Would you like fries with that?

I vacillated long and hard about writing this post, much less it being my first post on my new website. Truth is, there’s a good chance it’s going to tick some of you off. And I say “tick” because I promised Google this would be a “PG” website.

We pharmacists today, in general, bemoan the fact that we’ve been relegated to second-class citizenship in the nation of health care providers. We like the salaries we draw. For the most part we like the hours we keep. We do not like how far we have fallen in terms of value within the patient’s hierarchy of trusted treatment experts.

It has struck me, however, that the problem doesn’t really exist with patient perception but rather with our value proposition. Health care and patient management have undergone tremendous evolution over last 30 years in practically every part of the sector. Every sector except the pharmacy.

RxInBox.jpgYes of course we do things differently today than we did 30 years ago. But is what we do different of real value to the patient? To a great degree we’re suffering from sacrificing expertise for convenience. We’re automated to heck and back (see Google…keeping my promise).  We added drive-through windows like fast food chains. We became content to be counter-workers handing out sacks of pills. Sometimes it’s shocking that we don’t also ask “would you like fries with that?”

Not to say that certain elements, like drive-throughs, don’t have their place. My own pharmacy has one and it is very good for moving traffic when there probably isn’t a need for additional expertise and counseling. I don’t believe the problem is the actual drive through window but instead it is more a symbol that contributes to the attitude that has crept into our profession: expecting to be separated from our patients. Frankly, do we really think of most of the people we fill prescriptions for as our patients? If they’re not our patients, then that means they are our customers.

“Would you like fries with that?”

Instead of being paid out impressive hourly wages for being Redbox-Behind-The-Counter, we need to earn our salary by associating it with our real value proposition: the expertise we can exercise over a patient’s health care management.

“Seriously, when do you think I have time to do that?”

I swear sometimes I think a lot of pharmacists are IT people in a former life (no disrespect intended). Yes we’re all busy and we all get slammed with prescriptions from time to time. But also we need to realize that now in most states the tech-to-pharmacist ratio is 3-to-1.  What this extra help should do is unshackle us from the counter to actually engage with patients. Talk to them about their medication regimen or other health issues. Follow-up to make sure they are taking a full course of antibiotics, or using their nicotine replacement therapy correctly, etc.

So why don’t we do that? I think a lot of it has to do with the natural human tendency to be adverse to change. We focused on convenience and volume to the point that our comfort zone is behind the counter (working or not), and we’re unwilling to do anything different.

The bottom line is, we can’t stay behind the counter and stew in angst that our customers, er, patients don’t recognize the value of our expertise. Health care will/has/is changing, and pharmacists are behind the curve because we’re behind the counter.

There will always be a need for us, but how many of us it takes to fill that need and what our market price will be are two aspects that may be a hard pill to swallow.

If we don’t change the way we approach our profession, I’m afraid a lot of us might end up asking, “would you like fries with that?” for real.


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