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    Issues arising in chain-store pharmacy

    Here’s more front-line testimony that every bench pharmacist can relate to. One of these days, working conditions like these will be history. What’s it gonna take to get the ball rolling?

    In George Orwell’s classic satire Animal Farm, Boxer the horse and Benjamin the donkey are friends, disciplined workers whose devotion, hard work, and self-sacrifice contribute significantly to the positive image of the pigs who govern the colony.

    The practice of community pharmacy in chain stores may not be farm work, although nowadays you might find tomatoes and peppers under the same roof. The pharmacist is not a Boxer and the pharmacy tech is not a Benjamin. Nonetheless, these two hardworking pharmacy staffers are often treated in the same way that this diligent pair was treated by Napoleon, the chief pig.

    While Boxer and Benjamin pined away at the millstones, Napoleon fattened himself up in the farmhouse. Benjamin’s rations were continually hacked to satisfy the voracious appetite of the ruling pigs, while Boxer grew old and was eventually sent to the knackers for slaughter. In today’s chain-store pharmacy employment, the analogy might be expressed in these terms: The pharmacist and his technician are treated as mere cogs in the money-spinning wheels of chain-store management.

    Daily realities

    Among American pharmacists, a large proportion practices in chain stores. Some pharmacists have been in the same store or nearby stores for upwards of 25 years.

    The pharmacist who is the de facto professional and pharmacy practitioner does not have an office, not even a chair.

    He does not have a desk at which to communicate with his pharmacy tech or to receive other professionals who visit the pharmacy.

    In many facilities there is no training room or break-room. Some stores do not have a private consultation area for confidential discussion of patient information.

    When it becomes urgent for the working technician to undergo a computer-based training at work, even for only 15 minutes, there is no available training facility in the immediate location of practice.

    In many chain stores, counter corners are laden with cobwebs, and cockroaches and mice inhabit the pharmacist’s space.

    There’s more

    Peculiarly, there are no provisions for physical relief in the pharmacy. All employees are warned, “You cannot eat and you cannot drink here, because there is no lunchroom and no restroom, and there is no break because the pharmacy must remain open.”

    For the religious among us, some of whom must pray seven times daily, there is no private area that may be used as a prayer room.

    None of our older senior pharmacists have been spared the agony of standing throughout their shifts in the pharmacy. And those few who are brave enough to say that they cannot work a 12-hour shift traditionally have been greeted with “If you can’t do it, please leave.”

    Hard labor dulls consciousness

    There is a peculiar haze in chain-store pharmacy that veils the minds of the pharmacists who work there. Gradually they become insensitive laborers, whose awareness has dimmed to the reality of their “chains.”

    Chain-store pharmacy is a cul de sac, and those who are honest enough would admit that their future is limited without significant reform.

    No reasonable practitioner stays long in a trap, which explains why there is typically a shortage of pharmaceutical manpower in the chains whenever the United States’ economy prospers.

    The economy has been in upheaval for some time now. Many stay.

    Contention in the ranks

    Some pharmacists are in denial and lack the courage to admit the suffering inherent in their circumstances. After serving in “chains” for years, however, many will acknowledge that they deserve a “no-weekend shift.”

    Yet few are willing to embrace progressive changes. Whenever new approaches in their overall interests are implemented, some pharmacists may react as if they are being threatened by the improvements, or they show unease in the presence of a more adventurous colleague who believes that there is more to gain by standing up for our professional rights and our rights as human beings.

    In this instance, the pharmacy practice arena becomes a theatre of the absurd, with one pharmacist striving to undermine the colleague who demands a decent working environment; the progressive colleague is labeled too vocal, although his purpose and actions are for the good of the profession and the benefit of all pharmacists in this country and beyond.

    Have a great day

    It is not impossible for pharmacists in the chain stores to have two (2) 8-hour shifts per day. A senior pharmacist who has served for more than 25 in the chains ought to be spared weekend or 12-hour shifts.

    Job satisfaction and creative endeavor in practice are enhanced when employees are treated with dignity and respect in their working lives. It is uncivilized and unethical to bark at an employee of over five years, “If you don’t like it, please leave.” This is the way that many longstanding dedicated workers are treated in today’s chain-store pharmacies, a practice has consistently cheated pharmacists of their dignity.

    Humiliation and ill treatment of pharmacists in the chain stores are daily events. A chain-store pharmacist may be seen anytime without an appointment. He may be rudely interrupted at work and shouted down by a so-called “customer” who is ignorant of the realities and challenges behind the counter. While doing his utmost to serve his clients, the pharmacist may be told, “I shouldn’t be here talking with you; I only have to write a letter, and you’re out of here.” In one instance, a customer who demanded free pills and was denied threatened to report the pharmacist to management.

    It is usually shocking and tragic when a diligent and responsible worker is treated this way. Some are removed prematurely for their courageous confrontation of indignities in the workplace, and very little thought, if any, is accorded them for their many years of sacrifices in service to the chains.

    Inescapable questions

    Human resources management of pharmaceutical manpower in the chains is a sham at best. The pharmacist is chained, his assistant the technician is equally chained, and every working day for them is akin to jungle warfare, replete with guerilla tactics and customer blows.

    Is it impossible to practice pharmacy while being comfortably positioned on a chair?

    Is it not possible to verify prescriptions and consult with patients in a decent office?

    Can we regard the services of a pharmacist as healthcare delivery, when it is unusual for the pharmacist to see patients while seated behind a desk?

    Is it impracticable to have two or three shifts in the chain-store pharmacies during the 16 hours that the pharmacy is open to the public?

    Why should we dispense free prescriptions to patients, when we believe that compliance is a challenge in medication therapy and that patients ought to value the prescriptions they receive?

    QUESTIONS, very many questions, remain painfully unanswered in the chains.

    Pharmacists are the only ones who can redeem their profession, and they are the only ones to guarantee a respectable future for themselves in the comity of healthcare practitioners worldwide.

    Please think about these matters before you are 65 and retired. You have a stake in the future of your profession!

    Oluwole Williams practices pharmacy in the Philadelphia, Penn. area. Contact him at [email protected]

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    Oluwole Williams, BPharm, PharmD
    Oluwole Williams practices pharmacy in the Philadelpha, Penn. area. Contact him at [email protected]

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    • Joe DonBaker
      As a legend pharmacist (that's an old guy/gal with a BS degree and 30+ years experience) I have worked hospital, retail chain and retail independent. This article is spot on. I never thought until today what the word "chain" in chain pharmacy stood for. My chain experience was not always grueling but it did become so the last couple of years. Never enough help, tech or pharmacist. Always more and more things to do, patients to call about new medication therapy, MTM, immunizations, paperwork! Never ending. As a manager, I worked 40 hours on the counter and then was supposed to spend 2 hours on management stuff. It should have been more like 20-22 hours on management. Mind you, I don't mind working hard. I am at an independent pharmacy now and work four 10 hour shifts a week. There is usually two pharmacists and 3-4 techs on duty at a time and we fill 300-400 RXs a day. It's still hard work with little down time but we do take breaks for lunch. And the customers appreciate us and rarely do we have a disagreement with them. Plus, it doesn't hurt that our wait time is about 3-7 minutes. I need to work about 7 more years then I'm done. I just feel sorry for those who have their whole career in front of them. I do hope it gets better.