Pharmacists as Vending Machines
The pharmacy profession likes to think of itself as an indispensable part of the healthcare landscape. The APhA (American Pharmacists Association) says that pharmacists are "essential in patient care for optimal medication use". That implies that pharmacists spend a lot of time educating patients about their drugs and advising doctors on the best drugs to use.
But talk to a retail pharmacist about her job sometime. Listen closely to what she does most often. You'll find that she's basically a human vending machine. When she's not grabbing drugs off of a shelf and putting them in a bag for patients, she's probably swiping an insurance card and figuring out how much they owe. Occasionally, she'll get to answer questions about how the drug works and how it interactions with other medicines, but that's comparatively rare.
Enter the pharmacy vending machine.
Integrity Urgent Care, 4323 Integrity Center Point, in northeast Colorado Springs, recently installed a machine stocked with dozens of common prescriptions -- antibiotics, painkillers, asthma inhalers and oral steroids. It dispenses patients' medications like a bag of potato chips or package of Skittles, and it is the first such machine in Colorado, according to the Minneapolis-based manufacturer, InstyMeds.
The process works like this: The doctor or physician's assistant submits the prescription electronically to the machine and gives the patient a code. The patient types in the code and a birthdate and receives the medicine after the bar code is triple checked.
A phone on the machine connects the user directly to a pharmacist 24/7 if the customer has questions or concerns.
If you're job is to perform the function of a vending machine, you probably won't be too happy that an actual vending machine is being used. Enter, the APhA spokesperson:
Kristen Binaso, a New Jersey pharmacist and spokesperson for the American Pharmacists Association, said people need quick access to their medications, but she said people should understand that a drug is not a package of Ritz crackers. Even certain common drugs can increase sensitivity to the sun, react negatively to alcohol, cause diarrhea, or interact with vitamins, herbs and over-the-counter drugs.
Her statement ignores something: the FDA mandates that all drugs come extensively labeled with warnings about every possible danger or complication. So, it sounds like a vending machine can replace much of what a retail pharmacist does on a regular basis.
And, this is a good thing. I wish that more pharmacists would recognize this. There is a very limited future in taking an average prescription, putting the pills in a bottle in a bag, reading the list of drug warnings, and taking payment.
The future of pharmacy is in the work that machines can't (yet) do: helping a patient recognize what the "blue pill", "red pill", "square yellow pill", and "round yellow pill" actually are. Helping that patient understand what each drug is supposed to, how it should make them feel better, what to be aware of when it it's not working, knowing which side effect goes with which drug(s), etc. Pharmacists have a great future in helping patients know whether their particular cocktail is safe or whether there's a potentially deadly interaction between multiple drugs.
But all of that counseling work can't be done well in today's retail setting. Today's retail setting is focused around volume, not around thorough counseling sessions. And that's not going to change until retail pharmacists are willing to allow vending machines to take over the tedious, rote work of actually dispensing pills.
On a closing note: what does it mean when people talk about a shortage of pharmacists? Are they referring to a shortage of dispensers? Well, technology can help with that? Or are they referring to a shortage of counselors? Technology can help with that too. By freeing pharmacists from the drudgery of being a vending machine, technology will create more pharmacist hours to be used for counseling. It will be as though thousands more pharmacy graduates entered the market, ready to help.
Thank you InstyMeds. You're helping to take us forward to the future.