The ABC's of Community Pharmacy

As community pharmacists, how often do we hear things like, "Don’t you just have to put a label on it?" and “Why is my prescription taking so long?” As we all know, our jobs involve so much more. Recently, my 5-year-old was singing her kindergarten phonics song, and I decided to see if I could use the alphabet to describe all aspects of a community pharmacist, from our character traits to our job duties. Because pharmacists wear so many hats, I did not think that it would be too difficult to find 26 things. Feel free to share this with those who need a little schooling on what we do.

Allergies: These are a huge part of working in a pharmacy, in 2 ways. First, we must document patients’ allergies to medications and ensure that they do not get any to which they are allergic or that may cross-react. Second, seasonal allergies are probably 1 of the most common ailments that we help patients treat. Allergy medications, both OTC and prescription, are some of the biggest sellers in the pharmacy, and we are always busy helping people with questions and recommendations related to these meds.

Busy: I cannot think of a more accurate way to describe our day. As we all know, even if there are no patients standing near the pharmacy, there are pages full of prescriptions to fill, orders to be checked in, phone calls to make, etc. From the moment we open the gate, to the minute we set the alarm, pharmacists are busily working hard to fill prescriptions safely and help people all day.

Consulting and Counseling: As pharmacists, we are caring. As busy as we are, we always take the time to answer questions. Our advice is appreciated and respected (though sometimes ignored). Often, we consult with doctors as well, to help them find an appropriate alternative for a drug that is not covered or when we find a drug interaction and the treatment needs to be changed.

DUR: By performing drug utilization review, pharmacists often discover drug interactions and prevent very harmful outcomes by working with prescribers to find alternative medications that do not interact with current medications.

E-scripts: When these came along, we thought "no more messy handwriting; this will be a piece of cake!" Wrong! How many times do we see prescriptions with errors, such as, "Take 200 tablets daily?" I am not sure if we must make clarification calls more or less than we used to. Also, we spend a lot of time correcting messy sig codes. For example, the nice label that says, "Take 1 tablet by mouth daily" most likely came to the pharmacy like this "1 (one) daily take one tablet daily every day"

Frustration: Who better than a pharmacist than to help patients with their frustration? Whether patients are frustrated about an out-of-stock medication, long wait time, or high copay, pharmacists are excellent at calming these patients down so that they leave with a smile.

Generics: I wish I had a dollar for every time a patient said to me, "I don't want the genetic." As pharmacists, we spend a lot of time counseling patients on the equivalence and efficacy of generic drugs. And it seems to work. I remember years ago, it seemed as if everyone took Synthroid and very few took the generic. Now, I would estimate that 90% of the prescriptions that we fill are filled as levothyroxine and just 10% as Synthroid.

Helpful: It is easy to fall into a pattern of standing in 1 spot and checking prescriptions to make sure that everything is done on time. However, we have to take the time to be helpful to everyone, including the patients who need counseling on a new prescription or advice on OTC medications, and the technicians who are stressed out and have 200 prescriptions in the production queue. It never hurts to drop what we are doing, if nothing is urgent, and help the techs. Grab the phone, count some pills, etc. The techs will appreciate it.

Interesting: Although our jobs may be redundant at times, they are always interesting. There is always something new to look up, a new drug, a drug information question, or a drug interaction to review.

Jurisprudence: One of my favorite classes in pharmacy school was pharmaceutical jurisprudence or pharmacy law. Not only do we have to know about medications, we also have to know state and federal laws and ensure that these are being followed, as well as keep up with new ones.

Kindness: As pharmacists, we must be patient and kind to everyone. We must remember that the impatient patient may have been sitting in the doctor's office for hours before arriving at the pharmacy, only to find that the prescriptions are not ready. In retail pharmacy, a little kindness goes a long way.

Label: Contrary to popular belief, we do not just "slap a label on it." The label is almost the end product of an organized process that includes data entry, DUR review, production (assembling the prescription such as counting tablets and labeling), and then the pharmacist must verify the final product. While this is happening, the pharmacy is short-staffed, someone is honking their horn in the drive thru, and 4 phone lines are ringing.

Metrics: Some pharmacy chains use metrics to evaluate different aspects of the work of the pharmacy team, such as how fast the phone is answered, if prescriptions were verified on time, etc. Most companies use metrics in some form or another, and pharmacy is no different. We must make sure that we are performing our jobs safely while being mindful of metrics.

Neat: We keep our workspaces as neat as possible, with minimal clutter. Most pharmacists that I know are very meticulous about keeping a clean bench. It takes a lot of time and effort to keep the bench neat.

Order: We spend a lot of time keeping our pharmacies in order. That means that paperwork must be completed, reports must be printed, inventory activities must be done on certain days, and medications must be routinely checked for expiration and returned. The list is endless. Besides filling prescriptions, there are so many things that need to be done to keep a pharmacy in order.

Prior authorization: One difficult part of our job is explaining prior authorizations to patients. A prior authorization is when the insurance company requires more information before deciding if the medication will be covered. It can take anywhere from a few hours to a few days. Patients are often frustrated and do not understand, because they feel that the doctor's prescription is the authorization. Pharmacists should try to explain this to patients as best they can. Most will understand. For those who do not, have them call the member services number on the back of their insurance cards so that they have someone else to yell at.

Quiet moment: These are few and far between. Pharmacists who get a quiet moment should run to the bathroom immediately, because they may not get another chance. If there is another quiet moment, grab something to eat.

Refill everything: Oh, how we love to hear this. We do not mind refilling everything, but we would like to know what the patient is actually taking. Often, a patient will say this around December 30, when 200 other patients say, "Refill everything," before their deductible starts again. Many times, the patient will instruct us to fill 10 prescriptions. Then when they come in, they say, "I don't need this 1; I have that 1," etc. By the time they are ready to pay, they are purchasing 1 prescription, and we are putting back the other 9.

Sig code: This is the instruction for use. Many doctors will scribble the sig code, requiring clarification. Again, when e-scripts come in, the sig codes are a mess, and we spend a lot of time cleaning them up to sound understandable.

Technicians: It makes me sad when techs refer to themselves as just techs. I could write a book about how much I appreciate them. Our techs are our right hand, our crew, and our second family. They are awesome for so many reasons, but that could be another article. So, I will just remind pharmacists to be good to their techs. Buy them coffee, lunch, and an amazing holiday gift this year, because they make our lives so much better. Patients should also bring techs a cup of coffee or even a smile and some kind words of thanks.

Under-appreciated: As pharmacists, we are so important to our patients and our staff members, but we sometimes feel under-appreciated. My advice is to make sure the techs are appreciated, because it feels good to show appreciation to the staff.

Vials: How I love a full drawer of neatly stacked vials. We can learn a lot about staff members from the way they fill vials. A lazy staff member will leave the vials half empty, while a more hardworking one will ensure that vials are filled to the top before closing to ensure a smooth opening the next day. No matter how busy it is, it is important to take the 5 minutes at night to keep the vials filled for the next day.

Warehouse: Ordering medications, receiving orders, and putting orders away; these are all big parts of our jobs. We rely on our warehouses to keep our pharmacies fully stocked, so our patients get the medications they need.

fiX: Kind of cheating here because I could not find any X words, so I will go with "fix." As pharmacists, we fix everything. Obviously, we become skilled at fixing pretty much any medication and computer-related problem that comes our way, but we are also skilled at other things. For example, I used to fix the printer because I knew that I could probably do so more quickly than it would take for the help desk tech to come out. I also used to keep a screwdriver nearby, because the drive-thru handle on the drawer would come loose. We seriously fix everything.

Young: Although I sometimes think that working in a pharmacy can age us, standing up all day, running around, problem solving, and counseling can actually keep us young.

Zones: In busy chain pharmacies, there are work zones. One area is for data entry, one is for production, and another is for the pharmacist to verify prescriptions.

For pharmacists who are lucky, there may be a little counter space left over somewhere to hide for 40 seconds and eat a sandwich really fast.

What am I missing? How would you describe our job? I would love to hear feedback about what pharmacists are experiencing. Email me at karenmichelleberger@gmail.com