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    Pharmacy mistakes, Part 3: State BOPs and public safety

    Dennis MillerDennis MillerWe all make excuses from time to time, but rarely do our excuses cost lives. In my opinion, the favorite excuse used by state boards of pharmacy is costing lives.

    State BOPs love to claim that they can’t do anything about pharmacy understaffing because it is an employer-employee issue. They have been trotting out this pathetic excuse for decades.

    Give me a break. State boards of pharmacy exist to protect public safety. When people are injured by pharmacy mistakes, it is a public safety issue. Where are the state BOPs?

    The No. 1 issue

    I’ve been writing commentaries for Drug Topics for more than 10 years. Judging from the e-mail I’ve received, I don’t think there’s any topic that gets pharmacists more lathered than the inaction of state boards toward pharmacy understaffing. 

    Dangerously understaffed pharmacies are a threat to public safety. What’s so hard for state boards to understand?

    Pharmacists resent the fact that the state boards have the power to discipline us for mistakes we feel are a direct result of dangerously unsafe staffing levels in retail chain stores. The state boards act as if they have the moral high ground in this matter, when in fact they are failing to do their own job of protecting the public safety.

    Okay, politics

    I realize that state BOPs have more freedom and independence in some states than they do in others. And I realize that each board of pharmacy must be mindful of the political climate in its state.

    A regulation on pharmacy staffing levels probably has a better chance of passing in a blue state than in a red. But passing such a regulation in any state would be difficult.

    The retail chains are likely to fight back tooth and nail. And I’ll bet that the strongly pro-business interests in the red states would make passing such a regulation even more difficult.

    But that doesn't mean the BOPs should turn their backs on this issue.

    Dennis Miller, RPh
    Dennis Miller is a retired chain-store pharmacist living in Delray Beach, Fla. He welcomes feedback at [email protected] His books ...


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    • Anonymous
      Thank you for hitting the nail on the head. With all the distractions from "I have a quick question" to where is the bathroom, to which aisle is the sale item in. And let's not forget the the time on the phone to get customer insurance info (not having their card), to why is this so expensive (after calling and finding they have a deductible). We all know these add to the mistakes while we all multitask. The chains only look at script count, man hours,time to fill Rx, jobber to warehouse ordering. I always tell customers that rush us, "if you get the wrong hamburger from McDonald you can return it but if I give you the wrong drug you may not be back". I hope boards and organizations look at this before more tragic things happen. We all must sleep at night without worrying did we make a mistake today.
    • Anonymous
      Oregon actually wrote workplace rules that have had a significant effect on pharmacy workplace conditions. It isn't as good as it could be but it did eliminate/constrict a number of contributing factors to workplace stressors.
    • Anonymous
      Washington State did a similar survey to Oregon in 2014 and, not surprisingly, got the same results. A Pharmacy Quality Assurance Commission committee looking into business practices is reviewing the issue but are encountering some of the same problems mentioned in Mr. Miller's article. An attempt to do something about breaks and lunches for pharmacists was tabled as it was determined to be a Department of Labor issue (pharmacists classified as "professionals" and not subject to break regulations). As will always be the case, it'll take a death or two (or three, or four, or five) before any changes come from regulators.
    • Anonymous
      It has been my experience that as pharmacies approach 20 prescriptions per hour or more that corners get cut. Maybe a drug interaction gets bypassed or a dose for a given patient is overlooked. The NTSB has shown that multi-tasking is a myth & similar to pharmacy you can only take so many distractions before mistakes are made. I disagree that one Pharmacist and one Technician is adequate staffing unless you have a dedicated cashier. If you don't then your Technician becomes the cashier and the Pharmacist is left to process prescriptions, check prescriptions, answer the phone, follow up with Dr calls and lets throw in a flu shot for good measure. I agree that staffing is the key because you may have the best system and technology in place but if you don't have proper staffing then it all fails. What we need is leadership from Pharmacists that have worked the counter and over the last 23 years I have seen less than ever before.