Every time I turn around someone is talking about the need for change in pharmacy practice. That’s a good thing. In fact, it’s a great thing. I’ve discussed my thoughts in detail on this site before so I don’t feel the need to rehash everything I’ve said. Suffice it to say there is a buzz in the air.
I read an interesting article this morning at the ASHP Intersections website about the expanding role of technicians in pharmacy practice. While the article focuses a bit too heavily on the need for providing better education for technicians to fill this new role, it does make one thing perfectly clear: “As Pharmacists expand their roles and carve out new niches in an era of health care reform, they are counting more and more on highly skilled pharmacy technicians to take on added responsibility.†Well said.
Now that we all agree on what’s needed from our technicians, how do you propose we get there? It’s clear that ASHP believes in advocacy along with pharmacy technician certification as the answer. Sounds great, in a global sense, but what model allows technicians to assume more responsibility in the physical pharmacy, thus allowing pharmacists the freedom to move to the patient bedside to perform more clinically relevant duties?
The answer isn’t as complex as many would think. Along with a heavy dose of regulatory bureaucracy, healthcare will need to make use of all sorts of automation and technology. And along with that technology the Boards of Pharmacy in representative states will need to begin thinking outside the box.
Simple plan, right? Not so fast buckaroo. Remember when automated dispensing cabinets entered the pharmacy world? Everyone thought that pharmacists would be out of a job. Boy, were they wrong. How about when the Baker Cell arrived on the retail scene? Pharmacists thought their practice environment would improve. Bzzt, wrong again. How about when robotics were introduced? I remember when the facility I was working in went through a robot installation. It was supposed to handle the cart fill and make life easy. What a joke that turned out to be. I think in created more work than it eliminated.
Ok, so why did all these wonderful new technologies fail to make pharmacists more “clinical� No one wants to hear the truth, but I’m going to tell you anyway. The simple truth is we (collective we) didn’t take the time to adjust our thinking and change the core of what we do. I’ve been scolded by pharmacists for suggesting that 80%, or more, of the work done in the central pharmacy of an acute care hospitals could be handled by a combination of good technicians and technology. Am I wrong?
Think about it. Technicians already do a bulk of the dispensing. Most of the time pharmacists are simply there to wave their hand over the final product like some Jedi Drug Master. We don’t need Jedi Drug Masters to ensure proper medication dispensing. What we need are Jedi Pharmacists protecting the patients at the point of contact, intercepting medication management issues before they become a problem, helping the medical team decide on the best course of therapy to ensure effective treatment, working to improve medication outcomes, driving down resistance with judicious use of antimicrobials, saving the healthcare system billions by advocating cost conscious medication use and avoiding adverse drug events, doing research, etc. Quite simply, pharmacists need to get out of the pharmacy and create a better healthcare system in the image chosen by the profession not by someone else.
History’s a bugger, and it’s always in the rearview mirror challenging us. The trick is not letting it sneak up on you, again.
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