broadsideblog

Why I Talk To My Pharmacist More Than My Doctor(s)

In behavior, business, Health, Medicine on August 15, 2010 at 12:59 pm
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Turns out I’m part of a larger trend. Reports The New York Times:

“We are not just going to dispense your drugs,” said David Pope, a pharmacist at Barney’s. “We are going to partner with you to improve your health as well.”

At independent drugstores and some national chains like Walgreens and the Medicine Shoppe and even supermarkets like Kroger, pharmacists work with doctors and nurses to care for people with long-term illnesses.

They are being enlisted by some health insurers and large employers to address one of the fundamental problems in health care: as many as half of the nation’s patients do not take their medications as prescribed, costing nearly $300 billion a year in emergency room visits, hospital stays and other medical expenditures, by some estimates.

The pharmacists represent the front line of detecting prescription overlap or dangerous interaction between drugs and for recommending cheaper options to expensive medicines. This evolving use of pharmacists also holds promise as a buffer against an anticipated shortage of primary care doctors.

“We’re going to need to get creative,” said Dr. Andrew Halpert, senior medical director for Blue Shield of California, which has just begun a pilot program with pharmacists at Raley’s, a local grocery store chain, to help some diabetic patients in Northern California insured through the California Public Employees’ Retirement System.

Like other health plans, Blue Shield views pharmacists as having the education, expertise, free time and plain-spoken approach to talk to patients at length about what medicines they are taking and to keep close tabs on their well-being. The pharmacists “could do as well and better than a physician” for less money, Dr. Halpert said.

I have spent an inordinate amount of time this year at my local pharmacy, run by a veteran named Aqeel, a warm, plain-spoken guy with three daughters. His store is tiny, two aisles wide, and sits two storefronts away from a CVS, an enormous chain of drugstores. But since January, having to take a variety of serious medications for the first time to manage my osteoarthritis — from steroids to Fosamax — I don’t have the time, patience or interest in running back to my doctors every time I have another question about my health.

I first spoke to him a few years ago, when I asked which vitamins to use, and why. He actually sat me down on one of his folding chairs and explained how they work and would affect me. Some people don’t want that much explanation or want to take the time. I loved it. Someone who spoke to me like a fellow adult!

His friendly, open manner, combined with decades of experience, makes me feel safe asking him questions. When I took one drug recently (all of them new to me),  I felt so incredibly lousy — disoriented and highly anxious, this on a weekend — I went back to ask him about it. That side effect was indeed unpleasant, but not unusual, he reassured me.

He’s one of three local merchants in my town I interviewed for my new book about working in retail, “Malled: My Unintentional Career in Retail” (Portfolio, April 14, 2011.)

Patients live a weird existence. Away from the few, hurried minutes with our busy physicians, some of whom are brusque and intimidating, we wander about in a fog of confusion. Yes, I read the accompanying literature so know what side effects to expect. But I didn’t know that, (hopefully) on the second dose of Fosamax, for example, a drug meant to build bone, I might not feel so dopey and tired.

Do you have a pharmacist you like and trust?

  1. I had a good experience recently with a pharmacist at Walgreens. He seemed very friendly and knowledgeable and asked if I needed an explanation on dosage or instructions for use. He also saved me some money (I don’t have insurance so he managed to sign me up with a rewards card or something of the sort).

    I live in a small town where I feel most health care is inadequate, and wish that physicians (as a general rule) would take the time to diagnose what is causing the problems rather than just slapping a bandaid on the issue and moving along to the next patient.. I’ve had more luck dealing with a chiropractor who is knowledgeable about nutrition, hormones, and diet-related issues.

  2. I think many American doctors — not that I like the behavior one bit — are in a rush to make money, prescribe meds or treatment or surgery to appease patients who want them to DO something. And to stave off lawsuits for not doing anything.

    I much prefer talking to my doctor(s) to manage whatever I can through diet, exercise, physical therapy, not popping pills or getting cut. But maybe we’re in the minority.

    I agree with you about using other professionals; it was my massage therapist, treating me for pain, who suggested I get an MRI of my hip, which the doctor had not ordered and which showed a new problem.

  3. Good point. I think it’s an issue of availability. Like you said, who wants to go running back to their doctor with every little question. Sometimes calling into the doctor’s office turns into an ordeal in and of itself. Pharmacists are often an untapped resource in the U.S.

    By the way, glad I ran into your blog via “Freshly Pressed.” Seems we have a lot in common–I was in journalism myself for a few years and currently live in the NY area.

  4. Bria, I agree. If you are lucky enough to find a pharmacist you like and trust who will make time for you, s/he will always have more time and, I bet, a much wider set of experiences and direct feedback on how all these drugs work.

    Glad you like the blog!

  5. Hi Caitlin, I’m so happy to have found your blog through Freshly Pressed. I’m a pharmacist in Toronto, Ontario who loves talking with patients about their medications, rather than just doing the dispensing part of the job. It’s why I became a pharmacist and it’s the whole point of being a pharmacist.
    Pharmacists are also looking for patients who value this time and expertise as well. It’s very rewarding when we find each other!
    Thank you for your post!

  6. My hometown! I wonder how many others feel as you do? My guy can take as much time with me as he feels as it’s his own store, as opposed to working for a larger chain. Although he used to win awards when he worked for a large chain as well.

    This is the first time I’ve had to take really powerful medications (as opposed to aspirin or other OTCs) and they all have some side effects, which can be disorienting and frightening. Doctors are focused on results; even when I make sure to ask what side effects to expect, they often fail to mention them.

  7. I just made a stained glass window for my pharmacist. This is a small pharmacy that has evolved from a sole proprietorship and is now owned by the CVS chain. However, they know my name and are always very friendly. Fortunately, I require only a couple of regular meds but for a time I was responsible for a aged mother and all the drugs she needed. A personal pharmacist can save your life if one of your meds reacts badly with another and your doctor did not catch it. Tom medlicott

  8. It’s good to see that the little guy still has a fighting chance!
    In these uncertain economic times, it’s hard for a lot of smaller stores to make their keep, but as you’ve said, these folks are usually a lot more attentive and accessible, at least to me. Good post!

    – Calhoun

    http://selfproclaimedmegalomaniac.wordpress.com/

  9. Tom, I’ve been on a first-name basis with my pharmacist since January when I had to start buying meds and analgesics for pain. Think about it logically — even the most experienced doctor can’t know (or likely won’t hear about) every side effect or interaction, when it’s those who dispense the meds who handle them every day and shoppers can return to talk to them, unlike calling a busy doctor or waiting for an appointment when you are meant to be taking the meds in the meantime.

    Calhoun, thanks. I love knowing this person as an individual and have blogged a few times about making sure as much of my money as possible goes into the pockets of our individual local shops, whether the hardware store, pharmacy, whatever…I am a self-employed writer so I know how essential it is to find and keep repeat customers. Large, impersonal chains rarely do it well, if at all.

  10. Yes, there are many pharmacists who find the more clinical aspects of being a pharmacist (i.e. talking to patients about their medications) the most enjoyable. But this is unfortunately where a lot pharmacists spend the LEAST amount of time because pharmacists aren’t paid to spend time with patients. They’re paid via the dispensing of medication (dispensing fees, medication mark-ups). If your pharmacist doesn’t spend time with you it’s probably because the pharmacy is understaffed and the pharmacist is busy filling medications and then checking them, answering phone calls, cashing people out and basically running around the pharmacy like a chicken with its head cut off. It’s extremely stressful. It’s not because they don’t want to discuss your medications with you. Trust me, they want to. Badly.
    I am optimistic that this is changing though and the NYT article is proof. The pharmacists who are truly dedicated to the profession won’t allow this to continue. They won’t work in those kinds of conditions and find other areas where they can do more meaningful work.

  11. Yes, I do have a pharmacist I like and trust. I call him Dad……..

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