The Challenge of High-Volume Community Pharmacy

Filling up to 500 prescriptions as a solo pharmacist in a single workday takes a special type of focus, a well-organized support team, and perhaps a touch of OCD.

High-volume community pharmacy is not for the faint of heart. It is, instead, an arena in which the crazy brave of the craft are called to practice a highly specialized form of the profession. Filling 500 prescriptions as a solo pharmacist on a Monday takes a team (you are nothing without your techs in this game) with a very specific skill set. Moving at a script-a-minute pace, squeezing in an immunization—or 9—and counseling and making product recommendations to patients while your team keeps the ship from sinking and manages to close the place down in good order after a 12-hour shift requires a well-oiled cooperative effort.

I referred to high-volume as a game, and I approach it the same way that a gamer does a first-person shooter. The name of the game is Don't Kill Anybody—and you only get 1 life, so you have to be really, really careful. To date (knocking fiercely on my forehead) I have yet to lose. As you may remember from my last post, I have come close on a few occasions, but I learned from my mistakes and lived to fight another day.

At a wedding a few years ago, the daughter of a patient of mine who had become a PharmD had to tell me how chain community pharmacy was a boil on the profession's lower posterior and how she was using her clinical skills doing whatever making less money than me to be sure. Obviously, she had gotten her head handed to her on a Monday a few too many times. Having been there, taken my lumps, and learned from every one, I looked her dead in the eye and said, "Not everybody can handle high-volume community." For some reason the conversation ended there. I'm still not sure why.

Having an error-free day is challenging enough with a full staff, but when a tech calls in sick, it's like doing the job on ice skates. Unfortunately, the pace has to slow down, and patients may have to wait longer than the customary 15 minutes to get their meds. Did you ever notice that timed prescription guarantees always fall by the wayside? I wonder why that is...

In a for-profit health care model, it all comes down to the nickels and dimes, so you are only going to get so many tech hours, and there will be days when you will feel grossly outmatched no matter who is working with you. That is when you have to be at your absolute best. (OCD is the ideal syndrome for this line of work.) I trust the best techs I have known as far as I can throw them, and, at minimum, triple check their work—even on those days when I’m forced to work at a script-a-minute pace.

Other opportunities will present themselves, but I will always keep a foot in high-volume. I'm just crazy enough to want to see what will happen next. Peace.

Jay Sochoka, BSPharm, RPh, CIP, can see his 50-year pin off in the distance. Actually, he'll probably take the crock pot instead.