The Problem With Conventional Pharmacy

The pharmacy space is changing drastically, especially retail pharmacy. Retail pharmacist face difficult work conditions. Most pharmacist are hesitant to express their opinions on the issues facing pharmacy for fear of being fired from their jobs and losing their professional reputation. 

Retail pharmacy is shrinking. According to the 2019 employment data by The Bureau of Labor Statistics (BLS), the number of pharmacist working in retail settings is decreasing. Adam J. Fein at drugchannels.net put a great short video that highlights the challenges that retail pharmacy is facing today.

These challenges include the following facts (check out the short video in the link above for more details on these trends):

  • Retail pharmacy is heavily dependent on dispensing generics. 
  • There is an increase in competition for consumers. 
  • There is limited access to speciality pharmacy in the retail space. 
  • Disruption from new entrants in the market (the growth of the digital-pharmacy industry).

Every pharmacist knows about the issues in retail pharmacy. Even worse, those who work in the retail space have experienced those problems first hand. Retail pharmacist face difficult and unfavorable work conditions. 

Go into any pharmacy reddit thread and you can sense the frustration, disappointment, sadness, stress and anxiety that retail pharmacist face. Many of those pharmacist aren’t happy with what they are doing. Being in retail is stressing them out, making them unhappy, and leading to burn out. It is making them feel hopeless and frustrated with how their career has turned out. 

You can even see ZDoggMD’s rant on this issue here: https://www.youtube.com/watch?v=AFzi4dQOiiI&feature=emb_title

There are two problems in pharmacy: the first relates to the system in which retail pharmacies exist. It’s a system that overwhelmingly relies on drugs as the #1 resources for treating chronic disease. This is the conventional pharmacy model- much like the conventional medicine model. A model that provides short term solutions but never addresses the problems at the foundational level. As a result many pharmacies and many of the pharmacist have this same focus and attitude about disease.

In other words, they focus on chronic disease management rather than focusing on disease prevention and reversal (in some cases) through the following ways: nutrition, proper sleep, meditation, supplementation, exercise and other lifestyle behaviors. The foundation of great health is sleep, nutrition and exercise.

There is little room for innovation and progress for pharmacist to capitalize on in the conventional pharmacy space. The profession of pharmacy has been attempting to get pharmacist provider status for more than 20 years but little progress has been made. I’m not convinced that provider status will actually change much for pharmacist, at least not in the way many pharmacist hope that it will. 

The second problem that is not frequently discussed is that of leadership and management issues in retail pharmacy. 

Simon Sinek once said or wrote about his WHY. It was simple. He wants to live in world where people wake up everyday happy to go into work. 

How many retail pharmacist actually wake up happy to go to work?

How many pharmacist feel that they are helping patients achieve better health?

How many pharmacist are focused on prevention through habit and lifestyle change?

I want to live in a world where pharmacist wake up everyday happy to go into work.

The reasons pharmacist don’t wake up happy to go into their retail jobs is because of how they are being treated at those jobs. They work under management and leadership that doesn’t value them, their experience and their profession. They work under management and leadership that values the customer and profits more than they value their employees.

They work for companies that don’t provide them with autonomy, the freedom to innovate, the freedom to create, the freedom to come up with and share ideas, and the freedom to be entrepreneurs. They work in top down bureaucratic organizations.

Top down bureaucratic pharmacy organizations are problematic for two reasons: 

  • It’s a form of management that originated because of scare information and lack of natural entrepreneurial instincts (neither of these issues exist today).
  • It doesn’t empower the best workers to make more decisions and achieve a higher level of self-esteem. Both of which eventually leads to self-actualizing so people can create their own businesses inside or outside the larger company and live their dreams.

A new kind of pharmacy company is needed. A company that aligns with human evolution which grows towards greater self-expression and creativity and toward more rational or scientific thought. This new type of pharmacy business needs to achieve the following: 

  • To operate from the bottom up, not the top down. 
  • To leverage the creative and the entrepreneurial capacities of everyday pharmacist and technicians by bringing the information directly to them. Information about profitability and each customer they serve so they can make better decisions and create more profits for them and for their company while having a greater impact on the patient’s health. 
  • To have information enhanced pharmacist that create more customized services for a more defined segments of their customers. 
  • Gets rid of inefficient top down bureaucracies from the past. 
  • Doesn’t treat pharmacist like children that need to be constantly supervised and told what to do.
  • Understands that no body knows the job better than the pharmacist who is doing it.
  • Treats employees like owners by making them owners. 

Pharmacy is saturated from retail to residency. Pharmacy schools are conditioning students to go into residency because its the trend now. They are encouraged to do this because they think it will provide better jobs. The clinical jobs that are talked about in pharmacy school are far and few. Often the reality of the types of jobs you can get after residency are not as glamorous as it’s talked about in pharmacy school.

There are few pharmacist who are truly doing clinical work (in the sense that they regularly see and interact with patients, evaluate them, and adjust their medications). I think the pharmacy job that provides the most interactions with patients is still retail pharmacy. The problem is that pharmacist have seen their workload get bigger and bigger while their resources stay the same or even worse shrink. The result? Pharmacist don’t have the time to truly connect with, interact with and help their patients in a meaningful and healthful way. 

With the chronic disease epidemic we face in the United States many patients have already started to move away from conventional medicine. They are looking for alternative solutions because their needs are not being met by the current model. Patients have been moving away from conventional medicine because they understand that in order for them to truly improve their health and change their chronic conditions they need to be responsible for their own health. But they also realize that they need help along the way.

This doesn’t mean they do this alone. It means they need help from doctors that are focused on prevention. They are searching for doctors and solutions that are holistic. They are looking for doctors, providers and individuals with knowledge in nutritional biochemistry, exercise, disease prevention, supplements, and habit change. They seek a holistic approach, they seek to reverse their chronic conditions, they want a way to increase not only their lifespan but also to increase their health-span.

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