Pharmacists are trapped in a system that threatens patient safety

If you ask me what keeps me up at night, I’d say it’s the kinds of mistakes that Ellen Gabler described in her January 31 New York Times story, “How Chaos at Chain Pharmacies Is Putting Patients at Risk.”

During my time as a community pharmacist, I cherished the relationships I established with patients and understood the great responsibility that came with the trust they placed in me. Pharmacists take an oath to, among other things, “assure optimal outcomes” for patients. I can attest to the emphasis our profession places on patient safety. When it comes to medication-related errors, even one is too many.

Unfortunately, the current system sets pharmacists up to fail, and in turn, pharmacists are burning out at high rates. This is an issue that not only puts patients at risk but deprives pharmacists of the opportunity to provide the kind of patient care we all got into pharmacy to provide. You can see it in the desperate pleas for change to state boards of pharmacy Gabler highlighted in her story. And we’re seeing it in the responses to those who have taken our Well-being Index for Pharmacists: The weight of the potentially dire consequences of filling the wrong prescription or missing dangerous drug interactions is crushing too many pharmacists (I hope many of you will join us at the APhA Annual Meeting & Exposition in National Harbor, MD, March 20–23, to take advantage of our sessions on well-being).

We need change now.

The solution to this problem will not be executed in the four walls of a pharmacy. The solution comes from taking a hard look at how pharmacies are reimbursed and who profits from inadequate patient care. Meanwhile, state and local pilot projects that compensate pharmacists for greater involvement in team-based care have proven that when pharmacists are allowed to provide a full range of services, costs go down and patient outcomes improve.

It’s perverse that we pharmacists are begging for the opportunity to practice the kind of pharmacy we were extensively educated and trained to practice. And who benefits from this warped system? Here’s a hint: it’s not pharmacies or patients.

We must regulate the PBMs who make obscene sums of money without doing a single thing to serve patients. They say they keep prices and premiums down but simultaneously fight attempts to force them to be transparent about how they supposedly achieve this. If it’s not greedy, let’s see how it works. If it really helps patients, tell us how. But they won’t. It’s indefensible.

APhA is committed to empowering pharmacists to improve medication use and advance patient care. We understand the challenges that come with practicing pharmacy in today’s health care system. A lack of access to complete patient information via electronic health records, a payment system focused on volume over quality time spent with patients, and performance metrics that pressure pharmacists to work quickly all contribute to profound stress that can result in unintended patient harm. America’s pharmacies offer convenient access to medications, but patient safety must always remain a priority.

I encourage each pharmacist reading this blog to share it with friends, family, and colleagues and help us develop and implement strategies to end this unsustainable system.