Pharmacy’s Catch-22: Save a life — or save your livelihood?
I remember staring out the window of my pharmacy school on a sunny day longer ago than I care to admit, suffering from a full-scale attack of senioritits. Graduation was just around the corner, and the professor was doing her best to keep the roomful of restless future pharmacists engaged in something productive. I was tuning in and out of the conversation until I heard the professor say something like the following.
“Say a person was walking past your pharmacy counter and suddenly started having serious chest pain. They’d never been in your store before, so they’d have no prescriptions on file with you. Would you give them a nitroglycerin tablet?”
I ignored what I thought a silly question (of course you would!) and went back to my daydreaming, until I realized to my amazement that a lively discussion was going on, with many soon-to-be professional pharmacists asserting that it would be the best decision not to offer relief to a person in serious distress.
When I took my first pharmacist job I asked my boss, who was then serving on the Ohio Board of Pharmacy, about this, and he chuckled.
“No matter what you do,” he assured me, “if you can frame it as ‘It was what was best for the patient,’ then you’ll be fine.”
Sound, commonsense advice for professionals who uses their judgment and expertise to make decisions, I thought.
Best, yes — but for whom?
Fast forward a couple decades, and as it turns out, that classroom discussion wasn’t so hypothetical after all. Consider this:
Katherine O’Connor was having an asthma attack while walking home in New Jersey with her boyfriend. Luckily, there was a drug store right there. But she only had $20, and the inhaler cost $21. And the pharmacist wouldn’t give it to her.
“I said, ‘Can you just give her the pump? She’s on the floor wheezing ... I didn’t know if an ambulance would get there on time. He said there was nothing he could do for me.”
The above came from a story reported by New York’s Fox5 TV that made its way around the internet a few years ago.
By the time I saw it, I wasn’t nearly so surprised as I was in the classroom that day long ago. It was an extreme case, but after 20 years spent working for chain drugstores, I can understand how the corporate environment could intimidate someone into making the wrong decision.