Below is a pharmacy story from Oregon.
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
Jamie Francis/The OregonianPatrick
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
retired Paisley minister experiences sudden Parkinson’s disease
symptoms, so severe he believes death is imminent — only to learn it’s
due to the wrong medication.
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.”
