| Editorial: Change!
We have seen a lot of changes this year! In fact, recalling the past forty years in the perspective of a pharmacist, it seems that changes are occurring more and more rapidly. Much of the change is good; however, much of it is bad for the profession�or, it can be said as follows:
Change can result in improvement or degradation of the profession and the services and products/preparations provided to our patients. Change for the sake of change may result in more problems.
I remember�
�the time when every prescription was paid for with cash and the "markups" were sufficient to enable pharmacies to offer many services and make a good profit.
�when change occurred and the insurance cards came in, the state assistance programs were developed, and the attitude of patients changed, as evidenced by them obtaining prescriptions they felt they had a right to instead of purchasing their own prescriptions.
�when more changes occurred and the authority for changing a prescription from a brand to a generic, etc., was removed from the physician, patient, and pharmacist to the nonpharmacist managed-care providers and state-assisted programs.
�when pharmaceutical representatives gave pharmacists explanations about new medications and about how the medications were marketed to physicians. Now, it seems pharmaceutical companies spend more time with state legislators and purchasing agents trying to convince them to only allow "their" products on the formularies.
�a time when the hospital pharmacies were the "cash cows" of the hospital and many different items were included in the $25 aspirin tablet charge. Now, however, change has occurred and hospital administrators don't want to spend money to help bring their sterile preparation facility into compliance with USP Chapter <797> to ensure patient safety.
We could go on and on about the changes that are occurring in pharmacy. I am deeply saddened by the number of pharmacies that are closing, especially in small towns, because they cannot get adequate reimbursement to stay in business.
So�things are changing, and I have a few questions:
- Why is it that many patients feel that healthcare is a "right" and should be paid for by others? We simply cannot afford that scenario; especially when many health and medical problems are brought on by an individual's lifestyle. I don't feel I should pay for an individual's lack of discipline and lack of good judgment.
- Why is it that employees feel they have a "right" to health insurance and that it should be paid for by their employer? Employees may be better off if we had a free market with more competition where employers could sell their products at a lower rate and hire more employees.
- Why is it that "we" (pharmacists, physicians, nurses, hospitals, others) don't work together to get back on a "cash" system and eliminate the involvement of the government and third-party insurers? The patients would probably save a lot of money in the long run. We could still have catastrophic health insurance, but each person would be responsible for their own non-life-threatening health problems.
- Instead of allowing so many situations to occur that enrich the managed-care organizations, pharmaceutical industry, etc., why not look at working towards a change and "thinking outside the box" or with a "new tool box"?
There are "doable" solutions to some of these questions that would result in better patient care and profits for all involved (except, of course, for the managed-care providers and pharmaceutical companies).
In summary, let me leave you with the following thoughts for this New Year:
Improving our situation requires change.
Improving our attitude requires change.
Improving our workplace requires change.
Improving our profession requires change.
As Heraclitus wrote, you cannot step twice into the same river, for other waters are continually flowing on. Or, in the words of Bruce Barton, when you're through changing, you're through.
Philosophers try to interpret the world;
Prognosticators try to predict what will happen;
Politicians try to control and/or play games with the world;
Pharmacists need to work to change the world in our sphere of influence to make it a better place.
The staff of the International Journal of Pharmaceutical Compounding, Inc. wishes you a Happy New Year.
Loyd V. Allen, Jr., Ph.D., R.Ph
Editor-in-Chief
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