With Rising Costs Everywhere, Pharmacists Need To Act As A Collective To Identify What Expenditure Can Be Reduced, Writes Fintan Moore.
They say that money can’t buy happiness, but it can definitely get you closer to it. There’s a fair degree of unhappiness circulating in the world of community pharmacy at the moment as people try to cope with the daily trials and tribulations of life at the coalface. There’s no cohort of pharmacists that’s entirely content — employers are struggling with rising costs and staffing problems; and employee pharmacists are struggling with the endless problems of bureaucracy and stock shortages. Locum pharmacists get to side-step a lot of administration tasks, but trying to do a good job as a locum has also got more difficult over the years, especially in any unfamiliar pharmacy. Many patient-facing pharmacists find that the lack of proper lunch breaks can cause fatigue and stress, although it’s also true that some prefer shifts that let them work through lunch to increase earnings.
One consistent feature for all pharmacists is that extra money could help to improve things, whether by increasing the number of support staff, or increasing wages, or improving owner salary, or by subsidising any revenue lost by introducing a lunch-break. As we all know, the options to increase pharmacy income are limited by the fact that the market is largely a monopoly with the HSE as the single major buyer, and thereby dictating the price it will pay for our service. In theory, we can raise the prices we charge to our ever-dwindling pool of private sub-DPS-threshold customers, but the scope for that is curtailed by competitive pricing, especially by some ‘low-cost’ pharmacies with heavily advertised discount prices on common items. Given the limitations on our pricing, smart purchasing can help to improve margins, and I think most pharmacists have got better at that out of necessity.
The other side of the equation is the expenditure column, and to put it briefly, everything is going up. Electricity costs, wages, repair costs, insurance, packaging, bank charges and anything else that goes into running a place have all taken a hike. So I reckon there needs to be a renewed focus on what costs can be reduced, especially by acting as a collective. One area that definitely needs a bit of consideration is what we pay for first-aid training. A first-aid course usually costs about €300 per person, which sounds like a lot, but not unreasonable, until you start doing a bit more maths.
Most first-aid courses have about 10 people at a time, so the single first-aid instructor at the top of the room is costing all the pharmacists present €3,000. Now we’re talking serious money. Sure, there’s a bit of admin in booking people on the course, etc, but somebody is doing well out of this. Given that we’d all prefer to see the €3,000 stay in community pharmacy, how might that be achieved? Could the IPU contract a first-aid instructor directly at a fair but attractive hourly rate to give classes at set times and locations every month? There could be good reasons for that not to work, but I think it’s worth considering.
DELEGATION — A GAME FOR THE WHOLE PHARMACY
A phrase that crops up in healthcare every so often is that patients should be dealt with at the lowest level of complexity. It’s a simple idea in theory, and means that it’s better and cheaper to have a patient treated locally by a GP rather than in a hospital. Some similar thinking can be useful in a pharmacy, namely that routine administration tasks should be dealt with by any staff member other than the pharmacist.
For instance, daily audit trails need to be printed every day and signed by the pharmacist, but there’s no logical reason for the pharmacist to spend time doing the printing. Similarly, a log of fridge and dispensary temperatures can be competently maintained by anyone on the team. Checking in High-Tech deliveries on the Hub can also be delegated. Every single job should be assessed to see who is best placed to do it. There are so many demands on a pharmacist’s time and attention that it makes sense to take the pressure off wherever possible, thereby freeing-up their time to focus on the important things. It goes without saying that FMD compliance is a huge setback in this, because the logical flow of the dispensing process means that pharmacists are more likely to end up scanning than anyone else. Maybe sanity will prevail on this issue eventually, but for now I’ll use the sports phrase that we can only ‘control the controllables’, so delegate where possible.
THE HEAT IS ON
The temperature as I write this is hovering just shy of 30 degrees, and the scary thing is that there will be future summers that are even hotter again. I got air-conditioning installed in my pharmacy about 15 years ago, and debated with myself as to whether or not it was justified for the ‘couple of days a year’ where it might be needed. I went ahead mainly because in the winter-time, the unit is excellent for heating. However, those predicted few days where the cooling would be needed have sadly become weeks over the period since. If anyone is toying with the idea of installing it, I would wholly recommend it — we’ve noticed that in the hot weather, people don’t mind waiting a bit longer for their prescriptions when there’s a nice flow of cool air around them!