Tuesday, October 15, 2013

Never!

The pharmacies where I work generally offer free delivery of prescription medicines.
They also generally have many angry people waiting in line from time to time.

Many have expressed anger to me about prescriptions "Never" being ready.

Obviously "Never" is not absolutely correct or they would not return as customers.  But there are a few authentic "nevers" that I have observed.

Fortune 500 companies are never going to staff adequately to take care of each patient right away.
They are never going to stock inventories for every conceivable illness for multiple patients per day.

Labor and inventory in healthcare are huge overhead costs and making quarterly reports look more amazing than competitors invites more investment.  More investment equals more stores, growth and better quarterly reports ad infinitum.  This investment and the razor thin margins for retail prescriptions medicine have allowed corporate pharmacy to dominate and decimated the family owned independent pharmacies over the last decades.

Controlling labor and inventory costs are general constraints in business but in pharmacies ensconced in larger retail environments these constraints find a new purpose by inviting "collateral shopping."  It is part of the business model.  Under the guise of "lean and mean" business practices there is the well known ulterior motive to drive traffic to higher  margin items stocked by lower wage labor: candy, over the counter medicine, alcohol, cigarettes.  All the things people eat that require them to see physicians for treatment of chronic disease management i.e. diabetes and hypertension.
So by not having medicine ready or only having enough to advance the giant retail markets win agian.  It pays more to do be less effective.

The trifecta is 1) loss leader pharmacy drives traffic to umbrella retail environment 2) selling unhealthful products ensures return customers, 3) anemic inventory and understaffing requires multiple trips.  Think of the recycle symbol here but referring  to people in place of trash.

I recommend using the telephone to verify that your medicine is ready or use the delivery service.
Or mail order.
But certainly ask the pharmacist for highlight drug information whenever getting new medicine.  And check whatever metrics you can when taking that medicine --e.g. blood pressure, sugars, mood journal-- at least every month.  A check in with the pharmacist can lead to a better engagement with prescribers and better outcomes.  That's health care speak for being healthy.


Wednesday, October 9, 2013


I do relief pharmacy work and I come into contact with a parade of tragedy called "health care."
Absurdities of health care include its cost, misallocations of labor and capital, dearth of technology widely available in other economic sectors, legislation that panders to BigPharma at the expense of safety, snail paced advancements from lab to journal to practice, sequestrations and sales of health information and acutely: public apathy and fantasy.

As I work in different venues I am driven to grab a prescription pad and scribble an angry little note regarding how some process or adverse effect might be improved or ameliorated.  Coworkers imagine I am writing all kinds of things in the "care culture" where we work under multiple surveillance cameras and a missing dollar or tablet will go down on a permanent employment record.  But my notes have ended up in a smallish shopping bag next to my hamper.  And now the bag is filling up and it is time to share my scribbles on prescriptions in hopes of raising awareness and making some desperately needed improvements.

Welcome to Prescription Rant--  ℞ant

Please contribute and share and let problems and solutions be put in the open.  Let it be known that we can do a whole lot better.