The Druggist Is In
Steve Wienner has just gotten a call from a longtime customer. He listens intently while continuing to mark off the bottles behind the counter of Mt. Vernon Pharmacy, his Baltimore drugstore. "Is the muscle weakness worse?" he asks. "I would increase your fluid intake, but if you're not feeling better in a few days, then call your doctor." He hangs up the phone, continues checking prescriptions, and starts to get out ingredients to customize an acne prescription for a teenager. "A lot of what we do is more than one thing at a time," he says.
With drugs playing an ever larger role in health-care, pharmacists like Wienner are stepping to the forefront of healthcare. Between 1995 and 2003, the number of prescriptions sold each year in the United States rocketed up from 2.1 billion to 3.2 billion. Our growing drug habit means more prescriptions to fill and more customers in front of the pharmacy counter.
And those customers are looking to drugstores for more than just pills. For decades, nursing homes and hospitals have employed pharmacists who review patients' drug regimens and offer suggestions, but now these same services are being taken out into retail drugstores. Many drugstores around the country, including large chains such as CVS, are starting up programs to get pharmacists out from behind the counter and talking with patients about how to manage chronic diseases or complex drug regimens.
"The pharmacist is an underutilized asset in the community," says Mark Gregory of Kerr Drug, a North Carolina chain that was one of the first to train its pharmacists as consultants. Like CVS, Kerr believes that helping patients become more knowledgeable about their medications will make them feel better and spend less time in doctors' offices and may reduce their healthcare bill.
Negotiations. Pharmacists have also had to become insurance experts. For many, one of the biggest tasks each day is negotiating with insurers and doctors to get a patient's prescription covered. Most insurance plans have lists of preferred drugs, and if patients come in with a prescription for another drug, they have to either shell out the cash themselves--and sometimes that's hundreds of dollars--or get their doctor to rewrite their prescription for the preferred medication. At Wienner's store, right after the customer called about muscle weakness, another call comes in from a patient who has been waiting two months for his medications because the doctor has not approved a prescription switch. "I have faxed your doctor many times," says Wienner. "We're trying but . . ." and his voice trails off. He says that he no longer has the time to follow up as he once did and act as an advocate for his patients. "At some point, we have to say, 'I'm sorry, we've had 70 other people today that we've had to do the same thing for, and we don't have time to call anymore.' It's disgraceful."
A survey sponsored by the National Association of Chain Drug Stores found that about 20 percent of a pharmacist's time was spent dealing with insurance issues. Pharmacists ranked that as one of the most frustrating parts of their job. "The thing that's being sacrificed is communication with the patient," says Daniel Hussar, a professor at the Philadelphia College of Pharmacy.
Wienner still tries to talk with each person who comes through the door. "Have a great day!" he calls to a regular as he reaches to take another phone call. -Elizabeth Querna
This story appears in the January 31, 2005 print edition of U.S. News & World Report.
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