Is Pharmacy the Junk Drawer of Healthcare?
Everyone has a junk drawer. You know, the one you can barely get open because it’s crammed full of stuff. You put stuff there because, well, it doesn’t really have anywhere else to “go” — without the junk drawer, the stuff is kind of homeless. Sooner or later, the junk drawer is a mess, and a drawer to be ignored.
Someone on Reddit or Quora the other day said something in this post-pandemic pre-endemic era that got me thinking about my first profession. They said:
“Pharmacy is the junk drawer of healthcare.”
This, despite being a back-handed compliment, is interesting and relative to the matter of perspective, could be an accurate allegory.
Think about it. Since the pandemic, the pharmacists have taken on:
- COVID testing
- COVID vaccines
- All vaccines really
- Possible prescribing of COVID treatments, in some jurisdictions.
- More prescribing overall, based upon the jurisdiction.
Oh, yeah, and BTW they:
- Kept working throughout the pandemic and put themselves in harm's way, (because some employers didn’t think at the start of the pandemic masks were appropriate for customers coming in to see the employees wearing) and
- Worked with little to no help, and
- Without a lot of resources, in many cases.
Oh, and let’s not forget they are now:
- Taking cuts in pay.
The “matter of perspective” part is important because it hinges on whether or not we truly are the profession WANTED to do all this work or not. Said another way: Is this work that we really wanted to take on as a profession, or was it dumped on us?
The #pizzaisnotworking movement I think accelerated the fact that pharmacists for decades now have been taking on more work, for less pay and less reimbursement, with fewer resources. But, while we are noble creatures (I’d like to think that most pharmacists have high ethics and really truly want to do right by their patients), are we saying yes to all of this extra work because we want to as a profession, or because other professions don’t want to do it and the work has nowhere else to go?
Worst of all, is the extra (nearly unpaid thankless work) being hoisted on us by other professions?
Healthcare professionals do have ethical oaths they have to take, but where does the line get drawn between doing more work for less resources for altruistic reasons, to the point that our profession in community practice now may be decaying because there’s no more money or reimbursement in it?
Of course, a lot of pharmacies like to blame Pharmacy Benefit Managers (PBMs) for the loss of profits, and with good reason. Most PBMs are employing nefarious procedures like DIR Fees and/or clawbacks, or retaining drug rebates that should rightfully be going back to the plan that paid for the drugs in the first place (rather than just keeping the drugs lower cost WITHOUT drug rebates).* Again — did we decide to let the PBMs into our profession, or were they hoisted upon us, because — we couldn’t self-regulate in the first place?
Junk Drawer vs. The Swiss Army Knife
Either way — junk drawer or not, I’d like to offer another allegory for your consideration, if you’re a fellow pharmacist.
Instead of thinking of our profession as a junk drawer (a willing recipient of all work that no one else in healthcare wants to do or gets paid well to do), maybe we need to shift our perspective and consider the opportunity here.
The opportunity is our freedom to decide where and how we want to practice.
I think of pharmacists as a Swiss Army Knife of healthcare instead: we are able to employ a lot of tools in our profession, but we also should figure out and sharpen the tools in our quiver that we want to use more, and less. If you’re a pharmacist in community practice pharmacy, but you don’t really love giving vaccines and you’re not only being asked to give them but promote them and you’re completely overworked and can’t do the work you WANT to do within your job, maybe it’s time to find a job where you focus on other skills that you do enjoy. For example, if medical information or research, or patient advocacy, or clinical outcomes are your jam, there are plenty of jobs out there right now that leaves behind the vaccine administration and boosts the other skills that are mentioned above.
BECAUSE we have been asked to do so much with so much less, there’s an opportunity for us to find our niche and do work we love to do within the profession, and let the other stuff go.
We have the power within ourselves to clean out the junk drawer.
If you need a parting item for your consideration, it is this: you earned your license, and you can choose the way you want to practice. If you’re being asked to do things that no one else in healthcare is doing, or not, really doesn’t matter. What matters is what YOU want to do, how YOU want to practice moving forward. And if you’re in a setting post-pandemic where you feel work has been hoisted on you that you don’t want to do….
….you already know the rest:
…only YOU have the power to make a change.
Erin L. Albert is a pharmacist, author, and fan of cleaning out junk drawers. The opinions above are hers alone.
*Note: As I’ve said all along, not all PBMs practice these egregious tactics. Many do — but not all.