Congratulations Wal-Mart!!!

You have succeeded in turning pharmacy into nothing but a commodity. It's no longer a profession, just a product.

For years we've heard phrases like pharmaceutical care and disease state management being thrown around in the trade magazines. Too bad this stuff doesn't exist, at least not in the minds of the doctors in and around Pharmacy God Town.

I've got physicians telling patients to go to one pharmacy for Drug X, another pharmacy for Drug Y, and giving samples for Drug Z out of the office. The patient's three other doctors are doing the same thing. Apparently all of the so-called pharmacy leaders aren't being heard by the physicians with regards to pharmaceutical care and disease state management. But guess who is going to be sued if the patient suffers an adverse drug event due to an interaction?

Who cares if Pharmacist Mary is a Certified Diabetes Educator? Her pharmacy doesn't charge $4.00 for 60 glipizide 10mg, so we'll just send our diabetic patients to Wal-Mart. Do they have a pharmacist who is a CDE...... Nope. But the drugs are cheap. So is the toilet paper.

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I find it sad that the leaders and educators in our profession are so out of touch with those of us out in the retail world. You can design all of the pharmaceutical care models that you want, it's not changing how other medical professionals view us. I'm going to let the so called leaders in on a little secret about pharmacy that those of us in retail know... we get no respect. Period.

I think it's our own fault. Nobody has spoken up when these giant corporations have made moves that are detrimental to the profession in order to make higher profits. The people who get promoted to district and regional levels of management are yes-men (and women) all the way. Now we are treated like any other employee, not as health care professionals.

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We've got a tremendous shortage of pharmacists, and the outlook is even worse. So what have the leaders and educators in pharmacy done?... Extended the length of time it takes to become a pharmacist. I graduated with a five-year BS degree. I had the option of a six-year PharmD, but I opted to get the BS. Now in Pharmacy God state the minimum is the six-year PharmD, with a few schools taking as long as eight years. That plus the talk of requiring a residency after graduation isn't that attractive to high school students. They see how the public treats the pharmacy staff. Who wants to spend 8-plus years in college to get treated like crap? They can go to medical school and have a residency completed in about the same amount of time. Plus they would get respect. Six figure salaries don't mean a lot when you are getting treated poorly.

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There were some who thought that the whole MTM component of Medicare Part D would bring respect back to the pharmacist. After all, who wouldn't want to be able to sit down with their pharmacist to review their entire medication history. Oh wait, people don't view us that way any more. We're just like burger-flippers. The general public is more likely to sit down with the head burger guy a McDonalds to discuss their nutritional goals for the next year than to make an appointment to talk with their pharmacist. (I speak critically of the MTM because both pharmacists at Pharmacy God Pharmacy have completed the MTM training for three different providers and had a total of one, repeat one MTM session scheduled) YES!!! MTMs will save pharmacy. I think that the profession was hood-winked on this one. Here, we'll let you charge for counseling sessions. We'll also slash your reimbursement to cost minus 8 percent. But you can call the whole MTM thing a victory for the profession. Thanks pharmacy leaders. We scored big on that one.

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If you are one of the so-called pharmacy leaders, you need to drag yourself out of your office and visit some of the pharmacists on the front lines. I don't mean a Hey, how ya doin' visit. Come spend a day at a pharmacy that is filling 600, 700, 800 scripts a day. Try to see if your pharmaceutical care model would work there. Now go to a smaller pharmacy that has one pharmacist and maybe a tech to see how you can provide pharmaceutical care in that environment. Then go back and try to figure out how the over-worked retail pharmacist is going to be able to provide any type the pharmaceutical care while being reimbursed $5.35 over cost for each prescription. Once you can figure that out, we can talk. Until then I really don't want to hear from you.