col_10022 brought up some very good points, but I have one minor quibble:
quote: “spend a lot of time convincing doctors to use the “new drug”…” actually, I do just the opposite. The drug reps want the doctors to use the new drug. I spend time getting them to try the cheaper old drug first. Then, if and ONLY if the cheap old faithful drug doesn’t work, THEN you can try the expensive new drug.
Also, the machines don’t replace the techs…they just give the techs a new job: servicing and restocking the machines! The machines (we have Pyxis) are nice for the nurses, who have everything at their fingertips as soon as the order is entered on the Pharmacy computer, but those machines don’t hold much stock so they have to be refilled every couple of hours, 24/7. We have more techs than we ever had before to do this. It’s all in the interest of accuracy and reduced delivery time, not cost savings. (Believe me.)
By the way, I bet I know what the OP does for a living–robot repair!
“Robot” would be a compliment for the pharmacists at the Walgreens I go to. They can’t/don’t even count pills: they do it by weight. Consequently, they’re often off by one or two.
I can’t tell the difference between a pharmacist and a tech, except for different badges. I can only tell the difference between one who’s trying to help, and one who can’t be bothered. The reason I go to this particular store is that is generally has more of the former than the latter (although there is this one guy who’s there on the weekends who’s lucky he’s bigger than I).
I’ve never known a pharmacist to fight with the insurance company. If something goes against me, I or my doctor or his nurse have to do the fighting.
I’m not saying that, across the board, pharmacists are useless. I’m saying that, across the board, chain store pharmacists are useless.
Honestly, I’ve had some issues of my own (as a consumer) with drugstore pharmacists. Luckily, I live in a large city with approximately 50 gazillion pharmacies. When I was treated like crap at Fry’s, I went to Smith’s. When the pharmacist I liked had the nerve to up and leave, I went to Target. I do use mail-order for routine, continuing stuff–but for one-time fills (like antibiotics, or pain meds from the dentist) I hit the Target. Good service.
If their service goes downhill, off I will go to another pharmacy.
Walgreens around here is famous for being overwhelmed with work and giving lousy service. I wouldn’t go to a Walgreens unless the nearest competitor was 40 miles away. If somebody is clueless, or mean, or doesn’t give you enough time, or bugs you in any way whatsoever…off you go to another pharmacy. Prescriptions are transferable, you know.
Geez, I feel better about going in to work tonight. Maybe we’ll get that PharmacyInfoBot any time now, and I can retire early!
When prescribing, I take off my Dr. PP hat and put on my Pharmacist PP hat - the pharmaceutics/pharmacology education that I received in medical school was a joke compared to that which I received in Pharmacy school.
The general public may be blissfully unaware of the knowledge base and duties of a typical pharmacist, but enlightened physicians give them the respect they deserve, defer to their expertise and utilize them as valuable resources. Robo-Docs? Unlikely. Robo-Pharms? Never!
Well, you have convinced me hospital pharmacists earn their keep. I suspected that, and should have discussed that in my original post. (Ironically, one reason I suspected this is that they are paid LESS than retail pharmacists.)
But please convince me that retail pharmacists (i.e. Walgreens, CVS, etc.) are necessary.
Some posters mentioned security problems somehow increasing costs with robotic machines. But I would think that shipping the pharmaceuticals would pose very similar security problems, and I don’t think any shipping companies send a pharmacist along to supervise the truck driver.
In the usual guaranteed 15 minute filling time, I don’t see how any pharmacist can do any sophisticated calculations to see if there are possible medicine interactions, no matter how well trained. Anything that automatic is simple enough to be programmed. And most interactions would be difficult to establish theoretically. That is why we need experimental drug trials.
For the sake of argument, let’s assume that your automated pharmacy has an all-knowing program that checks for interactions and improper dosages. It receives a script and finds a problem with it. What then? A real pharmacist can talk to the prescribing physician and resolve the problem.
Not always. Drugs are, after all, chemicals and it’s known (to pharmacists, at least) that certain categories or families of drugs will not react well with other such groups.
I’d buy that - except very, very few ever compare one drug to another, or look for side effects. Almost all of them are comparing against placebo.
Most people here only have experience with retail pharmacies.
If it seems like they could be replaced by robots, it’s probably because they’ve been treated like that for a long time. But, a couple examples of people screwing up, or injecting their morals into it don’t make the case for it.
My Dad, two of my uncles, and my brother are pharmacists (it often is a family profession, I think). My Dad used to own one. When he sold, he became a hospital pharmacist, then a retail pharmacist at a chain, but a locally owned chain. He liked that until they were bought by a CVS or some other national chain. He was miserable for years. Bascially, they were an employer that treated their employees like shit. I won’t bore you with anecdotes – that’s a universal story.
He eventually hooked up with a guy who was starting a kind of specialty pharmacy and has been happily in that gig ever since. One thing this new place did was mix things for nuclear imaging (like when they inject tracers into you for PET scans). He didn’t do that though. That was a specialist.
My brother is the new generation. He has aa Pharm. D. and works in a clinic. He can teach someday if he wants (I think) and also do retail if he needs to.
It’s a funny profession. It’s somewhat technical, but distinct from something like engineering. I always thought of it sort of as a “blue collar job for smarter people.”
There is computer software that will flag potential drug interactions. However, there are always exceptions. Two drugs that will interact if taken together may be perfectly okay if taken separately. A drug that shouldn’t be used in a certain population, like my example above of fertile women, might be useful if the patient isn’t fertile. And so on.
In these cases, it’s up to the pharmacist to verify that there is a true interaction or a true reason not to dispense the drug. And in these cases, the pharmacist calls the patient’s doctor or nurse. They have a discussion, the pharmacist offers his input and suggestions, and the doctor (or nurse) makes a final decision and the pharmacist fills (or doesn’t fill) the prescription.
The reason drugstores can offer 15-minute guaranteed filling time is because most prescriptions don’t take that long. Most people aren’t on complicated drug regimens; they’re on one or a few meds that, by this point, are well-established; the tech dumps 30 pills into a bottle, the pharmacist verifies the contents, slaps a label on the bottle, and sends the patient on his way.
The fun stuff happens in patients like the ones my father’s pharmacy takes care of. Those people might take more than 10 prescriptions per day, or they may be on complex pain-management regimens.
I wager that humans would be far better at figuring out a doctor’s handwriting than a computer would. There are also issues of when a physician might fill out a script incorrectly, or misspell a drug name in a way that would probably alert a human but not necessarily a computer. Many drugs have similar names that if confused could be deadly. There are also issues with forged prescriptions that would be easier for a human to see, like erasure marks, photocopied prescription slips, etc.
Humans are also better at figuring out complex instructions, like when a doctor puts a woman on continuous oral contraception, so that a 28-pill pack (with 7 “sugar pills” in it) becomes only a 21-day dose.
