One more, again, APhA response...July 16th 2019

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.

farm4real

Full Member
5+ Year Member
Joined
Aug 8, 2017
Messages
153
Reaction score
163
July 16, 2019
Chapter Three: Behind the emotions

Note from Tom: The following is the third edition of APhA President Brad Tice's monthly guest blog.

June was a month filled with the first APhA Board meeting of my presidency year; opportunities to meet with pharmacists in Washington, Iowa, and Tennessee; and the release of new membership models by APhA designed to meet people where they are and make it easier to connect with pharmacists across the country. While I would love to go into more details on those experiences, other events that occurred recently necessitate going in a different direction.
Tough conversations
With the painful layoffs that occurred in community pharmacy at the end of June and following a fair amount of urging from some in the profession, I ventured out more into the social media space. My goal was to try to connect with those in the profession who are not engaged with APhA. I wanted to understand what is keeping people away as well as try to understand some of the negative comments I was seeing, especially as I was preparing for a consensus conference on workplace issues APhA is holding later this week.
What I experienced was honestly beyond my expectations. I’ll admit to stepping in a bit naively, and I learned a few hard lessons. As I said in my remarks at the Annual Meeting, we need to share our stories, stories filled with emotion, and make people see and feel APhA’s impact in their lives.
I was certainly on the receiving end of a good bit of emotion and fell into a bit of my own. I was also able to see how easily misinterpreted words on social media can be. For those who feel abandoned and that APhA has not been speaking loudly enough for them, words will not be given the benefit of the doubt.
For anyone who may feel my words were hurtful, they were certainly not intended that way, and I apologize if they came across that way.
I also thank you for your interaction. Negative or supportive, you provided a lot of insight that I hope will help in developing meaningful action. Emotions do belong in discussions like these. It’s heartbreaking to hear the ways people describe their work environments. In some cases, it’s described as “going into battle!”
We got into this profession to help people stay healthy and to have enjoyable careers, not to fight a bleary-eyed war to meet metrics where working conditions are sometimes more like working on an assembly line rather than engaging with people to improve their lives.
It is also frustrating to hear that as we have worked so hard to advance practice through new services like immunizations and MTM, many pharmacists’ work life has only become more difficult. Too many pharmacists are unfulfilled, stressed, and struggling to balance work and life.
Misunderstood
Another part of what I learned is how much is misunderstood about how APhA works and the actions it takes. Some of my favorite exchanges were simply to provide more insight and clarity so that hopefully people can understand how to engage in their profession and make their lives better. There is clearly a lot more work to do in this area.
I hope this can be just the beginning. While APhA tries mightily to support pharmacists, and there are many pharmacists working for and through APhA, it’s clear many don’t feel supported. Given the state of the profession, they (you) are entitled to feel that way.
I hope you will also see the opportunity. APhA is the pharmacist organization for the profession. It is driven by volunteer leadership of pharmacists putting their voices into the fray to guide and shape their profession. If you need help, want something said more loudly or want more action taken, get involved. So many pharmacists I know have said, “I get more from being involved than I will ever give.” A part of that is from being connected to other pharmacists, seeing the opportunities that are out there and being able to work through issues. And yes, sometimes it is frustrating and messy, change does not happen as fast as you would like, and the results are not always what you would want.
In one story I heard, a pharmacist got a call from a classmate from 20 years ago who was one of the pharmacists whose career was disrupted. She was looking for help in finding a new job and said she had no one else to reach out to. The pharmacist she called, who had been an involved and engaged member of APhA, had a long list of people her classmate could contact.
Once she explained this, the pharmacist looking for help was able to see a different angle on the value of membership. In addition to giving your profession a stronger voice, being involved with others in the profession will give you a stronger ability to bounce back and will help you see opportunities to create the place in the profession that works for you.
Pharmacists’ quality of life
We also know that we must address the issues of today. So, as we speak, we’re spooling up two big projects on pharmacist well-being that have been in the works and are underway now. Both were created to better meet the needs of the pharmacy professionals who do crucially important work under demanding circumstances.
This week APhA is launching the Well-Being Index for Pharmacists. This is a validated screening tool invented by the Mayo Clinic to evaluate fatigue, depression, burnout, anxiety, and both mental and physical quality of life. It has measured physician, nurse and other healthcare employee burnout, as many other health care providers are experiencing the same burnout issues pharmacists are. This survey, just for pharmacists, takes just a few moments to complete and is anonymous. You will receive immediate individualized feedback on how your well-being stacks up to that of your peers and whether you could be at risk for consequences at work or home. It is available to all pharmacists, regardless of whether they are members of APhA.
Through this survey, you’ll be connected to tools and resources that address individual well-being, and you can retake the survey to monitor your results over time. Participants’ results will be aggregated, analyzed, and released later this year. Follow APhA on Facebook and Twitter to learn more about the Well-Being Index and take the survey as soon as it goes live. We will also “come to you” and post updates where we can hopefully reach you and make them more visible.
You might say, “A survey, so what?” But we believe gathering this baseline info and giving you a tool for your own analysis will be valuable for you individually and will add to the well-being initiative, as it will provide an ability to objectively communicate pharmacists’ mental and physical state.
Resources are also available to help people work through burnout. The results will be compared across health professions and be used to establish an objective measure of pharmacist well-being that can be leveraged as a voice for change.
Conversations with industry stakeholders
APhA is also convening a consensus conference July 17–19 where pharmacists, employers—including representatives from chains, independents, pharmacy organizations, regulators, and pharmacy schools—will work together to identify opportunities to enhance the well-being and resilience of the pharmacy workforce. The conference is aimed at coming to grips with the realities facing today’s pharmacy professionals and pushing forward to foster well-being and resilience while accounting for the needs of all stakeholders.
Together, attendees will develop specific, solution-based recommendations that will be used as a guidepost going forward. We expect the consensus report to be available a few weeks after the conference ends.
This conference has been in the works for the better part of a year and was announced at the APhA Annual Meeting in Seattle in March. We cannot solve all the problems in one conference, but it is a starting point. It has been developed by a steering committee of practicing pharmacists with no predetermined outcome, where only those involved in the real-life day-to-day system are invited to participate.
Disconnected, disgruntled, ignored
While thousands of pharmacists use APhA’s Engage platform and Special Interest Groups to stay connected, we know that thousands more feel disconnected, disgruntled, or ignored. To meet those concerns, we are redoubling our efforts to let you know what’s happening on the issue—the good, the bad, and the ugly.
Watch this space for my next guest blog in a few weeks, and feel free to reach out to me personally any time. I posted my personal e-mail and phone number on social media knowing the risk I was taking and sincerely wanting to hear from pharmacists and be a resource to help. Here they are again: [email protected] or (615) 574-9638. Text first so that I know it is not a robocall!
I commit to you that this is only the beginning.

Brad Tice, PharmD, MBA, FAPhA, APhA President; and senior vice president, Aspen RxHealth




Note: they claim to protect pharmacist, but they are "accounting for the needs of all stakeholders", who are NOT interested in protecting pharmacists!!

Members don't see this ad.
 
  • Like
Reactions: 2 users
In theory, yes..... but if you were to hire a lawyer, do you want him/her to account for the needs of other stakeholders? Or a doctor (patient needs X, but insurance companies are a stakeholder that need to make a profit...)?

Understand these needs yes, but do not take them at face value ('we need 1000 scripts a day to make a profit' is one pseudo-need that should be ignored for the greater good of public health and safety).

Do our leaders understand the difference between stakeholder "needs" and stakeholder "wants"? Given our situation, it appears to be a hard NO.

It is the wrong mindset....it is, to use a phrase I have seen on SDN, a "beta" mindset, one where our leaders wish to be liked and appear reasonable more than they wish to protect the profession...after all, when they leave APhA they will be hired by some "stakeholder" at this meeting.
 
  • Like
Reactions: 1 user
Colleague sent me a link to some comments he made on reddit, even tried to invoke the name of Ralph Saroyan. APhA is like the date you left at the dinner table because she couldn't stop talking about her ex. Still thinks you're coming back to pay the check even though the clean up staff are telling you to leave.
 
  • Like
Reactions: 1 users
Members don't see this ad :)
The reason that politicians exist isnt to represent the people. It is for people to be engaged in endless debates and arguments while those in power govern the minds of a nation, hence govern-ment.

The point of APhA or any other organization that big corporations have huge influence on, isnt to abide or comply to the needs and the wants of the pharmacists. They exist to pep talk and throw bones at a problem that does not have a real solution to except for the benefit of those who hold power. Just like space programs. We dont actually have to go to space, the moon or the mars, we just gott keep on entertaining the idea. (Yes, i do believe space, moon landing and a bunch of other things are fake but thats for another time).

These blogs, journals or what ever the hell you wanna call them by so called leaders of our profession does not mean anything fully knowing the fact that they work for those in power.

Just this week, two of my friends who have been looking for a job for at least 6 months decided that they need to seek another career. One is looking for just any decent job that pays. Other is looking to go to nursing school since she doesnt have any loan. Our profession is dead. How can this actually turn around?
 
  • Like
Reactions: 1 user
I would want my doctor to account for my insurance company, particularly the coverage my insurance company offers, so that my doctor will be able to consider which treatments are actually accessible to me. I do not read the phrase "account for" the same way you do. You are making a lot of assumptions that I don't necessarily agree with or think there is evidence to back up.

Maybe being liked and appearing reasonable is necessary for protecting the profession? I don't know. What I do know is that if you want to be effective in making changes, you need to consider the needs of other people/stakeholders, or you won't get very far.
What do you mean "account for my insurance company"? I make recommendations that I think are best for my patient. I cant keep track of every insurance and what they cover! That is impossible!
 
What? The patients insurance is their responsibility, not mine. I recommend what I think is best.

You sound like one of the local prescribers here where I work that loves to write for pointless prescriptions like Duexis, then is dumbfounded when we call and explain the patient isn't going to get it.
 
What? The patients insurance is their responsibility, not mine. I recommend what I think is best.

And if the patient doesn't get any treatment because they can't afford it, then that is definitely not best for the patient. Several years ago a patient brought in a DAW RX for Coumadin, the pt could not afford it (the generic was something like only $5.00 with their ins) I called the dr and explained the situation and he absolutely refused to change it, went on blah blah blah about labs varying from the generic....which I get, of course, Coumadin is NTI, however what the doctor didn't get was that the pt could not and would not afford the brand Coumadin. So the pt received no Coumadin treatment, instead of the generic warfarin, which undoubtedly would have been far better for the pt to get, than to receive no treatment whatsoever.

It's great to recommend what you think is best, but you need to be willing to go with your 2nd best, 3rd best, whatever, in order to meet the needs of the patient. The best does the patient no good, if they can't afford it and go without any treatment.
 
  • Like
Reactions: 2 users
And if the patient doesn't get any treatment because they can't afford it, then that is definitely not best for the patient. Several years ago a patient brought in a DAW RX for Coumadin, the pt could not afford it (the generic was something like only $5.00 with their ins) I called the dr and explained the situation and he absolutely refused to change it, went on blah blah blah about labs varying from the generic....which I get, of course, Coumadin is NTI, however what the doctor didn't get was that the pt could not and would not afford the brand Coumadin. So the pt received no Coumadin treatment, instead of the generic warfarin, which undoubtedly would have been far better for the pt to get, than to receive no treatment whatsoever.

It's great to recommend what you think is best, but you need to be willing to go with your 2nd best, 3rd best, whatever, in order to meet the needs of the patient. The best does the patient no good, if they can't afford it and go without any treatment.

If this story is true, this is one incompetent doctor. Especially prescribing a blood thinner. I would understand if the doc didnt want to switch from plavix to warfarin but wtf?

I had a doctor who had no problem switching from clopidogrel to warfarin considering the patients insurance wasnt paying for it. We talked about how patient would have to come in more often for labs and what not but as long as the patient was okay, the doc was fine about it too.

So the doctor was okay with patient not taking an anticoagulant?!
 
If this story is true, this is one incompetent doctor. Especially prescribing a blood thinner. I would understand if the doc didnt want to switch from plavix to warfarin but wtf?
I had a doctor who had no problem switching from clopidogrel to warfarin considering the patients insurance wasnt paying for it. We talked about how patient would have to come in more often for labs and what not but as long as the patient was okay, the doc was fine about it too.
So the doctor was okay with patient not taking an anticoagulant?!

First hand story, I verify that it is true. I agree, the doctor was an idiot. The doctor seemed convinced that somehow the patient would pay for the medicine, even though I told the doctor that wasn't going to happen. The patient really didn't comprehend the importance of it, they were pissed at the doctor and didn't think they needed a blood thinner anyway. It was an older doctor, no longer in practice as far as I'm aware. Then again, maybe the doctor is staffing a UC down in Florida or Arizona.
 
Why are we switching from an antiplatelet agent to an anticoagulant?

Also clopidogrel is cheap now as opposed to 10 years ago

Also it's hilarious but not unexpected to have prescribers in this thread feel no sense of embarrassment or shame when stating "What? The patients insurance is their responsibility, not mine "
 
Top