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An excerpt from The Pharmacist is a Whore: How Pharmacists Lost Control of Their Profession and Why You Should Care.

The day patients became customers was a black day for us all. Don’t get me wrong, pharmacy has always been a service profession, and we take that very seriously. However, by virtue of our degree in Pharmacy and our license in the state in which we practice, we are considered drug experts, and as such, we are responsible for making sure our patients are not harmed.

Pharmacists were respected, not so very long ago. There was a time that if a patient decided they didn’t want to listen to their health care providers, or if they decided to try and coerce their doctor or pharmacist into acting against their principles or their better judgment, particularly if they used abusive language or became violent, they were told to kindly take their business elsewhere It seems like the weather began to shift when some retailers loosened their returned goods policies and began taking back products without a receipt. I don’t know when this happened, exactly, but looking back, I really think this was the beginning.

I have taken advantage of the more lenient policies born of increased competition, just like everybody else. I can’t always find my receipt, I have kept items too long before returning them, I have forgotten where I bought an item and tried to return it at the wrong store. I assume retailers have seen an increase in sales by bending over backwards to accommodate customers and give them what they want. Otherwise, there would be no incentive to allow returns any time, with no receipt, and no questions asked. Similarly, there would be no reason to offer free shipping both ways, allow the use of coupons and vouchers in addition to the sale price, or to issue “rewards” to be used toward the customer’s next purchase. Pharmacy is different, or it should be.

While I definitely want to be in charge of my own health care decisions, and I expect to be given accurate advice regarding the risks and benefits of any treatment recommended by my health care providers, I realize I do not have the knowledge or experience to figure out what my best course of action should be. That is why I hire an expert. If I don’t like what the expert has to say, or if I can’t establish a workable patient/provider relationship with the individual practitioner, or if I can’t afford the services of this professional, I go elsewhere. Eventually, I will get a consensus and decide on a treatment plan, based on the options I have been offered.

Once I select a practitioner based on qualities I value, like competence, dependability, follow through, communication, honesty, integrity, clarity, empathy, and courtesy, I put myself in their hands. I assume this professional has my best interests at heart and is going to do everything in their power to help me. I rarely complain about having to wait past my appointment time in my doctor’s office. I assume he is busy with his other patients, and that he will give the same kind attention to me when it is my turn. I schedule my appointment first thing in the morning to try and avoid the snowball effect that happens when appointments start to overlap. If I have a long wait every time I have an appointment, I consider whether this doctor’s expertise is worth waiting for. If it is, I may state my opinion to the receptionist or nurse, but I do not storm back to the treatment room and give him both barrels about having to wait. Somehow, I do not think this would be in my best interest.

In contrast, some patients that we encounter in the pharmacy treat us as if we are no more than burger flippers, preparing patties instead of poison. While most people understand that it would be ludicrous to walk into any other professional’s office without an appointment and expect to be served immediately by the practitioner himself, they have been taught by the chains that this is perfectly acceptable behavior when dealing with pharmacists. Being the “most accessible health care professionals” is a two-edged sword. The title used to be a source of pride, indicating that we were friendlier, less intimidating, more down to earth. Now, it means that we are standing in the eye of a hurricane and expected to be all things to all people without the resources to do our jobs properly.

People who wait patiently for their tall mocha latte at Starbucks, and understand that it takes time to create their favorite specialty drink, are often the same people who get upset when they have to wait more than 15 minutes for a prescription. Customers who drop off their prescriptions and offer to come back later, call their refills a few days ahead of time, bring in their new insurance card, understand when a medication is out of stock and must be ordered, and patiently wait for the pharmacist to acknowledge them and prepare their order, are few and far between. In fact, they are so rare that when we encounter one of these individuals, we are likely to get tears in our eyes and practically kiss their feet with gratitude.

The chains have set you and me up to have an adversarial relationship. Pharmacists are now the enemy, because we look like bumbling buffoons as we juggle too many tasks with too few resources. We have to wear too many hats.

Does your doctor greet you at the receptionist’s desk, process your insurance, collect your copay, answer the office phones personally by the third ring, gather the materials needed for your exam, clean the room after your exam, order supplies and put them away, and generally run the whole office by himself? Of course not. Pharmacists have allowed the chains to take over our profession, and this is the unfortunate result. The reason pharmacy has gone from the most trusted profession to an all-out war of wills is part of the larger problem of putting health care in the hands of corporations.

Kim Ankenbruck is a pharmacist and author of The Pharmacist is a Whore: How Pharmacists Lost Control of Their Profession and Why You Should Care.

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