Changing role of Walgreens pharmacists

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2012PharmDgrad

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I'm a new grad (Class of 2012) and have been working for Walgreens for a month as a floater. So far, it's been an interesting and scary experience because I still don't know all the ins and outs of Intercom plus.

Anyway, I've spoken to two pharmacists who claim the role of the pharmacist is changing. Very soon, Walgreens pharmacists will no longer be working within the confines of the pharmacy. Pharmacists will be stationed just outside of the pharmacy and have their own desk, chair, and do consultations all day. They will be in direct contact with patients. From what I understood, the only people working in the pharmacy will be technicians. The pharmacist will no longer be responsible for dispensing, ringing customers out for their meds, milk, or whatever other products they purchase at the pharmacy. These two pharmacists explained these changes are already taking place at select pharmacies in my city.

What do you guys think about these changes? The pharmacists told me these upcoming changes appear to facilitate a pharmacist's job, but who knows? It seems to be pharmacists will be less burdened and stressed while technicians will have even more work without the pharmacist helping them out.

Does anyone have any insight or feedback about these changes? How do you think they will affect a pharmacist's salary and the overall stresses of retail pharmacy? Thanks.
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It does sound a good thing because pharmacists are more involve. However...

One problem I see in this scenario is:

Who's going to check drug interactions and proper dosing?
 
I remember reading about this but who's going to verify the RX and monitor the technicians?

I really think this is just a way to get rid of the pharmacist. If walgreens can show a pharmacy can function without a pharmacist, why even have a pharmacist at the store? You can certainly do tele consult or over the phone.
 
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BMBiology said:
I remember reading about this but who's going to verify the RX and monitor the technicians?

I really think this is just a way to get rid of the pharmacist. If walgreens can show a pharmacy can function without a pharmacist, why even have a pharmacist at the store? You can certainly do tele consult or over the phone.
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Where did you read about this? Do you have a source? I'd like to read about it if possible.
 
the store manager at my Walgreens told me the same thing...but I have the same question: who's gonna verify and review scripts??
 
I think it's great that a pharmacist have the time to consult but again, who's going to make sure the right medication goes to the right patient?
 
BMBiology said:
I think it's great that a pharmacist have the time to consult but again, who's going to make sure the right medication goes to the right patient?
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I can envision that technicians will get additional training and become "pharmacist's assistant."
 
JohnFe said:
I can envision that technicians will get additional training and become "pharmacist's assistant."
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I have not met many technicians who can replace a pharmacist. I know they also work hard but I don't think they are up to the task.
 
BMBiology said:
I have not met many technicians who can replace a pharmacist. I know they also work hard but I don't think they are up to the task.
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Just a hypothetical comment, like a derivative of a physician's assistant.

But I think, if they do this, pharmacists will alternate the role of supervising scripts and tech and counseling patients. This requires at least two pharmacists per pharmacy.
 
JohnFe said:
Just a hypothetical comment, like a derivative of a physician's assistant.

But I think, if they do this, pharmacists will alternate the role of supervising scripts and tech and counseling patients. This requires at least two pharmacists per pharmacy.
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There is no way that's going to happen unless Walgreens finds some way to make it profitable.
 
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2012PharmDgrad said:
I'm a new grad (Class of 2012) and have been working for Walgreens for a month as a floater. So far, it's been an interesting and scary experience because I still don't know all the ins and outs of Intercom plus.

Anyway, I've spoken to two pharmacists who claim the role of the pharmacist is changing. Very soon, Walgreens pharmacists will no longer be working within the confines of the pharmacy. Pharmacists will be stationed just outside of the pharmacy and have their own desk, chair, and do consultations all day. They will be in direct contact with patients. From what I understood, the only people working in the pharmacy will be technicians. The pharmacist will no longer be responsible for dispensing, ringing customers out for their meds, milk, or whatever other products they purchase at the pharmacy. These two pharmacists explained these changes are already taking place at select pharmacies in my city.

What do you guys think about these changes? The pharmacists told me these upcoming changes appear to facilitate a pharmacist's job, but who knows? It seems to be pharmacists will be less burdened and stressed while technicians will have even more work without the pharmacist helping them out.

Does anyone have any insight or feedback about these changes? How do you think they will affect a pharmacist's salary and the overall stresses of retail pharmacy? Thanks.
Click to expand...

This is why I withdrew from Wags. As the pharmacist on duty it is your initials ultimately that are logged as the pharmacist-of-record on the final microfiche. It is this microfiche that the plaintiff gets in a civil suit. I know. I was deposed as a witness to clarify these records. The data review and dur rphs that we can see in intercom plus in the detailed refill history are not there. Now just just let that stew for minute and realize that all the scripts we've been just doing product review can come back and bite you years afterwards. And now tech-check-tech!
 
gotgame740 said:
the store manager at my Walgreens told me the same thing...but I have the same question: who's gonna verify and review scripts??
Click to expand...

There will be cameras. After the prescription is filled, the tech holds a few pills under the camera, it takes a picture and gets sent to the pharmacist station where it will get reviewed by them. Once they confirm the correct drug, it can be dispensed. Or so I've been told.
 
From what I hear from the Wags stores around me that are already doing this, the techs also fill C2 meds on their own, having their own keys to the lock box, etc.

The pharmacist will verify correct drug via a camera that shows the contents through the top of the bottle.
 
gotgame740 said:
the store manager at my Walgreens told me the same thing...but I have the same question: who's gonna verify and review scripts??
Click to expand...

I have a friend who worked at one of these stores. According to her, the pharmacist sits outside the pharmacy, but has a computer to still do data review, and the filling tech holds the drug under a camera, so the contents can be verified that way. So, the pharmacist is still checking everything, just in a different way.

I really think this is just a way to get rid of the pharmacist. If walgreens can show a pharmacy can function without a pharmacist, why even have a pharmacist at the store? You can certainly do tele consult or over the phone.
Click to expand...

This really isn't anything new, remote hospitals already do this on the off shifts.
 
"I have a friend who worked at one of these stores. According to her, the pharmacist sits outside the pharmacy, but has a computer to still do data review, and the filling tech holds the drug under a camera, so the contents can be verified that way. So, the pharmacist is still checking everything, just in a different way."


Just beautiful. Now let's have the pharmacist do data review right out in the battlefield constantly pulled and tugged in eighteen different directions moment to moment. Don't they realize how much mental energy it takes to maintain a spell of concealment from the pressing masses? The effort it takes to maintain focus on a script while endless "Oh I have just a quick question", "Where's the metamucil", "Does EBA cover this" forces a rph to start over and over on a data review. To serve as a gatekeeper, a buffer, a secretary that used to be the role a tech served. It kept the rph free to concentrate on pharmacy. Now the roles have reversed, the rph is the gatekeeper now but is still saddled with most important duty of pharmacy.
 
Could this be the future of retail pharmacy or something that only Walgreens will adopt? I don't know if I see CVS and other competitors doing this.
 
BMBiology said:
I really think this is just a way to get rid of the pharmacist. If walgreens can show a pharmacy can function without a pharmacist, why even have a pharmacist at the store? You can certainly do tele consult or over the phone.
Click to expand...

I see this.
 
JohnFe said:
It does sound a good thing because pharmacists are more involve. However...

One problem I see in this scenario is:

Who's going to check drug interactions and proper dosing?
Click to expand...

Duh! The techs. Techs check techs. The computer does everything for you anyway. It's already being done in parts of the country like Arizona.
 
They always seemed more organized than some of the other chains with a centralized fill in some states, and a call center where the pharmacists would do transfers for the individual store. However, I heard that freed the pharmacist up to do 12 flu shots in one day during the mass hysteria of 2012. Still, it seems that Walgreens may be cutting back on the number of pharmacists they are hiring, and making you sit at a desk away from the pharmacy doesn't sound like a good situation. You can't oversee the technicians and other customers coming to the counter at the same time.
 
2012PharmDgrad said:
I'm a new grad (Class of 2012) and have been working for Walgreens for a month as a floater. So far, it's been an interesting and scary experience because I still don't know all the ins and outs of Intercom plus.

Anyway, I've spoken to two pharmacists who claim the role of the pharmacist is changing. Very soon, Walgreens pharmacists will no longer be working within the confines of the pharmacy. Pharmacists will be stationed just outside of the pharmacy and have their own desk, chair, and do consultations all day. They will be in direct contact with patients. From what I understood, the only people working in the pharmacy will be technicians. The pharmacist will no longer be responsible for dispensing, ringing customers out for their meds, milk, or whatever other products they purchase at the pharmacy. These two pharmacists explained these changes are already taking place at select pharmacies in my city.

What do you guys think about these changes? The pharmacists told me these upcoming changes appear to facilitate a pharmacist's job, but who knows? It seems to be pharmacists will be less burdened and stressed while technicians will have even more work without the pharmacist helping them out.

Does anyone have any insight or feedback about these changes? How do you think they will affect a pharmacist's salary and the overall stresses of retail pharmacy? Thanks.
Click to expand...

If you look at the stats there are currently ~170 "wellness experience" transformed pharmacies. Walgreens operates ~8000 pharmacies. I have not heard anything about aggressive expansion of the wellness concept. There are complete wellness RPh job tutorials posted on StoreNet if you are curious about how they operate.
 
BMBiology said:
I really think this is just a way to get rid of the pharmacist. If walgreens can show a pharmacy can function without a pharmacist, why even have a pharmacist at the store? You can certainly do tele consult or over the phone.
Click to expand...

State boards of pharmacy would need to be persuaded that a pharmacy without a pharmacist is safe and good for the public. I don't see that happening IMHO.
 
What happens when you have to provide counseling at drive thru? Walk from the floor, to drive thru, spend time with the patient, walk back, before you sit down, get called over again?
 
I would not feel comortable checking things on a computer to verify pills when the pharmacy technicians are just a few feet away. Half of the time the pharmacy technicians where I once was at put the wrong patient handouts with the medications. Also sometimes you need to be able to hear what some of the customers say at the counter because they are running a game and trying to lie or whatever about controlled substances.
 
Angela1234 said:
I would not feel comortable checking things on a computer to verify pills when the pharmacy technicians are just a few feet away. Half of the time the pharmacy technicians where I once was at put the wrong patient handouts with the medications. Also sometimes you need to be able to hear what some of the customers say at the counter because they are running a game and trying to lie or whatever about controlled substances.
Click to expand...

excellent point

Does the image allow the checking rph to see the physical label on the vial or just a translation of the data? You have to make sure the pt handouts/label/medicine match. Liquids? I hated when techs would use multiple bottles but only present one.

What happens when a device crashes such as the camera? workflow chaos?
 
One awesome pharmacy I worked at, the pharmacy technician poured liquids into random bottles without checking how many ounces they were. Is it really that hard to check the amount you poured in for one second? They don't care, it's your license on the line. Some of them weren't even checking to see when the person got their last contolled substance refilled or if there was DEA number written on it. Bottom line, it's our license on the line and they'll blame us, cameras or not.
 
Angela1234 said:
One awesome pharmacy I worked at, the pharmacy technician poured liquids into random bottles without checking how many ounces they were. Is it really that hard to check the amount you poured in for one second? They don't care, it's your license on the line. Some of them weren't even checking to see when the person got their last contolled substance refilled or if there was DEA number written on it. Bottom line, it's our license on the line and they'll blame us, cameras or not.
Click to expand...

I agree with this, my main problem with this kind of model is the decreased level of supervision. As much as I support increasing time and resources for patient counselling and health services I feel that there should still be a pharmacist in the pharmacy supervising dispensing directly. If a pharmacy was always staffed with 2+ pharmacists I could see one supervising and the other at the desk.
 
There is one in my home town and yes the pharmacist verifies the prescriptions by camera.
 
lactonerx said:
If you look at the stats there are currently ~170 "wellness experience" transformed pharmacies. Walgreens operates ~8000 pharmacies. I have not heard anything about aggressive expansion of the wellness concept. There are complete wellness RPh job tutorials posted on StoreNet if you are curious about how they operate.
Click to expand...

Exactly! All new stores being built will have the "bones" of a Well Experience store, but in order for the pharmacist to be out at the desk and do remote verification (data and product) the store has to do a certain number of scripts per day before that happens. The dollar amount to transform each store is tremendous so a company wide roll out of this model probably won't happen.
 
txpharmguy said:
Exactly! All new stores being built will have the "bones" of a Well Experience store, but in order for the pharmacist to be out at the desk and do remote verification (data and product) the store has to do a certain number of scripts per day before that happens. The dollar amount to transform each store is tremendous so a company wide roll out of this model probably won't happen.
Click to expand...

You mean they will only do this in the busiest stores? What a clusterf**k this is going to be. This is when the rph will be pulled in 18 different directions at once throughout the day. It's ok he's not doing anything important--only data reviewing.
 
lactonerx said:
State boards of pharmacy would need to be persuaded that a pharmacy without a pharmacist is safe and good for the public. I don't see that happening IMHO.
Click to expand...

Guess who's on the state board pharmacies.....

And money talks.
 
Hope1974 said:
Guess who's on the state board pharmacies.....

And money talks.
Click to expand...

One of the problems though is who will be liable if there is a miss fill/bad DUR? It's illegal for technicians to provide counselling services as well. What about in states with mandatory counselling laws? They would also have to give up providing vaccines since I highly doubt techs would be allowed to administer them.

If there is going to be pharmacies without pharmacists in most states then I think many laws and policies of state BOP's will have to change.
 
BMBiology said:
I remember reading about this but who's going to verify the RX and monitor the technicians?

I really think this is just a way to get rid of the pharmacist. If walgreens can show a pharmacy can function without a pharmacist, why even have a pharmacist at the store? You can certainly do tele consult or over the phone.
Click to expand...

I first heard about this kind of thing 15-plus years ago - that if a pharmacist-less pharmacy can be legally open, Wags will be the first to do it.
 
BidingMyTime said:
I have a friend who worked at one of these stores. According to her, the pharmacist sits outside the pharmacy, but has a computer to still do data review, and the filling tech holds the drug under a camera, so the contents can be verified that way. So, the pharmacist is still checking everything, just in a different way.



This really isn't anything new, remote hospitals already do this on the off shifts.
Click to expand...



This must be the biggest waste of time ever .. how inefficient and unsafe

So while you are outside sitting at a desk with consultations you are looking at a screen with techs holding stuff under a camera ..

stupid
 
lactonerx said:
State boards of pharmacy would need to be persuaded that a pharmacy without a pharmacist is safe and good for the public. I don't see that happening IMHO.
Click to expand...

State boards can only make decisions based on law at the state level. If chains lobbied the states directly to change state law, that would be an end-run around any authority the boards have.
 
farmadiazepine said:
This must be the biggest waste of time ever .. how inefficient and unsafe

So while you are outside sitting at a desk with consultations you are looking at a screen with techs holding stuff under a camera ..

stupid
Click to expand...

Sounds like the role of pharmacists are doing the opposite of advancing towards pharmaceutical care.
 
We have tech-check-tech in MN (at least in our hospital), I don't think that this has expanded to retail here yet. Honestly, for the hospital it makes sense. We check the meds that get put up into the Pyxis machines. These are then scanned by each nurse before giving them to their patient. There really isn't a need for a Pharmacist in this process. 1st doses are still checked by a Pharmacist of course.

Also in our hospital the changes you talk about with Pharmacist checks happening via camera already happen here. It's a system called "DoseEdge." It adds a TON of tech time to actually put into effect. It literally tripled the length of time it takes for our chemo techs to do their work. That is for the computer savvy techs. Those who don't know computers take even longer. What took 2-3 hours before DoseEdge now takes 8+ hours for those techs. Supposedly it ensures that the right drug is going into each bag.. but really all it does is stage check the tech and takes a few pictures of the products that go into each bag they make. This was really no different than the process we had before. You still don't see the correct medication being shot into the bag, so you can never be 100% sure that there wasn't some sort of mix-up along the way. I see absolutely no point other than to spend money on fancy gadgetry at the expenditure of time.

I heard about the changes to Walgreens from an interviewer of mine. He said that when the Pharmacist gets a customer they will push a button and the tech's work will be submitted to slower stores or to corporate for continuous checking. Also whenever someone walks into a pharmacy (or goes through the drive-thru) it will read their cell-phone signal and you will know who each person is before they get to the counter. You will never council a drive-thru patient face-to-face as counseling will be done via Skype. Sounds like some interesting changes.. and they must be committed to it at a cost of around 1-2 million per pharmacy (comes out to around 1 billion total).
 
Skrumpy said:
We have tech-check-tech in MN (at least in our hospital), I don't think that this has expanded to retail here yet. Honestly, for the hospital it makes sense. We check the meds that get put up into the Pyxis machines. These are then scanned by each nurse before giving them to their patient. There really isn't a need for a Pharmacist in this process. 1st doses are still checked by a Pharmacist of course.

Also in our hospital the changes you talk about with Pharmacist checks happening via camera already happen here. It's a system called "DoseEdge." It adds a TON of tech time to actually put into effect. It literally tripled the length of time it takes for our chemo techs to do their work. That is for the computer savvy techs. Those who don't know computers take even longer. What took 2-3 hours before DoseEdge now takes 8+ hours for those techs. Supposedly it ensures that the right drug is going into each bag.. but really all it does is stage check the tech and takes a few pictures of the products that go into each bag they make. This was really no different than the process we had before. You still don't see the correct medication being shot into the bag, so you can never be 100% sure that there wasn't some sort of mix-up along the way. I see absolutely no point other than to spend money on fancy gadgetry at the expenditure of time.

I heard about the changes to Walgreens from an interviewer of mine. He said that when the Pharmacist gets a customer they will push a button and the tech's work will be submitted to slower stores or to corporate for continuous checking. Also whenever someone walks into a pharmacy (or goes through the drive-thru) it will read their cell-phone signal and you will know who each person is before they get to the counter. You will never council a drive-thru patient face-to-face as counseling will be done via Skype. Sounds like some interesting changes.. and they must be committed to it at a cost of around 1-2 million per pharmacy (comes out to around 1 billion total).
Click to expand...

again, this is a complete waste of time and a very inefficient process

so while a pharmacist is counseling a patient, he or she is expected to do data review and check drugs from a tech on a camera? i will be pressing the button all day to do nothing and send it to other stores to check.

STUPID..

WAGs can spend 1-2 million per store. just like their power initiative, keep wasting money on dumb ideas.

how about this for an idea? give more tech hours so that service at the store level will be much better and customers helped more efficiently?

how about this for an idea? lobby to prevent mandatory mail order rx's for both 30 day and 90 day rx's and leave them at the same copay for the patient AND the same reimbursement to the pharmacy that dispenses the drug.

Why should a PBM force a customer to THEIR OWN mail order pharmacy..

I don't understand why the competition laws in America haven't yet been applied to whats going on in pharmacy.

Anyways.. back to the point, what WAGs is doing is just dumb.. what a waste.
 
You as the in-store pharmacist will still held liabile for a mistake. It is your initials that will be on the microfiche after the records are purged.

Also there is the litter box game when it comes to a difficult, illegible script. It may be to cumbersome and awkward to call the MD to get clarification while out in the lobby of the pharmacy so the button will be pushed. Then the rx will be ignored or just verified wrong by out-of-store staff. Farmadiazepine is absolutely correct. To still practice responsible pharmacy you need to be behind the counter away from the bustle.
 
Plus using skype just adds another layer of technology that wrecks workflow when it fails. Remember that James Burke guy from the 70's talking about technological traps. Wags is the epitome of that.
 
farmadiazepine said:
again, this is a complete waste of time and a very inefficient process

so while a pharmacist is counseling a patient, he or she is expected to do data review and check drugs from a tech on a camera? i will be pressing the button all day to do nothing and send it to other stores to check.

STUPID..

WAGs can spend 1-2 million per store. just like their power initiative, keep wasting money on dumb ideas.

how about this for an idea? give more tech hours so that service at the store level will be much better and customers helped more efficiently?

how about this for an idea? lobby to prevent mandatory mail order rx's for both 30 day and 90 day rx's and leave them at the same copay for the patient AND the same reimbursement to the pharmacy that dispenses the drug.

Why should a PBM force a customer to THEIR OWN mail order pharmacy..

I don't understand why the competition laws in America haven't yet been applied to whats going on in pharmacy.

Anyways.. back to the point, what WAGs is doing is just dumb.. what a waste.
Click to expand...

I'm not sure how it is in other states, but in MN technicians will soon be required to take a 18 month course on how to be a technician. Any tech grandfathered in under this program will have to start doing CE's every year. If they miss a single turn-in date they will be forced to do the 18 month program, no matter how long they've been a technician for. What this means is that soon the day of the $8/hr tech at retail pharmacies is going to soon come to an end (at least here). I don't know of anyone willing to spend 18 months going to school, pay $20k and then be happy to come out and make $8/hr. So at least here, adding more tech's isn't going to necessarily solve the problem (because I see a HUGE shortage in our market area developing very soon).
 
how about instead of the pharmacist in their own office space/room.....

they are at home in bed wearing their PJs and doing this thru skype and a laptop

:cool:
 
Skrumpy said:
What this means is that soon the day of the $8/hr tech at retail pharmacies is going to soon come to an end (at least here). I don't know of anyone willing to spend 18 months going to school, pay $20k and then be happy to come out and make $8/hr. So at least here, adding more tech's isn't going to necessarily solve the problem (because I see a HUGE shortage in our market area developing very soon).
Click to expand...

I don't know....I know plenty of technicans who paid $10,000-$15,000 to go through a optional 9-month technician training course for an $8/hr job.
 
BidingMyTime said:
I don't know....I know plenty of technicans who paid $10,000-$15,000 to go through a optional 9-month technician training course for an $8/hr job.
Click to expand...

How many is "plenty" and what proportion does this represent of the actual market of available techs out there? I question the mentality of anyone paying for an optional program to come out making that type of wage, especially since it does not translate to an increased pay differential. If it was required for everyone to do a 18 month program at $20k, that is quite a bit different than an exceedingly small portion of techs who for some reason undergo a program that does not give them any benefit whatsoever. I'm not question your perception, as I'm sure these people exist.. I just think you are missing the point as this will soon be required for every tech in our state. I'm not quite sure I'd want to work with someone who would be fine spending the resources (time/money) to come out and barely make above minimum wage (especially when McDonalds around here are are hiring for $10/hr). Anyways, not trying to derail the thread.. just stating that throwing more techs at the issue isn't likely to be a solution in our state in the near future given the current trend of requiring more advanced education.
 
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