Self-denigration in pharmacy.

Abstract

In response to the editorials by Drs. Davies and Tsuyuki on self-denigrating words and actions in pharmacy,1,2 I do agree that change is required, at the grassroots level, but I don’t agree with some of the statements made by the authors. Many of the issues highlighted as self-denigrating relate to factors that are in many respects uncontrollable for most community pharmacists, that is, the nature of the environment itself. And while one may state “that’s why we should limit ownership to pharmacists,” this is in place in Australia yet the same “issues” are present. The definition of allied is “joined in a relationship in which people, groups, countries, etc., agree to work together”3—what’s wrong with this term? I don’t believe it connotes a secondary role. As well, I’m not sure how many pharmacists would ever refer to themselves as “retail” pharmacists; it’s either pharmacist or community pharmacist. Those who work in a hospital are almost always sure to distinguish themselves as hospital pharmacists. “Minor ailments” do not mean “insignificant” ailments, and this term is integrated into legislation in many jurisdictions.4,5 By pledging to avoid the term minor ailment in CPJ going forward, does this mean that those in the profession wanting to disseminate findings on these ailments in various jurisdictions must look to publish elsewhere? With regard to drive-through pharmacies, I too used to think they served no purpose in community pharmacy practice, until someone asked me where I would prefer to have counselling done on a potentially embarrassing condition—in the pharmacy itself, with other patients right behind me, or in the privacy of my own vehicle? Furthermore, if you were a parent with a child who had otitis media and was in pain, wouldn’t you rather stay in your own vehicle with your child (or children) while the antibiotic was being filled? The environment of the community pharmacy itself is what dictates many of the “stereotypes” mentioned in the editorials. How many physicians or dentists provide the opportunity to purchase pop, chips, chocolate bars and other unhealthy fare along with a metformin prescription and a professional health care service? This retail environment means that patients do not always see themselves that way, with as many as two-thirds of patients viewing themselves as customers.6-8 Perhaps the profession would be best served by professional and advocacy organizations arming individual pharmacists with the tools and resources to advocate for better recognition of what pharmacists are and can do, highlighting the true value of pharmacists. There are examples of pharmacists going to politicians and providing professional services to inform them of the role pharmacists play and the value of pharmacists9,10 and of organizations that provide grassroots advocacy resources for pharmacists, turning them into frontline advocates.11,12 Instead of saying that the medication review you just completed for a patient is “free,” why not let the patient know the value the government has placed on the service (e.g., $60)? Why not invite your local MP, MLA, MPP or municipal leaders into your pharmacy to show them what pharmacists are doing and where they add value to patients and the system? This would help develop and nurture a long-term relationship. Being reactive instead of proactive will almost always result in a less than desirable outcome and will use a lot more resources.