Holy Anarchy: How Chaos at Chain Pharmacies Is Putting Patients at Risk

I needed a break from studying for USMLE Step 3 tonight. This seemed like a fun topic. I mean, who doesn’t like a little anarchy and chaos every once in a while. The caveat is every once in a while, whereby the article describes an incessant push “to do more with less has made medication errors more likely. “I am a danger to the public,” one wrote to a regulator.” We’ve all heard the stories, maybe even happened to us, or maybe even happened to our patients. I mean, ordered Celexa, and patient received Celebrex. I firmly believe IT IS NOT pharmacist’s goals to make these egregious errors, but they do happen. This article is not bashing pharmacists, but it is about:

many pharmacists at companies like CVS, Rite Aid and Walgreens described understaffed and chaotic workplaces where they said it had become difficult to perform their jobs safely, putting the public at risk of medication errors.

            It reminds me of my Army days where we were always trying to do more with less. This article describes competing tasks for pharmacy staff at these pharmacies such as fill prescriptions, give flu shots, tend the drive-through, answer phones, work the register, counsel patients and call doctors and insurance companies, they said — “all the while racing to meet corporate performance metrics that they characterized as unreasonable and unsafe in an industry squeezed to do more with less.” It stands to reason that there will be an increase in errors. Competing interests of the corporation and the patient care emerges. 

            The article describes a survey done of pharmacists in Missouri. It reports

“Of the nearly 1,000 pharmacists who took the survey, 60 percent said they “agree” or “strongly agree” that they “feel pressured or intimidated to meet standards or metrics that may interfere with safe patient care.” About 60 percent of respondents worked for retail chains, as opposed to hospitals or independent pharmacies.”

            The article describes attempted fixes that however, fall short. Items such as limitng the amount of technicians a pharmacist can supervise, allowing technicians who have less training do more tasks to free up the pharmacist etc. Often when an error is reported to a board, action is taken against the pharmacist, an obvious target. It is less common for a company to be scrutinized. That could be a reasonable change to be made. At any rate, just some things to think about on this cold rainy evening. 

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