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Big, Busy Pharmacies — Prescriptions for Error


Hmmmm, sound familiar? In my prior posts I have tried to hone in on some of the real root causes of mounting pharmacy errors. Unfortunately the Big Retailers want to create their own personal version of Hammertime’s “you can’t touch this” by pigeon holing any error into the “we are all mere mortals that make errors” column.

Then, lo and behold, I read with great interest in USA Today that CVS’s top gun attorneys are out there defending  two CVS pharmacies from being shut down by the DEA ( Drug Enforcement Agency ).

The new excuse they are using? The “we are a big busy pharmacy” defense and we would never “knowingly” fill an illegitimate prescription for heavy narcotics for cold hard cash.

According to University of Florida Emeritus Professor Paul Doering, CVS should not have filled these sketchy prescriptions:

“Someone from Kentucky who travels to a doctor in Fort Lauderdale and presents a prescription for oxycodone in Sanford, Fla., is to me a huge red flag, I can’t speak for every pharmacist in the world, but this pharmacist is not going to fill that prescription.”

So maybe a big busy pharmacy that is understaffed is the root cause of the problem after all?

If I hadn’t read it for myself I would have thought I was dreaming. So when it comes down to being shut down, facing fines, and who knows, even criminal investigations, out comes the “big busy pharmacy” defense. However, when an understaffed pharmacy is looked at as the root cause analysis for prescription errors that maim and kill people, we get the argument that it’s “a red herring” and the big chain pharmacy argues that they always have sufficient staff to properly fill prescriptions.

The truth is the epidemic of prescription errors are part and parcel of adopting a fast food mentality to dispensing dangerous medications. Yes, we are indeed all human and we make mistakes. I certainly don’t think anyone would intentionally harm someone. However, I also suspect that neither does the person who gets behind the wheel of a car when impaired, but it is still unacceptable and even criminal to allow that dangerous condition to exist.

If you remember the classic I Love Lucy episode where Lucy had to grab chocolates off the conveyer belt to put into boxes her “human error rate” went from zero to whole lot of chocolates going on the floor, in her uniform, and in her mouth when the conveyer belt was set too fast.  Like I have said before an error with my burger or even with my chocolate may be a nuisance, but it won’t likely kill me.

Until the pharmacy industry recognizes the serious nexus between understaffing and pharmacy errors, more tragedies sadly will most certainly be on the rise. That is the dirty little secret that business models driven by profits as opposed to safety, have to be addressed. The truth is, depending on the product, one business model may not be right for another. The changes must ultimately come from within these groups, but it will be investigations like this one by the DEA in Florida and civil suits accompanied by punitive damages will ultimately be the impetus to force the necessary self-reflection for the retail pharmacy industry.

Until then I intend to keep calling it like I see it……

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