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    Feeling like a real pharmacist


    David Stanley, RPh
    Almost immediately I sensed the fear of the newly diagnosed. In this case, it was actually the wife of the newly diagnosed, asking on behalf of her husband, who probably had the typical male's aversion to asking for help or directions. The poor fellow had newly developed hypertension and diabetes, and no health insurance. His wife had an aversion to western medicine, but it was becoming clear that her husband's health was deteriorating. She was scared. In addition to the words coming out of her mouth, her tone was saying, "Oh, my God, the person I care about is sick, and I don't know what to do, and I just wish I could get a few minutes with someone who'll listen to me."

    So I listened. I dug into the husband's medical history and saw that one of the meds prescribed by the urgent-care doctor might not be the best choice, and not only because it was a budget-buster. After explaining to the wife that there's nothing wrong with a little healthy skepticism, I went over the plan to get hubby's blood pressure and blood sugar back to normal, in order to ease her mind. I could tell I was getting through by the gradual relaxation of the wife's tone.

    It was textbook pharmacy practice, and it happened nowhere near an actual pharmacy. I was exercising my professionalism through an e-mail exchange. Your first clue might have been that I said I had time to listen to the patient.

    Took the time to do it right

    My proudest moment as a pharmacist might have been the case of female priapism I once tackled. "I'm absolutely beyond embarrassed to ask you this," the patient told me, "but I'm doing everything possible to avoid going to the doctor and actually saying these words out loud." She had read on the internet that pseudoephedrine might help in these types of situations and gave me her drug history.

    I sprang into action. The first thing I did was to issue a strong warning against self-treating with pseudoephedrine while also taking Adderall; the second was to hit home the point that a doctor was needed here, and soon. Third, after a little research, I said there was a chance that one of her meds might be contributing to the problem.

    Turned out I was right. When I found out, I did a little Snoopy dance to celebrate. I could do this because once again, my masterpiece of pharmacy practice happened nowhere near an actual pharmacy. The clue here was when I said I did a little research. When was the last time you had time to do drug research while you were actually dispensing drugs? We both know the answer to that one.

    Helped others do it right

    In the last month I've also helped educate a nurse practitioner who prescribed the wrong dose of azithromycin and a doctor seeking the best choice for painful, as opposed to itching, hemorrhoids. Neither I nor my employer got paid for any of it, because none of it happened on the job.

    For more than a few years now, the chance to do my best work as a pharmacist has only happened after I left the pharmacy. The irony is that in their never-ending chase to collect an ever-greater number of ever shrinking dispensing fees, the powers that control our profession have made it nearly impossible for us to practice it. Professionalism is now seemingly defined only as a flu-shot quota. This is what it has come down to.

    Profession, heal thyself

    I recently left my job in the retail pharmacy world, and about a week after my last day one of my old customers tracked me down on my cell phone. "I hope you don't mind, but I begged the technician to give me your number," he said. "I tried to ask the pharmacist who was working about this, but he seemed so busy." We then had what was probably a 10-minute discussion about benzodiazepine withdrawal, uncompensated and far from any pharmacy. I was as happy to do it as I was unsurprised that it was happening.

    Sadly, our job and our profession have become two different things. I hope that changes soon, because I love practicing pharmacy. And while we all need a job, I don't want to stop doing what I love.

    David Stanley is a pharmacist, blogger, and professional writer in northern California. He can be reached at
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    David Stanley, RPh
    David Stanley is a pharmacy owner, blogger, and professional writer in northern California. Contact him at [email protected]