Back in July 2017, in a column about pharmacy technician staffing, I wrote: “In my 36 years on the bench I’ve found the difference between a great day and a challenging day isn’t the number of prescriptions, it is the level and quality of staffing.” Technicians in the pharmacy are indeed what keeps us pharmacists on task, so we can spend time helping the patients who seek our expertise, as well as verifying prescriptions.

The level of staffing unfortunately is left to those further up the food chain, usually district managers or someone sitting in a corporate office.

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For some reason they feel they have psychic powers that can determine the needs of a pharmacy that they don’t ever staff. Their formulas can’t possibly factor into account the health literacy of the population, which can require more “hands-on” work by the pharmacist and staff.

Most of my patients can’t punch their prescriptions in on the interactive voice response (IVR). Instead, they dial our phone number and hit the “0” button to talk to a staff member. Writing down 12 prescription numbers takes us more time than processing 12 prescriptions directly off the IVR. Add to the mix lottery machines and drive-through windows, and staff can be spread mighty thin. In contrast, where my wife works in a university town, her patients are rather low maintenance, seldom calling for early refills and always using the IVR.

Each chain has its own formula. One grocery chain uses the figure of 8.7 prescriptions per tech hour, which includes techs and cashiers on the pharmacy team. Fill 480 prescriptions in 12 hours, you get 55 hours to staff your pharmacy with cashiers and technicians. Another grocery chain allows 11 prescriptions per tech hour, not including the cashier (who is up front). Fill 480 prescriptions at this pharmacy and you get 44 tech hours. Most chains just assign tech hours without any reasoning.

I find it amazing that the state boards of pharmacy, APhA, NACDS, and NCPA have provided little, if any, guidance about the levels of staffing, which is the community pharmacist’s number one complaint. That might be a good way to increase their membership by taking a stand on staffing and maybe the average community pharmacist might see value in joining the ranks of these three associations.

Thus far the only group that has taken a stand on pharmacy technician staffing is the Chicago City Council. It wants to pass legislation that requires mandatory pharmacist breaks as well as 10-technician hours for every 100 prescriptions filled. Those levels would need to be adjusted for flu vaccinations as well as other promotions that pull pharmacists away from prescription verification and counseling. Fines range from $250 to $1,500 per day, also including whistleblower protection for the employees.

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As far as the quality of technicians, that responsibility rests on the training programs. I have had amazing techs over the years, because I always take the time to train them, then “cut them loose” to develop their own skill set. The technician that keeps my store running like a well-oiled machine is Brad Wiegand. Brad came to us as a high school senior and worked as a stock boy. When he expressed interest in becoming a pharmacy tech, we taught him our pharmacy filling software program. As with any young kid, he excelled in operating the computer and is a “dream technician.”

As his senior year concluded Brad was considering enrolling in a local pharmacy tech program. I promised I’d train him in store and save him around $11,000. He has “rock star” status, because everyone in the store gave him the opportunity to learn and excel. If your technician is inadequate, I’ll bet it can be traced directly back to their training. We pharmacists are responsible for the training of our technicians. A well-trained technician is the difference between a great day and a challenging day; just make sure you have enough of them!