December ’12 Article

I’ve just finished reading “The Prisoners of Comfort” by Jim Plagakis. Jim is an American pharmacist who has lived and practised in many parts of the US for many a year. Jim keeps a blog which you can easily find with google or via the link on my blog. His main contention in this book is that many employee pharmacists in the US have become so dependent on the large salaries that they earn with the chains that they are willing to put up with terrible working conditions. Some of the working conditions that he gives example of are almost inhuman. 14 hour shifts with no toilet break never mind a lunch break! Long periods with no technician or other support staff. Having to cover the OTC counter, dispense prescriptions and man the Drive-Thru window at the same time. Throw in that patient counselling for new prescriptions is compulsory by law in the US and that the pharmacist in charge is responsible for making all of this then you truly have some horrible working conditions. And then I asked myself “Could this happen in Ireland?” My immediate reaction was that because most pharmacies in Ireland are owned by pharmacists that they would not seek such conditions of their employee pharmacists. And even though salaries were good here they did not come close to some of the salaries in the US. But can this continue following the cuts of 1st November, the numerous cuts of recent years and reference pricing coming down the tracks. In the chains in the US salary and bonus levels and even the amount of technician support hours are all driven by the metrics. Number of items, value of scripts, customer (not patients mind you) waiting times and even customer satisfaction feedback are all used. Can salary and support staff levels be maintained in this new climate? While I can see how Irish pharmacy owners might look for more for less from their employee pharmacists could it reach US levels? And will Irish employees accept this? My initial feeling is that they would be more willing to see salaries to fall rather than see conditions worsen to US levels. Of course there will always be the testosterone fired up macho types who will accept bad conditions for higher salaries but I think that they will be the exception.
At the time of writing this book is available via Amazon.co.uk. or you can contact Jim via his blog and arrange for him to ship it direct. And as I’m in good mood the first person to contact myself can have my copy in return for a small donation to the PSI benevolent fund. And while you are at it another book that you might want to look up is “Why Your Prescription Takes So Damn Long To Fill” by Drugmonkey. I’ve only just started reading it and I am enjoying it immensely. Although it is written from an American perspective many of it’s themes would be common to Irish pharmacy.

There is also another element that we have to throw into the mix. Whereas many of the practices of pharmacy are mandated by law in the US in Ireland we have to deal with the PSI’s interpretation of pharmacy regulations. There have been many new regulations with the passing of the various Pharmacy Acts of recent years. For many of these new regulations the PSI have issued guidelines as to how these should be interpreted. Unfortunately the feedback that I’m hearing is that the PSI are treating their guidelines as definitive. Now I’m no legal scholar but it is my understanding that the interpretation of legal regulations is up to the courts. Certainly official bodies may issue guidelines but at the end of the day that is all they are, guidelines. We are all professionals and each of us has the final say on how these regulations are to be applied in our own pharmacies. And to add insult to injury one of the PSI’s stated objectives is to build up a fighting fund in case they are challenged in the courts. And how are they building up this fund? From yours and my registration fees every year! So if the PSI do decide to take somebody to court for not following their interpretation of the regulations not only will they have to pay for their defence but they will already have paid for the prosecution via their exorbitant registration fees of the last few years.

But it is not all doom and gloom. Those of you familiar with many of the pieces that I wrote about Ambrose while he was the Ober-Furher of the PSI might be surprised to find that I have something nice to write about him. Recently he was being questioned by a committee of the Dáil in his new capacity as Secretary General of the Dept. of Health. One of the many things that he said was that he foresaw a wider role for pharmacists within the health service. He saw little reason for instance as to why pharmacists as one of many services could not administer most vaccinations and not just the ‘flu vaccine. (Similar to the US) This he saw as a way of reducing the workload of the over-burdened GPs. In fairness to Ambrose he wasn’t just being nice to pharmacists. This was part of an overall disbursement of many services to other health professionals also aimed at reducing GP workload. All that remains to be seen now is if the GPs are happy to pass on all their patients or do they just want us to take the medical card patients while they keep the lucrative private cohort. And will the GMS repeat their strategy of paying pharmacists less than they pay GPs for performing the same service? The PSI would probably be eager to get their 2 cents worth by insisting at the last minute that we will need to get complete training (not just a refresher) every year so that we can carry out our new tasks. I’m slightly surprised that they haven’t demanded that we all return to college and re-sit our degree exams. I don’t know about you but I certainly learned a lot more in my four years in college than I did on the ‘flu vaccine training day. Until next month.

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