Where should we be?
Some time back (and in some pharmacy magazine) I read an article (or editorial, I can’t remember which) where the writer stated an opinion that retail pharmacists and retail pharmacies need to move out of the spotlight and view of customers and MORE into a more private and secure environment. As I read this I found myself nodding my head in agreement. We are America’s most “accessible” health care professional not because the world values us, but because most of us work in a fishbowl. Walk into most pharmacies and you will see exactly what I mean. Recently I went into one retail outlet that had been remodeled a few years ago and was surprised to see that on 3 of the 4 sides the pharmacy was able to be viewed by the general public. I was shocked and dismayed at the lack of privacy and security this pharmacy offered its employees. There was no place that I could see, that the pharmacist could stand and not be in view of onlookers. SAD.
My pharmacy is bad enough. With the exception of one small cubby in the back, I can be viewed from anyplace on the outside of the dept. AND, had I not covered the counseling window glass with opaque contact paper, THAT area would be in view also.
Aside from the obvious, there are some real sound reasons that this author feels that pharmacy needs to be out of the public eye.
1. Simple Security. DRUGS. We have a lot of them. My store alone has over a quarter million dollars in drugs alone. I have more narcotics now than I have ever carried thanks to the prolific writings of so called “pain” clinics. For too many its a thinly veiled narcotic addiction management program. The cabinet looks like a narcotic salad bar!…shelves and shelves of nearly identical products but ones I have to stock because they are ever so slightly different than their competitor. One tote and a long sweep of the hand and you will have a lot of money in street value. ADA eliminated our 1-2 step up entrance to the pharmacy so one hop and a thief is over the counter and into the pharmacy.
2. Concentration. We have a drop off window on one side, a long work counter, and a pick up window on the other end. We can be prodded at any place in this line. “ahem” “cough cough” “knock knock”….interruptions to a counting procedure, a final check, etc. I am most weary of people asking me “Can I ask you a quick question?” usually its an oxymoron. The only think quick about most peoples questions is how QUICKly I can get out of it and back to the task at hand.
3. Time management. we spend a lot of time fielding questions that simply do not belong to the pharmacist. “Can you tell me where such and such is?” The pharmacy is not an information booth. If you want to know where the canned corn is, where the bakery is (under the GIANT BAKERY sign) or where the bathroom is, ask the customer service counter. THAT is their job. People come to us for such questions because we are slaves the the dept.
4. Patient safety. A distracted pharmacist is a bad thing. I dont need to even discuss that fact.
How would I design a modern pharmacy?
For starters, I would take some of the design ideas of most hospital pharmacies (aside from the fact that many are unmarked anyway…you’d have to identify it as a pharmacy!). In my pharmacy 99% of the pharmacy would be out of view. 100% of the drugs and the dispensing counter would be out of view. I may even compartmentalize the pharmacy where the work would be done behind a second wall. Clerks would man the front portion of the pharmacy where the customer would be picking up prescriptions. Techs and pharmacists would be in the back where the filling and prep work would be done. The customer would not be viewing the pharmacist filling prescriptions. Its not his/her business to be watching the pharmacist at work. Nobody should be watching us count medications. This isn’t a pizza parlor where you sit and watch the chef throw a pizza crust.
The drop off window would be a rather small unobtrusive window with just one terminal for inputting patient bio data. The pick up window would be similar and after payment the customer would be guided to areas for counseling (if needed) and then the pharmacist would come out and provide the necessary information for the patient.
If some patient had a question for a pharmacist, then the pharmacist would be able to come out at his/her discretion and not be glowered at by said customer waiting while the pharmacist finished the task. No longer would we be in the fish bowl we are working in now.
In high risk areas, even the windows could be protected like a bank with glass to prevent unauthorized entry. Every pharmacy would be given an office….a place where vaccinations could be given (instead of the middle of the aisle?!?), and some privacy to where if a sensitive issue needs to be aired, it can be.
Security, Safety, and Privacy. Why are these things so obsessed about by the government when it comes to the patient (i.e. HIPAA) and so blatantly ignored when it comes to the people entrusted to assure these things?
Tell me what you think readers?
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