Posted by Bill Sandweg on 10 February 2020.
Last week I blogged about how to protect yourself from pharmacy malpractice and remarked that instances of pharmacy malpractice were increasing. The current situation was discussed at length in a New York Times investigation.
The days of the corner Mom and Pop pharmacy are gone. Today, the vast majority of Americans get their prescriptions filled at chain pharmacies. Between them, CVS and Walgreens fill almost half of the prescriptions in the United States. Walmart, Kroger and Rite Aid are the next three largest players. Together, they fill the vast majority of prescriptions that are filled at brick and mortar stores. The efficiency and accuracy of those pharmacies are important to all of us. Given their nature, they are prone to mistakes and are making more and more of them all the time.
State pharmacy boards have been getting complaints from pharmacy employees of these chain companies that working conditions are such that they are making mistakes. The employees complain that the chains are reducing the staff at the pharmacies at the same time that they are increasing the workload. In addition to filling prescriptions, the pharmacist and his or her assistants must deal with drive through customers, give shots, answer the phone, and counsel customers about the prescriptions they are receiving. While these jobs are pretty straightforward, the chains are also requiring their pharmacy employees to call doctors for refills and to urge customers to let them seek refills automatically. Everything is aimed at producing the highest possible revenue from pharmacy operations.
According to the complaining pharmacists, all of the duties they are required to perform add up to an unsustainable workload. They cannot do everything their employer wants and still maintain quality control. Mistakes are being made and patients are suffering as a result. As I mentioned last week, I have represented families of patients who died because of pharmacy mistakes. They happen. While there will always be mistakes, because pharmacists are only human, we should do everything we can to make the environment in which they work as conducive to accuracy as possible.
It is hard to get a handle on the exact magnitude of the problem. The chain pharmacies won’t reveal their error rates or talk about how many of their customers are injured by mistakes in prescriptions. When people are injured, many will not make a claim. Those that do make a claim and resolve that claim with the chain are required to sign a confidentiality agreement that prevents them from discussing what happened. The last comprehensive study of medication errors took place 10 years ago. It was performed by the Institute of Medicine. It estimated that medication errors injure at least 1.5 million Americans each year. Importantly, that figure includes all medication errors and not just those made by the chain pharmacies.
The state pharmacy boards seem to be having little success in overseeing the chain pharmacies and getting them to increase the number of pharmacy employees. The chains are just too large and the nature of the problem is too amorphous. Also, according to the New York Times, at least some pharmacy boards have industry representatives sitting on the boards, which further complicates imposing discipline against them.
There does not appear to be a fix for the problem of overworked pharmacists on the horizon. The only thing you can do is protect yourself using the suggestions in last week’s blog post. If, in spite of your precautions, you or a loved one gets hurt by a medication error, give me a call. Maybe I can help.