The end of pharmacy?

Started by TheAverageGuy
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TheAverageGuy said:
A robot that is more efficient and more precise with orders. Although, if you eliminate the pharmacist's role you will eliminate the relationship aspect of the patient and pharmacist.

http://www.azcentral.com/specials/special40/articles/0312lprobotarm12Z1.html
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The end of pharmacy? don't think so. First of all, these robots were introduced like 10-12 years ago and nothing has changed pretty much, so this 1.5 years old article is nothing new. Secondly, pharmacists verify scripts they don't count or anything (at least in my pharmacy), so it is no threat to pharmacists.
The end of pharmacy techs? Maybe:meanie:
 
There's a thread like this all the time. Pharmacists are not going to go away. The role will modify and change. Most of the new technology is more of a threat to pharmacy techs than pharmacist.
 
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genesis09 said:
There's a thread like this all the time. Pharmacists are not going to go away. The role will modify and change. Most of the new technology is more of a threat to pharmacy techs than pharmacist.
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Its the end of pharmacy and we all know it. Those who think other wise are in complete denial! What are we ever going to do!!??!?
 
:laugh: Where do these crazy ideas come from?????

I'm in more demand than I've ever been.....altho...some days - yeah - I'd love a robot to take over if it ever could! I love technology & don't feel any threat at all.
 
I'm not talking about this particular computer replacing pharmacists, but this is just a counter stone for what might possiblly happen in the future. Why can't you believe that, possibly, in the next 10-20 years, there will be no need for pharmacists anymore. If this computer is able to file 600-800 prescriptions a day then what good will the pharmacist be? This may not be the end of the pharmacist role, but certainly the end of the six figure paycheck.
 
TheAverageGuy said:
I'm not talking about this particular computer replacing pharmacists, but this is just a counter stone for what might possiblly happen in the future. Why can't you believe that, possibly, in the next 10-20 years, there will be no need for pharmacists anymore. If this computer is able to file 600-800 prescriptions a day then what good will the pharmacist be? This may not be the end of the pharmacist role, but certainly the end of the six figure paycheck.
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I think that you're forgetting the primary role of the pharmacist in the filling process - it isn't to put pills into a bottle. The reason that pharmacists are on hand is for quality assurance - to make sure that what is going into the bottle is the correct thing for the patient. Pharmacists do everything from making sure that the doctor's instructions are interpreted correctly (i.e. making sure that your machine puts the right pill at the right dose, at the right quantity) to making sure that the doctor is actually prescribing the best drug for the patient (the doctor isn't always right, by the way). This isn't something that a computer is going to be able to 100% replace - sometimes drug therapy can be subjective, plus it's always good to have multiple checks in the process.

Certainly machines and new technologies like electronic transmission of prescriptions have changed the traditional functions of the pharmacist, but I only think that these changes will help us overall - we will actually have time to be able to apply our knowledge and not just be a "count, pour, lick and stick" drone.
 
TheAverageGuy said:
I'm not talking about this particular computer replacing pharmacists, but this is just a counter stone for what might possiblly happen in the future. Why can't you believe that, possibly, in the next 10-20 years, there will be no need for pharmacists anymore. If this computer is able to file 600-800 prescriptions a day then what good will the pharmacist be? This may not be the end of the pharmacist role, but certainly the end of the six figure paycheck.
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Are you referring to a "cornerstone"...not sure what a counter stone is...

But, anyway....first - there is a major concept within the field of medicine, of which we occupy one part, that there is a benefit to having a separation of prescribiing & dispensing of medications. A century or two ago...there was not & it led to poor decisions, which is another thread entirely. But....we can leave it that there are clear laws which REQUIRE pharmacists to dispense medications.

Then..I'm not sure what exactly you mean by "the computer is able to FILE 600-800 medications".....do you mean fill???? (I don't file the rxs - my tech files them) Well..someone had to input those orders into the computer. That is done daily by nurses and physicians in hospitals & offices, but each order is reviewed by pharmacists - why??? because they make mistakes. Their orientation is not ours....we look for the detail they do not.

You are perceiving that each order a prescriber writes is a correct one. That is not the case. I only filled 127 prescriptions today & had to call on 3 which were incorrect & had them changed. I also refused to give an influenza injection to a pregnant pt because I only had a mdv vial & CA law does not allow thiomerosal to be given to pregnant pts. So..I had to educate her to wait until I could order a single dose syringe without that preservative. So...in my little day....that is only about 3% potential errors I caught....but multiply that by the number of pharmacists working today & you get a big #.

What I do is not robotic....machines can & do take over that. What I do is what my mind is worth to my emloyer & right now its worth 6 figures. My salary is determined by the economy...not what I do. (That is yet another thread which we discussed awhile ago).

Why worry about it? There is no indication in reality there is less need - in fact...there is only more need for us than ever.
 
I enjoy your responses.

I agree with you that pharmacist do more than fill presciptions - in fact, this is what the tech is for. However, what if the doctors had to file prescriptions via computer so a mistake couldn't be made. What if the patients had a hotline to call if they needed help? I personally am afraid of entering pharmacy now because I'm scared that computers will be the "wave of the future" in pharmacies. I enjoy the contact with the patients.
 
Excuse me for my sloppiness. It is very late and English is my second language. Thanks again guys for opining.
 
TheAverageGuy said:
I enjoy your responses.

I agree with you that pharmacist do more than fill presciptions - in fact, this is what the tech is for. However, what if the doctors had to file prescriptions via computer so a mistake couldn't be made. What if the patients had a hotline to call if they needed help? I personally am afraid of entering pharmacy now because I'm scared that computers will be the "wave of the future" in pharmacies. I enjoy the contact with the patients.
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Again, I think that you're confusing the types of mistakes that can be made - we aren't talking about the doctor just typing in the script wrong. Doctors can make dosing mistakes, overlook allergies, or not know about sensitivities to drugs. Many patients go to multiple doctors but only one pharmacy - so the ER doctor might not know about all the meds that a pt is taking and could prescribe something that has an interaction with an existing medication. A pharmacist can help catch this. I know that many computers have built in mechanisms to catch these mistakes, but there is so much to medicine that is subjective and requires interpretation based on individual patients.

Don't worry - if you do go into pharmacy, you won't be out of a job in a few years. But please look a little more into what pharmacists do - I'm not sure you understand our full role.
 
I think Im going to suggest that our school party this year be themed "Replaced by Robots" we can all dress in tin-foil.
 
sdn1977 said:
But, anyway....first - there is a major concept within the field of medicine, of which we occupy one part, that there is a benefit to having a separation of prescribiing & dispensing of medications. A century or two ago...there was not & it led to poor decisions, which is another thread entirely. But....we can leave it that there are clear laws which REQUIRE pharmacists to dispense medications.
.
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This just isn't true. I, and most family docs around here, dispense about 40% of pt's Rx's. In fact, there is a push to have generics dispensed via a vending machine like contraption right at the point of care, FREE OF CHARGE to the Dr. This is being rolled out by insurance companies to control Rx prices. Lastly, Allscripts.com is working to allow me to bill insurance companies directly for scripts allowing pt to only pay copay. Right now, pts who buy my Rx's are mainly cash pts.
 
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ApothRM said:
This is guy gonna take our jobs....?
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I would hardly think so, just correcting the poster's insinuation that only pharms can dispense. Don't believe me, check out allscripts.com where a lot of MD's buy the meds they sell in office. There are many other sites that I order Rxs from also..medline.com is also good.
 
FamilyMD said:
This just isn't true. I, and most family docs around here, dispense about 40% of pt's Rx's. In fact, there is a push to have generics dispensed via a vending machine like contraption right at the point of care, FREE OF CHARGE to the Dr. This is being rolled out by insurance companies to control Rx prices. Lastly, Allscripts.com is working to allow me to bill insurance companies directly for scripts allowing pt to only pay copay. Right now, pts who buy my Rx's are mainly cash pts.
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Yep - I know all about Allscripts.com & their vending machines. I have really mixed feelings on this. You seem to think its a good thing. I don't necessarily feel its bad - it just can influence prescribing patterns in a way which doesn't necessarily be beneficial for your patient or necessarily the way you'd want. Don't get me wrong - this is not always the case.

Here in CA....neither the concept nor the use of it is legal. There must be a separation between the prescriber & dispenser. I recognize that is not the case in all the states. In addition, prescribers in my state cannot provide medication to their patients for profit. They can & do provide samples, which some folks don't agree with. That is a whole different thread. Personally, I encourage the use of samples, but that is not shared by prescribers & pharmacists.

However....don't misunderstand - the insurance companies absolutely do not do this to control rx prices - they do this to control marketshare. I would have to do some checking to see what umbrella company actually owns Allscripts.com. But a good example is Medco & Paid Rx - both insurance companies which are owned by Merck Pharmaceuticals. Both those insurance companies have hundreds of insurance plans across the country...but, for the most part....Merck products are on the first tier of their plans. The current Zocor/simvastatin situation is an interesting economic lesson in the pharmaceutical company controlling marketshare by using its extensor insurance arm.

I'd like to hear from pharmacists in the states which allow Allscripts - I think PA is one of them, but I'm not sure. However...I still stand behind my assertion that this is not the most beneficial situation for the patient for many reasons. But...I cannot convince someone of my clinical usefulness if they choose not to believe I have any. However...if this works for you, I can't fault you for using it. I would have hoped you could have developed a relationship with a pharmacist who you felt provided something for your patients beyond "pills in a bottle".

Thanks for sharing - I'm glad to hear from someone who actually uses this. Keep us posted on how it goes - I'm truly interested!
 
FamilyMD said:
I would hardly think so, just correcting the poster's insinuation that only pharms can dispense. Don't believe me, check out allscripts.com where a lot of MD's buy the meds they sell in office. There are many other sites that I order Rxs from also..medline.com is also good.
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I believe you..Just trying to keep the humor going..Goodluck with the dispensing though..
 
This is the cross roads pharmacy is at today. For hundreds of years pharmacy has been about dispensing medication. There are many Pharmacists practicing today that can remember a time when a Pharmacist was prohibited by law from discussing a medication with a patient. Times have changed and Pharmacy has and will need to continue to change. I am not at all worried about machines and ATM's taking my job. Why? Because the day of the Pharmacist standing behind a counter counting pills and not interacting with the customers is nearly gone.

To the Doctor posting above, I would be cautious if I were you. Most Doctors today do not have enough time to practice medicine let alone practice Pharmacy along with it. If you want to do my job along with yours go for it. Get ready for your phone to never stop ringing because your patients keep calling asking 20 questions about every drug advertisement they see on TV. Or how about everytime they want to buy an OTC product they call you to get your advice. Better yet you do all this for them to find out the patient isn't even yours but sees a Doctor down the street. He just stopped in to interupt you because he had a question and you were close.

When people ask me what I do I tell them basically I answer questions. I fill in the gaps the Doctor left at their 15 minute once a year appointment. I help them pick OTC products and answer all their odd ball questions. Of course while I do this I put there pills in a bottle but this does not define or limit what I really do.
 
TheAverageGuy said:
I enjoy your responses.

I agree with you that pharmacist do more than fill presciptions - in fact, this is what the tech is for. However, what if the doctors had to file prescriptions via computer so a mistake couldn't be made. What if the patients had a hotline to call if they needed help? I personally am afraid of entering pharmacy now because I'm scared that computers will be the "wave of the future" in pharmacies. I enjoy the contact with the patients.
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Physician order entry systems are error prone also. They can't eliminate the human element entirely. Physicians make mistakes too. I wouldn't recommend letting the computer/robot threat keep you from pursuing pharmacy as a career. Drug experts are still vital to safe health care delivery, regardless if a tech packages the drugs or a robot. However, if you like patient contact, think twice about pharmacy. I left pharmacy this year after 4 years of practicing and started med school, because I was sort of disillusioned with my experiences. There are some great clinical pharmacy jobs out there, but the patient interaction is much different because pharmacists don't really have a lot of autonomy when it comes to making therapeutic decisions. Until we actually get paid for our cognitive services by insurance companies there probably won't be a significant expansion in clinical jobs.

Try to shadow some pharmacists in a variety of settings before you make a decision.
 
DownonthePharm said:
I think Im going to suggest that our school party this year be themed "Replaced by Robots" we can all dress in tin-foil.
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Perhaps we should all get this insurance once we graduate...

Oh, and to MountainPharmD - I coudn't have said it better. While physician dispensing isn't new (per ZpackSux), maybe it isn't the best direction that they should be taking.
 
About one hundred years ago, an agreement between the AMA and APhA was reached. Before said agreement both MD and Pharm were prescribing and dispensing. The agreement said the preferred method of prescription medicine dispensing will be MD prescribing and Pharm dispensing: a check and balance approach. MD can dispense in a case of emergency, but it should be avoided. That agreement still impacts us to this day.
In Illinois, they are rewriting the pharmacy practice act because it is about to expire in Dec 2007. I just wonder how all these new technologies are going to be handled.
 
I've been out of town & wondered where FamilyMD went. Perhaps he's refilling his vending machine (writing down lot #'s, tracking invoices, noting in pts charts, etc...) or perhaps he's checking if his malpractice insurance covers drug dispensing as well as his job of practicing medicine (another hurdle I read about.....)

Thanks for bringing the thread back up🙁 .
 
I hear people saying one of the major reasons why pharmacists are indispensable is because they act as the gatekeepers. They alert the patient and physician to adverse drug interactions, correct dosing, educate patients, etc. That is an important role. Let me play devil's advocate though. Why can't this knowledge and ability be captured in a computer program? Once electronic medical records become commonplace, that information can be used by a program to cross-check a patient's background for allergies and potential drug reactions. It can also verify that the dosing is within guidelines. It would have the most current and complete information of all drugs. It would even print out information about the drugs for the patients to take with them. If it has a question, it would message the physician for a response. Who knows if this will ever come true, but I don't see why it's not possible. What would drive the adoption of such a system? Money, of course. More efficiency at a reduced cost. You still need people around, but just not as many. Look at today's modern assembly line with all the robots and few humans around.

Having worked in the computer industry during the dot com days, I can tell you from experience that businesses love you when the times are good. But they will just as quickly drop you if they think the good times are over. Most businesses are profit-driven and if they think that a new way of doing business will lower their cost and increase their efficiency without increasing their liability then they eventually adopt it.
 
I work at a veterans affairs hospital...we have the electronic record (and have had for many years) that is being discussed. The physician (or PA or NP) can see all the patient's information - and we still have many errors. The problem boils down to human nature...as we become comfortable with the system we begin to fly through the order-entry process (and therefore ignore all warnings). For example, on a DAILY basis we get orders that are med duplications, meds ordered that the patient is allergic to, major drug interactions and just incorrect dosing (i.e. kinetics issues). The fact is...I don't like the automed-type units and I feel those things are a VERY BAD idea. We obsess about a patient's drug history, allergies, etc. and still mistakes are made...what happens when dispensing meds has the same forethought and care of a soda machine?
 
KCBRPH said:
I work at a veterans affairs hospital...we have the electronic record (and have had for many years) that is being discussed. The physician (or PA or NP) can see all the patient's information - and we still have many errors. The problem boils down to human nature...as we become comfortable with the system we begin to fly through the order-entry process (and therefore ignore all warnings). For example, on a DAILY basis we get orders that are med duplications, meds ordered that the patient is allergic to, major drug interactions and just incorrect dosing (i.e. kinetics issues). The fact is...I don't like the automed-type units and I feel those things are a VERY BAD idea. We obsess about a patient's drug history, allergies, etc. and still mistakes are made...what happens when dispensing meds has the same forethought and care of a soda machine?
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We're in the infancy of electronic records. Compare the web when it first came out to today's version. Did you ever imagine the web like it is today 10 or even 5 years ago? Can you just imagine what the web will look like 10 years from now? The web is evolving fast because there is a huge financial incentive. I would argue that there is similarly a huge financial incentive to streamline the process of prescribing meds. A Microsoft, IBM, or a Google could decide to get into the game and develop really reliable and powerful system. I could see a CVS, Wal-Mart, or Walgreen's installing automated systems that would automate many of the tasks that pharmacists perform. Again, you can't completely get rid of people because you need them when the system needs human intervention. Just like the modern assembly line with robots, you need the humans to fix the machines when they break down. What is the incentive for a drug stores to install these systems? Save money. What is the incentive for a Microsoft, IBM, or a Google? Some of the money that would have been spent on pharmacy staff goes to them. Again, I'm just playing devil's advocate. Who knows what will unfold.
 
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Taurus said:
We're in the infancy of electronic records. I could see a CVS, Wal-Mart, or Walgreen's installing automated systems that would automate many of the tasks that pharmacists perform. Again, you can't completely get rid of people because you need them when the system needs human intervention. Just like the modern assembly line with robots, you need the humans to fix the machines when they break down. Again, I'm just playing devil's advocate. Who knows what will unfold.
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I don't think pharmacists have anything to fear. The bulk of their jobs comprise a service to people. Compounding is already a lot less of their jobs than it used to be but patient counseling, advising other health care professionals, pharmacy management, all are jobs computers will never take away.
 
SobeGekko said:
I don't think pharmacists have anything to fear. The bulk of their jobs comprise a service to people. Compounding is already a lot less of their jobs than it used to be but patient counseling, advising other health care professionals, pharmacy management, all are jobs computers will never take away.
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I agree that pharmacists play an important role even with automated systems. But I don't know if the Wal-Mart's, CVS's, and Walgreen's of the world would agree with me. They will constantly look at the bottom line and ask themselves if your role is really that critical. They will ask themselves, "does this system reduce costs?", "does it reduce errors?", "does it follow federal and state laws?", "is liability exposure the same?". After some due diligence, if they come back with the answer of yes to all of the questions, then I would worry. Wal-Mart will pull out its infamous cost-cutting ax and others will follow. Even if you don't work for these large chains, you will feel the impact because the trend would be decreasing compensation and security industry-wide because they employ so many pharmacist staff.
 
Too bad the corporates dont have a choice because legislation says otherwise. The only way that robots can lead to a decrease in demand for pharmacists is by fulfilling more tech jobs making us less needed to do those jobs and us doing more checking. However, hiring more ancillary personals has the same effect.
 
Aznfarmerboi said:
Too bad the corporates dont have a choice because legislation says otherwise. The only way that robots can lead to a decrease in demand for pharmacists is by fulfilling more tech jobs making us less needed to do those jobs and us doing more checking. However, hiring more ancillary personals has the same effect.
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I would feel nervous if my career was dependent on the stroke of a pen. Remember, these big companies can lobby state legislatures to change laws. It won't be an easy fight for them, but once one state changes and nothing bad happens, then other states follow. This is especially true if companies argue that they can't find people to work in tiny, rural communities and therefore need to be given more options to fulfill the work. Having a large gap in supply and demand is not always a good thing. I see this pattern all the time in healthcare. Physicians vs. midlevels. Physicians vs. nurses.
 
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