Pharmacists’ Graven Image Needs Repair—or, “I Coulda Been a Contender”

I was watching America’s Most Badass,  a show devoted to telling the stories of tough Americans. They got around to featuring Harry Truman, the president who made the tough decision to use nuclear weapons in war. But first, when Mr. Truman’s World War I experience was being reviewed, it was noted that someone said, “He looked more like a pharmacist than a company commander.”

What does that less-than-bubble reputation say about our profession? Sounds to me as if it says we are wimps, or that our job is wimpy. Look at the entertainment industry. Did George Clooney ever get cast as one of us? Are we crafted as barroom aggressors in Heineken commercials? No, we are too often portrayed as the portly, balding types behind the prescription counter subject to the whims of the world, like the druggist in 1988’s “The Blob.” (“Hey, Pal, can I have a pack of Trojans and a Binaca Spray?”) Say all you want about catching drug errors and interactions, but our work does not quicken pulses or make the news, unless, of course, we are, like that Kansas R.Ph., adulterating chemotherapy for fun and profit. We are not seen to rescue damsels in distress. Actually, we are the ones who need rescuing!

I have no easy solution to the problem.  By its nature, pharmacy has difficulty carrying any panache.  Unlike nursing or medicine, its image lumbers along as a passive activity. It makes no scenes. It operates behind the scenes.  My own pharmacy alma mater viewed it as an allied health profession.  So, if we are allied, who are the main contenders? Why else, then, in this year of twenty fifteen, does it just now seriously seek a seat at the table of official providers? Although it has become a public health profession,  its inchoate air makes it seem as if its licensure still belongs to the boards that make the pipefitters and real estate agents.

We cannot control the screenwriters, but we might try influencing them by becoming activists.  A  motivational program I recently attended includes the phrase “proceed until apprehended.”  We must speak out, and act out, in all matters concerning our profession.  We must demand to take time to fill prescriptions cautiously, to counsel patients, and to cultivate patient rapport, no matter what the computer clock says about our numbers.  We must simply take our right to excretion, something all other workers seem to have.  If we do not take the risks, then we ought to just shut up and accept our weak rep. 

Defend pharmacy? Of course, since we are at war!

A reader has already asked how I can defend pharmacy today. He forgot to ask an even heavier question: why pharmacy needs defending.  Does medicine, nursing, respiratory therapy, laboratory or radiological technology need defending?

Pharmacy needs defending because too many of its adjuncts think of it as a vestigial activity in healthcare, as if it is still in the realm of the ancient apothecaries and that our primary tools are still the mortar and pestle. They need to pull up their state pharmacy practice acts for the legal definition of the practice of pharmacy today!

Non-pharmacists, professional and otherwise, still think think they can demand us to dispense medication without their issuing a formal order.  Can you tell a teller to give you cash without writing a check or a withdrawal slip?  And even when the order is written, they think that we then become a dedicated vending machine, giving out these dangerous substances without exercising the due care that the law also demands. What of drug abuse, allergies, and drug interactions? Pharmacy often involves the justifiable refusal* to dispense until a drug-related problem is duly resolved.

My Dad and I often discussed the professional and working conditions under which pharmacists live and slave.  A World War II combat veteran, he once remarked, “Gee, you know what it’s like to be in a war.” This was an eye-opener for me, that someone who had been at Guadalcanal identified with my daily work battle. In addition to doing our duty, pharmacists have to fight to safeguard its execution.  It is pretty sad that we who have custody of these powerful substances and the expertise to interpret their safe distribution have to labor to explain what should be self-evident.

*Recent prejudice among pharmacists inspired by the regulators has egregiously affected the legitimate pain patient.  That’s a whole other story. See the blog Pharmacist Steve. 

about me

I am a 63-year-old actively practicing pharmacist of 39 years’ experience, 15 in the community setting and the rest in healthsystem or hospital setting.  Born in Boston, I moved to Texas in 2000.  I have always thought of pharmacy in Dickensian terms, that we are working in the best of times and the worst of times, that pharmacy is at its greatest period of sophistication, but operating under the lash of Simon Legree type oppression which has always been up to us to eradicate.  Long a pharmacy blogger in the 2000s, I look forward to a revival of posting my views in this decade. In that regard, I surely have some interesting company.  Please stay tuned.

It takes an angry man….!

It is with great delight that I, the Ole’ Apothecary, return to the pharmoblogosphere, and do so less as a philosopher and more as a peeved statesman.  The pen is supposed to be mightier than the sword, but what is wrong with writing with a sword?

I became a pharmacist during the Bicentennial year of my country, the United States. If you know that year without looking it up, I consider you to be a normal American.  If you are an American and you have to look it up, then you are a cell in the flesh of my anger as to the astonishing deterioration of the nation I love, as it is possible that the current “normal American” does not know how old his or her country is. But, this is not to be a political blog, except as far as society and politics impinge upon the practice of pharmacy, my full-time profession since–well, since the U.S. Bicentennial year.

Anger has been the tool of other pharmacist bloggers, and I tried to eschew it as long as I could. But now, not only do I need to express justifiable anger at the way pharmacy has been treated, I need to show anger toward those in pharmacy who persist in remaining what old-timey druggist Jim Plagakis calls “prisoners of comfort,”  sacrificing professional principles for material amenities, or as singer John Mellencamp belts out, “trading…ambition for a warmer place to sleep.”

It DOES take an angry man to sing an angry song, but let it be anger expressed from the vantage point of a neat suit, a tie, and a pen made of cutlery.