Can pharmacy ever be outsourced?

[jjoeirv]

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Can pharmacy ever be outsourced? Do you see of any possible threats to the demand for pharmacists that may occur in the future? I have heard that in the past, the job market has been tight for pharmacists.

Companies everywhere are doing whatever they can to save money. Maybe a pharmacy can reduce its labor cost by reducing the number of pharmacists, and increasing the use of pharmacy techs? If that occurs, the pharmacy may need just 1 pharmacist and an army of pharmacy techs.

 

[MacGyver]

Pharmacists have an OK future for hte next 30 or 40 years.

In the long term future though, things get hazy. I could see a computerized system thats able to replace pharmacists.

Right now there are safety issues involved but eventually I think that kind of technology could develop.

Another option as you said is to use pharmacy techs and give them advanced practice rights. I'm betting that someday there will be extra training for pharm techs that allows them to take over some of hte role of pharmacist.

 

[baggywrinkle]

Originally posted by MacGyver I'm betting that someday there will be extra training for pharm techs that allows them to take over some of hte role of pharmacist. [/B]

The military has been doing this for years. Technician training is outstanding. Their training manuals will challenge most pharmacists. What is really amazing is they do it in 6-9 months of concentrated training

If a military trained pharmacy technician ever graces your door, welcome him/her with open arms and thank your lucky stars.

 

[tlh908]

Recently Walmart had a presentation at our school to show off their computer system. While most students thought it was cool, if you look at the system carefully there really isn't much need for a pharmacists. QA is done by computers and the techs do all the order entering although a check is done by the pharmacists to ensure the order was entered correctly. If only time the pharmacist is really needed is to check the order entry of the computer, that could be done offsite by a pharmacists covering several stores. So why not have one pharmacists covering several stores and put only lesser paid techs in the actual store?

Sure the laws don't allow this now, but if WalMart thinks they can save money with the system it won't be that hard for them to have the laws changed. Beware of chains that could care less about pharmacy - they will kill the profession to make a little more $$$$.

 

[baggywrinkle]

Originally posted by tlh908


Sure the laws don't allow this now, but if WalMart thinks they can save money with the system it won't be that hard for them to have the laws changed. Beware of chains that could care less about pharmacy - they will kill the profession to make a little more $$$$.

While not impossible there are two hundred years of inertia which sez it won't happen. They must prove that the public safety will be secure.

For the remainder of my career and most likely yours not much will change. Look at the trend. Obra 90 mandates greater, not lessor pharmacist involvement. Our roles might change, but that might not be a bad thing at all. Being a walking signature/counseler/back slapper wouldn't be a bad life. Follow Obra 90 to the letter and you get your own office/counseling area.


I view the impending professionalization of technicians as a positive trend, a career in it's own right. As it stands at this moment a pharmacist doesn't get paid for what he/she DOES, and he doesn't get paid for what he knows. We are paid to be RESPONSIBLE as in whipping boy or the buck stops here. That is the essence of professionalism and is a responsibility that the techs really don't want, but will assume the moment the pharmacist is removed from the equation. Watch them clamor for the "big bucks" the moment one of them gets sued.

 

[carpe diem]

I think pharmacy outsourcing is pretty common or becoming more so in the hospital environment. The hospital where I used to work (a major pediatric research hospital) outsourced tpn's (total parenteral nutrition) and daily IV's (shots), and some large volume parenteral infusions. When the hospital began this, some of us were like......ok, we'll see how long this lasts --- our major concerns being medication errors. After all the kinks were worked out, the system seemed to work well. I have heard recently that the hospital has decided to cancel the outsourcing contract, but from what I hear the outsourcing company still does major business with the many other large hospitals in the area.

 

[Heyyyyy]

Healthcare technology will always advance to the next step. Does it mean that critical healthcare professions will be "outsourced"? NO
For example, there is a great debate in the perfusion profession (A perfusioniost operates the "heart-lung machine" during an open heart surgery). As technology advances in open-heart surgeries, there is really no need of a perfusionist operating the machine. Since most healthcare profession deal with life and death situations, no human or societal law will allow technology (with minimal or no human effort) to take a bigger role in such situations. Therefore, a perfusionist will always remain a vital member of the healthcare community. The same rule goes for physicians, pharmacist, dentist and so on.

Also, every healthcare profession has a technician or assistant. Assistant/technician plays an important role and their skills provide a stable operating-structure of the healthcare community. Can an assistant/technician perform ?full job duties? without any supervision? Absolutely. However, it doesn?t mean that the assistant/technician is given ?full professional privileges? without any formal educational background (meaning 4yrs of pharmd school, 4yrs of medical school and so on). When it comes to life and death situations, NO shortcuts or leeway is allowed by society. I hope you can understand what I mean by ?full professional privileges? and ?full job duties?.

 

[Heyyyyy]

It wouldn't make sense for new pharmacy schools to pop up almost every corner of the country. Additionally, most states doNOT require educational training for pharmacy technicians. Would you let a person(with only a high school diploma) and robocop to be your pharmacist?

 

[baggywrinkle]

Originally posted by Heyyyyy
It wouldn't make sense for new pharmacy schools to pop up almost every corner of the country. Additionally, most states doNOT require educational training for pharmacy technicians. Would you let a person(with only a high school diploma) and robocop to be your pharmacist?

Pharmacy technicians are following the classic path to professionalization. They were grudgingly allowed behind the bench initally as typists and sales clerks. Then suddenly they are counting and pouring and the board is making noises about licensing. In florida no school is required (yet) but they can pass a simple exam that nets them an extra quarter an hour.
But in Washington they have stratified into two groups; licensed technicians who have gone to school and assistants who only need a pulse and the will to work. Licensed technicians can be and are sanctioned just like pharmacists. They are being held to a professional and legal standard. Another interesting development is technician continuing education. I see it but have no idea how much of it is legally required. Obviously it is coming.

There won't need to be new pharmacy schools to handle this load. All they need do is attend their local community college program which is another nice opportunity for pharmacists who like to teach. I predict that the licensed professional technician will evolve into an AA degree or a certificate program of some sort
which is heavy on function and light on theory. That leaves the classic RPh or PharmD scrapping about for a new role as drug information specialist or prescribing middle practitioner as is allowed under Washington law. The future may need fewer of us but the need will still be there

There is historical precedent for this career path. During World War II in Colorado all the pharmacists went to war leaving the more capable technicians running the bench. To keep some semblence of legality and professional decorum the BOP offered a one shot promotion to professional licensure for these war time technician/pharmacists. I worked with one in Pueblo. To this day in Colorado a small rural hospital can be run by a resident technician and have a part time RPH director who shows up a few hours a week to review paperwork and sign off on legal documents. The tiny hospital in Walsenburg is such a place. The technician ruled that roost and nobody told her nutin. She walked up to a colleague of mine who occupied the director position briefly, looked her up and down and snorted, "The only difference between me and you is you get paid more!" Ouch.

As far as outsourcing, why not? Nuclear pharmacy is outsourced as is chemotherapy and parental nutrition -- A very nice job in the Dallas metro area was mixing TPN bases for client hospitals and home health patients. Their territory was everything west of the Mississippi. Or why not outsource the whole doggone pharmacy. That is what the Owen Company is all about. Kindred does nursing homes using local pharmacies like Walgreens to start therapy. The only thing that changes for the RPH is the guy who signs his check.

 

[Triangulation]

Originally posted by jjoeirv
Can pharmacy ever be outsourced? Do you see of any possible threats to the demand for pharmacists that may occur in the future? I have heard that in the past, the job market has been tight for pharmacists.

Companies everywhere are doing whatever they can to save money. Maybe a pharmacy can reduce its labor cost by reducing the number of pharmacists, and increasing the use of pharmacy techs? If that occurs, the pharmacy may need just 1 pharmacist and an army of pharmacy techs.

i think we've got some confusion here about the term "outsourcing". Outsourcing is generally a corportate business practice that subcontracts tasks to other companies. a rudimentary example is the hiring of temps for certain projects. Grander scale is using a private firm to function all the time for say accounting. Health Insurance Co's outsource their pharmacy bennies by using Pharmacy Benefits Managers. So, outsourcing can't be a threat to pharmcists, bc the subcontractor would still need to hire pharmacists to perform the work.

I think you're worry is about corporate cost-cutting. All I can say is right now retail is gonna perpetuate the demand for pharmacists more than attenuate it in anyway. Wags is trying to open 600 more stores in So Cal right now.

 

[GatorRX]

Let's revive this discussion. What about outsourcing to offshore nations, such as Canada? What effect do you all think this will have, if or when drugs from Canada are able to be imported to the U.S, for much cheaper prices to people, over the internet?

 

[spoons]

What is one thing that PharmD can do better than anyone else in this world? Also what is the most bullet proof profession the pharmD can have??

 

[GatorRX]

What is one thing that PharmD can do better than anyone else in this world? Also what is the most bullet proof profession the pharmD can have??

Good Question. Any comments anyone?

 

[jdpharmd?]

What is one thing that PharmD can do better than anyone else in this world? Also what is the most bullet proof profession the pharmD can have??

-Specialty compounding
-Nursing home drug review/consulting (per the law)
-Teaching at a pharmacy school

 

[ultracet]

Maybe I missed the post that addressed this issue. The law!
In Alabama a pharmacist can only be incharge of 2 techs, 3 if one is certified. They can add interns on top of that but only 2-3.

I did one of my rotations at good 'ole wally-world and dealt with their computer system....
Yes, it was not a bad system but no, it most certainly does not eliminate the need for Rphs.
The techs were allowed to wear armbands that the order appeared on and then they would scan the barcode on the bottle and not have to enter the NDC code.
We had some techs who would scan the bottle, THEN pick it up off the shelf. Alas they rarely picked up the correct bottle.
The Rph was redoing things fairly often. Also insurance companies, doctor's calls, and patient counseling demanded the Rph's attention.
There were many calls to the Dr that were made inorder to clarify the prescription.

It would be easy for there to be a "central" pharmacist but i don't believe state law would ever allow it.

 

[flighterdoc]

Can pharmacy ever be outsourced? Do you see of any possible threats to the demand for pharmacists that may occur in the future? I have heard that in the past, the job market has been tight for pharmacists.

Companies everywhere are doing whatever they can to save money. Maybe a pharmacy can reduce its labor cost by reducing the number of pharmacists, and increasing the use of pharmacy techs? If that occurs, the pharmacy may need just 1 pharmacist and an army of pharmacy techs.

Sure, for chronic (long term) meds. It's happened now. HMO's give pts a break on the copay if they get the meds mailed to them from the HMO's pharmacy, people buy stuff via the internet, etc.

For immediate needs stuff, I don't think so. When you need it right now, you can't wait for it in the mail.

 

[flighterdoc]

Pharmacists have an OK future for hte next 30 or 40 years.

In the long term future though, things get hazy. I could see a computerized system thats able to replace pharmacists.

Right now there are safety issues involved but eventually I think that kind of technology could develop.

Another option as you said is to use pharmacy techs and give them advanced practice rights. I'm betting that someday there will be extra training for pharm techs that allows them to take over some of hte role of pharmacist.

Not flaming here (I get to sleep next to a pharmacist and I like my sleep), but what do retail pharmacists do know that requires more training than the techs? Does anybody really compound any more? As far as I can tell, the pharmacist is there to take the blame.

 

[spacecowgirl]

Not flaming here (I get to sleep next to a pharmacist and I like my sleep), but what do retail pharmacists do know that requires more training than the techs? Does anybody really compound any more? As far as I can tell, the pharmacist is there to take the blame.

I couldn't disagree more and I have spent years in retail and currently work in a hospital pharmacy. Yes people still compound, in fact compounding plant-derived hormones for HRT is a growing field given the negative press that traditional HRT is getting. Compounding is needed for special conditions where people cannot take the commercially available dosage forms. Pharmacists (even retail ones) need to know about drug interactions, common dosages and regimens (sometimes even doctors mess up), how to maximize a person's therapy by counseling them (how exactly to use an inhaler, when the best time to take a med is, why they can't take it with XYZ)....I could go on and on. I don't believe that techs can do these things without several years of school, which really doesn't make them techs anymore. It's one thing to repeat something you've heard a pharmacist say but another to understand what it is you're saying and why.

 

[flighterdoc]

I couldn't disagree more and I have spent years in retail and currently work in a hospital pharmacy. Yes people still compound, in fact compounding plant-derived hormones for HRT is a growing field given the negative press that traditional HRT is getting. Compounding is needed for special conditions where people cannot take the commercially available dosage forms. Pharmacists (even retail ones) need to know about drug interactions, common dosages and regimens (sometimes even doctors mess up), how to maximize a person's therapy by counseling them (how exactly to use an inhaler, when the best time to take a med is, why they can't take it with XYZ)....I could go on and on. I don't believe that techs can do these things without several years of school, which really doesn't make them techs anymore. It's one thing to repeat something you've heard a pharmacist say but another to understand what it is you're saying and why.

True enough, thats why I asked. Glad to hear that there is still science involved.

 

[jdpharmd?]

Not flaming here (I get to sleep next to a pharmacist and I like my sleep), but what do retail pharmacists do know that requires more training than the techs?

I noticed that you're thinking about going to medical school. A pharmacist cannot be replaced by a technician for the same reasons that a radiologist cannot be replaced by a rad tech, a physical therapist cannot be repplaced by an aid, a dentist cannot be replaced by a hygenist, etc. Techs are great with regard to computer functions, patient relations, inventory, etc, but they are not responsible for having professional judgement.

I came home from my retail (intern) job yesterday and talked to my girlfriend about my patients for an hour or so. I wasn't complaining about insurance trouble. I was sharing all of the interesting cases that I had seen in one day. Check the "line between pharm and med" thread for a few good examples and some interesting statistics. I'm kind of surprised that you would ask this question if your significant other IS a pharmacist.

 

[spacecowgirl]

Techs a great with regard to computer functions, patient relations, inventory, etc, but they are not responsible for having professional judgement.

I came home from my retail (intern) job yesterday and talked to my girlfriend about my patients for an hour or so. I wasn't complaining about insurance trouble. I was sharing all of the interesting cases that I had seen in one day. Check the "line between pharm and med" thread for a few good examples and some interesting statistics. I'm kind of surprised that you would ask this question if your significant other IS a pharmacist.

👍 👍

 

[flighterdoc]

I noticed that you're thinking about going to medical school. A pharmacist cannot be replaced by a technician for the same reasons that a radiologist cannot be replaced by a rad tech, a physical therapist cannot be repplaced by an aid, a dentist cannot be replaced by a hygenist, etc. Techs are great with regard to computer functions, patient relations, inventory, etc, but they are not responsible for having professional judgement.

I came home from my retail (intern) job yesterday and talked to my girlfriend about my patients for an hour or so. I wasn't complaining about insurance trouble. I was sharing all of the interesting cases that I had seen in one day. Check the "line between pharm and med" thread for a few good examples and some interesting statistics. I'm kind of surprised that you would ask this question if your significant other IS a pharmacist.

Was, and hospital. She did retail for a couple of years and then went into hospital work. Got out of it after 20+ years.

 

[jdpharmd?]

Was, and hospital. She did retail for a couple of years and then went into hospital work. Got out of it after 20+ years.

She got out of pharmacy completely? Can I ask what she does now?