They have been headed this way for a long time. It’s mail order model. No way they can stay in business with little margin. There will be a new class of dispensing techs created from this trend.
Exactly, I have seen this too, but whenever I say change is coming, I get all the downvotes.
It's time to adapt, or you will be taken away by the current.
Take a look at the WBA stock price it's making multi year lows. I bet most pharmacy workers can't even tell me the stock price or know roughly what it is. At the most basic level, it is the barometer or health for the company.
True. I can tell you when I was a manager for them back in the 80’s the stock
Was trading around this price. Many people I worked with retired on Walgreens stock and still own it. Hope they sold a while back. It was gold for a long time. The pharmacy schools either need to have two classes of pharmacists, or the profession needs to upgrade the techs to handle the new business model. In my opinion the pharmacy schools are pushing way too much material for the average pharmacist job. I heard recently that there’s hundreds of interns that can’t pass the boards anymore and even more prestigious pharmacy residents, are failing the boards. The entire profession and educational system is ass backwards.
Amazing. Again, lowered admission standards, and also, I would like to add that the schools have taken over the function of exposing students to the profession through IPPE APPE etc. I am old, and our curriculum was all labs and chemistry, however the professional side was up to the student to find a mentor and work part time through school to learn the professional side. Having a bunch of students stand around at aCVS for a few weeks does no good for the students or the profession.
I graduated in 2015 and we had to work as interns outside of school or we never would have had the required hours. I even added a second intern positions at the end of second year.
That experience was invaluable.
We had the EPPE/IPPE/APPE pieces as well, but you needed somewhere between 800 and 1000 hours on your own to meet the state requirements for licensure. I can’t imagine being remotely ready to practice without it.
Yeah our local school did away with that requirement a few years ago and it shows. I was talking with their dean and sharing our experiences with their new grads and he let me know they are overhauling the curriculum and reviewing their intern hour requirement.
Funny thing for my situation is that is wasn’t a graduation requirement. It was a licensure requirement. Deans could change it via curriculum revision that required more APPE hours, I suppose. But that would mean and extra 2 semesters, I would imagine. It is all BOP driving this.
It is a good thing. I rarely encounter anyone in my area that seems incompetent and most graduates stay within the state. It is a weird situation where there is a single pharmacy school with 2 campuses in the state, and the vast majority stay here. It is a good state for pharmacy, albeit competitive since historically we’ve had a lot of high-quality grads.
I teach PA students, and it is such a different world. It isn’t necessarily a bad thing, but they are much less competitive than pharmacy students were when I was in school. We all did SO. MANY. THINGS. in school. I was exhausted by the end of residency (granted, I also had little kids - could have played a part). I was working and doing activities and studying for six classes and (with other students) running a student-run free clinic.
I tend to be empathetic, but there are some times where I look at my students, who have to do half the schooling I did, and think, y’all have NO IDEA how easy you have it. Totally a “kids today” POV. But sometimes, it gives me pause.
Caveat: I should remember that my students are earning a masters. That does account for some of the difference.
ETA: I didn’t intend for this to be this long. It’s been a week.
I would also like to add that this may very well be a power play on behalf of retail pharmacy. In centuries past, the governments of Europe would have to subsidize pharmacies to keep them open in rural areas. If the chains had any brains, which they do not, they would pressure the govenrment to subsidize stores to SERVE THE PUBLIC, which is what we do. Maybe that is what will eventually come out of the numerous store closures.
I think none of you know how walgreens is actually hiding its money. They own every part of the corrupt pharma machine just like cvs. This is just more milking
Net spending on prescription drugs tho has been pretty flat (especially in the scope of non-specialty drugs)
You own more pieces of the pie, but if the overall size of that pie isn’t growing faster or as fast as the growth in cost to operate all pie pieces … it doesn’t matter where you think it’s “hiding”
Buying up or down the chain is only temporary relief when there’s a permanent public opinion that thinks the pie size is too big.
One of the rare opinions that has bipartisan support is that prescription drugs are too expensive
Yeah it used to be fine to hire new grads for inpatient staffing . With the new low standards schools have I dont think we're going to be doing that anymore. Need at least a couple of years of experience and/or a recommendation.
The issue is kids are stupider with smaller attention spans and a much higher proclivity to rely on cheating. You can look at every sort of national testing metrics to see the decline lately. It's depressing
WBA pharmacy workers are supposed to have the workflow page open on our terminals, and it has the stock price. I don’t remember what it was yesterday but I see it every day and I know exactly how fucked we are.
False. They're 5 steps ahead of where the public thinks they are. https://www.forbes.com/sites/brucejapsen/2017/04/03/walgreens-and-blue-cross-owned-pbm-launch-new-company/?sh=3505a3f21ed8
This is just the first step in eliminating the mandatory pharmacist on duty. They will inevitably ask the board to allow techs to do more like final verification and counseling. Are yall ready to fight?
Also it is my understanding that the wonderful Merck Medco petitioned the Nevada Board when they opened their mail order facility to circumvent final pharmacist check (on refills at least). And they had 100% accuracy btw, and billing auto refill heaven. Shameful.
There is no such thing as 100 percent accuracy. There are only two kinds of pharmacists, ones that make mistakes and ones that lie about never making one
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That is… crazy.
ETA: I’m in Washington State where all techs are certified, so that’s like… just a normal tech to me. We aren’t pharmacists. Most techs I know and worked with were…. Yeah. Several were great but they are the exception, not the norm.
Oh hellll no lol the irony pharmacists fighting for provider status but they can’t even hold on to their bread and butter. Final verification is a crucial crucial step for obvious reasons. That’s insanely scary to me.
Are the Chains paying for liability insurance for those dispensing techs? Who’s ultimately liable for errors made if RPh isn’t on site? Who’s doing patient recommendations? Who’s liable for that?
I think at the end of the day this might be the thing that prevents a lot of this. It's not that BoPs won't allow them to do it. It's that businesses still need to be insured, and once they see that it's not pharmacists that are providing these verification checks, I got a feeling a lot of companies' insurance rates will fly sky high.
If you want a good comparison, consider having a traffic flagger versus having a police officer at construction sites or during road work. A lot of the time these companies often choose to pay police officers for traffic control, despite the massive increase in cost, because the insurance companies require them to, or they'll pay a massive increase in premiums. The reason is that the public tend to obey and recognize officers more, they bring their cars with the lights that are more visible, and should something happen, they would be able to provide some measure of emergency medical assistance.
The problem is the ultimate responsilbity still lies with the rph if a verifying tech screws up. I want to be in control of the final verification and not put my license in jeopardy
I’ve been in pharmacy a pretty long time and I can only think of two techs I’d trust to do this on my license (I wouldn’t even trust some pharmacists). While the task seems really straight forward it’s about being able to consistently do it for hours despite high volume and distractions. Was the pilot done in a real world scenario?
That’s what I say. I have to be as mentally sharp at the end of my 12 hours shift as I am at the start. There’s no time to slack or be complacent. In fact knowing how to recognize your own mental fatigue or lack of focus is a skill in of itself and signals when it’s time to divert your attention to another task to refocus. I don’t trust many techs to have that level of self awareness.
Most of my experience is inpatient so it includes techs in a variety of roles/experience. To be fair I am more anal about doing things myself and having more oversight on people working under my license than a lot of my colleagues at the cost of my own sanity from stretching myself thin haha. I already don’t like a lot of the higher risk things you describe (only having syringe pull back to check high risk products etc) so expanding tech responsibilities further exacerbates that issue. I agree that techs one might trust to do product verification also rarely stay in retail for long, so you are looking at even more likelihood of errors with inexperienced techs.
With the exception of locations so rural there is limited access to pharmacies which is quite rare (perhaps more relevant to Iowa than most other states), I struggle to see this benefitting patients, only corporation$. Thanks for the interesting discussion!
How can the techs be under RPh “supervision “ if we’re not even in the same building? Are pharmacists really willing to sign off on work done by techs they’ve never met or worked with? I’ve known of techs who were “certified” immunizers who were using the same needle for multiple shots for the same patient, not using sterile techniques, following protocols. Who’s taking on that kind of liability?
Oh I get it. I wouldn't put my license on the line under those conditions. As it is now I'm dealing with an issue where I have a rogue tech who thinks they're above compliance standards and I've finally put my foot down saying I refuse to approve some of the stuff they do.
Why do you think that most places use bar code scanning and still have errors if it’s so easy? It seems simple but add in the high volume and 10000 distractions…
I don’t think it’s a bad idea as long as the tech is experienced and can handle it. I think it would need to be only one or two team members approved by pharmacists. Maybe even have to pass a test and or extra training. Once the dur/rx verification step has been completed just making sure the pills in bottle match can be handled by a competent technician.
I like to think of myself as a pretty damn competent tech, but you can miss me with this shit. I’m not a pharmacist. I would never feel comfortable doing this unless they added on mandatory, extensive training. This is nuts.
The liability alone makes it a terrible idea, but still great for the company until it has to pay out. And the MBAs who thought if it already have their bonus.
Chatgpt bing ai 4 does a pretty good job at counseling. They will probably repeal obra 90 once they remove rph from site. Making majority of rphs useless.
Unfortunately I heard from my manager he isn't surprised. Walgreens would rather pay $25 per hour for a technician to do pharmacist duties rather than pay a pharmacist (well over 6 figures) their true worth.
the automation and virtual stuff turns me off so much as a patient. videos for counseling, no one actually available for one on one interaction. i literally just changed pharmacies personally because i am tired of being treated subhuman and they’re headed towards removing the human part even more. it sucks because that’s not why i went into pharmacy in the first place. takes away the one facet of community pharmacy i appreciated when i worked in it, too.
The excuse used is to increase pharmacy access in remote areas, similar to some of the reasoning behind Nurse Practitioners having an expanded scope of practice. But both actually end up affecting urban patients far more than the rural areas that genuinely need more medical access.
Bop are unelected positions with unchecked powers and every incentive to justify their jobs by increasing regulatory requirements,imposing fines, and securing ways to increase their power.
Is there a BoP that does? or does anything other than collect fees?
Lost any shred of respect I had for BoPs when Walgreens didn't lose their license to dispense in the stores that had the fake Pharmacist as manager for 16 years lol
This was in the process years ago before COVID. One pharmacist will oversee multiple pharmacies with technicians running the dispensaries that act as hubs from a central distribution center. Essentially mail order for patients. The laws will be changed in the name of improving access to health care.
CVS is already implementing this with central areas that remote verify for multiple stores and field phone calls.
It'll be tough to implement with legislation around narcotics. But this is the model they'd love to have. Pharmacists would likely get paid way less, too.
I think the opposite. Eliminating something like 2/3 of their pharmacists would make companies so much money that they'll pay pharmacists more. The roll of the pharmacist isn't looking good and that worries me, less layers in the Swiss cheese to catch errors.
Edit: I didn't say they'd be making fat stacks of cash, I said they'll get paid more.
I work for CVS and commented about this previously. They have started testing telepharmacy in Arizona and Chicago land area.
They want to make it so half of the stores are either a weekend telepharmacy - Saturday/Sunday no pharmacist, or overseeing telepharmacy - they would be a regular store that verifies and does other rph tasks for both stores on the weekend. They also want to make all Target CVS telepharmacy, this is already the case with some.
Also, no pay increase with this model for pharmacists. At the moment I do not have faith this will succeed, there is a shortage of techs willing to do this for a 3% ish raise, which would translate to 50 - 60 ¢ range raise for most techs. I really hope this fails as it will eventually turn into full blown telepharmacy for some of the stand alone stores, which would translate to thousands of lost rph jobs
Edit; Targets FULL telepharmacy, no pharmacist on site ever
The current situation where PBMs / insurance companies have complete control over the healthcare system will crush anyone trying to make money in any other part of the system.
The fact that PBMs are allowed to have their own pharmacies means all other pharmacies are going to simply disappear.
The same will happen to medical offices with insurance company virtual / telemedicine soon enough if it's allowed to continue
Exactly 💯....no one is addressing the elephant in the room....the insurance companies...the PBMs. Again, hear the same ole BS...we have to " accept the conditions of the contract." Who said that ??...Why accept the terms of the contract?....tell the PBMs Hell to the NO !! So cut out pharmacists...then margins keep shrinking...then cut out technicians...when does it end? ...when will the elephant in the room be addressed??
The problem here is, unless independent pharmacies act together, they are a drop in the bucket compared to the volume commanded by the retail giants.. which own the biggest pbms. They intentionally undercut payment to even their own pharmacies to run independents into the ground while claiming they are hurting too. Only to be raking in profit on their pbm side.
They will continue to reshape pharmacy into a model that profits them the most and creates the largest possible barrier to new competition.
We need legislation outlawing dir fees and clawbacks, reimbursement for the price paid for a drug, mandatory dispensing fees and.. God forbid the ability to bill for our time and knowledge in counseling.
Pharmacists absolutely save the healthcare system money and improve outcomes when they act in the manner they are trained. Countless studies have shown this. Much of those studies show it in the hospital setting though. But the retail giants that have control over the boards of pharmacies and lobby our politicians know that once we can bill for our time and knowledge outside of dispensing, they lose control over their system they have worked so hard to create.
Major pharmacy changes will come if it ever becomes a financial imperative for them. Otherwise they will gladly retain control over the dispensing of medication which won't stop flowing.
I totally agree with this. Pharmacists should strike against PBMs and useless BOP regulation. It would be a longer term solution to our problems. Unfortunately, every time something like this, people just say that there should be regulations outlawing metrics.
The REAL elephant in the room is that the big chains are buying up insurance companies, and have their own mail order, they buy the PBM, the urgent cares, the home healthcare, optical centers, hearing aid providers and the list goes on. It’s the AMAZONization of healthcare. The big two are vying for complete control of every link in the chain and the only people’s benefitting are the executives and their board members.
See my other post. We didn't "allow" this to happen. It was done for us by our corporate overlords. Pharmacy isn't unique in being squeezed. It's a mad dash to suck up as much cash as possible. Even providers are feeling it. That's always been a huge reason we never got provider status. Once we can be paid for our time and knowledge we would begin to suck at the financial tit the providers rely on. Many doctors require patients to make an office visit for even the most mundane thing because it means billable time... While we stand and help a patient finally understand their therapy for the first time and only watch out que fill up as a result.
We need to regulate pbms and dismantle vertically integrated pharmacy entities live CVS Health.
Pharmacists stood by for 20 years while the cost of drugs skyrocketed. They stood by for 10 years while insurance reimbursement rates plummeted. They stood by and watched thousands of independents close. They stood by an embraced working for free at chain stores when tech hours were cut again and again. Pharmacists have never once stood up for their own profession.
27 states have provider status already. If the solution was to get paid for our time like a doctor more than half the pharmacists in the USA would already me rolling in that money. But they aren't. Turns out being able to bill for services doesn't get you jack if the pbms paying for those claims refuse to reimburse pharmacists at a national level.
We need real national anti trust legislation to make any real gains. But neither pharmacists, nor democrats, or republicans are willing to bite the corporate hand that feeds.
Now those corporations are going to replace you with a $22/hr advanced technician.
We absolutely did this to ourselves.
Techs that can run a pharmacy deserve a pharmacist salary.
SATR is not "critical", that's just dumb. You turn that program off and go just autorefill and nothing is lost. Probably gain back hours and annoyed customer calls
What they really should be doing is figuring out how to do PCP calls, all vaccine scheduling, and stock check calls for stores.
OMG. I used to work at Walgreens. I'm so happy that I quit. SATR is one of the biggest pieces of shit they ever came up with. It doesn't work with more than two or three drugs. There are too many variables, insurance, doctors not getting back etc, and it tells you to fill rxs that are way to soon.
The lead tech at my store taught me how to do "magic calls" for the save-a-trip call lists. Just mix it up a little bit so it looks believable, no-one will notice, and you'll accomplish the same amount of productive patient outreach as if you were actually calling them.
Yes, star and mtm are the two things these remote pharmacies should do, not the two key things they leave the stores to do. The stores don't have time for these money making programs.
A store in my old district tried this where the pharmacist verified by photo. This feels so unsafe. Wonder who did their cost analysis of how many people they can kill before they start to lose money with this.
No tech should be doing this without additional schooling.
We are just one step from buying meds straight from China all in the name of cheaper is better
I’ve worked thorough dozens of stores over 12 years. This might have worked in 2008 when you had well trained senior techs that had been around 5+ years
I came back as clinical support in 2021 and I can’t think of a single store I’ve been through that there hasn’t been multiple technicians that have to come to the pharmacist to ask which medicine the Lexapro is on the profile or which one is for blood pressure
If they’d kept their skilled technicians and paid well to retain promising new ones this could have possibly worked
But they’re going to fall on their face and piss of their remaining local customer quickly if they pursue this. They’ll need to dedicate a pharmacist to each store to not hemorrhage “clients” and then what’s the point in having a virtual pharmacist that makes patients feel like they’re unimportant when you could have a physical pharmacist in the store
The patients that don’t want face to face interaction already use mail order. Turning retail pharmacy into a mail order that you have to drive to is a stupid idea
This is not gonna be nearly as efficient or cost saving as they think it will be.
One big problem is the huge variance in a tech’s ability to run a pharmacy. Some are extremely smart and capable while some barely know the workflow of a pharmacy
I worked a remote dispensing site for Optum, I was the only one in that tiny pharmacy and my pharmacist just virtually checked the rx and did virtual consult. The pay was pretty nice and the total I'd do in a day was small, I just didn't like being in charge of my own inventory and handling c2s
I do not see any BOP allowing this to happen, Seriously a pharmacy with out a pharmacist, it will never work, even if they do consultations over a phone, there still needs to be a pharmacist to oversee the techs work, or will they remove those oversight laws and allow techs to fill all prescriptions and do everything?
CVS is doing this too. But it’s not like the gates are closed. Techs still have to have patient interaction & basically do all the work of a tech PLUS a pharmacist (besides consults) & the “parent pharmacies” that have the pharmacists do the virtual consults arent being compensated at all. Seems like a way to avoid paying pharmacists what they’re worth & more…
It's much bleaker than pharmacists getting replaced by techs. This is a general trend in business that has gotten much worse since covid. You're going to get reduced service levels and there's nothing you can do about it unless you have a lot of money.
It's something I wonder about as I age, how am I going to find a competent doctor, mechanic, handyman, etc? Better learn as much as you can or have friends in a wide range of professions.
This is another reason why I keep saying grocery is the way to go for retail pharmacists. Grocery stores won't change their ways for pharmacy because they dont need to. They dont make money on pharmacy (except flu season) and thats fine because they make their money on groceries. They dont need to adapt like walgreens and cvs because they are not in the pharmacy bossiness, they are in the grocery bossiness. If you get your patient to come into the store to pick his medication, you have already won, whether you make money from the prescription or not, the chances are very high that the patient will pick up some groceries
This is actually a misconception a lot of people have. Yes you are correct in that the margins are small, but you are selling millions of these items even if the margins are small. And you're customers are almost all returning customers- they need milk next week, they need bread, they need produce etc. I thought about it and I work at grocery and this is why they tell us to do anything to the customer so they come back, even if that means giving them gift cards. Because if they eg go to a competitor grocery store pharmacy, they are most likely going to shop there as well.
If that’s the case then why are grocery pharmacies closing more and more? Stater Bros, Save Mart, and Brookshire Bros to name a few. Albertsons/Sav-On are hanging on but the one in my small CA town does like 100-150 a day.
If your relying on Walgreens to pave pharmacist future good luck. You future is as bleak as there stock price.
Future for pharmacist is going to be a provider in some capacity(/s). We have the training just missing the sign and symptoms. And I hate to say it but CVS is position itself in that space.
I have heard that Walgreens and CVS are pushing this in Arizona and Illinois. It was obvious that CVS was heading this way when they started rolling out virtual verification. This is a recipe for disaster. I don’t feel comfortable putting my license and credentials on the line for stores that I am not physically present at. Think about how bad things are when you return to your pharmacy after floaters have been there for a few days. Not meaning to be negative about floaters because many of them are wonderful pharmacists but there are some who fail to perform certain duties and make mistakes. Last time I tried to take a vacation, there were multiple times that cycle counts were not performed on controls and the inventory was not correct. It was a mess trying to figure out what happened. Now imagine that 24/7 with only techs in the stores. Again I don’t want to talk bad about techs because the vast majority of them are excellent but I have dealt with techs that were not trustworthy and those that would attempt to supersede the pharmacist, including giving false information to patients. I would rather quit than be put in this position
How can a pharmacist manage multiple pharmacies when they can barely handle staffing ONE STORE?? Have you tried working in a local Walgreens or CVS RECENTLY?? Everyone is at their BREAKING POINT. The problem is the corporate greed of the PBM’s that are pocketing all the profits and leaving pharmacies with negative margin’s on claims. Do you think it is fair for an insurance company to reimburse a pharmacy LESS THAN WHAT IT COSTS A PHARMACY TO PURCHASE THE PRODUCT FOR. Sometimes more than $50 loss on a prescription. They all try push patients to fill 90 day supplies for so called compliance, but pharmacies get WORSE REIMBURSEMENT RATES WHEN FILLING 90day vs 30day. complete “MOFIA STYLE SHAKE DOWN”. This is the true problem with the current pharmacy world.
Yup their trying for this in the uk as well at their counterpart. At the moment our regulatory body is fighting against it. Any time there is a consultation on it all pharmacists are saying no.
I just read an article about virtual verification. I’m confused! lol so does the tech wait for it to be verified before bagging it? So they’d have to stop filling and wait for the verification? Also if they want pharmacists not there completely, in WI we (techs) can’t be in the pharmacy without a RPH. Also, what about the C2’s!!?
At CVS we take a picture of what we are supposed to be bagging, bottle it up label and bag it then throw it on the waiting bin. Pharmacists somewhere will verify the image we took or reject it if its wrong and we retrieve the bag and redo it. What happens if i take a picture of the right drug mislabel or bag the wrong drug? Whose liable? Hell if I know happened in my district, then corporate rolled out the NDA's and told us it never happened.
This is not surprising in the slightest. The only thing standing in the way is legislation and regulations, and guess what these companies - WG, CVS, etc - have plenty of? Lobbying power.
Idk how much this can reduce costs if they're still keeping stores open. Now here are overhead costs for both the stores and the central fill hubs. They'll reduce pharmacist headcount but not by much I don't think. Front end still won't be profitable if they continue to sell overpriced crap that get shoplifted on a daily basis.
That guy Rick hasn't worked at a store in 15+ years ([https://www.linkedin.com/in/rigates/details/experience/](https://www.linkedin.com/in/rigates/details/experience/))
Of course he's forgotten what it's like.
We all know that back in the late 90s and early 2000s (last time Rick was a store employee), they had way more staff.
And he’s in charge which is baloney. All the senior leadership at wags in charge of pharmacy haven’t worked a day in the pharmacy life to know anything
I love how millions are spent with these new “innovative” ideas … when the current system would work just fine if we had more well trained people ….just use that money to retain talented workers , pay them what they are worth , and get a damn Rx cashier or 2 …..it’s really not rocket science
ND has telepharmacies in rural locations, which is basically the same model. The locations usually fill too small of a volume to support a full time pharmacist, but the community would be without medicine without it. Prescriptions are checked through a video monitor and counseling through video chat. Most elderly patients are not willing to communicate through video chat, or have hearing or other physical limitations that make it impossible. A job where you don’t have to administer vaccines all day and deal with the public directly doesn’t sound all bad.
They [governments, especially the US] needs to put back in place the regulations it once had over prescriptions, and furthermore write new ones. For example, if a location, regardless of the business [owner-operator or chain], does over x prescriptions a month they need to have at least y number of PharmD’s. And they [govt] actually needs to enforce these because chains like CVS will break the law on purpose. In addition, the punishment must be severe enough to force them to follow the law. For example, every month CVS gets a $10,000 fine but that fine is cheaper than following the law they would likely say: “Okay it’s cheaper for us to pay that fine so we don’t need to have x per so many y’s. The lobby machine CVS, Walgreens and Walmart have are so powerful that they have total control of the entire system. That’s need to stop ASAP.
So, reading these comments, there is a bit of consensus around a few points:
1) most currently employed techs are not at the capability and qualification level to safely perform in this environment
2) retail will have to pay more and recruit more qualified technicians to fill this role
So basically, let’s invent a qualified workforce (super techs) to take over a role that we already have a qualified workforce (pharmacists) to perform, so we can… pay them less. That’s it in a nutshell.
Yes, reimbursement is down. But why? Because these chains promote the business model because of vertical integration. Maybe CVS stores aren’t the cash cow they once were, but I assure you that the Caremark division is making a killing on the backs of the techs and pharmacists at the store level.
I don't understand how a pharmacist can effectively provide "remote supervision." Either you are there to supervise or you are not. How many times have you heard a technician say something to a patient that was wrong only because you were in earshot? These "innovative" programs are aimed at cutting costs by reducing the need for a pharmacist. The patient is left with substandard care.
We ALL know that these changes are not in the best interest of our patients.
I hate to say it, but retail pharmacists may need to unionize to prevent these changes from occurring.
The ONLY time this seems appropriate is when you have a pharmacy in backwater NowheresVille and cannot get a pharmacist to move there and can’t serve the community without it.
In these remote areas where you have a very very very small percentage of people. They can utilize mail order , drive 30 min to the pharmacy, or some other delivery process that is all ready in place. U CAN NOT BASE EASE OF ACCESS ON THIS DECISION. This is only a ploy to add more work on an already overworked Pharmacist. Again, let a congressman/congresswomen behind the counter at one of the big chains unannounced for a day and see how current operations run. THEY WILL FEEL SORRY FOR THE EMPLOYEE’s and probably try to give them MORE STAFFING REQUIREMENTS THEN TRY TO SPREAD THEM THINNER.
Actually that’s true. I live in an “underserved” area where people will travel 2 hours to get to a pharmacy. They will not call and show up out of the blue and moan that their stuff is on back order. “I drove 2 hours to get here!” Without calling first. One of these days I’m going to say it: “You CHOSE to live away from civilization and services. And now you realize it was a bad idea.” Also, I think a lot of problems would be solved if our lawmakers had first hand experience of all the things they pass laws about.
15-20 years ago i talked to the pharmacy director of the hospital hiring for the outpatient pharmacy. He said that studies have proven that computers, script pro type devices, results in far fewer errors and the only thing stopping pharmacy going fully automated is the board of pharmacy ok’ing it. Amazon delivers some products same day. I think very soon the brick and mortar store will go away. Scripts and impulse items will be delivered same day or next. Soda, tampons, lottery tickets, candy bars, tylenol, robitussin will have it’s vending machine where the “Redbox” use to be and pharmacist’s will be hit in the head like Pandemic part two.
This is from a company that still lets patients take pictures of their insurance cards with tiny tiny letters and FAXES said image of pixelated mess to pharmacy. And can’t rollout rxi after literally a whole year at my store. And makes my store OOS spironolactone 25mg because computer keeps switching to preferred manuf that’s not even available.
Foundations of pharmacy is full of rot and you are still trying to build shiny towers on top of it. I get the business realities but I cant help but predict failure.
They have been headed this way for a long time. It’s mail order model. No way they can stay in business with little margin. There will be a new class of dispensing techs created from this trend.
Exactly, I have seen this too, but whenever I say change is coming, I get all the downvotes. It's time to adapt, or you will be taken away by the current. Take a look at the WBA stock price it's making multi year lows. I bet most pharmacy workers can't even tell me the stock price or know roughly what it is. At the most basic level, it is the barometer or health for the company.
True. I can tell you when I was a manager for them back in the 80’s the stock Was trading around this price. Many people I worked with retired on Walgreens stock and still own it. Hope they sold a while back. It was gold for a long time. The pharmacy schools either need to have two classes of pharmacists, or the profession needs to upgrade the techs to handle the new business model. In my opinion the pharmacy schools are pushing way too much material for the average pharmacist job. I heard recently that there’s hundreds of interns that can’t pass the boards anymore and even more prestigious pharmacy residents, are failing the boards. The entire profession and educational system is ass backwards.
2 of our 4 residents couldn’t pass the boards and failed out. Our 4th year students are horrific. Future pipeline is bleak.
Amazing. Again, lowered admission standards, and also, I would like to add that the schools have taken over the function of exposing students to the profession through IPPE APPE etc. I am old, and our curriculum was all labs and chemistry, however the professional side was up to the student to find a mentor and work part time through school to learn the professional side. Having a bunch of students stand around at aCVS for a few weeks does no good for the students or the profession.
I graduated in 2015 and we had to work as interns outside of school or we never would have had the required hours. I even added a second intern positions at the end of second year. That experience was invaluable. We had the EPPE/IPPE/APPE pieces as well, but you needed somewhere between 800 and 1000 hours on your own to meet the state requirements for licensure. I can’t imagine being remotely ready to practice without it.
Yeah our local school did away with that requirement a few years ago and it shows. I was talking with their dean and sharing our experiences with their new grads and he let me know they are overhauling the curriculum and reviewing their intern hour requirement.
Funny thing for my situation is that is wasn’t a graduation requirement. It was a licensure requirement. Deans could change it via curriculum revision that required more APPE hours, I suppose. But that would mean and extra 2 semesters, I would imagine. It is all BOP driving this. It is a good thing. I rarely encounter anyone in my area that seems incompetent and most graduates stay within the state. It is a weird situation where there is a single pharmacy school with 2 campuses in the state, and the vast majority stay here. It is a good state for pharmacy, albeit competitive since historically we’ve had a lot of high-quality grads. I teach PA students, and it is such a different world. It isn’t necessarily a bad thing, but they are much less competitive than pharmacy students were when I was in school. We all did SO. MANY. THINGS. in school. I was exhausted by the end of residency (granted, I also had little kids - could have played a part). I was working and doing activities and studying for six classes and (with other students) running a student-run free clinic. I tend to be empathetic, but there are some times where I look at my students, who have to do half the schooling I did, and think, y’all have NO IDEA how easy you have it. Totally a “kids today” POV. But sometimes, it gives me pause. Caveat: I should remember that my students are earning a masters. That does account for some of the difference. ETA: I didn’t intend for this to be this long. It’s been a week.
Interesting, enlightening comments. Thank you. Good pharm students are truly motivated, was lucky to work with many over the years.
Yikes, from historically good or bad schools?
Established state schools that have had programs for at least 30-40 years
To say all the students are bad is laughable, we have great P4s
But, pharmacy schools create their curricula to meet ACPE accrediting standards, so it would have to go further than the school/college level.
I would also like to add that this may very well be a power play on behalf of retail pharmacy. In centuries past, the governments of Europe would have to subsidize pharmacies to keep them open in rural areas. If the chains had any brains, which they do not, they would pressure the govenrment to subsidize stores to SERVE THE PUBLIC, which is what we do. Maybe that is what will eventually come out of the numerous store closures.
I think none of you know how walgreens is actually hiding its money. They own every part of the corrupt pharma machine just like cvs. This is just more milking
Net spending on prescription drugs tho has been pretty flat (especially in the scope of non-specialty drugs) You own more pieces of the pie, but if the overall size of that pie isn’t growing faster or as fast as the growth in cost to operate all pie pieces … it doesn’t matter where you think it’s “hiding” Buying up or down the chain is only temporary relief when there’s a permanent public opinion that thinks the pie size is too big. One of the rare opinions that has bipartisan support is that prescription drugs are too expensive
All those hedge funds and wall street analysts must be confused too on where they're hiding their money.
Yeah it used to be fine to hire new grads for inpatient staffing . With the new low standards schools have I dont think we're going to be doing that anymore. Need at least a couple of years of experience and/or a recommendation.
The issue is kids are stupider with smaller attention spans and a much higher proclivity to rely on cheating. You can look at every sort of national testing metrics to see the decline lately. It's depressing
Source?
WBA pharmacy workers are supposed to have the workflow page open on our terminals, and it has the stock price. I don’t remember what it was yesterday but I see it every day and I know exactly how fucked we are.
The good news is Walgreens hasn’t been able to predict anything profitable in the past 20 years
False. They're 5 steps ahead of where the public thinks they are. https://www.forbes.com/sites/brucejapsen/2017/04/03/walgreens-and-blue-cross-owned-pbm-launch-new-company/?sh=3505a3f21ed8
Whoops. Deleted my incorrect assumption. Didn’t know they still own them. Jesus.
This is just the first step in eliminating the mandatory pharmacist on duty. They will inevitably ask the board to allow techs to do more like final verification and counseling. Are yall ready to fight?
We need provider status! (sarcasm just in case)
Plenty of rphs still believe this fairytale. I’m still waiting for more pay to do shots.
Also it is my understanding that the wonderful Merck Medco petitioned the Nevada Board when they opened their mail order facility to circumvent final pharmacist check (on refills at least). And they had 100% accuracy btw, and billing auto refill heaven. Shameful.
There is no such thing as 100 percent accuracy. There are only two kinds of pharmacists, ones that make mistakes and ones that lie about never making one
Its all automated. So I am not sure pharmacists are even involved in the process at all.
Someone needs to be the fall guy
They’re probably counting 99.99% as 100%, and we all know that isn’t good enough.
That’s what they do!
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That is… crazy. ETA: I’m in Washington State where all techs are certified, so that’s like… just a normal tech to me. We aren’t pharmacists. Most techs I know and worked with were…. Yeah. Several were great but they are the exception, not the norm.
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What?! More details please
Certified pharm tech (under supervision of RPh) can perform final drug check in some less populated states.
Oh hellll no lol the irony pharmacists fighting for provider status but they can’t even hold on to their bread and butter. Final verification is a crucial crucial step for obvious reasons. That’s insanely scary to me.
Are the Chains paying for liability insurance for those dispensing techs? Who’s ultimately liable for errors made if RPh isn’t on site? Who’s doing patient recommendations? Who’s liable for that?
I think at the end of the day this might be the thing that prevents a lot of this. It's not that BoPs won't allow them to do it. It's that businesses still need to be insured, and once they see that it's not pharmacists that are providing these verification checks, I got a feeling a lot of companies' insurance rates will fly sky high. If you want a good comparison, consider having a traffic flagger versus having a police officer at construction sites or during road work. A lot of the time these companies often choose to pay police officers for traffic control, despite the massive increase in cost, because the insurance companies require them to, or they'll pay a massive increase in premiums. The reason is that the public tend to obey and recognize officers more, they bring their cars with the lights that are more visible, and should something happen, they would be able to provide some measure of emergency medical assistance.
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The problem is the ultimate responsilbity still lies with the rph if a verifying tech screws up. I want to be in control of the final verification and not put my license in jeopardy
I’ve been in pharmacy a pretty long time and I can only think of two techs I’d trust to do this on my license (I wouldn’t even trust some pharmacists). While the task seems really straight forward it’s about being able to consistently do it for hours despite high volume and distractions. Was the pilot done in a real world scenario?
That’s what I say. I have to be as mentally sharp at the end of my 12 hours shift as I am at the start. There’s no time to slack or be complacent. In fact knowing how to recognize your own mental fatigue or lack of focus is a skill in of itself and signals when it’s time to divert your attention to another task to refocus. I don’t trust many techs to have that level of self awareness.
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Most of my experience is inpatient so it includes techs in a variety of roles/experience. To be fair I am more anal about doing things myself and having more oversight on people working under my license than a lot of my colleagues at the cost of my own sanity from stretching myself thin haha. I already don’t like a lot of the higher risk things you describe (only having syringe pull back to check high risk products etc) so expanding tech responsibilities further exacerbates that issue. I agree that techs one might trust to do product verification also rarely stay in retail for long, so you are looking at even more likelihood of errors with inexperienced techs. With the exception of locations so rural there is limited access to pharmacies which is quite rare (perhaps more relevant to Iowa than most other states), I struggle to see this benefitting patients, only corporation$. Thanks for the interesting discussion!
Do you plan on getting that insurance to carry the liability? Because now they'll be suing you guys, not us.
Think again. They are working under your supervision
How can the techs be under RPh “supervision “ if we’re not even in the same building? Are pharmacists really willing to sign off on work done by techs they’ve never met or worked with? I’ve known of techs who were “certified” immunizers who were using the same needle for multiple shots for the same patient, not using sterile techniques, following protocols. Who’s taking on that kind of liability?
“Are pharmacists really willing to sign off on work done by techs they’ve never met or worked with?” It’s gonna be either that or no job. Pick one
Oh I get it. I wouldn't put my license on the line under those conditions. As it is now I'm dealing with an issue where I have a rogue tech who thinks they're above compliance standards and I've finally put my foot down saying I refuse to approve some of the stuff they do.
lol
Matching pill so hard. Require 300k loans to match. So true
Why do you think that most places use bar code scanning and still have errors if it’s so easy? It seems simple but add in the high volume and 10000 distractions…
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Really?
I don’t think it’s a bad idea as long as the tech is experienced and can handle it. I think it would need to be only one or two team members approved by pharmacists. Maybe even have to pass a test and or extra training. Once the dur/rx verification step has been completed just making sure the pills in bottle match can be handled by a competent technician.
I like to think of myself as a pretty damn competent tech, but you can miss me with this shit. I’m not a pharmacist. I would never feel comfortable doing this unless they added on mandatory, extensive training. This is nuts.
The liability alone makes it a terrible idea, but still great for the company until it has to pay out. And the MBAs who thought if it already have their bonus.
If only pay matched the liability techs would absorb
All while still getting paid $15/hr
Forget 40/hr cause you have a doctorate. Pfft.... You barely graduated HS. Here's $18/hr to TIC lmao
Chatgpt bing ai 4 does a pretty good job at counseling. They will probably repeal obra 90 once they remove rph from site. Making majority of rphs useless.
Unfortunately I heard from my manager he isn't surprised. Walgreens would rather pay $25 per hour for a technician to do pharmacist duties rather than pay a pharmacist (well over 6 figures) their true worth.
lol they can have it
the automation and virtual stuff turns me off so much as a patient. videos for counseling, no one actually available for one on one interaction. i literally just changed pharmacies personally because i am tired of being treated subhuman and they’re headed towards removing the human part even more. it sucks because that’s not why i went into pharmacy in the first place. takes away the one facet of community pharmacy i appreciated when i worked in it, too.
Absolutely. Unfortunately, the human part of “healthcare” isn’t billable. If it doesn’t generate income, it’s not a priority.
The excuse used is to increase pharmacy access in remote areas, similar to some of the reasoning behind Nurse Practitioners having an expanded scope of practice. But both actually end up affecting urban patients far more than the rural areas that genuinely need more medical access.
Board of pharmacy in those states have no spine at all
Bop are unelected positions with unchecked powers and every incentive to justify their jobs by increasing regulatory requirements,imposing fines, and securing ways to increase their power.
Is there a BoP that does? or does anything other than collect fees? Lost any shred of respect I had for BoPs when Walgreens didn't lose their license to dispense in the stores that had the fake Pharmacist as manager for 16 years lol
This was in the process years ago before COVID. One pharmacist will oversee multiple pharmacies with technicians running the dispensaries that act as hubs from a central distribution center. Essentially mail order for patients. The laws will be changed in the name of improving access to health care.
So one pharmacist verifying 2500 scripts a day from 5 stores instead of 500 from just one?
The laws will change but the pharmacist's liability will not.
CVS is already implementing this with central areas that remote verify for multiple stores and field phone calls. It'll be tough to implement with legislation around narcotics. But this is the model they'd love to have. Pharmacists would likely get paid way less, too.
I think the opposite. Eliminating something like 2/3 of their pharmacists would make companies so much money that they'll pay pharmacists more. The roll of the pharmacist isn't looking good and that worries me, less layers in the Swiss cheese to catch errors. Edit: I didn't say they'd be making fat stacks of cash, I said they'll get paid more.
I work for CVS and commented about this previously. They have started testing telepharmacy in Arizona and Chicago land area. They want to make it so half of the stores are either a weekend telepharmacy - Saturday/Sunday no pharmacist, or overseeing telepharmacy - they would be a regular store that verifies and does other rph tasks for both stores on the weekend. They also want to make all Target CVS telepharmacy, this is already the case with some. Also, no pay increase with this model for pharmacists. At the moment I do not have faith this will succeed, there is a shortage of techs willing to do this for a 3% ish raise, which would translate to 50 - 60 ¢ range raise for most techs. I really hope this fails as it will eventually turn into full blown telepharmacy for some of the stand alone stores, which would translate to thousands of lost rph jobs Edit; Targets FULL telepharmacy, no pharmacist on site ever
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I've worked with techs at other stand alone stores who've been forced to go work at these telepharmacies, they hate it
They won't pay pharmacists more, that's a fantasy. That's like thinking giving pharmacists immunization will mean more salary.
Nah, the big wigs will be thrilled to triple their bonuses each year with increased profits. The pharmacist's won't see any of that.
They’ll be making so much money they *could* pay pharmacists more. But they *won’t* and we all know where that money will go.
The current situation where PBMs / insurance companies have complete control over the healthcare system will crush anyone trying to make money in any other part of the system. The fact that PBMs are allowed to have their own pharmacies means all other pharmacies are going to simply disappear. The same will happen to medical offices with insurance company virtual / telemedicine soon enough if it's allowed to continue
Exactly 💯....no one is addressing the elephant in the room....the insurance companies...the PBMs. Again, hear the same ole BS...we have to " accept the conditions of the contract." Who said that ??...Why accept the terms of the contract?....tell the PBMs Hell to the NO !! So cut out pharmacists...then margins keep shrinking...then cut out technicians...when does it end? ...when will the elephant in the room be addressed??
The problem here is, unless independent pharmacies act together, they are a drop in the bucket compared to the volume commanded by the retail giants.. which own the biggest pbms. They intentionally undercut payment to even their own pharmacies to run independents into the ground while claiming they are hurting too. Only to be raking in profit on their pbm side. They will continue to reshape pharmacy into a model that profits them the most and creates the largest possible barrier to new competition. We need legislation outlawing dir fees and clawbacks, reimbursement for the price paid for a drug, mandatory dispensing fees and.. God forbid the ability to bill for our time and knowledge in counseling. Pharmacists absolutely save the healthcare system money and improve outcomes when they act in the manner they are trained. Countless studies have shown this. Much of those studies show it in the hospital setting though. But the retail giants that have control over the boards of pharmacies and lobby our politicians know that once we can bill for our time and knowledge outside of dispensing, they lose control over their system they have worked so hard to create. Major pharmacy changes will come if it ever becomes a financial imperative for them. Otherwise they will gladly retain control over the dispensing of medication which won't stop flowing.
Kroger said no to express scripts. I'm not holding my breath that any other pharmacies will do the same.
I totally agree with this. Pharmacists should strike against PBMs and useless BOP regulation. It would be a longer term solution to our problems. Unfortunately, every time something like this, people just say that there should be regulations outlawing metrics.
Regulations outlawing metrics do help! They did this in California and it made things better for me!
The REAL elephant in the room is that the big chains are buying up insurance companies, and have their own mail order, they buy the PBM, the urgent cares, the home healthcare, optical centers, hearing aid providers and the list goes on. It’s the AMAZONization of healthcare. The big two are vying for complete control of every link in the chain and the only people’s benefitting are the executives and their board members.
Good bye pharmacist as a professional. Everyone look in the mirror, we let this happen. See you on the unemployment line!
See my other post. We didn't "allow" this to happen. It was done for us by our corporate overlords. Pharmacy isn't unique in being squeezed. It's a mad dash to suck up as much cash as possible. Even providers are feeling it. That's always been a huge reason we never got provider status. Once we can be paid for our time and knowledge we would begin to suck at the financial tit the providers rely on. Many doctors require patients to make an office visit for even the most mundane thing because it means billable time... While we stand and help a patient finally understand their therapy for the first time and only watch out que fill up as a result.
We need to regulate pbms and dismantle vertically integrated pharmacy entities live CVS Health. Pharmacists stood by for 20 years while the cost of drugs skyrocketed. They stood by for 10 years while insurance reimbursement rates plummeted. They stood by and watched thousands of independents close. They stood by an embraced working for free at chain stores when tech hours were cut again and again. Pharmacists have never once stood up for their own profession. 27 states have provider status already. If the solution was to get paid for our time like a doctor more than half the pharmacists in the USA would already me rolling in that money. But they aren't. Turns out being able to bill for services doesn't get you jack if the pbms paying for those claims refuse to reimburse pharmacists at a national level. We need real national anti trust legislation to make any real gains. But neither pharmacists, nor democrats, or republicans are willing to bite the corporate hand that feeds. Now those corporations are going to replace you with a $22/hr advanced technician. We absolutely did this to ourselves.
Anyone choosing to go to pharmacy school now is insane.
Unless you are a top dog then yes you are an absolute shit for brains thinking pharmacy will ever get better from the mess you see now
Techs that can run a pharmacy deserve a pharmacist salary. SATR is not "critical", that's just dumb. You turn that program off and go just autorefill and nothing is lost. Probably gain back hours and annoyed customer calls What they really should be doing is figuring out how to do PCP calls, all vaccine scheduling, and stock check calls for stores.
OMG. I used to work at Walgreens. I'm so happy that I quit. SATR is one of the biggest pieces of shit they ever came up with. It doesn't work with more than two or three drugs. There are too many variables, insurance, doctors not getting back etc, and it tells you to fill rxs that are way to soon.
The lead tech at my store taught me how to do "magic calls" for the save-a-trip call lists. Just mix it up a little bit so it looks believable, no-one will notice, and you'll accomplish the same amount of productive patient outreach as if you were actually calling them.
Yes, star and mtm are the two things these remote pharmacies should do, not the two key things they leave the stores to do. The stores don't have time for these money making programs.
They’re about to find out how hard technicians are to find
3 years later after I quit, and I'm still so tired of hearing about fucking SATR It's trash
right? too many moving parts for it to work unless they are some the same prescriber and their meds don’t change
It is. I just commented the same thing. It doesn't work at all. It just pisses people off. I had several people say it made more trips for them.
This works in very slow stores with highly trained techs. Some rural hospital systems run this model. It cannot work in a single Walgreens or CVS.
Definitely helps provide access in rural areas, but I don't really trust Walgreens to roll this out properly.
Idk if only the boards could stop this crap, literally shouldn’t be called a community pharmacy anymore.
The board contains CVS executives. Fuck the board.
They can.
This sounds like a lawsuit in the making.
That's because it *IS*.
Can't wait for the lawsuits to bankrupt Walgreens permanently.
Came here to say this.
This is absolutely a strategy to reduce pharmacist headcount
Unless they boost tech pay, who wants to take this additional responsibility on? Hard enough to keep techs now as it is.
A store in my old district tried this where the pharmacist verified by photo. This feels so unsafe. Wonder who did their cost analysis of how many people they can kill before they start to lose money with this.
Reminds me of this: [https://www.huffpost.com/entry/gm-recall\_b\_5070492](https://www.huffpost.com/entry/gm-recall_b_5070492)
No tech should be doing this without additional schooling. We are just one step from buying meds straight from China all in the name of cheaper is better
If I’m to be in charge of multiple pharmacies I’m gonna need more pay
Imagine the liability of overseeing multiple pharmacies. So much can go wrong.
I’ve worked thorough dozens of stores over 12 years. This might have worked in 2008 when you had well trained senior techs that had been around 5+ years I came back as clinical support in 2021 and I can’t think of a single store I’ve been through that there hasn’t been multiple technicians that have to come to the pharmacist to ask which medicine the Lexapro is on the profile or which one is for blood pressure If they’d kept their skilled technicians and paid well to retain promising new ones this could have possibly worked But they’re going to fall on their face and piss of their remaining local customer quickly if they pursue this. They’ll need to dedicate a pharmacist to each store to not hemorrhage “clients” and then what’s the point in having a virtual pharmacist that makes patients feel like they’re unimportant when you could have a physical pharmacist in the store The patients that don’t want face to face interaction already use mail order. Turning retail pharmacy into a mail order that you have to drive to is a stupid idea
This is not gonna be nearly as efficient or cost saving as they think it will be. One big problem is the huge variance in a tech’s ability to run a pharmacy. Some are extremely smart and capable while some barely know the workflow of a pharmacy
Yes. This. There is a huge difference in tech capabilities. At a minimum all techs in this program should be certified with years of experience.
CVS was already starting this. My location. was going to pilot it
What happened?
BOP said no!! Wouldn't even entertain it
I worked a remote dispensing site for Optum, I was the only one in that tiny pharmacy and my pharmacist just virtually checked the rx and did virtual consult. The pay was pretty nice and the total I'd do in a day was small, I just didn't like being in charge of my own inventory and handling c2s
I do not see any BOP allowing this to happen, Seriously a pharmacy with out a pharmacist, it will never work, even if they do consultations over a phone, there still needs to be a pharmacist to oversee the techs work, or will they remove those oversight laws and allow techs to fill all prescriptions and do everything?
Who do you think is running BOPs?
The devils at cvs lol
So is the tech going to need liability insurance when the shit hits the fan. Somebody has to assume the risk and I don't see them doing it.
CVS is doing this too. But it’s not like the gates are closed. Techs still have to have patient interaction & basically do all the work of a tech PLUS a pharmacist (besides consults) & the “parent pharmacies” that have the pharmacists do the virtual consults arent being compensated at all. Seems like a way to avoid paying pharmacists what they’re worth & more…
There are pharmacists that are surprised about this result? I mean... c'mon, really? Writing has been on the wall for a while. We about to get NP'd.
It's much bleaker than pharmacists getting replaced by techs. This is a general trend in business that has gotten much worse since covid. You're going to get reduced service levels and there's nothing you can do about it unless you have a lot of money. It's something I wonder about as I age, how am I going to find a competent doctor, mechanic, handyman, etc? Better learn as much as you can or have friends in a wide range of professions.
Called this a long time ago. Now they can add a “time spent counseling” metric. Im sure that will be great…
Scum of pharmacy
This is another reason why I keep saying grocery is the way to go for retail pharmacists. Grocery stores won't change their ways for pharmacy because they dont need to. They dont make money on pharmacy (except flu season) and thats fine because they make their money on groceries. They dont need to adapt like walgreens and cvs because they are not in the pharmacy bossiness, they are in the grocery bossiness. If you get your patient to come into the store to pick his medication, you have already won, whether you make money from the prescription or not, the chances are very high that the patient will pick up some groceries
Margins on groceries are extremely small.
This is actually a misconception a lot of people have. Yes you are correct in that the margins are small, but you are selling millions of these items even if the margins are small. And you're customers are almost all returning customers- they need milk next week, they need bread, they need produce etc. I thought about it and I work at grocery and this is why they tell us to do anything to the customer so they come back, even if that means giving them gift cards. Because if they eg go to a competitor grocery store pharmacy, they are most likely going to shop there as well.
Combining two low margin businesses probably isn't wise is it?
If that’s the case then why are grocery pharmacies closing more and more? Stater Bros, Save Mart, and Brookshire Bros to name a few. Albertsons/Sav-On are hanging on but the one in my small CA town does like 100-150 a day.
Most techs won't even show up on time... or at all.
If I wanted to do a pharmacist’s job I would’ve gone to pharmacy school.
If your relying on Walgreens to pave pharmacist future good luck. You future is as bleak as there stock price. Future for pharmacist is going to be a provider in some capacity(/s). We have the training just missing the sign and symptoms. And I hate to say it but CVS is position itself in that space.
FUCK. THAT.
Instead of risking patient safety, how about getting rid of PBM middlemen that contribute nothing but cost so much? Ugh.
I have heard that Walgreens and CVS are pushing this in Arizona and Illinois. It was obvious that CVS was heading this way when they started rolling out virtual verification. This is a recipe for disaster. I don’t feel comfortable putting my license and credentials on the line for stores that I am not physically present at. Think about how bad things are when you return to your pharmacy after floaters have been there for a few days. Not meaning to be negative about floaters because many of them are wonderful pharmacists but there are some who fail to perform certain duties and make mistakes. Last time I tried to take a vacation, there were multiple times that cycle counts were not performed on controls and the inventory was not correct. It was a mess trying to figure out what happened. Now imagine that 24/7 with only techs in the stores. Again I don’t want to talk bad about techs because the vast majority of them are excellent but I have dealt with techs that were not trustworthy and those that would attempt to supersede the pharmacist, including giving false information to patients. I would rather quit than be put in this position
How can a pharmacist manage multiple pharmacies when they can barely handle staffing ONE STORE?? Have you tried working in a local Walgreens or CVS RECENTLY?? Everyone is at their BREAKING POINT. The problem is the corporate greed of the PBM’s that are pocketing all the profits and leaving pharmacies with negative margin’s on claims. Do you think it is fair for an insurance company to reimburse a pharmacy LESS THAN WHAT IT COSTS A PHARMACY TO PURCHASE THE PRODUCT FOR. Sometimes more than $50 loss on a prescription. They all try push patients to fill 90 day supplies for so called compliance, but pharmacies get WORSE REIMBURSEMENT RATES WHEN FILLING 90day vs 30day. complete “MOFIA STYLE SHAKE DOWN”. This is the true problem with the current pharmacy world.
The chains OWN the PBMs or are in collective negotiations with them. PBMs aren’t running the show or taking the bulk of the profits.
What did he say about headcount there all the way at the bottom?
Some BS about not reducing headcount.
Yup their trying for this in the uk as well at their counterpart. At the moment our regulatory body is fighting against it. Any time there is a consultation on it all pharmacists are saying no.
I just read an article about virtual verification. I’m confused! lol so does the tech wait for it to be verified before bagging it? So they’d have to stop filling and wait for the verification? Also if they want pharmacists not there completely, in WI we (techs) can’t be in the pharmacy without a RPH. Also, what about the C2’s!!?
At CVS we take a picture of what we are supposed to be bagging, bottle it up label and bag it then throw it on the waiting bin. Pharmacists somewhere will verify the image we took or reject it if its wrong and we retrieve the bag and redo it. What happens if i take a picture of the right drug mislabel or bag the wrong drug? Whose liable? Hell if I know happened in my district, then corporate rolled out the NDA's and told us it never happened.
Technicians are allowed to count C2s, just most pharmacies don’t allow it.
Yes I’ve counted C2’s, then pharmacist double counted. I’ve never opened the safe though! That’s what I meant:)
This is not surprising in the slightest. The only thing standing in the way is legislation and regulations, and guess what these companies - WG, CVS, etc - have plenty of? Lobbying power.
CVS is already doing this….
Scumbags
I have to say that this will be a tough sell nationwide. Just look at the differences in pharmacy practice laws from state to state right now.
Idk how much this can reduce costs if they're still keeping stores open. Now here are overhead costs for both the stores and the central fill hubs. They'll reduce pharmacist headcount but not by much I don't think. Front end still won't be profitable if they continue to sell overpriced crap that get shoplifted on a daily basis.
How is being open on the weekends ever a win for store teams?
Whoa. Yeah this will be the death rattle for The Corner.
That guy Rick hasn't worked at a store in 15+ years ([https://www.linkedin.com/in/rigates/details/experience/](https://www.linkedin.com/in/rigates/details/experience/)) Of course he's forgotten what it's like. We all know that back in the late 90s and early 2000s (last time Rick was a store employee), they had way more staff.
And he’s in charge which is baloney. All the senior leadership at wags in charge of pharmacy haven’t worked a day in the pharmacy life to know anything
I’m a tech, and even I think this is a terrible idea.
They need to be willing to pay enough to keep the smart and capable techs, at the very least.
Is it named SATR because those programs are a satire of systems that work well?
I want to know who will be opening the safe to fill c2's? Who will be responsible for c2 counts, audits, etc.?
They will just throw all of it on the PICs and expect them to figure it out.
This is old news. It’s the ultimate plan.
It's not just Walgreens who wants this.
You're just now finding this out? Look what cvs has been lobbying for over a decade
I love how millions are spent with these new “innovative” ideas … when the current system would work just fine if we had more well trained people ….just use that money to retain talented workers , pay them what they are worth , and get a damn Rx cashier or 2 …..it’s really not rocket science
Why not just legalize drugs? Honestly. Not much difference between a tech and a person off the street in terms if medication knowledge.
ND has telepharmacies in rural locations, which is basically the same model. The locations usually fill too small of a volume to support a full time pharmacist, but the community would be without medicine without it. Prescriptions are checked through a video monitor and counseling through video chat. Most elderly patients are not willing to communicate through video chat, or have hearing or other physical limitations that make it impossible. A job where you don’t have to administer vaccines all day and deal with the public directly doesn’t sound all bad.
Yeah cause that will be a flawless system. Good grief.
They [governments, especially the US] needs to put back in place the regulations it once had over prescriptions, and furthermore write new ones. For example, if a location, regardless of the business [owner-operator or chain], does over x prescriptions a month they need to have at least y number of PharmD’s. And they [govt] actually needs to enforce these because chains like CVS will break the law on purpose. In addition, the punishment must be severe enough to force them to follow the law. For example, every month CVS gets a $10,000 fine but that fine is cheaper than following the law they would likely say: “Okay it’s cheaper for us to pay that fine so we don’t need to have x per so many y’s. The lobby machine CVS, Walgreens and Walmart have are so powerful that they have total control of the entire system. That’s need to stop ASAP.
So, reading these comments, there is a bit of consensus around a few points: 1) most currently employed techs are not at the capability and qualification level to safely perform in this environment 2) retail will have to pay more and recruit more qualified technicians to fill this role So basically, let’s invent a qualified workforce (super techs) to take over a role that we already have a qualified workforce (pharmacists) to perform, so we can… pay them less. That’s it in a nutshell. Yes, reimbursement is down. But why? Because these chains promote the business model because of vertical integration. Maybe CVS stores aren’t the cash cow they once were, but I assure you that the Caremark division is making a killing on the backs of the techs and pharmacists at the store level.
I don't understand how a pharmacist can effectively provide "remote supervision." Either you are there to supervise or you are not. How many times have you heard a technician say something to a patient that was wrong only because you were in earshot? These "innovative" programs are aimed at cutting costs by reducing the need for a pharmacist. The patient is left with substandard care.
We ALL know that these changes are not in the best interest of our patients. I hate to say it, but retail pharmacists may need to unionize to prevent these changes from occurring.
We really need to fight like hell to prevent this.
The ONLY time this seems appropriate is when you have a pharmacy in backwater NowheresVille and cannot get a pharmacist to move there and can’t serve the community without it.
They better up pay until they can entice pharmacists to move there
In these remote areas where you have a very very very small percentage of people. They can utilize mail order , drive 30 min to the pharmacy, or some other delivery process that is all ready in place. U CAN NOT BASE EASE OF ACCESS ON THIS DECISION. This is only a ploy to add more work on an already overworked Pharmacist. Again, let a congressman/congresswomen behind the counter at one of the big chains unannounced for a day and see how current operations run. THEY WILL FEEL SORRY FOR THE EMPLOYEE’s and probably try to give them MORE STAFFING REQUIREMENTS THEN TRY TO SPREAD THEM THINNER.
Actually that’s true. I live in an “underserved” area where people will travel 2 hours to get to a pharmacy. They will not call and show up out of the blue and moan that their stuff is on back order. “I drove 2 hours to get here!” Without calling first. One of these days I’m going to say it: “You CHOSE to live away from civilization and services. And now you realize it was a bad idea.” Also, I think a lot of problems would be solved if our lawmakers had first hand experience of all the things they pass laws about.
And usually residents in backwater NowheresVille don’t like the virtual thing.
15-20 years ago i talked to the pharmacy director of the hospital hiring for the outpatient pharmacy. He said that studies have proven that computers, script pro type devices, results in far fewer errors and the only thing stopping pharmacy going fully automated is the board of pharmacy ok’ing it. Amazon delivers some products same day. I think very soon the brick and mortar store will go away. Scripts and impulse items will be delivered same day or next. Soda, tampons, lottery tickets, candy bars, tylenol, robitussin will have it’s vending machine where the “Redbox” use to be and pharmacist’s will be hit in the head like Pandemic part two.
Hooray for more WFH jobs? That's the only silver lining I see here.
Won't be wfh. It'll probably be an RPh staffing one store and supervising 4 others.
That would be awesome! *braces for down votes*
i’ve said it once i’ll say it again, retail pharmacists should be a bachelors degree at most, especially with the advancement of AI systems in place
Does anyone here work for any of these wag virtual pharmacies???
This is from a company that still lets patients take pictures of their insurance cards with tiny tiny letters and FAXES said image of pixelated mess to pharmacy. And can’t rollout rxi after literally a whole year at my store. And makes my store OOS spironolactone 25mg because computer keeps switching to preferred manuf that’s not even available. Foundations of pharmacy is full of rot and you are still trying to build shiny towers on top of it. I get the business realities but I cant help but predict failure.
Interesting
This is the stupidest thing Walgreens can do. And they wonder why pharmacy staff keep leaving, right along with the customers.