There are a number of aspects that could be discussed; to give you some background, I would like you to review 2 documents. The first is the Joint Commission on Pharmacy Practice vision for the pharmacist of 2015. The other is a similar position statement from the American College of Clinical Pharmacy. Please review these documents and be familiar with the main points of each.
Additionally, please view the video below from InstyMeds and think about the use of technology and robotics. Threat or opportunity?
61 comments:
In Pharm Care we have been talking about the future of pharmacy in particular central fill stations and call centers for pharmacist. I was wondering what the mentors think of this system? Also, if any of the mentors have participated in this type of system before what are the pros and cons?
The second article is about requiring a residency for every practicing pharmacist. I was wondering what the mentors tought about the ACCP's 2020 plan? Also, do the mentors think that a residency is required to practice community pharmacy?
On behalf of Eric Beamon:
Good question, Rachel. I have a similar question, but a little more specific. A couple of weeks ago, we posted our comments and questions on the topic of Professionalism; I was wondering what the Mentors thought of this idea of counseling a patient via Web cam from a central fill facility? I know this is the direction that, not only our profession is heading in, but also our society, but I believe discussing a patients problems and concerns over the internet isn't, what's the word, professional.
WUSOP, what do you think??
Eric Beamon
WUSOP P1
Just as with any other industry today, healthcare is being automated and there is no doubt that technology will play a big role in shaping the future of pharmacy. I cant say for sure if this is a threat or opportunity but i do know its here to stay and its the future. I will very much want to hear what the mentors and others in practice think about automation.
My thought is that if this is driven by the commitment to improve patient care and medication therapy outcomes and not solely to maximize profits, then its good for the profession.
J. Mwathi.
The good thing about "future of pharmacy" is that all of pharmacists required to have a standard or above standard of knowledge, skill before becoming pharmacy practice. Yes, society needs it. We will provide patient-care center, this is a good expectation.
However, will pharmacy be industrialized? We are using technology, new pharmacy model to have more economical benefit, such as central-filled pharmacy, web-cam counsel. And with those technologies, we, pharmacists, will hard to find a job like nowadays. There are some problems here; so as we discussed in pharmcare class, people said these changes are unnecessary.
I hope we, all future pharmacists, can make a good change for our pharmacy community that benefits for our society.
PS: To Dr. Nuzum, I'm not sure but there is a problem with the video. I watched a 1/3 of it but can't watch the rest. Something is wrong?
Ngan Tran
P1
“The safety and security of an ATM with the simplicity of a soda machine!” – InstyMeds
That is funny!
I wonder how convenient this machine would be if there was an issue with insurance. Would you have to stand there in-line with your prescription info on the screen having to call the InstyMed Call Center (while there is a line building up behind you)? Would that violate HIPAA having your info up there on the screen for everyone behind you to see? Also what about drug interactions? How does the machine know what other drugs the patient is taking? Sometimes patients don’t even know what they’re taking or at least the name of their meds. This machine may reduce handwritten errors, but there still is a human typing this prescription into the machine = still room for errors. But this time there isn’t a human (the pharmacist) to catch that error. Pharmacists are pretty much taken out of the loop, unless there is question and the phone is picked up. That alone I think is a bad idea because I think the community needs to know the role a pharmacist plays in their healthcare. You get that with the face-to-face contact, hopefully. With this machine in place, it’s the doctors and nurses that counsel, not the pharmacist. If our (future) profession is to be taken more seriously and to progress, wouldn’t it start with those who need our help the most? Yet, we are being removed from that process with these machines.
Machines aren’t perfect.
-Suemi Coaxum, WUSOP P-1
Technology, yes its part of the future and we must deal with it, but we are humans we shape the future and how far technology is taken. Does one think robots have feeling? Can they talk and counsel patients? Also when we work with electronics there is always a chance for failure. So if something was to go wrong in a store that has central fill locations; what do we do about patient care if a system is shut down or a hard drive crashes? There is no way to have patient/ pharmacist interaction. In saying this, where should the line be drawn in electronics and patient care?
Josh Waters P1
Future of pharmacy will be determined with the evolution of educational system.
Pharmacy educators must work more closely with the profession, particularly in the areas of experiential education, development of new patient-centered practice models, and student professionalization.
Colleges also must seek to collaborate with health systems and organizations to finance and develop demonstration projects that explore new, evolving models of pharmacy practice.
In the interim, pharmacy school faculty and administrators should make every attempt to ease student frustrations with the mismatch between education and practice, while still maintaining their resolve to prepare graduates for future patient care roles.
Ngan Tran -P1
I can see how a system such as InstyMeds would be convenient for patients, however, there is always a risk when technology comes into play. As Josh pointed out, there is always room for failure or malfunction. Also, will this machine catch drug interactions? Judging by the size of the machine, I have to wonder if it only holds the more commonly prescribed medications, in which case, some people will not benefit from this machine being conveniently located.
- Brittany Samples, P1
I know a lot of pharmacist may look at these videos and start to panic, but keep in mind this just isn't where the field of pharmacy is going, but it is also where civilization is going as a whole. Technology is getting better and as a result we are able to do certain jobs more efficiently. I honestly believe that this is very positive for the field of pharmacy. Pharmacists will no longer be tied down counting pills and entering orders, but it will allow them to focus on pharmaceutical care and assessing patients. Keep in mind that pharmacists are experts on medications and this is something that can't be replaced by a machine as physicians can't be replaced by webMD. Do you think this technology will require pharmacists to have additional schooling/training so that they can assess patients and practice more like a clinical setting?
- Nick Conley (p1)
After watching the video, I wonder- does anyone else find themselves feeling very defensive? It's like I have an overwhelming desire to show people why pharmacists and pharmaceutical care are of value. I think this ties in really well with the discussion from last week about professional organizations. It's about uniting and showing what we as pharmacists and student pharmacists can do. We have to stand up and do the best we can to allow patients to EXPERIENCE pharmaceutical care so that they know the difference between the simple dispensing of drugs and true patient-focused care. I think this is the heartbeat of the statements made by the Joint Commission of Pharmacy and the ACCP. At times, it breaks my heart that pharmacists can be so undervalued, and now with the acceleration of technology and the PUSH to make things touch and go between patients and pharmacists, I feel that a lot of people are missing the point. It is my personal hope that we will be able to change the mindset of those around us so that society will see what a difference pharmacists can make in a community.
P.S. Now that I have finished venting, I thought Suemi made some excellent points. Removing the human element from the process will ultimately create a mess...yes- for a moment, patients may be excited about the prospects of getting the drugs they need "quickly and conveniently"(that is, if they don't have to contact the call center for whatever issues they may encounter), but I think ultimately they will sense the loss of personal touch.
Amanda Lynn Hill
P1 Student
It has never really occurred to me how far technology has advanced in the pharmacy profession, that is until I watched the InstyMeds video. I agree with Suemi and Eric. Machines aren’t perfect and they definitely lack the professionalism for which our branch of health care is so well-known. I personally feel like technology, such as the InstyMeds machine, is trying to replace the pharmacist. With the implementation of all this technology, will there be a need for pharmacists and technicians in the future?
Allison Hoyle
P1 student
With regard to the IntsyMed in the video posted here and the conversations we about central fill pharmacies we have been exposed to, I am certain that society will continue to push for technological convenience. The future of the profession of pharmacy is being pressed in another direction however, by the up and coming pharmacy students as well as some substantial professional pharmacy organizations. Since the Doctor of Pharmacy degree is the requirement for all practicing pharmacists since year 2000 the profession is moving to specializing in one on one patient care with emphasis on autonomy of the pharmacist, adequate and affordable medication advice, as well as a pharmacists being the most accessible source of medications and components. With the suggested recommendations from the ACCP and the Joint Commission’s future vision for pharmacy do you see the InstyMed as a true convenience and benefit for the patient as suggested by the video or do you think that this pulls the goals and the hopes for the future of pharmacy and the profession in the opposite direction making the goals set forth for the future less attainable?
Tiffany Benfield P1
I agree with Amanda Hill's statement about being defensive when I hear about the technology that seems to be taking over pharmaceutical roles. It is natural to feel threatened by programs such as IntsyMeds and the Walgreens POWER program. However, I want to reiterate the point that Nick made earlier about technology. I agree that our society is progressing to a world that revolves around technological advancements. People want to run errands in ways that are the most time efficient. I believe that technology is going to be thrown in the pharmaceutical and other health care fields more and more, especially after we graduate. We might as well start embracing it now, because it's coming whether we like it or not. In fact we may even be able to use it to our benefit. With less need for oversight of dispensing we can focus on responsibilities like the ones illustrated by JCCP. While technology may seem like a threat to our future at first, it may become an opportunity society to view pharmacists a little differently. As technology starts taking over the dispensing process, pharmacists will be able to have time to directly manage patients medications, provide in depth counseling, etc. There are bound to be glitches at first, as there were with another technological advancement. But in the end I think technology will make a positive impact to the pharmaceutical profession.
-Ishita Gandhi P1
The thing about using central fill sites is that the drugs must somehow be delivered to the patients. I am almost positive that during this transfer that someone’s drugs will be lost or misplaced. When this happens who is going to take the blame for the customers not having their drugs and how are we supposed to make sure that they have enough to make it through until they get another shipment in? Are we suppose to just tell them tough luck and that we will call and have the machine fill another and that it will be to them in a few days?
I may be biased since I am only a P1 student but as of right now I feel that a residency would be unnecessary after receiving a doctorate of pharmacy. On the other hand, I would have absolutely no opposition to completing a residency program if they paid better. When we get out of school we will have a doctorate degree and I feel it is ridiculous to get paid as if we didn’t. I know that when I graduate I am going to have over 100,000 dollars’ worth of student debt in my name. It is going to be very hard for me to choose to do a residency if it isn’t mandatory and get paid $40,000 a year. I don’t even think that I could afford to make payments on my loans and pay all of my bills on that salary. I have also heard horror stories of residents working 80+ hours a week which is crazy for the amount of pay. That shouldn’t even be legal. How can you have a life or family when doing that? I don’t think that the extra year or two of training would hurt anything and it would definitely leave people more prepared to complete their jobs in clinical settings though. I know that it is impossible to pay residents what pharmacists make though and this is why I am against it. Also I don’t think it would ever be possible to create enough residency positions to accommodate all of the graduates wanting to go into clinical pharmacy. If residencies are made mandatory who says it will stop there anyways? The program has drastically changed and gotten more strenuous in a short amount of time and there is not an end in sight. Also, how is it fair that so many pharmacists have gone into clinical settings and worked out just fine without residencies? Many pharmacists I have worked with only have an RPh, no PharmD and had not completed a residency. They turned out just fine. It is easy for people who are already practicing pharmacists to say the residencies should be required but they aren’t the ones who have to complete a 6 year doctor of pharmacy program and then go on to complete two more years of residency. It is a lot harder and more financially impossible when looking at it from a student’s perspective. -Kristen Willard P1
One of the articles mentions that a residency be required for any pharmacist choosing to work in clinical pharmacy. I was wondering what the mentors thought about having more education being required for a certain position? I feel that that if pharmacist requires more education, it enhances their ability to secure a place in the workforce, to give them stronger ground to stand on when saying "I can not/will not be replaced by a machine," and that many other benefits would arise. What is everyone else's opinion on this?
Food for thought….in the second article it was suggested that should residency training continue to be an option for clinical pharmacists, than payment to that practicing pharmacist should be made according to their residency status. I think this is a very valid statement and should be considered by all those affected by this possibility. It reminds me of being a technician; a certified technician is paid a higher hourly wage than a non-certified technician. So shouldn’t a clinical pharmacist, who has completed a residency, receive a higher salary than a clinical pharmacist that has not completed any post graduate training? Although I don’t see clinical pharmacy in my future, I believe compensation should be given to the clinical pharmacist who has spent at least one year post-grad.
On the IntsyMed dispenser…while it sounds like a great idea for the patient, it will definitely have its flaws. So what happens when the dispenser spits out the wrong medications by accident, how is it corrected? When the patient suffers from a severe reaction, allergic or side effect, how is that handled by a machine? Who does the patient call when the ER doctor has already completed his/her shift, the IntsyMed is clearly going to be of no help, and the pharmacy is closed at midnight? Aside from getting the medication at any hour and with virtually no waiting, this medication vending machine is of no use to the patient should problems arise. And with the most recent advancement of E-prescribing, patient wait time is greatly minimized at the pharmacy. In my personal opinion, if a patient is truly that sick and is discharged from the hospital during late hours, the hospital should provide that patient with a take home dose until they can reach a pharmacy the next morning.
~~Chrissi Tyrrell, P1
Food for thought….in the second article it was suggested that should residency training continue to be an option for clinical pharmacists, than payment to that practicing pharmacist should be made according to their residency status. I think this is a very valid statement and should be considered by all those affected by this possibility. It reminds me of being a technician; a certified technician is paid a higher hourly wage than a non-certified technician. So shouldn’t a clinical pharmacist, who has completed a residency, receive a higher salary than a clinical pharmacist that has not completed any post graduate training? Although I don’t see clinical pharmacy in my future, I believe compensation should be given to the clinical pharmacist who has spent at least one year post-grad.
On the IntsyMed dispenser…while it sounds like a great idea for the patient, it will definitely have its flaws. So what happens when the dispenser spits out the wrong medications by accident, how is it corrected? When the patient suffers from a severe reaction, allergic or side effect, how is that handled by a machine? Who does the patient call when the ER doctor has already completed his/her shift, the IntsyMed is clearly going to be of no help, and the pharmacy is closed at midnight? Aside from getting the medication at any hour and with virtually no waiting, this medication vending machine is of no use to the patient should problems arise. And with the most recent advancement of E-prescribing, patient wait time is greatly minimized at the pharmacy. In my personal opinion, if a patient is truly that sick and is discharged from the hospital during late hours, the hospital should provide that patient with a take home dose until they can reach a pharmacy the next morning.
Chrissi Tyrrell, P1
With technology beginning to replace some of the standard duties a pharmacist performs, it is no wonder that the Joint Commission on Pharmacy Practice and the ACCP have developed a vision for a more clinically assertive pharmacist. Technology has always been the driving force of the economy, and as such, providing ways to cut costs or turn a profit will always be viewed as the most efficient means for offering healthcare services. While there is nothing wrong with turning a profit, we need to realize that furthering the responsibilities of the pharmacy profession is key to showing society we supply a service they demand.
My question to the Mentors: do you currently utilize MTM at your practice site, and/ or, how could your practice site change to embrace the visions listed above?
--James Burrows (P1)
In response to the requirement for post-graduate residencies,I can understand the need for them in certain situations, but I do not think every single graduate should be forced to take part in post-graduate training if their career goals do necessitate such specialized training. I think the best option is a requirement for these residencies on an employer by employer basis. The field that the pharmacy graduate wishes to pursue should dictate whether or not a PGY1 or PGY2 experience is necessary.
In reference to InstyMeds, I'm really turned off to the whole idea. Besides the pharmacist being taken out of the loop, there is perhaps too much dependence put upon a machine. As stated before, machines aren't perfect. And I second what Suemi said about the issue of HIPPA violations, lack of counseling, and just general lack of privacy.
First of all, I was unable to view the entire video. Ms. Tran also had this problem. After reading through the posts, I think I have a basic understanding of the video. The tagline (and even the name of the company) sound to me like a parody of 1920's era technological visions of the future. However, I see potential in special cases. Imagine an automated system where patients' drug regimen information is stored in a database. The boy in the video develops strep, is taken to a physician who digitally prescribes an antibiotic. The mother goes through a "Drug ATM" which runs a cross-check in the database to prevent interactions with current meds, and automatically dispenses the medication. In the future, could this technology be used for commonly prescribed medications or emergency refills?
Andrew Herrin, P1
I can understand why many of us have our feathers ruffled when watching this video because that was my initial response. But let's take a step back and look at the issue from a different perspective. If I had a child that was very sick and needed antibiotics or if I had just left the ER with an injury inflicting much pain, I would absolutely want the option of picking up my prescription as I left the building. This particular scenario has nothing to do with robots taking over the role of a pharmacist and there IS the opportunity for the patient to receive professional consultation from a real live pharmacist via the phone...not so different from many consultations given today from a "traditional" community pharmacy. The purpose of InstyMed is to provide superior service to the patients in need through the convenience of their distribution method. We cannot discount the fact that there is limited to no DUR, and after the doctor hands the "voucher" to the patient there is not another human being to check the prescription, but think about the medications that fit the bill to be dispensed. Most of them are very standard doses, straight-forward instructions and relatively uncomplicated. And for those who use the argument that "computers make mistakes" as a solid validation to discredit the system need be reminded of our innate fallibility as humans... Additionally, remember that these patients are utilizing this system in times of emergency and great need. Just as a physician at an UrgentCare clinic does not serve the same purpose as a specialist, the InstyMed does not serve the same purpose as a pharmacist, and that is not the manner in which either system was designed. I just wanted to play Devil's Advocate and bring up some points that seemed to have been overlooked.
Morgan Miller
P1
I can't help but feel anxious after watching the InstyMeds video. I can see the pros and cons of this system and am very interested in the opinions of the mentors on this issue. What would happen if a patient entered in someone else's id number by mistake? How many medications will fit in the InstyMed dispenser? I think once many of my concerns are answered I may feel better about this system.
Amanda Crouch WUSOP P1
First, as based on most of the comments left so far, many have watched the InstyMeds video, but it is left remaining how many actually read the articles. I believe this implies exactly what Nick Conley was getting at: society will push for the most convenient method of obtaining what they need (i.e. watching a video is easier to obtain information for us than reading...so most of us more naturally watched the video first). Increasingly, technology will strive to fill our fast-paced world with convenience.
Is InstyMeds lacking the "personal touch"? Yes. Are there concerns about patient safety and unanswered drug interactions with InstyMeds? Yes. Does technology sometimes fail? Yes. Do humans sometimes fail? Yes.
My opinion regarding the InstyMeds most closely sides with Nick Conley's thoughts...I don't think we need to fear InstyMeds as future pharmacists if we let technology take over the jobs that don't require the brains. If InstyMed machines become more stream, it just allows us more opportunity to demand that our profession performs at a higher standard.
Am I saying that it's always a good idea to pick up your meds from a machine? No...but if I had a sick child in the middle of the night, I am not shy about admitting that I would want that one-stop convenience as well.
I think the new technologies are actually great. Mail order is mail order, some patients love it - most hate it after they try it- so there will likely always be a need for brick and mortar pharmacies in the future. I believe the biggest issue is that as a whole pharmacist have been complacent in their roles and tend to be less proactive as opposed to our health care peers. Granted, our profession is at the cusp of a new evolution but will the momentum continue or will we become complacent once the money starts flowing again ? I do believe the era of large sign-on bonuses has come to an end (at least for now)and in order for our profession to be sustainable we simply have to be more marketable and useful to the general public. To be honest, I'd rather stand in front of the pharmacy talking to people about drugs and otc meds than counting pills and staring at a computer looking at pictures of pills. Let the robot do that.
Raean
P1
Personally, I don't think I like the direction pharmacy might be going in in the next few years. The possibility of central fill being commonplace and pharmacists counseling patients via webcam seems too impersonal. I want to be a pharmacist because I like knowing that I can one day talk to people and give them the advice they are looking for. I didn't sign up for a job staring at a webcam all day.
I agree with Eric’s earlier comment about online consultation being unprofessional. I think that it is also completely impersonal and that there will be many people who do not want their "primary pharmacist" to be a computer screen. I know that in my particular experience certain patients will come in asking for a specific pharmacist because they like the connection that they have with a specific pharmacist. I believe that a pharmacist being available in person for consultations is a much better example of patient care just for the fact that you can feel they are there for you. You can go into your local pharmacy and know exactly who you are going to go and ask about the best thing to help your child, your mother, or even yourself. The future of pharmacy may be leading towards a more online approach for patient care but I hope for the sake of true patient care and interaction that it does not.
I have two points to be made.
First, be cautious of new technologies. Test new systems diligently, and only roll them out when they are truly ready. If I am going to be expected to prevent errors in my pharmacy as a professional, I should hold the equipment I use to the same standard. In this regard, I should also insure that I am familiar with any technology being used.
Second, accept that technology will advance with or without you. Like it or not, times change, and in today's world computers and robotics are advancing at exponential rates.
As I have already commented, test and know the systems, but also know that the systems will advance.Don't accept the changes thrust on you, be the agent of change.
Regarding the second article - Residencies may be where the pharmacy profession is heading. To mentors who have completed a residency - what areas did your residency specifically help you grow in? And to mentors that did not complete a residency - Do you regret not seeking this opportunity out? Is there something you feel you may have been able to do differently in your career had you completed a residency?
Katelyn Agee - P1
I think there is a place for technology. That place is to aid the pharmacists in doing their job; not doing the job for the pharmacist. I understand the reasoning behind the drug vending machine by Instymeds; however, there are a lot of problems associated with that. The patients information is up on a screen for the world behind them to see. What happens if the power goes out? Or the system malfunctions? Where is the need pharmacist? There is no one to counsel, check for interactions, or provide patient care.
With technology beginning to replace some of the standard duties a pharmacist performs, it is no wonder that the Joint Commission on Pharmacy Practice and the ACCP have developed a vision for a more clinically assertive pharmacist. Technology has always been the drive of the economy, and as such, providing ways to cut costs or turn a profit will always be viewed as the most efficient means for offering healthcare services. While there is nothing wrong with turning a profit, we need to realize that furthering the responsibilities of the pharmacy profession is key to showing society we supply a service they demand.
My question to the Mentors: do you currently utilize MTM at your practice site, and/ or, how could your practice site change to embrace the visions listed above?
--James Burrows (P1)
Regarding the use of technology and robotics, InstyMed is a great idea, but there is definitely room for improvement as with any development. It is definitely the soda vending machine for medications. It is quick and convenient for patients to use. However, private patient information is on the screen for everyone in line to view...a HIPPA violation for sure. In many instances at an actual pharmacy, there are many phones with multiple lines, each with a technician or pharmacist addressing the questions and concerns of several patients at a time. Also in viewing the video, there is one telephone shown for patients to contact insurance companies. I imagine that unless there is an adequate number of phones in place, InstyMed will either create very long lines or result in the questions of many patients going unanswered. In addition, patients may not know how to exactly ask their question of the insurance company. In a pharmacy, the technician or pharmacist is the liaison between the patient and insurance company who transmits information between the two parties.
I believe that the types of medications available via InstyMed is somewhat limiting. In a pharmacy, there always seems to be some ancient antibiotic that no physician prescribes, with the exception of a handful of physicians. InstyMed can not contain every possible medication within the machine. However, that mom needs that antibiotic for her child just as much as the next mom with a prescription for a common antibiotic.
All in all, InstyMed is a great idea, but one where all aspects and situations must be considered before it is put into action.
P1 - Amanda Flores
I not only think that InstyMeds is bad for the future of pharmacy, but also for our future economy as a whole. This trend of jobs becoming more and more automated is horrific. If doctoral professions are being cut due to machines now, where will it not cut jobs as more technology is developed? No jobs seem to be safe. I believe there are other viable solutions to prescriptions being filled as soon as patients leave medical clinics and/or hospitals other than machines such as InstyMeds. Technology like this will not only cut pharmacist jobs, but also technicians, cashiers, drug reps, etc. Automated technology like this will continue to undermine our economy and OUR future as pharmacists. Our profession in the job market has already changed dramatically in the past four years, InstyMed will only further hurt it.
John Miller P1
I just wanted to respond to Morgan’s Post. In this particular scenario, it IS a robot taking over the role of the pharmacist. There is no pharmacist to oversee the dispensing of the prescription (even if it is just as simple/common as a prescription of an antibiotic) which IS one of our main roles. One of our main responsibilities is to ensure the safe and effective use of medications. How are we to do that when we are not involved in the dispensing of that medication to any extent except as an optional phone call? If someone is in pain or with a sick child, what would be the chance that they will even pick up the phone? Just because these are standard doses with straight-forward instructions—how often are there still mistakes even now with a pharmacist involvement. This is a physician dispensing machine, not tele-pharmacy. I don’t think this is providing superior service when tele-pharmacy seems to be a much better method for those in need, because you still have a pharmacist involved. And just to consider your point as far as this is just in emergency situations--my fear is that yes this is only for emergent situations, but how long before these machines become common or demanded if their use becomes popular because they are so convenient? Those who don’t see these machines as a negative because this will allow pharmacist to focus on important areas, (as unlikely these machine would become that popular) if these machines where to become popular you won’t have an area to focus on because the counseling aspect would be taken care of by doctors and nurses (which doesn’t seem right to me since we will be the experts). I like playing devil’s advocate as well!
I think we are missing the point when we are stressing that technology is here to stay. We can all agree to that. But is that technology a threat, is it helpful, is it a benefit or will it cause harm? What I believe is more important is what can we within our field do or say about it, especially if that technology is a bad idea? We are not going to have much grounds to stand on if one of our main responsibilities are easily handed over to a machine to accomplish and then equated to “as easy as an ATM machine”. This is much more than just counting pills, having that human to human contact(even if its over the web-cam) gives us that opportunity to take care of that patient and to find information that the doctor missed that would be important to the patients welfare even with those common everyday medications. We are even now having a hard time being included in the governing bodies who make decisions on health care, healthcare laws, technology, etc…I don’t see InstyMeds improving this.
I just wanted to respond to Morgan’s Post. In this particular scenario, it IS a robot taking over the role of the pharmacist. There is no pharmacist to oversee the dispensing of the prescription (even if it is just as simple/common as a prescription of an antibiotic) which IS one of our main roles. One of our main responsibilities is to ensure the safe and effective use of medications. How are we to do that when we are not involved in the dispensing of that medication to any extent except as an optional phone call? If someone is in pain or with a sick child, what would be the chance that they will even pick up the phone? Just because these are standard doses with straight-forward instructions—how often are there still mistakes even now with a pharmacist involvement. This is a physician dispensing machine, not tele-pharmacy. I don’t think this is providing superior service when tele-pharmacy seems to be a much better method for those in need, because you still have a pharmacist involved. And just to consider your point as far as this is just in emergency situations--my fear is that yes this is only for emergent situations, but how long before these machines become common or demanded if their use becomes popular because they are so convenient? Those who don’t see these machines as a negative because this will allow pharmacist to focus on important areas, (as unlikely these machine would become that popular) if these machines where to become popular you won’t have an area to focus on because the counseling aspect would be taken care of by doctors and nurses (which doesn’t seem right to me since we will be the experts). I like playing devil’s advocate as well!
I think we are missing the point when we are stressing that technology is here to stay. We can all agree to that. But is that technology a threat, is it helpful, is it a benefit or will it cause harm? What I believe is more important is what can we within our field do or say about it, especially if that technology is a bad idea? We are not going to have much grounds to stand on if one of our main responsibilities are easily handed over to a machine to accomplish and then equated to “as easy as an ATM machine”. This is much more than just counting pills, having that human to human contact(even if its over the web-cam) gives us that opportunity to take care of that patient and to find information that the doctor missed that would be important to the patients welfare even with those common everyday medications. We are even now having a hard time being included in the governing bodies who make decisions on health care, healthcare laws, technology, etc…I don’t see InstyMeds improving this
Suemi Coaxum P1
Wow! There are so many great points being thrown out there about the future of pharmacy, specifically things like InstyMeds, that just really makes you think. I agree with many of the things Suemi pointed out in her comment. I am sure patients will not like having to deal with someone over the phone to solve any problems that may arise from using the InstyMeds machine. But once that does happen to a patient, like Raean said, they will be more likely to just go to an actual pharmacy the next time because the community will always need the drug experts pharmacists are.
I do, however, see many advantages to using something like the InstyMeds machine. First of all, from what I got from the video the machine is only used to dispense pain medication and antibiotics. These are drugs that are needed right away after an emergency hospital visit and if no pharmacies are around or they are closed what is a patient to do? I believe this would be a great alternative for patients to receive their emergency meds in case a patient is not able to obtain a take-home dose from the doctor, like Chrissi suggested.
Having said this about InstyMeds, they are just a small glimpse into what technology has in store for us. I cannot help but wonder how far society will push technology to make getting prescriptions easier and more cost-efficient? Like I said before, there will always be a need for pharmacists but how will technology change the frequency a patient really needs a pharmacist? How is the job market for pharmacists going to look after all these innovations come out?
Alisha Rivera-Menendez
WUSOP P1
Mentors,
As you can see technology has advanced and will continue to advance over the upcoming years. Do you see this affected the pharmacy field in a positive or negative way? I believe with the extra time saved from some of the patients using (InstyMeds) to fill their prescriptions, pharmacists could focus more on pharmaceutical care. What about the mistakes that could possibly occur when using this technology?
Shawn Jessup
WUSOP P1
About the first article, the Joint Commission on Pharmacy Practice vision for the pharmacist of 2015, I feel like this article reflects many similar proposals we have been reading about in all of our classes. I feel like we all support these ideals and want to work toward showing the public how passionate we are about optimizing patient care.
The topic that clearly stood out in the second article for all of us was the possibility of residencies becoming mandatory. When deciphering my feelings on this issue I ultimately had to put myself in the patient’s shoes. As a patient, would you want a doctor who hadn’t completed a residency? Would you want your loved ones being taken care of by a doctor who hadn’t completed a residency? We all want pharmacists to obtain extra responsibilities, such as being able to prescribe; making us more in line with doctors. With this responsibility we need to be able to accept there may be some extra requirements of ourselves.
Finally, on the video, I have to agree with a point that Morgan made:
“remember that these patients are utilizing this system in times of emergency and great need. Just as a physician at an UrgentCare clinic does not serve the same purpose as a specialist, the InstyMed does not serve the same purpose as a pharmacist”.
Though I see both pros and cons of the InstyMed system, I don’t see it replacing the job of a pharmacist in our sense of the occupation. In our own ways we all want to become pharmacists to help patients, to go above and beyond dispensing medications and show them that we care and that their safety and quality of life is our priority. InstyMed simply dispenses drugs. It provides basic medications in standard dosage forms such as certain antibiotics and particular opioids. It obviously doesn’t go above or beyond, or practice pharmaceutical care, but once again we need to view this from a patient standpoint. In no degree do I think this is an infallible idea and I’m not oblivious to all of the problems it could present but in the case the video presented I, as the mother, would without a doubt utilize the InstyMed system.
Danielle Nichols
P1
I agree with Brittany and Josh that technology is going to fail and it is going to be unfortunate for that patient who is waiting in line when it happens. After watching the InstyMeds video I feel that by using this system the focus on patient care is lost. Yes, this is convenient for patients, but the majority of patients are elderly and are probably not going to be able to operate this machine properly. This will result in more problems and frustration for the patient! Today in pharmaceutical care we discussed that a covenant should exist between the pharmacist and patient. By using InstyMed a relationship of mutual trust and commitment will not exist.
Tiffany Humber
WUSOP P1
I can see why some people would see InstyMeds as a good thing, but overall I believe it's a terrible idea! As future pharmacists, we know why it is important for our patients to be able to speak with us face to face. This machine reduces the availability of pharmacists to patients as well as reducing the opportunity for direct patient care. I could understand why someone would be angry for not being able to fill at a pharmacy during late evening or early morning hours, but that's what hospitals are for. If this is going to become the norm, I believe it should at least have a time frame restriction on it (like after 9:00 pm when most pharmacies are closing, to 6:00 am before pharmacies open). I feel this would be a dangerous habit for patients to get used to. Does it even regulate how often someone visits or WHO is getting the drugs? What if someone gets access to someone else’s medication code and birth date? YIKES!
It is scary to think how far technology has come sometimes, but the reality is that it is here and it will replace only a single role of a pharmacist. The good part is that pharmacy practice vision has the role of the pharmacist changing anyways away from a mainly dispensing role. I’m not saying that InstyMeds is by any means a good idea, but a lot of new technology is coming out and if a job can be replaced with an automated process it most likely will simply due to its effect on cost. Mentors, I was wondering if you have seen any new technology similar to InstyMeds and if your experience was good or bad?
The application of technology and robotics by InstyMed may not be able to provide every medication to every patient. Their dispensing machine may not work perfectly, or the counsel via phone may not be immediate. However, this kind of service clearly helps some patients to get quickly most of the medication whenever they need. The idea can be a threat for job cut if we continue to practice pharmacy the old way. The video gives us a good reason why we need to focus more on practicing pharmaceutical care if we choose to do community pharmacy. Mentors, do you think we don’t need to care if we do research or clinical?
I feel that residencies are very important in the realm of the pharmacy world, but I think it is unnecessary to require all new graduates to complete a residency. It seems reasonable to require residencies for individuals such as clinical pharmacists, but not for certain areas like retail pharmacy. I feel that all pharmacy schools should require their students to get pharmacy practice experience starting in their first year and it should continue through the 4th year. It is important to gain early experience because students won’t be so shell shocked when they step into a pharmacy during their 4th year and eventually transition into their full time job. Also, this allows students the opportunity for growth and knowledge over four years as opposed to other schools that wait and do all of their pharmacy experience in the last year. I am very impressed with Wingate University School of Pharmacy because they allow students to begin gaining pharmacy experience in their first year. It should be mandatory to require all pharmacy schools to start pharmacy experience in the 1st year. This would allow students to gain efficient skills to practice retail pharmacy without doing a residency. Any thoughts?
-Kevin Morris
WUSOP P1
I want to comment on the second article. I do not think community pharmacists should require a residency program. On the other hand, I do agree that residencies should be required for pharmacists wanting to enter a clinical setting. Most students do not receive the training, from school alone, necessary to jump right into a clinical environment. I have heard some pharmacists who have not set foot into a pharmacy until their fourth year in school. Wingate students are lucky enough to have a faculty and program which focuses on “practicing what they preach” by placing us in pharmacy work environments. Wingate’s program will allow us to diversify our pharmacy experiences. If we find an area that interests us, we can continue the education through a residency program. As for requiring a 1 or 2 year residency term… we want the responsibility to manage patients’ medicines, but we don’t want to take the time to train for this responsibility? We want to compare ourselves to doctors, and expect a comparable pay scale, but don’t they complete residencies and possibly specialize in certain areas? I do not want to enter a clinical setting and be a part of a learning curve because I do not have the experience. I want to help my clinical team by knowing all about drugs (school) and applying this knowledge (residency) to real live situations. This requires practice, something that could be obtained in a required residency program for clinical pharmacists.
Tyrsa Creel P1
A few observations/answers/insights:
• There’s a lot of discussion about how technology (dispensary machines, robots) will remove the “personal touch” that only the pharmacist can provide. Think about the opposite. In your experience, does the pharmacist always add a “personal touch,” or are they simply a “person”? Yes, we have extensive knowledge derived from the 4+ years spent earning a doctorate, but do our patients always seek our services? We, as a profession, must maintain a high standard of patient care in an effort to be recognized by the patient as a major player on their healthcare team. I have two goals with every patient that comes to my pharmacy: (1) they should know my name, and (2) they seek my help before seeking it from any other pharmacist. These are pretty lofty goals – know me and trust me – but, in meeting these goals, I think my patients recognize my value.
• Post-grad residencies: I didn’t do a residency, so I hope that I don’t misspeak when I clarify a few points: (1) you can defer payment on your school loans as a resident so that the monthly payment doesn’t cripple your bank account, and (2) residents are residents to LEARN and the site provides access to tools/preceptors/resources/real world scenarios to allow the resident to do that – if you need help justifying the lower pay rate, think of intangibles that the site provides. I work in community pharmacy and did not complete a residency – that’s not to say that I never can. You don’t have to be fresh out of school to take a residency position. I don’t regret not doing a residency immediately after graduation because it simply wasn’t the direction that my career was headed toward at that point in time. At this point, I think the biggest reason that I would consider going back to a residency would be to make myself more marketable in academia. While a residency is not absolutely required for a teaching position, it’s most often preferred.
• MTM: As a community pharmacist (that works at a major chain, and not in an independent or more local pharmacy), MTM will not be a viable part of my practice until it becomes a commodity that patients expect, value, and trust. I personally believe that an untapped opportunity for the healthcare field lies with utilizing the pharmacist in a doctors’ office or clinic. Having a pharmacist on staff could do so much – having an established protocol of authorizing refills and ordering labs to free up nursing staff, counseling patients on new prescriptions before they leave the office (and checking to see that drug/dosing is appropriate), performing ‘brown bag’ MTM reviews in office so that medical records match pharmacy records, educating the staff on new drugs or drug updates, and so on. The flaw with the idea is that pharmacists are probably too expensive to keep on staff at most practices for a role that doesn’t involve handing out medications.
________________________________
Erica Harms, Pharm.D., R.Ph.
Executive Pharmacist | Target Pharmacy
Charlotte, NC
eharms@carolina.rr.com
As a new mother, I thought that working part-time for Walgreen's Central Pharmacy as a work from home pharmacist would be a sweet deal; I could stay at home with my son and have the benefit of a steady paycheck. At first the situation worked nicely and learning the new job requirements kept my interest. I switched between two queues throughout the day, verification of prescription information entered by a specialist or assessing problems triggered through the system such as duplications of therapy.
I did not have any patient interaction what so ever. I did not have access to the patients profile while in the verification queue. I felt that I was not really using my pharmacy knowledge and I didn't feel like I was making a difference. I quickly became dissatisfied and felt zero job satisfaction, which lead to my decision to seek opportunities elsewhere.
But just because the job wasn't a good fit for me - I am more of a people person who requires multiple tasks through the day to keep my mind occupied - doesn't mean that it isn't the ideal job for others. The set up works nicely for Walgreens to, as they have proven substantial cost savings. They plan on expanding Central Pharmacy locations to areas other than Florida and Arizona. Because of Central Pharmacy, Walgreen's has been able to reduce the number of employees and hours in their stores - insurance problems go through Central, prescribers call in scripts through Central, refill requests and filling go through Central and are mailed to the patients pharmacy of choice for pick up - and the set up ultimately frees the pharmacist in the stores for counseling, immunization, education, and problem solving.
I now work part-time for a hospital and as a relief pharmacist with an independent community pharmacy. Both systems require animation to expedite work flow, from Pyxis and automated intravascular preparation in the hospital to the filling robot stocked with top 300 drugs in the community pharmacy. Both set ups require a pharmacist to provide checks to assure that the proper medication reaches the proper patient. Today's pharmacist has many hats to wear and little time to perform these expected duties, thus requiring more responsibilities to be entrusted to technicians as well as the use of automation. Without these advancements, pharmacists could not be the valuable healthcare providers that we have worked so hard to be.
Lisa DePetris, PharmD
I would like to talk about the video posted in our blog.
Well, it's obviously advantage for us because it's quick. But looking back, there are many dangerous things that may happen. For example, if the machine is died or crazy and cause some mistakes? Technology is always technology. It's not smart as our humans and also it can't speak. So why we need pharmacists? Because they can provide patient care, counseling them and directing them to a good method to improve their life's quality. If we just need a machine to dispense drugs, it's easy to do that. But the one can care us, try to cure disease etc. is pharmacist, isn't it?
But there are some problems about pharmacy they were talking about. And it's true. But we can find a better solution to solve those problems. Therefore, the future pharmacy is depended on us, the next pharmacists' generation. We must do something to make a good change in our pharmacy community.
Ngan Tran- P1
Do ya'll think that pharmacist will have a greater role in the future to find an optimal drug regiment for people, especially who are taking many drugs?
On behalf of Erica Harms:
A few observations/answers/insights:
• There’s a lot of discussion about how technology (dispensary machines, robots) will remove the “personal touch” that only the pharmacist can provide. Think about the opposite. In your experience, does the pharmacist always add a “personal touch,” or are they sometimes simply a “person”? Yes, we have extensive knowledge derived from the 4+ years spent earning a doctorate, but do our patients always seek our services? We, as a profession, must maintain a high standard of patient care in an effort to be recognized by the PATIENT as a major player on their healthcare team. I have two goals with every patient that comes to my pharmacy: (1) they should know my name, and (2) they seek my help before seeking it from any other pharmacist. These are pretty lofty goals – know me and trust me – but, in meeting these goals, I think my patients recognize my value.
• Post-grad residencies: I didn’t do a residency, so I hope that I don’t misspeak when I clarify a few points: (1) you can defer payment on your school loans as a resident so that the monthly payment doesn’t cripple your bank account, and (2) residents are residents to LEARN and the site provides access to tools/preceptors/resources/real world scenarios to allow the resident to do that - the stipend is an additional perk (you get paid to learn instead of paying to learn). I work in community pharmacy and did not complete a residency – that’s not to say that I never can. You don’t have to be fresh out of school to take a residency position. I don’t regret not doing a residency immediately after graduation because it simply wasn’t the direction that my career was headed toward at that point in time. At this point, I think the biggest reason that I would consider going back to a residency would be to make myself more marketable in academia. While a residency is not absolutely required for a teaching position, it’s most often preferred.
• MTM: As a community pharmacist (that works at a major chain, and not in an independent or more local pharmacy), MTM will not be a viable part of my practice until it becomes a commodity that patients expect, value, and trust. I personally believe that an untapped opportunity for the healthcare field lies with utilizing the pharmacist in a doctors’ office or clinic. Having a pharmacist on staff could do so much – having an established protocol of authorizing refills and ordering labs to free up nursing staff, counseling patients on new prescriptions before they leave the office (and checking to see that drug/dosing is appropriate), performing ‘brown bag’ MTM reviews in office so that medical records match pharmacy records, educating the staff on new drugs or drug updates, and so on. The flaw with the idea is that pharmacists are probably too expensive to keep on staff at most practices for a role that doesn’t involve handing out medications.
Erica Harms, Pharm.D., R.Ph.
Executive Pharmacist
Target Pharmacy | Charlotte, NC
On behalf of Erica Harms:
A few observations/answers/insights:
• There’s a lot of discussion about how technology (dispensary machines, robots) will remove the “personal touch” that only the pharmacist can provide. Think about the opposite. In your experience, does the pharmacist always add a “personal touch,” or are they sometimes simply a “person”? Yes, we have extensive knowledge derived from the 4+ years spent earning a doctorate, but do our patients always seek our services? We, as a profession, must maintain a high standard of patient care in an effort to be recognized by the PATIENT as a major player on their healthcare team. I have two goals with every patient that comes to my pharmacy: (1) they should know my name, and (2) they seek my help before seeking it from any other pharmacist. These are pretty lofty goals – know me and trust me – but, in meeting these goals, I think my patients recognize my value.
• Post-grad residencies: I didn’t do a residency, so I hope that I don’t misspeak when I clarify a few points: (1) you can defer payment on your school loans as a resident so that the monthly payment doesn’t cripple your bank account, and (2) residents are residents to LEARN and the site provides access to tools/preceptors/resources/real world scenarios to allow the resident to do that - the stipend is an additional perk (you get paid to learn instead of paying to learn). I work in community pharmacy and did not complete a residency – that’s not to say that I never can. You don’t have to be fresh out of school to take a residency position. I don’t regret not doing a residency immediately after graduation because it simply wasn’t the direction that my career was headed toward at that point in time. At this point, I think the biggest reason that I would consider going back to a residency would be to make myself more marketable in academia. While a residency is not absolutely required for a teaching position, it’s most often preferred.
• MTM: As a community pharmacist (that works at a major chain, and not in an independent or more local pharmacy), MTM will not be a viable part of my practice until it becomes a commodity that patients expect, value, and trust. I personally believe that an untapped opportunity for the healthcare field lies with utilizing the pharmacist in a doctors’ office or clinic. Having a pharmacist on staff could do so much – having an established protocol of authorizing refills and ordering labs to free up nursing staff, counseling patients on new prescriptions before they leave the office (and checking to see that drug/dosing is appropriate), performing ‘brown bag’ MTM reviews in office so that medical records match pharmacy records, educating the staff on new drugs or drug updates, and so on. The flaw with the idea is that pharmacists are probably too expensive to keep on staff at most practices for a role that doesn’t involve handing out medications.
Erica Harms, Pharm.D., R.Ph.
Target Pharmacy
Charlotte, NC
On behalf of Erica Harms:
A few observations/answers/insights:
• There’s a lot of discussion about how technology (dispensary machines, robots) will remove the “personal touch” that only the pharmacist can provide. Think about the opposite. In your experience, does the pharmacist always add a “personal touch,” or are they sometimes simply a “person”? Yes, we have extensive knowledge derived from the 4+ years spent earning a doctorate, but do our patients always seek our services? We, as a profession, must maintain a high standard of patient care in an effort to be recognized by the PATIENT as a major player on their healthcare team. I have two goals with every patient that comes to my pharmacy: (1) they should know my name, and (2) they seek my help before seeking it from any other pharmacist. These are pretty lofty goals – know me and trust me – but, in meeting these goals, I think my patients recognize my value.
• Post-grad residencies: I didn’t do a residency, so I hope that I don’t misspeak when I clarify a few points: (1) you can defer payment on your school loans as a resident so that the monthly payment doesn’t cripple your bank account, and (2) residents are residents to LEARN and the site provides access to tools/preceptors/resources/real world scenarios to allow the resident to do that - the stipend is an additional perk (you get paid to learn instead of paying to learn). I work in community pharmacy and did not complete a residency – that’s not to say that I never can. You don’t have to be fresh out of school to take a residency position. I don’t regret not doing a residency immediately after graduation because it simply wasn’t the direction that my career was headed toward at that point in time. At this point, I think the biggest reason that I would consider going back to a residency would be to make myself more marketable in academia. While a residency is not absolutely required for a teaching position, it’s most often preferred.
• MTM: As a community pharmacist (that works at a major chain, and not in an independent or more local pharmacy), MTM will not be a viable part of my practice until it becomes a commodity that patients expect, value, and trust. I personally believe that an untapped opportunity for the healthcare field lies with utilizing the pharmacist in a doctors’ office or clinic. Having a pharmacist on staff could do so much – having an established protocol of authorizing refills and ordering labs to free up nursing staff, counseling patients on new prescriptions before they leave the office (and checking to see that drug/dosing is appropriate), performing ‘brown bag’ MTM reviews in office so that medical records match pharmacy records, educating the staff on new drugs or drug updates, and so on. The flaw with the idea is that pharmacists are probably too expensive to keep on staff at most practices for a role that doesn’t involve handing out medications.
Erica Harms, Pharm.D., R.Ph.
Target Pharmacy
Charlotte, NC
On behalf of Erica Harms:
A few observations/answers/insights:
• There’s a lot of discussion about how technology (dispensary machines, robots) will remove the “personal touch” that only the pharmacist can provide. Think about the opposite. In your experience, does the pharmacist always add a “personal touch,” or are they sometimes simply a “person”? Yes, we have extensive knowledge derived from the 4+ years spent earning a doctorate, but do our patients always seek our services? We, as a profession, must maintain a high standard of patient care in an effort to be recognized by the PATIENT as a major player on their healthcare team. I have two goals with every patient that comes to my pharmacy: (1) they should know my name, and (2) they seek my help before seeking it from any other pharmacist. These are pretty lofty goals – know me and trust me – but, in meeting these goals, I think my patients recognize my value.
Erica Harms, Pharm.D., R.Ph.
Target Pharmacy
Charlotte, NC
So much has been posted and I feel that the opinions posted by Chrissi, Morgan and by the Dr Harms mirror mine.
We live in a capitalistic environment, a competitive one. We will not be replaced if we have proven our worth. Those things that take our place do so because they fill a void.
We speak eloquently of patient care and consulting and yet many of us who have worked in large fast-paced pharmacies can honestly say that the patient/pharmacist consultation time is low.
Patients sense that we are too busy, frustrated with the insurance monstrosity, being pulled in too many directions. They don't want to be seen as stupid for asking 'silly' questions about the medicines. Many times they won't or don't know to ask because of language barriers.
The reality is you can't sell what isn't wanted... So no how much we DEMAND: to not be replaced, to be required, to be paid well - we can't. BE VALUABLE, and as the saying goes, "they will come."
After watching this video, I am very surprised that people are satisfied by getting their medications from a machine. The mother comparing being able to pump her gas and get money out of the atm whenever she wanted with getting her son's medication is outrageous. Medication cannot be compared to those things and it is obvious that the importance of taking attaining proper treatment is not the main focus anymore. The focus of many people is to get their medicine fast and yes, they do not feel well, but there are certain boundaries such as drug interactions that delay the process of getting a prescription filled. It's not about how fast you can get the medication, but about getting it accurately and safely. It's no joke and it's not simply reversable at times so caution must be taken into consideration.
-Maryann Choy-Ames
P1
From what we are learning in Pharmaceutical care, pharmacists have been walked over by law makers and even other health-care professions. It is comforting to see pharmacy finally stepping up and taking their role in health-care in their own hands. With that being said the future of pharmacy practice states “patient care that ensures optimal medication therapy outcomes”. I feel that since this will be the core of what pharmacists do, there is no way that we could be replaced with a machine. Nowhere in that statement does it say to just dispense prescriptions, which is all the machine does. There will still need to be someone to fill it, answer customer questions, and promote MTM that will probably and ultimately save the institutions more money than a machine could. Also, the video shows one situation where the machine works well for that institution. Therefore, prescription dispensing machines will fulfill the only task a pharmacist does that doesn’t need a doctoral degree, which is counting pills.
Evan MacDonald P1
These advances in the pharmacy technology leave me both excited and a little unnerved. I do believe that in most instances technology is a good thing and can be used to advance the profession as a whole. The medicine ATM's will have to be tested numerous times in order to prove that they are dispensing the correct medicines to the correct people. The technology makes me wonder how much pharmacists will be needed in the future if this works out but then I think about how it is up to us, as pharmacists and future pharmacists to prove to the community that they need us and that we can not be replaced with these robots and machines. We have to provide a personalized service that satisfies our customers. So while this technology is slightly daunting, it is giving us an opportunity to show society just what we have to offer and why the personalized pharmacy is much better than a robot.
-Hollee Kitts, P1
I have to say that there have been many excellent points thrown around in this blog. First, I must agree with a comment Morgan made. If the InstyMed machine is used for emergency situations like the video states, than I think the machine is a great idea. Some people may not always have access to a 24-hour pharmacy. However, like many of my classmates stated, they are, and so am I, afraid that patients will replace us with these machines. Like Dineane said, there is already few opportunities for counseling and patient care. Most of us have worked in a pharmacy previously, can you all say that the pharmacist you worked with was able to provided great patient care like we are being taught to provide? Patients often do not ask questions or are afraid or embarassed to ask questions. If these InstyMed machines are rolled out everywhere, I believe it will attract many patients. But like we've been taught so far, we are the future of pharmacy, it is our responsibility to better the profession. If we a truly afraid of being replaced by these machines, then we must work that much harder to prove we are essential and necessary.
Christine Atkinson
P1
There have been a lot of great points on both sides of the spectrum and it is hard to see which side is right. And honestly, I do not think one side is right. I think technology is a great asset in the pharmacy. If used correctly it can aid a pharmacist tremendously, but the downside is not letting technology kick you out of a job. It is important for us to improve on our skills so that society will not one day decide that we are replaceable by machines and robots.
I view technology as a good thing for pharmacy as a profession. It shows that we are innovative, and wish to move into the 21st century as a profession. I believe that even with advancing technology, there will always been a need for a human, pharmacist, element. With the help of technology, we can dispense medications more accurately and faster. With the extra time spent not filling/checking, we can direct our time towards patient pharmaceutical care and counsling.
I think technology is not only here to stay but is also aggressively improving. What technology is out there now that can fill a prescription automatically will be that much better 4 years from now when we graduate. This technology will not only be better but will be far cheaper as well which will allow many more companies to afford them and become automated. So I do not think there is any sense fighting these improvements because I think it will be very commonplace in a few years or more. With this advancement, I do think that pharmaceutical care similar to what we saw in the Asheville project will be critical in carving out a niche for us that will preserve our income level and demand in society.
However, I do believe that the rise in pharmacist’s salaries from $70,000 to over $100,000 annually really stemmed from supply and demand economics. There was a shortage of pharmacists and this caused the spike in salaries. If the combination of more students graduating along with machines depleting the need for pharmacists I believe there will be an oversupply of pharmacists which will decrease salaries across the board. The market always dictates price and value and unless a big enough niche of pharmaceutical care is carved out for pharmacist I fear the above will happen. I also think that the more we push for expanded roles in pharmaceutical care that two things are going to happen. Firstly, a residency requirement will be inevitable. If the profession is going to get more clinical, clinical training will inevitably be mandated. Secondly, I think this push for pharmaceutical care is really going to cause some border wars with primary physicians as they have already seen their salaries dip by over 50% from the early and mid 1980s to today and are not going to want to give up more of their billable services to pharmacists who mostly have no residency training. We as a profession will have to brace for that and I believe ultimately we are going to have to fight for limited prescriptive rights. In this changing environment, the right to write prescriptions will ultimately preserve our salaries and demand from society. It will require a residency but that one or two extra years will be well worth it because if we do not get that right I believe the laws of supply and demand will prevail and our salaries will take a steep decrease. We go to school the same amount of time as medical students do and graduate with just as much in student loans, why do we not have that right already?
Jim Zacharias
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