By Cheap drugs online
Pharmacy group joins union in coalition to 'protect' patient
Two traditional rivals, the California Pharmacists Association and unions representing pharmacists, have begun a mating dance. Both sides say the goal of their newly formed Pharmacists for Safe Care Coalition is to protect patients from unsafe practices foisted on pharmacists by owners focused on the bottom line rather than patient care.
"Realization is setting in that the control of the profession and the public welfare are being threatened by current chain and HMO practices," commented Ralph Lubick, longtime union activist and former president of United Pharmacists of California, UFCW Local 24, the state's sole pharmacist-only union local.
CPhA chief executive officer Carlo Michelotti put it this way, "We hold ourselves out as the standard bearers for standards of practice in pharmacy. We have a common constituency with unions, the safety of patients. We're both looking for ways to work together in dealing with corporate and other owners of pharmacies. We want pharmacists to be able to practice their profession safely and in a professional manner."
Lubick and Michelotti said the primary issue is how employee pharmacists are being forced to practice. At least one major chain in the state, they reported, is pushing R.Ph.s to work up to three back-to-back 14-hour shifts. "That might look good to a store manager who's getting a little over minimum wage plus commissions," said Michelotti, an R.Ph. and former store owner, "but I wouldn't want to be one of those patients getting a script filled the last three or four hours of a shift."
Economic survival is the driving force behind attacks on chain drugstore management, and politics is the weapon of choice, commented Bill Dombrowski, president, California Retailers Association. "What you're seeing here is an ongoing political and economic fight," he said. "Independents are going out of business. They are reacting in a number of ways, one of which is to try to use the political process to put additional restrictions on chains. That's what this is all about. In addition, chain pharmacists in California follow safe practices. They are constantly monitored and inspected by the state board of pharmacy. The violations found against chains are in proportion to their market share, so the numbers don't hold up to the charge."
Some believe CPhA is partly to blame for the problem. Under previous leaders, the association had convinced the state labor commission to reclassify pharmacists as professional employees, not hourly employees.
The change bolstered pharmacists' professional standing, but it also exempted them from most state regulations governing working hours, shift length, overtime, lunch breaks, toilet breaks, and other working conditions. That left pharmacy employers free to demand more hours, longer shifts, more scripts, and fewer breaks. A growing number of pharmacists are warning that increased time pressure on pharmacists is already increasing the rate of Rx errors in high-volume retail and managed care settings.
"I've got an internal memo that says 'We're businessmen first, pharmacists second,'" said a senior CPhA source who asked not to be named. "That may be an acceptable priority from a store manager's standpoint, but in terms of public health and safety, the chains and HMOs have their priorities backwards."
What the coalition can do to change those priorities isn't clear. Michelotti noted that California governor Pete Wilson (R) has come down firmly on the side of laissez-faire conservatives and against worker- or consumer-
protection issues. The Democrat-
controlled legislature is more sympathetic, Michelotti added, but lacks the votes to override gubernatorial vetoes.
Other coalition members noted that standards of practice are a non-issue outside the profession because the public doesn't realize the potential harm that can result from Rx errors.
"There are going to have to be bodies in the streets before we can get the politicians to even look at the problem," complained Fred Mayer, coalition member and president of Pharmacists Planning Services Inc.
In the end, Michelotti warned, pharmacists may have to put themselves on the line by refusing to accept potentially unsafe workloads and working conditions. An airline pilot has unquestioned authority to ground a flight for safety reasons without fear of dismissal, he noted, adding that pharmacists should exercise the same degree of professional judgment without fear of retribution.