In the past 20 years the pharmacist’s new role as therapeutic advisor is most noticeable in the hospital setting. But the duty to oversee drug therapy in the community through the use of patient profiles is another vital aspect of pharmacy practice. Social and market forces have combined to influence the environments in which pharmacists fulfill their roles. These forces include longer life expectancy, a growing elderly population, third-party insurance coverage for prescription drugs, and a strong public desire for convenience in an increasingly busy, complex world. There are approximately 70,000 licensed pharmacies in the U.S., filling an estimated 4 billion prescriptions per year. To adapt to the demands of a changing society, pharmacy practice has become more varied and its settings more specialized.
Mail Order Pharmacies
Mail service pharmacies typically contract with health insurers, national associations or third-party payers to fill and/or formulate prescriptions. These pharmacies offer potentially lower out-of-pocket consumer costs as well as the convenience of prescription drugs delivered by mail. These entities are high volume operations, filling more than 3,000 prescriptions per day. In mail service companies, pharmacists are more likely to be found supervising the work of technicians than in filling the prescriptions themselves. They also make calls to physicians and respond to patient inquiries by telephone.
Clinical and Institutional Pharmacists
Traditionally, clinical pharmacists are found in large teaching hospitals connected with medical schools. They often specialize in specific areas like cardiology or infectious disease. In the past, institutional pharmacists were generally confined to a centralized hospital pharmacy where they filled prescriptions sent down by the medical floors. Today, institutional and staff pharmacists interact more directly with physicians and clinical pharmacists, becoming valuable information resources rather than simply the dispensers of medication. This pharmacy practice model is being adopted by smaller community hospitals as well.
Independent pharmacies were long considered to be pillars of the community, open long hours and readily accessible for help and advice. Today’s independent pharmacies now often specialize in home health care services, durable medical equipment, long-term care services and the compounding of specialty medications. In addition to regular dispensing services, independent pharmacies might offer services to a nursing home in the form of medical equipment, general stock items and devices like feeding tubes. Independent retail pharmacies can be very busy places, each filling 300 prescriptions a day. Because managed care companies provide lower reimbursement, retail pharmacies have had to make up the difference in income by increasing volume. As a result, they fill at least 50% more prescriptions than they did several years ago.
Chain Store Pharmacies
Chain store pharmacies generally outnumber independent retail pharmacies by 3 to 1. They are larger than most independent pharmacies and offer a greater variety of product selection. Some supermarkets also contain pharmacies in order to offer convenient one-stop shopping. Two of the largest chains are CVS and Rite-Aid, each of which owns at least 4,000 stores throughout the U.S. Chain store pharmacies are even busier than independent pharmacies, filling as many as 600 prescriptions a day. Pharmacy staff often work 12 hour shifts with few breaks in order to cope with the demand for prescriptions. This leads to stress and overwork. As the volume and variety of prescriptions continue to mount, so do concerns about work pressures and medication errors. In both chain and independent pharmacies, overburdened staff have little time to devote to patient counseling.
Contact The Orlow Firm Today
The practice of pharmacy has become more diverse and exciting, but also more pressurized and demanding. Today, it is a highly complex enterprise and prescription errors seem nearly inevitable. If you or a loved one has been injured due to a pharmacist’s mistake, contact the New York medical malpractice attorneys at The Orlow Firm to see whether you have a legal remedy.
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