Download the 7 Sins:

A Special Report:
If You Don't Get it Right Somebody Else Will

Download Report:
7sins.pdf

Need Acrobat Reader?
Click Here

From a lack of company-sponsored training and continuing education, to misaligned incentives that set compensation to reward pharmacists based more on fill rate than patient outcomes, compliance or even just basic customer satisfaction, panelists say they are receiving mixed messages about what is really important. In the end, many feel it is still just a 'numbers game' for the chains.

According to an online poll of pharmacists conducted by Drug Store News, of the nearly 25 percent who said they were not satisfied with the level of compliance counseling they are able to provide, more than 75 percent said it was—in whole or at least in part—because management measured their performance by the total number of prescriptions they filled. More than half said it was at least partially because their companies do not see a need for patient counseling, as it impacts profitability.

While most on the panel were reticent to provide a comment on the subject of compensation, one pharmacist from a big-box discount chain noted that his company surveys customers on their experience at the pharmacy counter, with measures such as wait time, as well as whether or not the pharmacist consulted them about their health and/or medications. "There is a whole list of criteria they have to answer and it is actually part of your bonus at the end of the year," he explained.

Another panelist noted that his chain just introduced a new evaluation system that relies very heavily on wait-times; a mistake, he thinks. Many customers are not able to distinguish the time it takes a pharmacist to do a standard consultation—just a little more than three minutes, according to a Drug Store News online survey—from the time they spent waiting for the script to be filled. In the end, it's just "wait time" to many customers. "In my opinion, it's kind of a step backwards [in terms of patient care]. Your district manager will tell you, 'We don't really look at wait times.' But it's right there on your evaluation."

Of course, as another pharmacist pointed out, to a certain extent wait time is a matter of perception, and some of that pressure can be mitigated by the pharmacy staff simply setting a more realistic expectation for the customer. "They measure wait times in terms of the time we give them," she explained. "When we're busy I have no problem telling my customers that it might take two hours to fill their prescription. Usually that keeps our wait times in line because
we set an accurate expectation for them and if we can exceed that expectation—say, we have it ready in an hour instead—it's just that much better."

For some, the introduction of Medicare Part D was a telling experience in terms of mixed messaging from the corporate office. "When Medicare Part D rolled out, all the chains, [mine included], went out to the consumer, saying, 'Ask your pharmacist—they're the Medicare experts.' But nobody really took the time to tell us anything or give us any direction as to how to find out. So we have people coming to us like we are supposed to be the experts, but we're as clueless as they are.

"My comment would be to let our bosses know that if you're going to tell everybody that we're the experts, that [you] need to make us the experts."

One common trait among pharmacists on the panel: a distinct ability to both think big but act small when they need to. Case in point: To help his patients navigate the complexities of choosing a PDP, one panelist who felt under-supported by headquarters on the rollout of Part D rolled up his sleeves and created his own program.

"For the past two years I have advertised—I start about a month ahead of time—and I help patients find coverage. I set up in front of the pharmacy with my laptop—I have a wireless card—and I sit down with patients, plug in their drugs and talk to them about their options. I did two days each year so far; I take appointments."

Importantly, he doesn't just see it as an opportunity to serve his current customers; he sees it as a way to steal customers from his competition. "I picked up 20 to 30 customers just from that—and a lot of referrals on top of that."

In general, pharmacists responding to an online survey conducted by Drug Store News noted that on average they receive about 2.5 days of training per year—a number all pharmacists on the live panel agreed was far too little.