
Joseph Lassiter, a Pacific University pharmacy professor who sits on the Oregon Patient Safety Commission, said the Oregon survey results are disturbing. “This survey is a signal for us that there’s something going on.”
The board of pharmacy is considering rules to keep an eye on working conditions. The rules do not set strict workload levels, but allows the board to fine or suspend a pharmacy license over safety issues.
Oregon is not the first to take on the issue, said Carmen Catizone of the National Association of Boards of Pharmacy. Iowa and North Carolina adopted stringent standards, with a workload review of every reported error where a customer was harmed. He said state pharmacy boards have to strike a balance between public safety and workplace interference.
Zweber says the Oregon board seeks the same balance. “I don’t think we’re going to be that specific,” she said.
Patrick Bowman, owner of Tualatin Pharmacy, says he’s not surprised at the survey. He founded his business 11 months ago after working in chains.
“I don’t have headaches anymore. I don’t have trouble sleeping anymore,” he said. “People come to me because they’re not a number.”
No comments:
Post a Comment