How fully do our patients and fellow healthcare professionals understand that pharmacy is a serious business, asks Ultan Molloy

I have just got a Harvard Business Review article through this morning detailing the value of having a laugh at work, “even when the work is serious”, it said.  This got me thinking about the work of community pharmacies, pharmacists, technicians and our teams. Is it a serious business we are in, doing ‘serious work’? Also, who sees it as serious work, and what even constitutes serious work, mind you.  

I recall a story of a pharmacist called Mrs Bourke in Dublin, whom a now ex-pharmacist friend of mine used to work for.   The story goes that a lady ran in the door with a prescription, pushing it towards Mrs Bourke, saying “I need that quickly. I’m in a terrible rush”, to which Mrs Bourke replied, “that’s no problem dear, you better bring it with you so”. Staring at Mrs Bourke in disbelief, the would-be customer listened on.  “We don’t do things in a rush here. Medicines are a serious business, you know.”  Clearly she didn’t, and perhaps we forget this from time-to-time. 

My friend is still a pharmacist by the way, as in, he is on the register, but after getting abused down the phone by a hospital consultant who wasn’t following up on his patient’s Humira consumption, he decided the craic was gone out of pharmacy for him.  The local GP was writing valid prescriptions to dispense from, of course, so all good there. That happened some time back, at the start of what appears to be a trend of pharmacists leaving the profession. Certainly, pharmacists staying in it, who have an interest in patient care somewhat proportionate to the salaries that they hope to command, are few and far between.  

Doctors, of course, are in a serious business.  Surely we can’t argue otherwise. Life and death and all that. There’s a level of trust there that’s needed from patients, and pharmacists are even more trusted than patients’ GPs, according to some surveys.  The till can be the complicating factor perhaps.  Paranoia can kick in that ‘you are just selling me stuff’, but there is an antidote in the majority of cases. Advise on the most safe and effective medicines for the symptoms that the patient presents with, let them decide on the severity and choose from their options, and if they want something just for their throat, or for their nose, throat and chest, then they can decide. 

Let’s think link-advising with integrity, rather than link selling, with more tenuous links to patient care.  

On perceived value

€50 for a seven-minute slot in a GP surgery, or €6.99 for some Advil cold and flu, where appropriate of course, following a ‘free’ consultation. Surely it’s a no-brainer, if a head cold is the diagnosis. What is the perceived value, however, is the thing to consider. Much like our “I’m in a terrible rush” lady, one can readily argue that ‘free’ isn’t going to be valued at the counter when it comes to pharmacist advice. At the tail end of 10 years of FEMPI, we nearly had another round of cuts, demonstrating unfortunately that any ‘vision’ for pharmacy appears to be solely cultivated and embraced on our side of the fence at present. 

A couple of talented local musicians have stopped playing “for the craic” in the local for some time now. They’re gigging musicians, depending on it for their income, and the ‘why would I spend €25 to see him in the Claregalway Hotel when i can just drop in down the road to the local on a Thursday evening’ was killing their income and the perceived value.  

Pile them high and sell them cheap… just ‘a conduit for drug delivery’

Market forces, and ones positioning in the market of course, determine the perceived value of a product or service. I used to get frustrated at colleagues competing solely on price. Okay, I still do, but there’s a place for everyone, or at least that’s the theory.  Just 20 per cent or so of medicines are paid for by patients visiting the pharmacy, with the rest paid for by the State — still what appears to be a little known fact. If we were to actually do the 80/20 in terms of which is more important, no doubt stretching our mental arithmetic skills in this case, then I would continue to be very, very, concerned at what nearly happened before Christmas to pharmacy payments. I’m neglecting, of course, the unexplained patients whose phased fees were just stopped without explanation. Rather than nearly, they actually happened, and this appears to have gone unacknowledged and unnoticed in the media. More PCRS bullying behaviour too, mind you, led no doubt from certain characters in there. Respect for the profession? Indeed. Maybe it needs to be better earned at the same time, and an acceptance of what has been accepted as best efforts to date have not proved to be good enough. 

Omnipresence 

Remember this month to dispense, check, do the paperwork, ensure regulatory compliance, look after the business needs, staff etc… and of course be available for patients.  When Irene says she is from “all over” in Me, Myself and Irene, Jim Carrey replies: “Omnipresence. I like that in a woman!” Are we trying to be omnipresent, and yet not really present in any one place, and if so, what determines and sets our priority?  

Sure, it’s only a bit of craic

We’ll know the story of our Government for the coming months by the time this is published, or perhaps we’ll be preparing for another election. Interesting times, when candidates who go on holidays through the election period and can’t get elected to local councils end up in our Dáil. Sure, it’s only a bit of craic, isn’t it? If you’re down this way, look me up and we’ll hit the pubs in Galway and get a few pints in for Donegal Tuesday with our local Sinn Féin candidate. 

Lowering the voting age to 16 was talked about some time back, wasn’t it? Which just wouldn’t be on, of course, as they’d be missing out on the craic. One of our friend’s daughters gave our Sinn Féin friend a vote “because he’s cute”. Sure why not, isn’t it all a bit of craic? Although, on my wife’s advice, any political aspirations I had have been now well and truly put to bed.