As a profession, are pharmacists dim-witted or do we just do a good impression of stupid people when it comes to pricing, asks Fintan Moore
There’s a great line in the 1990s movie, Dangerous Liaisons, spoken by the scheming and manipulative Marquise de Merteuil, played by Glenn Close, in which she contemptuously refers to a young man, saying: “He is an intellectual, and like most intellectuals, intensely stupid.” I sometimes wonder if that description could be fairly applied to pharmacists. It’s a pretty safe bet that a lot of us are intellectual, or at the very least have an exam-measurable intelligence. The open question is whether or not we are stupid, or continually behave like we might be.
When it comes down to it, pharmacy is a service industry. The same can be said of most professions — there’s no fundamental difference between a GP and a window-cleaner. So let’s take a look at the street-smarts used by barbers back when the VAT rate on haircuts changed from 9 per cent to 13.5 per cent. My haircuts before the VAT change used to cost about €11. Given that cutting my hair just involves running a number 3 blade over the few relevant parts of my skull, the barber was doing pretty well on €11. When the Government changed the VAT rate up by 4.5 per cent, the cost of a haircut should have gone up by less than 50 cent, but instead it jumped to €14. Coincidentally, other barbers in the area also hiked prices by similar amounts. So the cover story provided by the Government let them all become more profitable.
In theory, pharmacists are more intelligent than barbers. If you wanted a Sudoku solved or a cryptic crossword filled in, I reckon the average pharmacist would be quicker than the average scissor-snipper. But would we have the brains to pull off a comparable stroke to make us more money for the same amount of work? Not likely, based on performance to date, especially given our willingness to do ever-increasing amounts of work while reducing prices. Look at our track record on FMD scanning. We’ve had to fork-out money on hardware, as well as the ongoing cost to the various companies we register with. But that’s actually the least of it, when you measure the workload cost.
Let’s do a back-of-envelope calculation, assuming a pharmacy is doing 4,000 items a month. Each scan takes probably a minimum of 10 seconds when you factor-in bringing every pack to the scanner, twirling the box to find the bar-code, etc. That’s 40,000 seconds a month, or 480,000 seconds a year. That is 133 hours, which is more than three working weeks of productivity lost per annum. You can do your own maths on how you put a financial price on that loss, but I reckon that to get back to break-even would require a 30 cent increase on every private prescription. Yet instead of price increases, whenever I look around, all I see are more pharmacies advertising ever-decreasing prices in some kind of frenzy to presumably gain ‘volume’. Maybe I’m the stupid one, but you can be the busiest person in town if you work for nothing. At least my local barber is smart enough to cut hair instead of prices.
Notwithstanding our profession absorbing the cost of FMD compliance rather than having the sense to pass it on to the public, there may be glimmers of hope that we are starting to realise that any proper service needs to be paid for by somebody. I’m reliably informed that the Joe Duffy show recently had callers complaining about having to pay to for their medication to be blister-packed. Nothing could induce me to listen to the show, but apparently the usual confusion reigned as to what could, would or should be paid by the HSE when it comes to phased dispensing and/or blister-packing. The good news about all this is the fact that enough pharmacists are charging for a service instead of doing it for nothing, in sufficient numbers to be a Joe Duffy item. So the question for the pharmacists who still aren’t charging is, ‘why not?’ If the guy down the road from you is doing it, then you might as well too. If you lose the odd patient, you’ll still be making the same money overall, with less of a workload. And the people you are still serving will be the ones who appreciate what you’re doing enough to respect it by paying for it.
Yellow-Pack Health Service
Has anybody ever told the HSE employees who work in the PCRS that there are only 12 months in a year? I merely ask because another envelope containing 12 yellow bags for paperwork was delivered by courier recently, which means that I now have enough bags for about the next four years. If even half of the pharmacies in the country got the same unnecessary delivery, then the expense to the HSE was probably about €10,000. The waste involved in this may be relatively minor in the greater scheme of things, but it is symptomatic of a bureaucracy that is unreformed, despite supposed improved productivity and reform. The shelving of proposed recent cuts to pharmacy was welcome, but it doesn’t look like the HSE will react by using its existing funds any more efficiently.