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“Counters and Pourers” vs. “Patient-Oriented” Pharmacists
Pharmacy manpower as viewed by a pharmacy practitioner . ..
By Melvin A. Lichtenfeld "Counters and Pourers" vs. "Patient-Oriented" Pharmacists
This year the saturation point will be reached as jobs have become scarce and we face an oversupply in Indiana for the first time in our history. This problem was partially recognized several years ago by our schools of pharmacy and the Indiana Pharmaceutical Association. Even though the course of action was to prepare the graduating pharmaCists for a faster assimilation into the practicing ranks, it, in effect, really attacked the utilization of that future manpower. A tripartite committee representing the two schools of pharmacy, the board of pharmacy and the Indiana Pharmaceutical Association developed and gave support to a preceptor-extern program for fifth-year pharmacy students. I have been associated with this program from its inception and believe it to represent a partial answer to the utilization of pharmacy manpower. In brief, this is how the program works. The young people in this program are given 16 weeks of on-the-job training and exposure in their senior year. They have eight weeks of community pharmacy training and eight weeks of hospital pharmacy training. The program takes the pharmacy students out of the classroom and exposes them to practicing pharmacists and real-life situations, usually in their own hometown. They spend the last semester of their last year of school in the field and return to pharmacy school at the end of this period. Within a few short weeks they graduate and take their state boards to obtain their license to practice. Technically the apprentice program has been eliminated. What does this mean for pharmacy manpower? It means that these graduates are ready to take over and get involved in new areas of pharmacy and pharmaceutical services. These new pharmacists are showing us how to improve the available manpower by utilizing our talents in pharmacy towards improved primary patient care. These new
graduates are showing us how to delegate our past work habits to subordinate personnel. The typing, counting, and pouring all must be done under our direct supervision. These young people are showing us how to drug monitor, how to check for drug interaction, how to do patient consultation. They are making us more aware of the patients' needs. They are showing us the way to blend our talents with the clinical approach. There is nothing more irritating to me than to see a state-licensed professional take a prescription order from a patient, two-finger type a label, grab a bottle, pour and count, stick the label on the bottle and say, "$5.00 please." I can understand why the public feels the way they do towards us. Anybody can count and pour. Anybody with a little practice can two-finger typewrite and anybody can say, "$5.00 please." That patient must have a few questions to ask, but invariably that pharmacist is so interested in speed and turnover that by habit, he or she is neglecting the primary function of patient care. I personally believe we have a manpower oversupply of counters and pourers. I also believe we have a critical shortage of patient-oriented pharmacists. Pharmacists must accept the challenge to dispense knowledge. They must talk with that patient. They must convey the warnings, the side reactions, the possible conflicts, the usage, and most important, show that they care about that patient getting better. More jobs will be created in this manner as more people want and need these services. In my pharmacy we now have three pharmacists doing the job that two pharmacists and many clerks did before. We consult with the patient. We talk about their drugs. We give them printed information on their drug regimen and we ask questions. The prescriptions are dispensed and supervised by pharmacists with technician assistance. We are available to any patient at anytime for any reason. We have justified the economics of ( Continued on page 399) .
Melvin A. Lichtenfeld
Presented at the APhA Annual Meeting General Session, New Orleans, Louisiana, April 7, 1976.
Melvin A. Lichtenfeld, BS, is chief pharmaCist and manager of Ross Medical Pharmacy Inc., a medical clinic pharmacy in Merrillville, Indiana. He graduated from Purdue University school of pharmacy and pharmacal sciences in 1951 . His professional background includes independent and chain store pharmacy experience; he also owned and operated his own pharmacy for nine years . Presently he serves as a district director (Northwest Indiana) for the Indiana Pharmaceutical Association, and is a preceptor clinical instructor for pharmacy externs in conjunction with Purdue University and the Indiana Board of Pharmacy Training Program . Lichtenfeld is a member of APhA, APhA Academy of Pharmacy Practice, NARD and the Florida Pharmaceutical Association.
Vol. NS 16, No.7, July 1976
391
I have been a practicing pharmacist since 1951 and have gone through one of the most frustrating, inspiring, heartbreaking and rewarding periods in the history of pharmacy. I have practiced in small neighborhood community pharmacies featuring personal service to large chains with self-service. I have seen the pharmacist change from family-oriented to big business interests. I have observed the demise of neighborhood pharmacies and the growth of large multiplex operations. I have watched the values of pharmacy change from care to cost. I have watched the practicing pharmacist become more confused and frustrated not knowing what to do about what is happening to him. All of this has made the pharmacist unique and has created special problems, one of which is manpower-a critical issue which could cause severe consequences if the challenge is not met realistically. I believe the days of pour and count are rapidly disappearing for the practicing pharmacist who must learn quickly the importance of education and the responsibility to the total health care system. The days of the pharmacist as a "jack-of-all-trades" are gone and will never return. The pharmacist must learn to develop a practice based on ability, education, expertise and above all, direct patient contact. The future of pharmacy will be based on all kinds of services and the pharmacist must be paid for this function. Very few of our graduating students want their own pharmacies. They want positions in which they can practice what they have been taught. In Indiana we will graduate approximately 215 potential pharmacists this year. This is the first time in decades that all 215 are not assured of jobs. Does this mean an oversupply? Does it mean fewer jobs are available? I really don't know the answers. This I do know-at present we are losing most community pharmacies which have not changed their mode of operation since World War II. We are losing most neighborhood pharmacies as families become more mobile and are not restricted to their neighborhood shopping habit. Big operations, clinics, large chains and quick turnover operations are getting a larger share of the prescription practice. Generally they operate on price with very little service-to me this is the key to unlock the door for the future of pharmacy and pharmaCist manpower. From what I have determined, the growth of chains and the decrease of the neighborhood pharmaCies have affected manpower.
By Melvin A. Lichtenfeld "Counters and Pourers" vs. "Patient-Oriented" Pharmacists
This year the saturation point will be reached as jobs have become scarce and we face an oversupply in Indiana for the first time in our history. This problem was partially recognized several years ago by our schools of pharmacy and the Indiana Pharmaceutical Association. Even though the course of action was to prepare the graduating pharmaCists for a faster assimilation into the practicing ranks, it, in effect, really attacked the utilization of that future manpower. A tripartite committee representing the two schools of pharmacy, the board of pharmacy and the Indiana Pharmaceutical Association developed and gave support to a preceptor-extern program for fifth-year pharmacy students. I have been associated with this program from its inception and believe it to represent a partial answer to the utilization of pharmacy manpower. In brief, this is how the program works. The young people in this program are given 16 weeks of on-the-job training and exposure in their senior year. They have eight weeks of community pharmacy training and eight weeks of hospital pharmacy training. The program takes the pharmacy students out of the classroom and exposes them to practicing pharmacists and real-life situations, usually in their own hometown. They spend the last semester of their last year of school in the field and return to pharmacy school at the end of this period. Within a few short weeks they graduate and take their state boards to obtain their license to practice. Technically the apprentice program has been eliminated. What does this mean for pharmacy manpower? It means that these graduates are ready to take over and get involved in new areas of pharmacy and pharmaceutical services. These new pharmacists are showing us how to improve the available manpower by utilizing our talents in pharmacy towards improved primary patient care. These new
graduates are showing us how to delegate our past work habits to subordinate personnel. The typing, counting, and pouring all must be done under our direct supervision. These young people are showing us how to drug monitor, how to check for drug interaction, how to do patient consultation. They are making us more aware of the patients' needs. They are showing us the way to blend our talents with the clinical approach. There is nothing more irritating to me than to see a state-licensed professional take a prescription order from a patient, two-finger type a label, grab a bottle, pour and count, stick the label on the bottle and say, "$5.00 please." I can understand why the public feels the way they do towards us. Anybody can count and pour. Anybody with a little practice can two-finger typewrite and anybody can say, "$5.00 please." That patient must have a few questions to ask, but invariably that pharmacist is so interested in speed and turnover that by habit, he or she is neglecting the primary function of patient care. I personally believe we have a manpower oversupply of counters and pourers. I also believe we have a critical shortage of patient-oriented pharmacists. Pharmacists must accept the challenge to dispense knowledge. They must talk with that patient. They must convey the warnings, the side reactions, the possible conflicts, the usage, and most important, show that they care about that patient getting better. More jobs will be created in this manner as more people want and need these services. In my pharmacy we now have three pharmacists doing the job that two pharmacists and many clerks did before. We consult with the patient. We talk about their drugs. We give them printed information on their drug regimen and we ask questions. The prescriptions are dispensed and supervised by pharmacists with technician assistance. We are available to any patient at anytime for any reason. We have justified the economics of ( Continued on page 399) .
Melvin A. Lichtenfeld
Presented at the APhA Annual Meeting General Session, New Orleans, Louisiana, April 7, 1976.
Melvin A. Lichtenfeld, BS, is chief pharmaCist and manager of Ross Medical Pharmacy Inc., a medical clinic pharmacy in Merrillville, Indiana. He graduated from Purdue University school of pharmacy and pharmacal sciences in 1951 . His professional background includes independent and chain store pharmacy experience; he also owned and operated his own pharmacy for nine years . Presently he serves as a district director (Northwest Indiana) for the Indiana Pharmaceutical Association, and is a preceptor clinical instructor for pharmacy externs in conjunction with Purdue University and the Indiana Board of Pharmacy Training Program . Lichtenfeld is a member of APhA, APhA Academy of Pharmacy Practice, NARD and the Florida Pharmaceutical Association.
Vol. NS 16, No.7, July 1976
391
I have been a practicing pharmacist since 1951 and have gone through one of the most frustrating, inspiring, heartbreaking and rewarding periods in the history of pharmacy. I have practiced in small neighborhood community pharmacies featuring personal service to large chains with self-service. I have seen the pharmacist change from family-oriented to big business interests. I have observed the demise of neighborhood pharmacies and the growth of large multiplex operations. I have watched the values of pharmacy change from care to cost. I have watched the practicing pharmacist become more confused and frustrated not knowing what to do about what is happening to him. All of this has made the pharmacist unique and has created special problems, one of which is manpower-a critical issue which could cause severe consequences if the challenge is not met realistically. I believe the days of pour and count are rapidly disappearing for the practicing pharmacist who must learn quickly the importance of education and the responsibility to the total health care system. The days of the pharmacist as a "jack-of-all-trades" are gone and will never return. The pharmacist must learn to develop a practice based on ability, education, expertise and above all, direct patient contact. The future of pharmacy will be based on all kinds of services and the pharmacist must be paid for this function. Very few of our graduating students want their own pharmacies. They want positions in which they can practice what they have been taught. In Indiana we will graduate approximately 215 potential pharmacists this year. This is the first time in decades that all 215 are not assured of jobs. Does this mean an oversupply? Does it mean fewer jobs are available? I really don't know the answers. This I do know-at present we are losing most community pharmacies which have not changed their mode of operation since World War II. We are losing most neighborhood pharmacies as families become more mobile and are not restricted to their neighborhood shopping habit. Big operations, clinics, large chains and quick turnover operations are getting a larger share of the prescription practice. Generally they operate on price with very little service-to me this is the key to unlock the door for the future of pharmacy and pharmaCist manpower. From what I have determined, the growth of chains and the decrease of the neighborhood pharmaCies have affected manpower.