Imagine going to the supermarket to buy a month's supply of Cheerios, but you can't merely pick up the box size and flavor of Cheerios you want. You have to wait for a supermarket clerk to count each Cheerio from bulk to put into a plain box and charging a 1000% mark up! This is how prescriptions are sold in America.
Why do pharmacists manually dispense drugs bought in bulk into little bottles - wasting time counting pills and increasing the risk of mistakes. Given how much drugs cost, shouldn't they already come prepackaged and clearly labeled?
Indeed, without a "safety seal" from the manufacturer, how does anyone know what they are really getting? Perhaps that Cheerio is store brand and not the real thing, just like that Viagra refill!
Last week I picked up a prescription and the copay went from $40/mo last year to $338.85/mo. Just like that! I thought it was an error - like in the article - but of course it wasn't.
That's the new realities of my new and more expensive non-subsidized Obamacare plan that the insurance company rep said I had picked - as IF I had a choice! It is the only one offered to me while claiming it was the equivalent as last year's plan - trumpcare in action! I currently pay the equivalent of a new well equipped mid-sized car in healthcare costs per year - just for me. And America is exceptional? Give me a break!
Oh, I refused the new price and have stopped taking the drug. I refuse to enrich the parasitic profiteers. Media threat? Yes!!
129
All it takes is spending five minutes as the pharmaceutical counter picking up your prescription to see that this article is 100% accurate. I feel very badly for the pharmacists trying to help their clients and being driven crazy by the insane, unrealistic expectations of the corporate store owners.
Will common sense ever prevail? It is possible to have profits without putting peoples lives in danger. The greed is despicable.
139
Anyone know if Costco is similar or different to what's being described at CVS, Walgreens Rite Aid?
23
Great eye-opening article ! Now I know why my local Walgreen's can't follow instructions. I do not want 90 day refills, and they keep giving me them, despite it supposedly saying on my records 30 days. On two occasions, they have tried to give me 90 day refills on a drug that I use a coupon for - the coupon is VERY specific that only 30 days at a time can be refilled. And in the process, attempting to charge me nearly $100 for the two extra months … when the coupon price is $ 5 ( five ) dollars per month. Thieves. Add in the surly staff, and the times I've seen staff impatiently roll their eyes at elderly customers who are not quite on the ball …
I will be taking my business elsewhere. I'm not sure where, yet, but certainly not to Walmart or Rite Aid. I detest Walgreen's attitude of they're doing me some kind of favor by not doing what I need/ask done, and trying to rob me as well, as though I'm too stupid to notice. Twice now I have refused to take the medicine with me, leaving the pharmacist verbal instructions to correct the order. They really don't like the possibility of someone making a scene ... I then wait a couple days and return and pick up my corrected order.
Sounds like this kind of thing is the new common practice ...
51
This is worklife in America for anyone who's not the final person calling the shots.
Pharmacists, have you thought about organizing? Unions are not just for dirty assembly line workers, you know. Sounds like you need one and need it desperately.
173
I know this is very true because I have a relative working as a pharmacy tech at one of the big chains. They are treated like slaves and overwhelmed. Also, what a surprise that state pharmacy boards are filled with corporate shills.
77
Forgive me for my ignorance but in the U.S. are Pharmacists Doctors? Just wondering.
11
Over a decade ago I worked as a Pharmacy Technician in San Francisco where it was expected that I stop typing a prescription into the system or counting pills to ring up a customer's toilet paper or potato chips in the name of CUSTOMER SERVICE
41
Once upon a time our town of 3000 had 3 pharmacies.. Today 1CVS serves 18000..
31
Undereducated, understaffed, and underpayed. This is profits outpacing healthcare quality. This is healthcare under Republicans an Trump.
63
The headline should have been, "Worker exploitation at chain pharmacies is putting patients at risk." "Speed-up" has a long, inglorious history. Previously, workers in a hog-processing or auto plant might injure themselves... at chain pharmacies, our friends, neighbors, family suffer.
64
I’m no longer using Walgreens, CVS or any of the large chains. That’s the only way to stop this- is to not use them.
48
CVS took over the formerly excellent Longs Drugs chain here on the west coast... Service promptly went downhill, as the stores expanded and became more and more 'KMart' style junkstores. And as time has moved forward its just gotten even worse.
36
While th "big guys," especially CVS, gobble up other chains and multiply their profits, they seem intent on saving money by understaffing their pharmacies. If a pharmacist can "easily by replaced," the chain should be hiring more of them. Greed again racks up profits and threatens lives.
33
Based on the response i read from cvs, they are either negligently unaware or totally uncaring about the sentiments of the employees who are literally sick and tired of the harmful working conditions that permeate retail pharmacy as a whole. A corporately sanctioned blind eye is not only dangerous, but unworthy of the efforts of the thousands of employees who are essentially being ignored. It is sad to see how much pride and dignity is being drained from the pharmacy profession. And for what?
41
Pharmacists are medication experts who graduate with doctorate degrees (PharmD), yet they are not treated as such.
Please treat your pharmacist with kindness and respect.
95
The CVS I use in the Bronx is pathetic. Always a huge line, prescriptions not ready when they are supposed to be, refusals to fill life saving (insulin, for instance) meds that cannot be missed, constant phone calls pushing refills, and general mayhem. The last time I was there, I swear a riot almost broke out! To all the people yelling at him that the pharmacy was understaffed, the poor pharmacist could only reply “We’ve told that to the boss, but he won’t let us hire more people”.
People have died. More people will die.But corporate profits over all, right?
55
I could have told u this several years ago. Walgreens’ is so understaffed it’s unbelievable.’ When you consistently have to wait 30 minutes to get your prescription that’s a hint there’s a problem and you need to go somewhere else. If a business is that understaffed go somewhere else.
15
JM,
Think healthcare is a reck now, just wait for Medicare for all is instituted.
Keep calm and carry on, it will be worse soon.
3
This has been true for decades! It’s about profits, not healthcare.
21
This article confirms what I have observed at my local CVS over the past few years. The staff is inadequate to meet the customer demand. The pharmacist on duty literally runs from one side of the dispensing area to the other in an effort to keep up. Telephone calls to the pharmacy are frequently not answered for 10-15 minutes. My doctors have been asked to renew prescriptions for drugs I am no longer taking, and I am always asked by CVS to put my prescriptions on automatic renewal, which I refuse to do. Thanks to this article, I will now carefully check my pills on Google to make sure I am getting what I have been prescribed.
35
Two weeks ago the CVS in Elmont, NY filled a prescription for a stomach acid reducer. While I received the correct medicine, the instructions attached to the bag were for Ritalin. When I spoke to someone at the CVS pharmacy they made a lot of excuses and said mistakes happen! Really?
It is apparent that the staff are all multitasking (and not well). You can see the chaos going on!
17
Walgreen’s has repeatedly been negligent with prescription refill requests for meds that cannot be skipped. Ordered a week ahead and they still aren’t available. I’m sick of the blame game- there’s no refill left, the dr. hasn’t responded to us, no we didn’t receive the fax you watched the dr. office send. After a week of no meds I discovered they were trying to refill old prescriptions instead of the new one’s they received a month earlier. The key here is that the patient had to figure out and correct the problem without having access to the screen or files the employees use daily. It’s bad enough that pharmaceutical companies are raping consumers, now the service providers feel entitled to a share of profits so they take it off the backs of employees and patients.
16
My local CVS has always been busy, and a bit chaotic, but right after Thanksgiving the whole pharmacy staff changed overnight, and nothing has been right since. Incorrect billing,
false text messages, botched renewals, missing orders, filled prescriptions returned early to inventory, it has just been a nightmare while the lines of indignant customers grows longer.
16
I'm so glad that this article was published and that these chain pharmacies' negligent, abusive, and dangerous practices are being exposed.
Perhaps the next article could address the number of pharmacists who have been robbed at gunpoint, especially on the night-shift, by those seeking to steal narcotics, and how negligent CVS is in ensuring employee safety before, during, and after an armed robbery.
Dangerous working conditions, unrealistic goals in turning around prescription orders, understaffing/cutting pharmacist and tech hours likely due to cover the cost of purchasing Aetna/Caremark, lack of competent management, abusive customers, fraudulent, illegible, inaccurate prescriptions, and being forced to come to work febrile with the flu "because no one wants to cover a sick call, and if you don't come in the store will have to close and we'll lose money"...The list just goes on and on. All about the almighty dollar.
I'm forced to use CVS due to my prescription plan, but other than my meds, I would not even buy a pack gum from them.
49
“Do more with less” is always a lose - lose plan of action in the healthcare industry. Every time I hear this phrase from Administration, I cringe.
Sure, we should minimize waste and be efficient in healthcare, but this insatiable desire to extract every last cent in profit in this sector is claiming lives and doing nothing except pad the already overflowing pockets of healthcare executives.
Unregulated “capitalism,” where greed gets to play itself all the way out to its endgame, will cost the world dearly, especially in the medical sector.
Moderation, thoughtful structuring, and recognizing the possibility for error is fundamental to making healthcare businesses efficient, while also striving for high-quality care. We can do better, but stretching threadbare resources until they get overloaded is not a good way to achieve these lofty goals. Basta.
14
Years ago my prescriptions were held at a local CVS. I always check my prescriptions and one time I noticed a handful of different colored pills in the bottle with my synthroid. I brought it back to the pharmacy where I was told those were diabetes drugs that wouldn't have hurt me!! No apologies offered and that was the end of CVS for me.
15
I was just at my book club and we were discussing the amount of medication errors by our local CVS pharmacy. Thankfully, we customers each caught the errors ( being given medication that belonged to someone else in error). We each were given $25 gift cards for our “trouble”. It is a lawsuit waiting to happen!
12
This is incredibly disturbing, but sadly, not surprising in this climate. We also have doctors who are too terrified to do their jobs and treat patients properly (and please let's not get into blaming opioid addicts for this one - doctors take an oath to treat patients, becoming carefully educated and super vigilantl when prescribing certain medications is one thing, denying people proper medical care is something else entirely). One can walk into a doctor's office or ER these days with his entire headed detached and doctors will say "ok, take a Tylenol". We also have police officers who are so "frightened" that they need to pump a minimum of 8 or 9 bullets into a suspect who is running AWAY from them. I put "frightened" in quotes because I'm not entirely convinced that some of these types of shootings are more about someone with a god complex reacting to the gall of people who don't halt when the "almighty" officer orders them to. Anyway, I know I've veered a little off topic here, but I'm feeling like this is an overall breakdown of the machines of society and it is going to get worse before it ever gets better.
25
As a physician, I can testify that the chain retail pharmacies are a mess. About once a week I have to deal with a clinical issue that has arisen because a chain pharmacy has failed to dispense a medication I e-prescribed, or has dispensed the wrong quantity or has prescribed the wrong dosage.
17
@Mary May About five times a day I’m cleaning up a doctors mess because whoever puts that e-prescribed medication in wrote for a qty of 720 1BID for 10 days. Doctors are not without fault in creating the mess going in retail pharmacies.
44
Thank you for this article. As a psychiatrist, it this article covers a problem I have had for the past few years.
I’m fairly meticulous about writing the prescription for enough medication for 30 days with enough refills to last until the next appointment (generally with no more than 2 weeks overlap in case of a rescheduled appointment).
A new patient prescription I write specifically for 2 weeks supply seems to generate a request for a 90 day supply just days after the initial prescription was filled.
By hounding a young pharmacy tech for answers, I found out that at CVS there are many buttons on the keypad the patient need to press to pick up the prescription. Confirm name, confirm date of birth etc. One of those screen says something to the effect of “do you want all of your prescriptions to be filled for 90 days?”
When someone isn’t feeling well physically or mentally It’s almost a trick to put that screen there. I started asking patients and almost all of them didn’t know they had checked that screen.
Basically the pt has to “opt out” to stop this from happening.
I complained to CVS corporate regional. No answer and no changes
I feel bad for the pharmacists and techs that are up against this problem. They get it from all sides. Corporate is on their backs, patients are unhappy, and I will admit to being less than friendly until I found out it was not the pharmacy staff at fault.
30
Laacata,
As a former RN, I am very familiar with the formulary used by many institutions, the PDR, in this book, one can both see the writing and numbers on the table plus any physical description of the tablet; I am pleased that my CVS gives me a print out that describes the color, shape and any inscriptions on my medications.
I watched this stuff carefully but I have never observed an error in prescription.
Any lay person can follow this method from the print out that is attached to the prescription for patient use; it is our responsibility as educated people to check the labels too, trust but verify.
10
My family recently had to switch pharmacies due to our health plan benefit manager removing many of our other pharmacy choices. We ended up at CVS and it is every bit as bad as this article describes.
Their pharmacies are horrendously understaffed. When at the pharmacy counter, the phone rings and rings, but the pharmacy staff simply ignores it because there is literally no one who has a spare moment to answer it.
I have been there in the middle of a busy weekday and there is ONE person running the entire operation. In a large and busy pharmacy. This is a recipe for disaster.
25
The CVS near me is so chaotic and dirty with massive amounts of prescriptions waiting to be picked up. When my husband gets drops for his eyes and is given a 3 month supply, a month later he's bombarded with calls and texts to pick up his next batch every day. Unfortunately, we are required to use this pharmacy due to his insurance coverage.
14
At my CVS pharmacy, it is obvious how stressed the pharmacists and other folks behind the counter are.
16
I quit CVS over a year ago. I was very concerned for the safety of my patients. The company is doing this knowing the risk to the patients and lack of concern to their employees .
30
I'm a certified pharmacy technician and worked at CVS for three years and frankly the article doesn't go far enough. I was told to not even ask patients if they want us to contact their prescriber for a new med but to send the request anyway, even if it was for a limited use medication. My own doctor will no longer take refill requests from CVS because of the number of unnecessary calls she's received about scripts, including ones archived due to allergy. I worked at a very busy location that had only three hours of overlap between pharmacists, routinely went over the pharmacist-technician ratio, and that customers frequently wait 45 minutes at. There is no time to counsel a patient on anything and most counselling is done by a CPhT asking the questions and relaying the pharmacist's answers so the pharmacist can keep filling.
The computer verification steps are ludicrously easy to bypass if it tells you you have the wrong drug, and the speed at which we had to work meant that multiple bottles were always at the production counter, making it very easy to use the wrong thing.
In the interest of metrics, I was asked to ask questions that I felt violated HIPAA and got "dinged" when I flat out refused.
In short, we are overworked and underpaid and subject to an endless amount of useless metric meetings as opposed to giving our patients the care and attention they deserve.
66
Thank you for the article. I now understand why my Walgreens pharmacy gives me 90-day supplies of medications when I only want 30-day supplies, automatically refills medications when I haven’t requested them, and calls my doctors for refills of medications I no longer use. I have repeatedly requested them to stop automatic refills, but they do it anyway. They recently wasted my doctor’s time requesting a refill of something I don’t still use, generating a concerned call from the doctor asking me to make an appointment to see him. I have grown so frustrated with this that I no longer pickup the medication. I let it sit on the shelf at the store and call in for refills when I need them.
12
I refuse to use the Chain pharmacies because of this and other issues I have encountered. Waiting on hold can take up a lot of time not to mention the long lines and understaffing. I find Walgreens to be inconsistent in prescribing the same brand monthly for medications that require this, i.e., Levothyroxine Sodium. A new pharmacist at the Walgreens I had been getting my prescription filled at refused to fill my prescription (an opioid) because he didn’t agree with the dosage telling me I should tell the doctor to prescribe the amount of his choice. That was when I left there and haven’t looked back in years.
The chain pharmacies are supposedly cheaper than the retail ones but that is not always the case.
I go to a wonderful family owned pharmacy because I get a person on the phone immediately, they deliver, and they have a huge staff who are helpful as well as knowledgeable. I am so much happier and much less stressed!
18
As a pharmacist for more than 30 years, I can tell you this is all true. And don’t single out CVS and Walgreens. This is a problem in all large chain pharmacies.
Thanks to computers employers can see how long it takes individual pharmacists to perform each step in the prescription filling process. So we can see that it takes us a certain number of seconds to, say, preview a prescription. Where it gets fun is you also get to see how you compare to your co-workers. Now it becomes a race. You do NOT want to be the slowest in any metric.
That’s only part of the story. We are also under incredible pressure to perform clinical functions (eg prescribe oral contraceptives and administer vaccines) on demand. It is absolutely hair-raising.
I can complain endlessly about the 13-hour days without so much as a 5 minute break, age-ism, threats from management,etc, but honestly we pharmacists allowed this to happen to our profession. It doesn’t mean it can’t be fixed, though.
Let’s start by removing corporate representatives from state boards of pharmacy.
93
@Margaret: It would be interesting if ALL the pharmacists at a given location agreed to slow down and see who could be the *slowest* in any particular metric. Maybe then the metric would need to be re-calibrated.
But point taken, and agree that corporate representatives have NO place being on state boards of pharmacy.
21
Our nearby CVS is chronically understaffed. I have seen it take more than 24 hours to fill a prescription when they had the medicine on hand. The drive-through takes too much attention away from the job of filling prescriptions.
17
Please continue to research and report on this vital and mostly overlooked topic. I also encourage you to dig deeper into the work, training, working conditions, compensation and responsibilities of Pharmacy Techs. Pay is low and turnover high. Tech's too are over-worked which is yet another point of potential danger to patients and definitely a stressor for pharmacists who rely on them so heavily!
35
@Susan Knight I agree as a tech! It is a lot of stress and running around. I've run around and been on two registers at once and running around for two peoples set of scripts. I've given an item without a person paying, they thankfully returned it, and it's a mess when we have a long line esp when registers crash so we can't get back up. Add in all the questions we have to ask the patient...or just answer ourselves in a way which helps our metrics, which is what we seem to do.
9
I am so thankful to the Times for publishing this paper. As a CVS pharmacist , I can honestly say everything in the article is true. Having worked for Cvs for 8 years, I have seen the things depicted in the article first hand. We never have the proper staffing to get the job done. Last year they cut hours drastically and pharmacists were forced to work off the clock. We were told we have to do more with less. Most pharmacists have to come 1 hour early and leave 1 hour late to keep up with the work flow. With only one assistant most of the time ,the pharmacist must do everything from typing the prescriptions ,to answering phone calls ,making over 50 calls every day,and verifying the scripts while making sure the patients get the right meds. Working for cvs is like riding a roller coaster in a war zone.!
55
It’s similar to RN staffing at the hospital. Understaffing is the usual practice even when its proven that it causes preventable mistakes on patient care. It is mitigated by the California safe staffing law on RN /patient ratio. Only happened because of union lobbying for the law. Maybe Pharmacist should form unions .
27
This article is so true. I’m retired after over 50 years as a RPH. For 40 years I loved my profession but for the last 5 years I practiced the work load and lack of help was impossible to practice and feel safe. I especially was distraught over not having enough time to consul my patients and give them the time to do what I knew was necessary to answer their questions. Many days I had no break to eat lunch, have a bathroom break. I’m now retired but was diagnosed diabetic which I contribute to an unhealthy diet of snacks as a substitute for a balanced diet. The boards of Pharmacy needs to do their jobs to assure Pharmacist work under safe and reasonable staffing and breaks to eat and have time to relax!
35
I just want to say thanks to Tom and the other excellent pharmacists at CVS in our Westchester, NY drugstore for being fantastic and caring human beings. They have saved us a number of times from hassles and made us feel so very grateful - often. NOW - I want to thank them a million times over for doing so in the face of the articles’s description of corporate practices that are anti-consumer health and safety. Pharmacists - tell us what we can do to help you. Leaving for the local neighborhood drugstore is not the only answer - let us help you - and protect ourselves!
36
I am a retired pharmacist who spent the last five years of my career with CVS. Everything in this article is true, and then some. I would still be practicing if I could work in a sensible and safe environment. I loved my patients, I loved being a healthcare resource, and I especially loved the patient contact and working diligently to make sure the underserved could somehow afford their medication. Working with insurance companies was labor intensive and required communication with physicians to get the Rx for a drug that was affordable or covered. But the 13-hour days, checking a prescription roughly every 2 minutes, being the only pharmacist on duty, no breaks for meals, no chair, looking at my watch and realizing I had worked for 11 hours without having time to go to the restroom ... it became exhausting. I made no major errors, but thank God I had excellent technicians working with me. Putting just one additional part-time pharmacist in each store would dramatically improve safety, working conditions and get the pharmacists back in touch with their patients. I loved my job, but I just could not take it. When a young person wants to talk about a pharmacy career, I tell them to study engineering it business. I think they allow you to go to the bathroom on Wall Street.
77
@Lori Botkin Bagley I agree with you and I wish my pharmacists had chairs. I wish us techs did too - it would be easier on the feet. I just got home from a 9 hour and my feet ache. I have three pairs of running shoes just so I can switch it up, and not wear any of them out, so I can handle the amount of time on my feet. It's sad that my pharmacist, the head of my store, doesn't like to take the time to find a coupon for customers who are in need of the savings. When I do it he gets mad. He even said that "It takes 20 seconds to find a coupon, 20 minuets to rebill it, and 20 more seconds to reverify it. I don't have the time, I have other tasks to do."
18
As a Pharmacy Technician in a Walgreens, I can attest to everything in this article being true. The amount of phone calls and refill requests that my co-workers and Pharmacists must make in order to keep our metrics good is not helping anyone. We have two Pharmacists for the whole store, which means that they each must work at least two 12 hour shifts per week (at minimum), and the technicians routinely work 10 hour shifts, sometimes with no breaks, because we are short staffed and unable to get hours from corporate to train any new hires.
I am currently looking for a new job in my field of study during my graduate degree, but I do hope that Walgreens changes their policies with respect to pharmacy and measuring success. It leads to a toxic work environment and has turned the job that I once enjoyed going to, into something I routinely dread when I pull into the store parking lot.
29
Oh...two years ago, my three year old got croup (spelling?) like cough. I used an video consultation app. The physician I consulted took 35 minutes to calculate the dosage for the medication (which didn't inspire confidence). Finally, she sent the prescription to Walgreens.
When I arrived there, the pharmacy tech informed me that out of the two meds, they had only one and they had filled it. Obviously, that wasn't helpful.
So, I took the prescription and went to a small pharmacy near my house. I know the owner and we chatted for a bit before he read the prescription. When saw the dosage, he was appalled. The dosage prescribed was 8 times higher than when I should give my kid. So, I followed what he recommended.
Now, if I had filled my prescription at Walgreens, i am unsure what would have happened if I had followed the dosage prescribed by the doctor.
My guess is, if the Walgreen pharmacist wasn't crazy busy, he/she would have spotted the error in the dosage.
21
Thank you for the great article. We use CVS for our prescription drugs because they are our Part D insurance company’s “preferred” pharmacy which gives us a lower co-pay to pay. There is almost always a line at the pharmacy. After a few particularly long waits I complained to corporate. Corporate’s reply was a suggestion to talk to the store manager. We already had talked to her; she had no authority to increase the staff. The constant automated calls from corporate are annoying; we have cut down the number by taking all of the prescriptions off of automatic refill.
I wish that states would step up and regulate the working conditions, it might make things safer.
19
My last job as bench scientist in multi national pharmaceutical company, we were short staffed, had 9 hour days on average, had to work weekends to meet the deadlines. we needed to account every hour in 40hr work week.
3
I haven’t read anything this outrageous in a long time. Corporate greed to the max! These companies factor in the cost of making mistakes (what’s a injury or death here and there) because it likely costs less than establishing a decent and safe working environment. I used to get crabby with the pharmacists. NO MORE. I will cheerfully wait with patience and respect for the work they undertake.
53
I have been a pharmacist for 26 years and worked for CVS and Walgreens both, for a supermarket chain and an independent pharmacy. All in this article is true and then some.
You are absolutely correct in saying that a medication mistake, injuries and peoples lives are factored in as risk in running a business. You as the patient are a number in their profit. If you are not injured the corporations make more money, if you are injured then they make less money.
To me that is unconscionable. I as a pharmacist in both chains lived in fear of harming my patients all the time and ultimately had a nervous breakdown and haven’t practiced pharmacy for several years.
Something needs to change.
25
You are absolutely right. That being said this reminds me when I was a family physician and had similar problems. It’s all about the money not about patients and doing the right thing. I am sure all these pharmacies are trying to do the best they can in a terrible environment.
10
I am a 30+ year pharmacist for Walgreens. Ever since this company stopped being Walgreens and became WBA ( Walgreens Boots Alliance), it has gone south. The current leadership of this company is only interested in the bottom line. They are just concerned with metrics! As for errors. Yes, I admit that I have made some over my career. Fortunately none have been fatal. One thing a consumer can do is to just simply relax and give us time to fill your prescription. I can't tell you the number of patients who whip thru our drive-thru expecting their rx to be done 2 minutes after leaving the walk-in clinic a block down the street from my store. Have you noticed how crowded the waiting rooms are at a walk-in clinic? We sometimes gets 10 to 20 images at once from surrounding clinics and offices in a matter of minutes. These don't get filled magically. Here is another thought in helping minimize errors. When you come to the counter or the drive thru, HANG UP YOUR PHONE. Maybe the 1 or 2 minutes the rph has to go over the medication with you could actually benefit you or catch an error. I can't tell you the number of people that continue to talk on their phones while I am trying to go over a medication with them. I ask if they have questions and I get a look like why am I talking?? We have way too many distractions and demands on us everyday. All we are told is that doing these ancillary jobs is how we now get paid by PBM. I am no longer proud to say I am a rph anymore.
52
@Joe - My pharmacy is great. They know me by name and if there is any wait at all, no problem. They are located in the back of a second-hand store and so I just wander around looking for a kitchen item or pair of baggy sweats. Or, I just walk across the street to my favorite coffee shop in town and enjoy.
I remember one time, my last doctor wrote a prescription for a muscle-relaxer for a very painful shoulder. I got three different calls from staff members at the pharmacy asking me if my doctor knew that this medicine can cause seizures and that I have epilepsy? Yes, he had told me about the outside chance of this med causing seizures but I fit neither category and so all was well. Try going to a VA pharmacy for scary:))
5
@Joe I'll add to it that when customers keep coming up to the consultation area to bother the pharmacist and distract them from their task. It can cause mistakes.
9
I'm a pharmacist. Over 30 years ago I complained to the pharmacy board in Illinois about my 12-hour days with no bathroom, lunch or regular breaks. I complained about under-staffing, distractions built into my daily work by design of both the physical structure of the pharmacy and the structure of the work flow -- all out of my hands. The employee pharmacist has huge responsibilities & no authority to correct the dangers. In managerial speak, that's ulcer gulch. The answer I heard from the board was that they don't insert themselves into the employer-employee relationship. If you don't like your job, QUIT. Furthermore, we are not in the business of protecting you from your employer, we are in the business of protecting the public from YOU. Blaming the victim, perhaps? I went on to earn M.S. and Ph.D. degrees with my research focused on employee pharmacists and the fact that their professional knowledge and judgment are trumped (ugh) by corporate edicts and the bottom line. Labor Law? The Fair Labor Standards Act of 1938 (FLSA) does not protect highly paid professional employees even if over 50% of their work is routine & mechanical not requiring professional judgment. As I began my research (1988), when the as-amended FLSA-defined highly-paid professional employee was earning $7.25/hour or more -- the 1970s amount that Reagan reverted to in overriding Carter's changes before he left office. About $17/hour was the going rate for pharmacists at the time. Any ??.
18
I didn’t know anything about the working conditions for retail pharmacists until my daughter-in-law graduated from pharmacy school and accepted a job with CVS. She has been subjected to 12-13 hr work days, no breaks, no lunch, not even a chair to sit on! CVS apparently feels their pharmacists are more efficient when they stand. On top of this, continuous reductions in staff and crazy metrics that they are evaluated against...regardless of what the corporate talking heads say about use of the metrics. CVS cares about 1. Money 2. Money 3. Money.....somewhere down the line patients...and still further down the line, employees. When a company treats employees like this, you cannot expect good outcomes!
57
This short staffing trend is widespread with nurses. In the meantime, my healthcare system hires Vice Presidents after Vice Presidents. Remember that all the these VPs are just overhead (the revenue is generated by doctors) The not for profit health system’s CEO make 2 mil, Senior VP makes 1.5 mil, CFO makes 1.3 mil. There are many more senior VPs who make 700 to 900 K. (All this info is public. That’s how I know. )
In the mean time, nurses who bring comfort to the patients have to struggle with long hours and short staff constantly.
26
As a retired clinical laboratory technologist, I can assure that these working conditions apply to 'the labs'; similar problems. Wrong name on the collection container is the number one mistake. In most states techs are not licensed. It is not productive to blame any one stakeholder in any system. This requires, fact based, systematic reforms.
8
joe rockbutt. or the managers are doing what they are told. taught and told to do by their District manager, who is told by their Regional manager...and so on...the problem is systemic, these behaviors dont just randomly appear at the store Pharma service desk.
1
I rely on a CVS pharmacy. It is staffed, in my experience, by one pharmacist and one technician.
These two folks seem very competent and are unquestionably devoted to serving their customers.
The staff is often extremely busy (hint....,not as busy between 7 and 8 pm). Sometimes the wait time is in the vicinity of 20 minutes. There are only two seats in the waiting area. There should be eight.
I have often thought about writing a letter to CVS headquarters admonishing the executives to increase the staffing of the pharmacy.
I am dead certain that CVS executive are highly compensated. I wish that CVS invested increased resources for its frontline pharmacy staff.
Customers would benefit. So would the staff.
30
@Michael Ebner: Yes to everything you've written. I think CVS execs should be REQUIRED to anonymously wait on line for a prescription to be filled - 20 different times, once each at 20 different CVS locations.
They should also be required to phone in with a question and calculate how long they are stuck listening to CVS's execrable "hold music" before they lose their patience or their minds.
8
I’ve always been pleased with my locally owned pharmacy. The service is good, and I enjoy going in. But I did not realize that I am also safer in their hands.
16
I, too, use a local independent pharmacy. The staff are friendly, knowledgeable, kind, and not rushed. My prescriptions are filled in about 5 minutes. I’m relieved to know that along with a wonderful staff, my safety is not being compromised.
12
My recommendation is to go with a local pharmacy. I used Walgreen's for years but had such bad experiences with it that I was grateful to find a local pharmacy that not only tracks all my meds but delivers my Rx for free. They keep good records, report to my doctors and when I talk to someone there, I am talking to a stess-free individual who is happy working at this pharmacy instead of one of the big giant pharmacies where there employees are stressed to the max and very unhappy. Medications are potentially dangerous. Don't risk your health at these big pharma-companies
12
I wish I had the option of an independent pharmacy. The last one within reasonable driving distance (25 miles) closed last year. Our only choices now are big national chains and no matter how many different locations I try the results are always the same: long lines, clearly overworked pharmacists and relentless pressure to get refills I don’t need. I didn’t realize how lucky I was to have that independent pharmacy until it closed.
7
@Patti Smith - There is one independent pharmacy near my house. Another closed over a year ago. Yet I am within walking distance of a CVS and a Rite-Aid, and within a very short (5 minutes) drive of two other CVS locations.
My parents’ small town has a Rite-Aid and a Walgreens. A charming independent pharmacy opened in the town a few years ago, but closed after a year or two. My mother assumed they couldn’t compete with Rite-Aid or Walgreens, and I’ve no doubt she was right.
2
I stopped using Walgreens and CVS both because of chronic understaffing. Excessively long hold and wait times along with frequent errors made doing business there a big headache. I switched to my local grocery store pharmacy and they give me excellent customer service without mistakes.
8
This article makes me so sad.
I've been going to my neighborhood CVS since moving here four years ago and I've always had good experiences with the people who work there. They're all very nice and somehow manage to not make our interactions feel rushed. But over the past year or so, I've noticed what seems to be a chronic understaffing problem. The pharmacy techs and pharmacists all look haggard with stress and exhaustion—and they look like that literally all the time. I couldn't do it their jobs. Recently I've been picking my prescriptions up at a CVS in the suburbs to try to lighten the load on the workers at the one by my house, but after reading this article I've decided to transfer back to the indie neighborhood pharmacy. Going there was always a superior experience, but the hours at CVS were easier for my schedule. Not worth it.
Besides, CVS receipts are next-level insanity. The planet would be better off if we all went elsewhere.
24
Our local CVS now has ONE pharmacist on duty - down from two. Prescriptions take 6 hours to fill when phoned in.
I pity the one pharmacist on duty.
20
For profit health care system run awry. Lack of independent pharmacist choices in health plans and pharmaceutical companies and insurance companies partnering so it is all about money and not the patient. Should not be publicly traded companies or much stricter licenses for pharmacist hours.
As far as part time goes, has anyone going through radiation therapy asked if they are full time? Huge change in that profession. Mostly part timers now when the for profit schools began opening programs everywhere. Competent people who passes licensure cannot get jobs because they are part time. That should not be the norm. Many nurses like part time work but that is not the case for most people in health care to keep their skills up.
4
CVS says they “put a system in place” to avoid oversupplying drugs to patients...why do they need a “system?” How about they just follow the instructions the doctor wrote on the prescription? Sounds like they have a problem with unethical managers. Just fire them!
11
I’ve had a feeling of dread for years standing in 20 minute lines at CVS. It’s obvious the pharmacies are understaffed.
Thanks for giving credence to my suspicions, NYT. I’m switching to an independently owned pharmacy.
11
“Corporate Performance Metrics”
Ahh, the immorality of corporate capitalism raises its head yet again.
11
There is no “chaos”. Chain pharmacies are doing what they were designed to do, which is to create value for stockholders. If you want someone who cares about your prescriptions, find a locally owned pharmacy.
7
Were are our elected officials in all of this? These are the things we elect people to office to manage for us as a whole! I know regulation is a dirty word to greedy politicians but have these people no shame? There is no defense for this type of corporate behavior. Write to you congress person and your senate person and ask what they plan to do to protect us! If we don't get the action we deserve it's obviously be time to clean house(s)!
10
LOL this is the tip of the iceberg of what they are doing. Ask any CVS pharmacist. They'll be happy to spill the beans. Here's some clues to start with..... they own CVS Caremark, the largest benefit manager. Nothing suspicous there.. They also age discriminate with pharmacists. Don't take my word for it, ask any pharmacist in the company. Just make sure they are in a place they can speak freely.
26
It's not just the pharmacists who are getting shafted, it's the consumer, and the insurance companies who hire pharmacy benefits managers to "manage " the costs of prescriptions for them. In practice this means enriching themselves. The costs of the benefit managers enriching themselves gets passed on to the consumer in form of higher premiums. The whole system is sick with corruption and greed. Don't wait for the politicians to fix it. Their part of the problem, not the solution. It will require grass roots efforts. If I were taking drugs, I'd go to an independent pharmacy not one of the big boys who are engaging in corrupt business practices.
3
Welp, I think I just decided to get my stuff from an independent pharmacy, I want to LIVE thank you very much
6
This is 10000% accurate. I was a pharmacy manager in Texas and for Walgreens for almost 15 years thus is exactly what we are forced to do. And if you spoke up or went against the grain you were labeled a troublemaker!!! This needs more attention in the name of public safety!!
9
CVS is a healthcare disaster run by an absolute incompetent CEO and his underlings. It has cut pharmacy staff to bare bones, forced its pharmacists to meet ungodly performance goals that make many accomplished pharmacists look like incompetent professionals.
Why is there no official bio / lunch breaks for pharmacists and their staff who are forced to stand continuously for 8 hours or more? Even the factories have better working conditions
Sooner this CEO and his incompetent direct report executives are ousted, better it will be for the patients. CVS should now be renamed Customer gouging disservice.
21
This is only the tip of the iceberg. Walgreens is the same, as bad as CVS. As pharmacists, we can never sleep well at night...did we make a mistake that day? Corporate culture is against us. Our jobs and livelihoods depend on metrics...worse then what Wells Fargo made their employees do. We get penalized for taking too long counseling patients, get threatened with bad evaluations and write ups because we try to care about people. In fact, I had been meaning to write to NYT about this very ugliness recently, as it has become much worse.
Unfortunately we have found no support in our boards of pharmacy. If you complain, they threaten you with dismissal, and it is about hiring someone else by paying them less. We do not even get paid for the hours we put in, since we spend hours on end trying to clean up, and help each other. As another fellow pharmacist mentioned above, patients need to understand that by pressuring us, they are putting thier lives at risk - simple as that.
There are no consequences for these companies, so long as there is money to be made by the CEOs and CFOs and shareholders. We, the people are the ones who suffer, and will continue to.
Employer-friendy states treat us even worse. We have no rights. Whether one believes in unionization or not, a union would help our profession resulting in better health outcomes for our patients. Needless to say, if our supervisors hear anyone talking about a union, they are reported to corporate.
17
@Zor, I’ve hated CVS ever since they stopped taking checks as payment.
On behalf of someone who worked for the company for 4 years + is married to a current CVS pharmacist, THANK YOU for publishing this. And for patients reading this article, I hope you understand that the Pharmacists and technicians are not incompetent - it's CVS corporate (higher ups) who are putting your safety at risk by over working their employees. CVS will literally try ANYTHING before hiring help. My partner stays hours after his shifts and often comes in on his days off (without additional compensation) out of anxiety to keep the store afloat. 13+ hour shifts without a real lunch break. Everything in this article is the truth, and the CEO of CVS's response to this is very disappointing: https://cvshealth.com/newsroom/press-releases/cvs-health-responds-recent-news-pharmacy-workplace-concerns
34
Don’t you just love the freedoms we have under extreme capitalism—the freedom to shoot each other with high powered automatic weaponry, the freedom to die in a military conflict that is designed to benefit only one person (and it is not you) and maybe big fat cronies of that person, the freedom to just about make slaves out of employees in the pursuit of as much profit as possible, the freedom to be buried under so much medical debt that you end up on the street pushing a grocery cart of your remaining belongings, the freedom to be pestered by notices your refilled prescription is impatiently ready for you to drop by and pay for it, needed or not, and the freedom to die from getting the wrong prescription ( it is those overworked, underpaid slaves, you see). God bless this unkind, uncaring, brutal mess, I guess as long as it is not affecting you directly. But they will come for you or your grandmother or your child if we let them continue to take apart our democracy that was government of, by and for the people.
19
As a Psychiatrist, I was perplexed by how many refill requests I get per day from pharmacies. This explains why. Disgusting. And unsafe.
9
The CVS form that asks if a patient is a ‘media threat’ says it all.
16
But... but... these companies are only out to better our lives. Oh, wait! So is Trump.
5
we feel so helpless. these companies are so big. Thanks to the NYT there will at least be some embarrassment.....hopefully.
5
This article is about 10 years late to the scene.
9
After 30 years with Walgreen's I quit them last year. I had appreciated that my prescriptions could be easily filled anyplace in the country etc. However, after a move, my new local Walgreen's was clearly very understaffed. The pharmacists were rude, harried, unwilling to do simple tasks like confirm refills and they made insurance mistakes which cost me a fair amount of time to straighten out.
So, I dumped Walgreen's and went with my tiny local independent. Best decision I made, great service etc. Had Walgreen's properly staffed my local store, I'd still be their profitable customer.
Businesses need to feel the pain when they cut costs unreasonably and treat workers poorly in search of quarterly profits.
5
Same issue in medical clinics across America. What do you expect when our healthcare system is set up as a business?
I'm sick right now and taking care of patients in clinic. This is ridiculous.
10
If each state Board of Pharmacy could coordinate with its state legislature to enact laws requiring dispensing pharmacists and pharmacy techs to have (1) minimum RPh staffing per every 200-300 daily Rxs (2) mandatory rest periods, breaks & meals) and (3) maximum # hours per shift. The consequences of overworked, unrested pharmacy staff can be deadly. If chain pharmacists cannot make their 'shareholder value' targets with humane working conditions, they should exit this business and retire. Enough is enough.
11
This is life, and more often, death that is the dystopia of trump’s “America.” People are literally dying in the streets because of his brutal capitalist, racist, illegal regime. The Senate must remove him and install Secretary Clinton as caretaker until Bernie can assume total power for The Workers!
3
CVS is simply lying.
5
What I've heard is that, locally, pharmacies are only hiring part-time pharmacists. As a result, there are pharmacists who have to get 3 jobs to make a living. Of course, Athens, GA has a pharmacy school. Therefore, pharmacies have plenty of candidates they can offer just part-time positions. This way they avoid having to pay benefits like insurance and retirement.
12
I'm a Canadian retired pharmacist, who was also involved with our College and sat on the Disciplinary Committee for several years. Yes, the pharmacists should definitely be disciplined, but also their employers! I was totally appalled by the time I finished this article. Ellen Gabler, you did a fine job!
4
It's the scourge of modern capitalism. It's not enough to have a good business with large profits. The modern thing is you must grow at compound interest or the stock price goes down and the executives bonuses and stock options lose value.
Compound interest yields an exponential rate of growth.
10
Peter Halle,
I would tell you that almost all of my prescriptions come in prepackaged 90days supply and the pharmacy technician, usually in my case, Sweet April, parcels them out if they are not prepackaged, then the pharmacist verifies the prescription; seems like a jungle out there; we, as nurses certainly had our share of 14-16 hours per shift of working, even in NYC with NYSNA on site, but the only pharmacist I have seen so overworked were in the hospitals, especially the pharmacist assigned to chemotherapy.
I agree with the article; I am not practicing in a chain but I am a pharmacist. Inspired, negatively
as I read reports of pharmacists so free to admit to making mistakes, I propose there is another side. Consider that the pharmacist bears some of this burden as well. Our profession requires a license, one must pass rigorous board examinations. We take an oath to ensure safe and effective care is delivered to our patients. For those pharmacists who complain, and who write letters, is this followed up by action? Too often those complaining do not do anything but complain. What are the consequences of defending one's professional duty, ethics with action vs. writing letters? Hypothetically, I assume, someone taking a bold move of not meeting a metric but saving a life might be fired and a new equally well-compensated pharmacist inserted. The compensation incentive cannot be ignored. Is this a reason pharmacists do no more than talk about mistakes? Only 1 pharmacist in this story took action. If the errors are so high, why aren't there more pharmacists defending their license with actions? I observed a long line; some people iller than others. The pharmacist was unable to prioritize those in pain, returning from surgery. Are we now akin to a deli counter?
Does the public know that CMS does not recognize this profession as one worthy of compensation for care; we are merely made to survive on the product mark-up? I suspect compensation for our true worth would help.
6
I have no horror stories about the big chains that are taking over the business, I'm not forced to use them. So I don't. I receive true quality service from the pharmacists and other employees at my local, privately owned pharmacy in downtown 02421. We may as well call them "Cheers", they greet me by name and would know if something was amiss with my prescription. And if there is some issue - they step up and call my doctor while I wait (they offer, I don't need to ask). I buy as much "not medicine" as I can there because I want them to be there for me forever. So giant drug cartels- "Back off".
8
Wrote before, writing again (on different aspect):
In our area, independent pharmacies are extremely few and far between. The one very good one and convenient location, abruptly announced their closure about 6 mos. ago.
A community institution, and 3 generations at that, present owner/operators were at or above retirement age, no one wanted to come in or buy them out ... as most major health insurance (including Medicare) didn't have them as a preferred pharmacy or didn't mention them as an option at all.
Just very sad, and the 'funnel' effect further pushing nearby Walgreen's and I suppose CVS (won't even walk in there) has made for more stress on all involved.
A formerly very helpful and friendly tech, on a first-name basis with me and husband, can't even spare a brief greeting or acknowledgment. I hear the weariness in her voice and see it on her face every time refills roll 'round. Ditto the pharmacists.
Just awful for them, as dedicated and conscientious employees, and equally unpleasant for the consumer.
8
This is so on the point that reading every paragraph was like listening to my long suffering retail chain pharmacist spouse. Years of consolidation and pharmacy boards’ irresponsible decisions to accredit pharmacy schools that are pumping out pharmacists into a market that can’t support them plus government’s takeover by for profit corporations created perfect conditions for the large chains to squeeze their workers to the breaking point.
Healthcare and corporate profits are not compatible. And until this and the $ in politics are no longer an issue nothing will get better. In fact it will most likely get worse.
Check your prescriptions and be safe.
17
We've been using the CVS in our local Target. They once gave my wife the wrong pills. The label was correct, but the pills looked slightly different, so we researched online and found it was a different drug. We didn't make a big stink about the mistake, and the pharmacist was always very nice to us after that.
Last time I was in that pharmacy, a different pharmacist was working alone, without his usual counter assistants. A long line had formed for pick-ups, and a woman who seemed mentally unstable hovered around the line, complaining loudly about how slowly the pharmacist was moving, even though he was obviously rushing as fast as he could.
I just discovered an independent pharmacy just a little farther from my home than the Target/CVS, and I intend to send my next prescription there.
8
Several years ago my wife had some fairly extensive surgery. She was prescribed pain pills for about the first week of her recovery. At the time, our usual pharmacy was CVS. The first CVS store said the prescription would be ready in an hour. After 90 minutes it still wasn't ready so I took the prescription form back. The next CVS said it would be an hour, so I finally went to Rite Aid and they were able to fill the prescription in about 10 minutes. It seems to me there should be a bit of a triage process for dispensing medications, and post-surgery pain pills would seem to be kind of high on that list.
After having switched to Rite Aid I was given the wrong dose of the correct medication one time and under-dispensed (too few pills) another time. In one case, my doctor prescribed a medication, not knowing that it had very recently been discontinued (it was still listed as an available medication). After several days I contacted Rite Aid and they told me the situation. They also said they contacted me but that was an outright lie - I had no phone calls from them in my recent calls and no voicemail from them. I reported them to our state board of pharmacy both times, and I now insist that all medication pick-ups be discussed with the on-duty pharmacist and that all dosages be verified in my presence.
I highly encourage you to contact your own state board of pharmacy whenever you encounter a problem.
3
As with medical providers and nursing, Capitalism is forcing pharmacists into untenable positions. So called pharmacy benefit managers manage for the benefit of drug and insurance companies as well as the major chains. This has to stop but until other Americans also demand sanity in health care instead of buying into the nonsense that we have best system in the world, things will remain as they are.
It is also worth noting however that we physicians likely prescribe too much and counsel/listen too little. Patients on the other hand demand pills and eschew common sense advice about diet and exercise.
14
The situation is worse than it appears. Long lines at pharmacy counters, stressed clerks, phone trees that are impossible to navigate in an attempt to speak to a pharmacist why a medication went unfilled, etc. America's pharmacies make the old Soviet Union look like a frictionless paradise of efficiency and competence.
12
And many insurers require you to use certain corporate pharmacies. So you don’t have a choice.
9
I don't see really busy pharmacists very often. Nearly never. They do not look like a very overworked or overly busy people
1
@Sue I’m a pharmacist...I work 13 hour shifts multiple days in a row. When we go in, there are orders piled into a computer for us to calculate doses for, decipher drug interactions, fill, dispense, and counsel on. Per law, only a pharmacist can do certain duties and most pharmacies are staffed by one pharmacist all day. Ontop of this, we are required to give immunizations, consult with doctors and nurses on rxs, consult with other pharmacists/pharmacies, and daily office tasks like inventory and paperwork. Your pharmacy may be well staffed or slow or maybe you go at a good time of the day. I can assure you, due to the way the companies are cutting back on hours for help and attempting to increase profits, we are in over our heads. I’m allowed to have one half hour break in my 13 hour shift. I’m not allowed to leave the pharmacy to go to the bathroom if a customer is picking up (which in my pharmacy it’s a miracle to go 20 seconds without a customer)
This reply was not an attack on what you’ve witnessed. If anything it’s offering you the inside info on what’s really happening back there and if you have family, friends, or anyone you love that a pharmacist is filling for, you should be aware of the truth.
It’s hard sometimes to see what’s really happening in a position you don’t understand so if anything pretend it was someone looking from the outside in on your job and just making an assumption.
Well wishes to you!
35
Unionize!!!!!
12
@Sue
It can vary drastically depending on where you live.
3
I see the madness behind the counter at my local CVS. In the past I have received the wrong number of pills there. I now regularly check the imprint and count my medicines.
Good people work there but they are clearly overtaxed and understaffed.
21
Now that big pharmacies have pushed all the small neighborhood pharmacies out of business, this is what we get. My local CVS has twice given me a months supply of drugs and never charged me for them or credited them to my account, failed to deliver a necessary drug to me on a timely basis, and been out of a necessary drug for more than a week. The solution? There is none.
8
If CVS would cut out the endless robocalls, roborefills and other things patients don’t want, it would save their staff a lot of time dealing with customer requests to make such nuisances stop, redoing prescriptions for only the 30 (not 90) day supply that was requested, etc. Their whole operation seems so boundlessly greedy that they shoot themselves in the foot.
Unfortunately some of us have insurance that doesn’t cover independent pharmacies and most have been run out of business by now anyway. So, they get away with it. Runaway capitalism on the one hand, but with twists that have helped them become a wholly inefficient monopoly. The DMV could hardly do worse.
14
I am a pharmacist working at CVS and I couldn’t agree more with this article. At CVS we are extremely overworked, humiliated, abused and understaff. I have been written up multiple times in the past few months for not meeting their outrageous metrics. I have complained to my district leader, my district leader’s boss, ethics line and advise and counsel (all the avenues provided to me to report) about how the increase in workload and cut in man hours has increased the number of mistakes and harm to the public, but instead of doing anything about it, I just get another write up for something else. In other words if you speak up, you get punished. These corporations will always find a way to get their way. As you can read in the article, CVS always answers with excuses, lies, or statements like “We are not going to comment on one individual”. On one statement CVS stated that they have systems in place to prevent errors from happening, and it is true CVS has a lot of great programs, the problem is they don’t provide enough man hours to operate them correctly. What good does it do to give someone a car but no money to buy the gas????? The federal and state governments need to step up and protect the public and the pharmacists. Enough is enough. What needs to happen so that our politicians can hear our outcry and do something about it???
This article and our comments should be enough for our leaders to step in and regulate the PBMs and corporations.
38
Form a union, you are all smart and intelligent and caring and also math and chemistry whizzes but you’re all being exploited like the telephone workers in the past. They had to wear diapers because they could not get bathroom breaks when needed. They did not have nearly the education you folks have and they formed CWA AFL-CIO after years of exploitation.
Fast food workers again, without the education you possess have banded together for better wages and working conditions, nurses and teachers, firemen, police officers have formed unions.
Enough is enough!
No one is going to help you but you!!!!!!!!!!!!!!!!!!
11
This is capitalism at its worst. Healthcare as a commodity, owned by a company who cares nothing about either are or health. All of these pharmacists are doctoral-level educated. How would it be if a physician had to see one patient every 60 seconds? It all falls to reimbursement.....who is willing to pay for what. Insurers and Governments are not yet convinced that they need to pay pharmacists to provide care rather than simply to fill prescriptions. It is a horrendous, horrendous work environment for the pharmacists and an unsafe care situation for patients. Please speak with your State legislators and URGE THEM to pay pharmacists for their service so that corporations will not use them as pill-mills in order to turn a slender profit.
10
I'm a physician who routinely gets inappropriate refill requests from chain pharmacies. They are clearly in the business of selling drugs, not healing people.
No pharmacy should be allowed to request refills for patients unless the patient requests it.
Our office and hospital are held to a high standard yet the pharmacies seem to do whatever they want all in the name of profit. It stinks.
11
@Matt I’m a pharmacist and our company makes us do something called “rxcompanion” where it will give us tasks to contact doctors and request new medications for patients based off perceived conditions the patient has because of the medications they’re on. I REFUSE to call an MD and stick my nose in that and totally understand your frustration with pharmacy contacts. I’m not sure who’s doing this or what programs the pharmacies have running, but please remember through your frustration above anything else thay it’s not a pharmacist just rummaging through profiles asking for random refills for profit.....we don’t have time to even fill the legit ones that are sent in! Lol if an inappropriate refill is being requested by my location it is either by the patient requesting us to send or a secret software rigged and ran by a corporate dude at a desk just firing them off lol just be nice to the pharmacist, we aren’t normally behind it!
8
I hope this article gets in the hands of a congressman or senator. Some laws need to be passed to protect the public from this danger caused by corporate greed.
6
Might just as well get into the cold dead hands of Charlton Heston for all the good that would do. Afraid we are doomed. Money won.
Omg, finally seeing this in print ... hallelujah.
I watch these (in my market) Walgreen's commercials, and think, really, what magical Walgreen's pharmacy are they at? You know the one (and it could be most any chain) -- the one where the pharmacist has oodles of time to talk with you, to actually come out from behind the counter and have a heart-to-heart about your various meds and/or questions.
The one where there isn't a line 5-10 deep at all times.
The one where auto-refill and drive-throughs are a a breeze.
I do fear for what gets filled, and check it carefully once home.
6
Thank you Ellen Gabler. The article is well researched and so accurate that I’m wondering when exactly I cooperated with you. I bursted out laughing in spite of myself, when I read paragraph about filling prescriptions, giving flu shots, answering the phone etc. A better description of this reality has never been written.
Thank you indeed, and please continue to shine a light on this very real public safety issue.
15
The American form of capitalism/make stock prices rise in perpetuity/ is destroying the American way of life if it hasn't already. Even a casual observer can see trump is pouring all the gas he can find on the stock frenzy.
Thanks, Ronald Reagan. You started this fiasco.
8
In the PBS doc. "Sick Around the World" from 2009? A UK. pharmacist was asked why he sold only meds in his store, he answered "I didn't go to college to sell toys." To separate Meds from the grocery store atmosphere would boggle the minds of the Boards of Directors.
9
Truly frightening article. A sign of dysfunction of this government which is by the corporations, of the corporations, and for the corporations.
15
CVS decided that they will only dole out 7 days of opiates at a time. Who are they to refuse a prescription written by my doctors? I’ll never step foot in any CVS store.
10
My local CVS in Cresskill NJ is a madhouse. It’s a testament to the pharmacists and techs that my meds get filled as accurately and timely as they do.
And stop with the auto fills. I’ll refill my meds when it suits me.
15
I was really pleased to see this article as it describes a problem I've witnessed, but few seemed to be aware of. Several years ago I was scheduled for eye surgery and needed three prescription items. It took my local Rite-Aid two full weeks to fill my prescriptions, which shouldn't have taken more a few days. It was blunder after blunder. They were clearly understaffed and some of the staff were short-tempered. I finally obtained my prescriptions and was able to proceed with the surgery, but I was so appalled by the level of customer service that I switched to an independent pharmacy, where I can talk to the pharmacist if I have a question or concern. Not all patients can be knowledgable about drugs. There needs to be greater awareness of this problem and feedback from customers who are unhappy. I, too, would like to see follow-up articles on this topic.
10
100% accurate. 15 years experience. Every year working conditions erode further. Until some one famous or a congressman is gravely affected by a medication error, chain pharmacies and PbMs [prescription insurance companies] will continue to go unregulated and harm patients...
21
I fill a fair number of prescriptions at CVS and pick them up at the drive through window. It is such a busy store, yet they find time to fill prescriptions I don’t ask for. Now, I know that they really need to fill a metric. Once though, I picked up about five prescriptions- for my bipolar disorder and allergy. When I arrived home I realized instead of my mild allergy medicine, I was given a 30-day supply of 10 mg Ambien. Things could have turned out badly if I had taken it as prescribed.
11
I understand that this is easier said than done, but there seems to be a crying need for pharmacists, doctors, nurses and other health care providers to take stronger collective action to thwart the excesses of our corporate medical system. If existing professional organizations cannot adapt to current realities, medical professionals need to form union-like groups (or maybe actual unions) to advocate for the working conditions they and their patients deserve. Can there be any doubt about which side the public would overhelmingly support in such a fight? Also, it's likely that state regulators, particularly in smaller and poorer states, aren't up to the task of adequately regulating the giant pharmacy chains. Some federal role seems to be called for in this area.
15
Sure. Try that after working a 13 hour shift and an hour commute home then taking care of the chores and kids just to rinse and repeat the next day.
Also a sure fire way to get fired.
11
I haven't read through all the comments, obviously, but I would like to suggest this to everyone, and especially to those who are taking a NEW medication: When you get home, google the name of the drug, and then look at the google IMAGES - if you don't see an image of the size, shape, color, and the markings of the correct drug, you may have been given the wrong medication.
In terms of generics, the label SHOULD say the name of the manufacturer of the generic, and you can similarly google the manufacturer's name and the drug name (usually the generic drug name will be on the label also) - and again, look at google IMAGES and make sure what you've been given matches up to a known photo of that pill or tablet.
We need to protect ourselves as best we can!
7
CVS is one of the most chaotic and disorganized pharmacies I've ever had to deal with - and worse, I'm FORCED to deal with CVS because they are the 'preferred pharmacy' on my Medicare Part D plan.
I always open my prescription bag while still at the pharmacy counter - I don't care how long the line behind me is - because I need to see if CVS has gotten even the basics right (such as generic vs. name brand, and number of pills).
This is one more way we are becoming a second-rate country.
14
We were forced to go to CVS after about 25 years with a local pharmacy by the pharmacy benefit manager used by our health insurance. All maintenance drugs (as defined by the PBM) can only come from the PBM by mail, CVS, or Walgreens. No other choice. CVS couldn’t fill
one so I was able to keep one locally. According to the local pharmacist, these rules from the PBMs are costing him over $60,000 a year in lost revenue.
15
CVS is one of the most chaotic and disorganized pharmacies I've ever had to deal with - and worse, I'm FORCED to deal with CVS because they are the 'preferred pharmacy' on my Medicare Part D plan.
I always open my prescription bag while still at the pharmacy counter - I don't care how long the line behind me is - because I need to see if CVS has gotten even the basics right (such as generic vs. name brand, and number of pills).
This is one more way we are becoming a second-rate country.
7
I had to resign from CVS last year because of the reasons described in this article. CVS doesn’t care about patient safety. They have lost their way.
22
More evidence the privatized, for profit, medical industry has failed. Vote Sanders for badly needed change.
12
Everything stated in this is 100% accurate. CVS claims that the number one priority of the company are the patients but I never understood how they could achieve this with the working conditions we were under. Their number one goal is not taking care of the patients (or their employees) but to make money. That is the truth and I do not know how they have been getting away with this for so long. Hope something is actually done about the horrific working conditions all pharmacists and techs are under.
32
It's not just pharmacists who struggle with patient volume, pressure from higher ups and bench marks to meet certain metrics. I'm a medical provider in an urgent care. Now, during flu season, we see 65-70 patients per day during a 12 hour shift. The pressure is immense and when you're tired, it's easy to make a mistake. Health care in the U.S. is a for profit business. It shouldn't be. Rather than insisting 'we have the best health care in the world', which we don't, we need to go back to the drawing board and learn from other countries who have better health outcomes with lower costs. The American way of providing health care is just not working.
28
The more stories like this that I see the more thankful I am that I get my health care from the VA.
7
Ah yes private enterprise where healthy profits always come before healthy people.
22
Avoid CVS at all cost for prescriptions! Their pharmacy employees are extremely rude and seemingly trained to be so, judging from Google reviews. They will also put you on an auto refill list without your authorization and bombard you with daily texts requiring you to respond if you don’t want a refill. But then they will refill it anyway, blocking any other pharmacy from filling it. When you go to the store to tell them not to auto refill, they will tell you that you have to call the Customer Service number, hahaha.. At that point you have to do what I did, scream at the top of your lungs in front of all the other waiting customers. Never heard from them again after that.
9
Perhaps your particular CVS is a problem, but here in my small town in NC, my CVS pharmacy is great, my pharmacist, Amber, will call me at home if there is an issue; when I go into the pharmacy I am greeted at the door, as are other customers who enter the store.
Every one of the regular technicians call me by my last name with a greeting when I go to the pharmacy area before I say my name.
I certainly feel that my CVS pharmacy is efficient and caring.
6
Thank you! I am a psychiatric nurse practitioner in a solo practice. CVS deluges me with bogus refill requests (for prescriptions that have been discontinued, for prescriptions meant as brief treatments, for prescriptions for deceased patients, etc). I have had to choose between spending hours sorting through these requests or spending that time providing good care to my patients. I have chosen the latter and I ask my patients to contact me, not their pharmacy, if they need refills.
I learned recently from a "floater" pharmacist at CVS (i.e., not a CVS employee) that patients are asked when they pick up their prescriptions if they want a 90-day supply of medication in the future. If they say yes, then CVS deletes all the one-month refills I have put on their prescription. The next month when they go to pick up their prescription, they are told they have no refills. This is a major headache for the patient and the prescriber - and a profit-motivated health risk.
28
When you receive your meds, look at the description of the medication. It should be printed on one side of the prescription container: color, shape, any markings. If what's in the bottle is not the same take it back.
I had to take radioactive test dose by mouth once. There you're in the hand of God. There's no way to check what you're getting. Errors do occur there too. And kill people too. And compounding pharmacies can be a mine field.
The chances are, unless a group of people are injured/killed, or it's a celebrity, or the scandal involves fake drugs, nothing will change. Money rules. Welcome to capitalism as canibalism
6
Everyone should do something about the greedy pharmacy corporations. Write your representative and demand regulation. Write your representative and demand single payer health care system. Just act. Do not watch in frustration how corporate greed ruins lives of the employees and hurts patients while chasing obscene profits. Don't be passive, don't sit around. Do something to break up greedy corporations and make the world more just. Elizabeth Warren cannot be more right...
9
Completely dystopian. Medicare for all now. Every piece of health care needs to be taken out of a for-profit model.
13
Thanks for this article. I have noticed staff reductions at my local Walgreens over the past few years, leading to longer waits. As a result, I try to time my visits to what I have observed as their less busy times, but I realize many people do not have that luxury.
Also, my advice to all customers, before you hand over your cash or credit card, insist on inspecting the prescription to insure it is actually yours, is the medicine subscribed, at the right dosage, and contains the right number of pills. At home, actually count the number of pills. More than once I have been shorted. More than once, I have caught errors in the prescription.
11
I enjoy the two minute walk to my excellent local Safeway pharmacy (17 years of great service) much more than the 15-minute drive to the employer-insurance mandated "local" CVS. Mail delivery is not an option for me.
I recently noticed that the Safeway pharmacy, which I cannot in compliance use, is closed for 45 minutes at lunch. Conditioned by our culture, of course I thought this was inconvenient and bad for business. After reading this article, I see that the Safeway respects its employees - well, maybe it actually just respects the law - and the safety of customers.
So, I hereby reject the mandate to use CVS. I am going back to Safeway even though I will need to pay about 100% more. Fortunately, I can afford it. I feel sorry for those that cannot stick it to the man. CVS, it was not nice knowing you.
15
As a pharmacist I years ago worked in retail and we always worked 13-14 hr days without breaks. We used to regularly fill over 600 prescriptions a day. My relax time was to go to the bathroom that I would have to plan in advance. We used to joke we should wear Depends. After several years of this I went to work in the hospital and never regretted the change. I encouraged every student I worked with who would tell me they were offered a job by a chain after graduating to get their foot in the door of a hospital because surely the day would come that they just could not take it anymore. But those days were before pharmacists had to start giving immunizations and cold calling doctors etc. I go to a pharmacy now and have such sympathy for them. But the truth is people think the pharmacist and techs are just standing around. I was so happy to read this story as it was a story of every pharmacist who works in retail and who deserves so much more respect for what they are required to do with less as each year go by.
38
@George Kenna
And everyone who can should use independent or outpatient hospital pharmacies. Hospital jobs are much coveted by pharmacists, even though they generally pay less. The more business independent and hospital outpatient pharmacies can take away from the likes of CSV, the better things will be for patients, pharmacists, and doctors.
2
My CVS pharmacist has my sympathy. I feel like we are constantly battling with their computer system. For one Specialty scrip (it has to be special ordered each month), it simply cannot be removed from the system. She's tried everything. We joke about it when I go in for pickups. "Everything but the [drug name], please."
And then half the time, I have to go back anyway. Their computer system is convinced that I can get 4 doses of an injected medicine out of 2 vials. While technically there IS enough liquid... the vials are strictly single-use. So most months I end up going back while she has to override the computer to dispense the other 2 vials. If she or one of the regular pharmacists there is filling the scrip, they catch it, but since they are understaffed, they often have "floaters" from other pharmacies helping.
6
Unfortunately the over 10 year study on medication errs most likely refers mainly to only those errors in hospitals and institutions as studies in outpatient pharmacies are not done. I’m am a retired pharmacist who was also a clinical professor at a major university. I enjoyed a wonderful career and I am afraid those in practice now are not. Our boards and academic institutions really need to push for limiting the number of prescriptions that can be safely filled by a pharmacist in a specified period of time. Primarily for patient safety and secondarily so pharmacists can really do the job they are trained to do...serve as an intermediary between the patient and the doctor. I am afraid due to corporate constraints this common sense approach is not something that will be considered or undertaken.
18
As the mother of a young pharmacist who worked at CVS for 10 years (he recently escaped to a privately owned pharmacy), I am grateful this dirty secret has finally been exposed. The CVS pharmacists are so terrified of losing their jobs, none of them dare complain of the long hours or short staffing. In order to comply with the mountain of paperwork generated by CVS's metrics system of corporate greed, managers routinely come to work on their day off and pay technicians out of their own pockets to assist them. The pharmacists work 12 hour shifts on back to back days with no meal breaks or bathroom breaks. At first my family member worried about losing his job because he wasn't dispensing medication fast enough. That worry was soon replaced by the fear of possibly harming a patient because he was required to focus on expediency instead of accuracy.
55
CVS already responded with a bunch of straight out lies and inaccuracies. The turnover rate is mind boggling. My district alone of 17 locations had 16 pharmacists quit in last two years . More want to quit but the market is flooded with pharmacists right now forcing them to stay . Patient safety is not a priority. Filling as many scripts as possible and harassing people on the phone to fill more is. As health care professionals our concern should be to get people off as many of their medications that we can when possible and get them on a better path to a healthy lifestyle. Voicing a concern at CVS is a waste of time . First of all it’s almost impossible to reach anyone and if you finally do after months of trying you are given a typical Corporate response obviously contrived by their law team. I’ve been a pharmacist for 25 years and most of my colleagues, like myself, require anti-anxiety medication or anti-depressants to make it thru the long stressed filled days. A typical hour at a busy store consists of checking 60 plus prescriptions, answering a dozen or more phone calls , being called to the register every other transaction for counseling or questions ( if you don’t hurry the line backs up more) , giving immunizations, mixing reconstituted meds, counting a few NARCs, making some of your 300 plus tele-marketing phone calls that are overdue , grabbing the register at drive thru because everyone else is too busy,,,repeat 13 more times
37
As a former CVS pharmacy tech, I can attest to the fact that there are no breaks for techs or pharmacists at CVS chains in Florida. Success is measured by how many phone calls result in refills or number of vaccines administered, all while incoming scripts must be filled within a set time frame. Customer care is so difficult to perform for customers who are waiting 5 deep (at least), and when issues arise, the customer has to go wait in another line for resolution. It broke my heart to witness the stress pharmacists, techs, and customers endured. I was lucky, I could afford to leave this job. Most of my fellow workers didn't have this luxury. All these chains need to start listening to their workers on the ground, and not to nebulous metrics, that trust me, are not measuring success, just shareholder interest. A very poor investment model.
24
This article is perfectly timed for me. I just moved to a big city from a small town and was very disappointed in my new Walgreens. They were way understaffed. I didn't realize this was common place. I was going to try out CVS but thanks to your article I'm going to go to an Independent pharmacy instead. You don't have to be a medical professional to see how dangerous the situation is. The way to solve the problem overnight is for the pharmacists at CVS and Walgreens to walk out on the same day. Many years ago when Medicaid cut funding for OBGYNs all of them refused to deliver babies on the same day and Medical changed their rule literally overnight. Pharmacists don't even have to form a union, simply state it's unethical for them to continue. No company can force you to do unethical behavior or fire you because you refuse to without significant consequences if the pharmacist pushes back.
16
So many have commented that more people should use an independent pharmacy. How many of us cannot because of how our insurance is set up?
So many fear government control, which I appreciate, but it’s arguable that corporations are doing better.
6
I experienced several of the customer complaints here. For example, being sold expired prescriptions before I learned to pay closer attention, and relentless computerized phone calls several times a day for prescriptions I didn’t need filled for another month. It became obvious these were directives from corporate. I contacted them directly and said if this doesn’t stop, I’m changing my prescription plan. Haven’t had a problem since. Hopefully the pharmacists weren’t punished for what I did. Very sad.
6
I hope Ellen will take her investigative report a step or two further.
She identifies a problem with the way prescription drugs are distributed in the US. But, does not seek out solutions. For example why do well-paid, highly-trained, pharmacists count and sort pills in the pharmacy at all? They are turned into inefficient pill counters. When I go to France, and fill a prescription, it comes entirely prepackaged. All the pharmacist has to do is look in a drawer for a small box correctly labelled with the medication that has been prescribed. No counting out pills from a big container into a small one. No handling of the medication in the pharmacy during pill counting. That in itself may compromise the purity of the medication. Why is that not done across the board in the US? Some of my meds come pre packaged 30 at a time. Most do not. Prepackaging would free up the pharmacist to do all the professional things they are well trained to do.
On the issue of 30 versus 90, I find it hard to believe a pharmacist directed to dispense 30 in a prescription would dispense 90. That would seem to be actionable malpractice. On the other hand, three-month prescriptions are more efficient where appropriate for both the patient and the pharmacist. One third the transaction cost for both.
In sum, I find the article full of valid gripes, but not focused on how the pharmaceutical industry and the chains might alleviate the problems identified without much cost or effort.
6
This article did not surprise me. My heavily-used local Walgreens is staffed by only one pharmacist, whom one can observe being pulled in umpteen directions at once while waiting at the pharmacy counter. I do not envy her.
18
Thank you for this enlightening article! It explains so much about what I've observed at my local pharmacy. In the future, I will take the time to carefully check my family's prescriptions before I leave the counter.
13
It would be a better world for Americans if we adopted the methods of the French pharmacies. First, there are no mega-companies driving people to their extreme for profit. Second, all medication comes prepackaged in boxes clearly labeled with the contents, and stored in the pharmacy according to type. The person behind the counter sees the prescription, goes to a drawer and takes out exactly what is prescribed. The patient can see that it is indeed what the doctor prescribed. I have not heard of any complaints about this system when we lived for 14 years in France.
11
I'm surprised and disappointed that the article contains no mention of the ubiquitous use of minimally trained pharm techs who now work alongside registered pharmacists. Pharm techs, of course, are far cheaper than pharmacists. Are they being overused, or inappropriately used for certain tasks once reserved for pharmacists? It seems essential that in investigating how specific errors occured (root cause and chain analyses), careful attention should be paid to whether licensed or unlicensed personnel were involved in any aspect of the mistake. Of course, the profit making chains bent on saving money may choose to ignore or minimize the issue of whether pharm techs have in some way contributed to more errors--in which case the professional pharmacists must speak up, perhaps conduct their own studies?
15
Thank you for making this point. I’ve always suspected that CVS uses Pharma Techs for their mail order Caremark business and not real pharmacists.
8
Welcome to capitalism in America. Pharmacists are not the only ones being treated like workers in a sweatshop. Everybody is treated the same way, no matter where they work. Wages are stagnant, unions have been busted and anyone who does not like it will be replaced by someone else who will do it-for a while.
27
This problem exists in mail-order pharmacies, as well. My prescription for Pantoprazole for GERD was held up for weeks because the pharmacist at OPTUMRx .com said that sending me the medication would have a negative interaction with Clopidogrel for thinning the blood-- totally different medication that had nothing to do with the former.
1
@Jack — Your pharmacist was probably worried about the theoretical reaction between the pantoprazole and clopidogrel. Both medications are prodrugs, and require activation by CYP2C19. The concern is that the pantoprazole metabolism may prevent the activation of the clopidogrel, therefore preventing clopidogrel from doing its job. Whether the interaction between PPIs and clopidogrel is clinically relevant has been up for debate, but is probably not clinically relevant.
6
Last Friday I brought the first prescriptions I've had in years to my local CVS in Marin County California. Told I could pick them up in an hour, I got busy and didn't come back till Monday.
Monday, the tech couldn't find my order, sent me back to "Drop Off" window. There, the clearly frazzled tech FOUND THE SLIPS TAPED TO THE COMPUTER in front of her. (privacy much?)
She graciously apologized and said she'd have the pharmacist fill it STAT. Her words, "Our pharmacist called out over the weekend and we are 600 prescriptions backed up." Her co-workers, running around like crazy, rolled their eyes and nodded. I felt so bad for all of them, especially the pharmacist who rushed out to advise me - she had literally just finished pharmacy school.
21
Maybe pharmacists' and pharmacy techs' working hours and store conditions could be regulated in the same manner that airline pilots' are.
- Maximum number of hours per week
- Maximum number of consecutive hours
- Just as pilots of certain capacity aircraft must have a co-pilot, pharmacists (based on size of the store) may not work alone.
- Error brought to the attention of a store must be reported, and would become a matter of public record.
That's just a start.
There are plenty of industries whose workers are entrusted with maintaining the safety of their customer-base, whether it's the flying public or Rx users. It's ludicrous to believe state boards can't find an existing model to use as the foundation for some regulation. Oh, and violation of the law should result in some hefty fines.
27
Pharmacies don’t have to report errors? Jeez, in our hospital, due to privacy laws, we have to report to the state if we send a patient report to the wrong fax number. And that does not even affect patient health. Guess these pharmacy companies found the right people to bribe.
5
You know what would help pharmacists and pharmacy employees? Organizing into a union.
Remember unions? Before the republican propaganda machine succeeded in making union a derogatory word, unions prospered in the U.S.
They prospered because they represented employee rights to fair wages, benefits and humane working conditions.
35
After being given the wrong pill several years ago (benign result, thankfully), I do my own check whenever possible. Using google, I find the shape, color, and markings for the front and the back of the pill that was prescribed. Of course this does not work for all types of errors, but it does help a great deal. I also check usual dosage and anything else of concern. If there is a discrepancy, I call doctor and/or pharmacy.
4
Is there any reason why doctors can't dispense some of the very basic medications and sell them at cost + 20% for administration? I'm talking about generic statins, metformin, amoxicillin, and probably another dozen or so. There is no conflict or profit motive, the customer can go straight home and the pharmacy will be less crowded.
3
@Erik In the states that allow physician dispensing, Direct Primary Care physicians are doing exactly that. It's just one of the ways that Direct Primary Care brings value to the doctor-patient relationship. www.dpcfrontier.com
1
My elderly father continues to get calls about refills ready to be picked up at his national chain pharmacy, even after I called several times to stop automatic refills. This means pharmacist time was ineffably used to fill scrips that we would not pick up. Also, those 90 day prescriptions , especially if mail-order are an extra money maker for the pharmacy. My every 12 week prescription comes every 9-10 weeks. Which means over a year I have a surplus. When I called to ask I was told so patient won't run out before next order arrives. This 2 or more week early might be a valuable help to patients on the first refill, so will always have a 2 week reserve if a problem arises. But doing this each time is only valuable to the pharmacy who gets paid for the extra month or more of medication each year.
4
@Ellen Go in and stand, refuse to leave until they stop the auto refills. Or see if you can do it online. They probably forget you the moment you hang up the phone. I stopped Walgreens from doing auto refills the first time they called me sounding like a bill collector for a refill I hadn't requested. Eventually I dropped them altogether.
We have used the same local pharmacy in our town for more than 40 years. They know us, the medications we take and have been unfailingly cooperative and professional. I have never had a complaint about my service from them. They have even driven to our home to provide emergency delivery when we needed it. This year, out of the blue, my Blue Cross RX plan decided that only a tiny number of pharmacies would be 'approved' to service the plan. CVS was the only one within 4 miles of my home, and now my husband and I (both of us in our mid-70s) have to drive to get medications instead of using our local pharmacy. For several days, they were unable to find my medications although I had personally brought the list and contact information to the pharmacy. Even after filling one Rx, they called to say they did not have the prescription for the same medicine. I feel sorry for them that they have such a heavy workload with inadequate staffing, but for sure mistakes have been and will be made.
13
@Ellen -- my plan once required Walmart for prescriptions. The problem? I don't live within 30 miles of a Walmart, whereas there are CVSs and Walgreen's within walking distance. So every so often, I would plan an expedition and try to get other errands dealt with on the same trip.
1
I am shocked, shocked, I tell you, to learn that a huge company might not have the interests of its workers or customers at heart.
The local supermarket and regional chain pharmacies near our house have all been excellent, I am happy to say. It is disappointing to know that many people don't have access to the type of care we're getting.
Having company representatives on a state regulating board seems an awful lot like having the fox guard the hen house.
9
At my local cvs, the pharmacist and techs always offer to go over the rx, quantity, dosage, etc
States should start by requiring that pharmacists be exempt from phone calls, etc
And patients and caregivers need to look carefully at the bottle, label, etc I will not ingest anything that does not have my name and a clear description of the rx on the packaging
2
Another problem I keep running into is now as of Jan. 1st, 2020, I must get every prescription at one pharmacy and because the small family pharmacies can’t compete with the lowered prices, am now forced to go to a chaotic, very rude chain pharmacy that has made numerous mistakes on my medications and that’s why I always stand there, open the bottles and make positive I’m getting what it says on label and always get the rolled eye look. It’s just my opinion but any health care in the US is a mess!!
17
Many years ago a friend of mine who was a pharmacist warned me ALWAYS look not just at the labeling - but they Pill itself. Or in the case or drops - yes READ the label.
Period. People make mistakes. This is not news.
8
I am a family doctor. This does not surprise me at all. In fact, I would be very surprised to learn it is not happening.
The same thing happens in medicine, where doctors and nurses are forced by their corporate overlords ( usually hospitals) to increase billable activities so as to increase revenue for the overlords.
Professionals, not businesspeople, should be running things, but we are not. The lunatics are in charge of the asylum, have been for close to 20 years now.
How the US health system working out for you, folks?
55
@vbering yup. Making $$ off our education and medical licenses. Each doc generates over 2m in net revenue annually. Are you making 7 figures? I’m not, but seems like the fat cats upstairs are. It’s time for all of us to go back to private practice and watch the house of cards implode. Do you want a CEO running grandma’s code? If given the education and the opportunity, the patients will follow us back to civility, sanity and undoubtedly better health outcomes.
5
CVS has been my go-to pharmacy for over 30 years. During the past 2-3 years I've encountered various stiuations of concern. A prescriptions automatically put on 90 days refills for a drug my doctor instructed I take 3 xs per week as we worked through my reactions to the drug; having 1 time prescriptions automatically refilled (and my resulting refusal to accept the prescriptions). Requesting that I be taken off their auto system, and their failing to do so. I one point I commented to the pharmacist that they were over-reaching into my medical needs and my relationship with my doctor. Thank you for this article confirming what I suspected. Unconscionable that these metrics are placed on and affecting how a doctor/pharmacist cares for their patients. Goodbye CVS....heading to the local, independent pharmacist.
24
Fantastic idea to leave the large corporate pharmacy. I’m an Internal Medicine doctor and frequently recommend patients use small privately owned pharmacies. The service is better.
8
There are several 'systems' problems interfering with pharmacists' 'best practice' in supervising dispensing medications and, therefore, safety:
1. Unlike the smaller pharmacy, the large chain store is supervised by an 'administrator' - who is unprofessional in the sense of holding no health-care license and, therefore, holds no ethical obligation to patients qua customers whom the (subordinate) pharmacist serves.
2. The large store stocks many items, including groceries, unrelated to health; for which sales' targets must be met.
3. Hence, a pharmacist may be administratively directed to 'cover' for the supply of such non-health-related items.
One questions whether size of a pharmacy or its being one of a multiplicity - as in a chain - may be any more of a problem than the workings of one in a large hospital, one which is part of a group. However, the (ethical) chain of command and spread of items are still critical as a/m; large or small, profit or non-profit. Ian R. Lawson, MD
2
My wife was a Pharmacist at several chains and found the working conditions there brutal and dehumanizing with the emphasis on metrics of speed rather than on patient relationships and pharmaceutical counseling. She found the managerial staff to be unsupportive, disinterested in the working conditions for the pharmacist and her staff, and solely concerned about speed and efficiency but never quality.
My wife would stay after hours to finish the burdensome work load and instead of being treated with respect and congratulated for her efforts was often berated and harassed for being slow and being
concerned about helping her patients in resolving their pharmaceutical problems. She won an award as being an outstanding pharmacist by her patients just as they were going to fire her for having bad metrics.
These chains need to be reformed immediately. Their pharmacists need to be in charge of improving the pharmaceutical staffing and insure that they are full staffed with well trained technicians so that they can deal with pharmaceutical problems well. They need to abolish the computerized metrics and place an emphasis on quality and professionalism to deal with complex pharmaceutical issues that are often ignored in the rush to profits. They need to have Pharmacist Unions to be empowered to improve working conditions, to ensure adequate pay, and to serve the public with the highest level of professionalism so that they are treated with the respect that they deserve.
51
I'm on a sheetful of medications, which I monitor closely because small differences in medication can produce sizable consequences. I've worked to build strong relationships with my pharmacists because this way they know me and my conditions and are sensitive to changes. Nevertheless I can tell my CVS pharmacists are overworked, tired, and stressed. If their corporate overlords are asking them to assess the 'media risk' that I and other patients may pose, then CVS is thinking of corporate health and not my own, and are working at cross purposes to make sure that when a mistake is made -- and it will be, under these conditions -- that I am the one to be blamed, not them.
This situation is not just dangerous for patients, but potentially lethal for the entire profession of pharmacy, who can lose their hard-earned public trust and become nothing more than pill-dispenses, easily replace by vending robots, their knowledge and compassion lost in the stampede to squeeze ever-so-much-more money out of the public. Unacceptable. Not to be permitted. Stop interfering with the patient-pharmacist bond or we will show up at your corporate meetings and demand satisfaction. Heed us. Some of us own quite a bit of your stock and know what to do with it.
15
I am lucky to have two independent pharmacies in my town, with a CVS and a Walgreens competing against them. If more people would choose to support local businesses whenever possible, the grip of corporations would be loosened. It's the consumer who has the power to decide which businesses to support.
5
@MD I totally agree. Patronize non-chain pharmacies. Unfortunately my favorite local pharmacy cannot be relied on to have one of my medications, because it is not common. This has forced me to use CVS for at least some prescriptions. I’ve had bad experiences with them years ago, and switched to the local pharmacy, until they couldn’t supply what I needed. I despise going into CVS, especially their 90 day sales pitches. On controlled substances. And recently I took home an empty sealed box. No medication. At least they quickly supplied it.
1
New York State misguidedly does not require providers to give patients a copy of a prescription making it more difficult to catch errors. Electronic prescribing may have a place for certain controlled drugs, but it prevents shopping for better pricing and a reputable drug supplier.
I have caught mistakes by checking the coding on tablets that were not in factory sealed bottles.
2
I'm a pharmacist 7 years out of school and relocate every 2 years for my partner's job. I've seen drastic changes in the profession- far more pressure, pharmacy schools graduating way too many pharmacists but still charging 250k for a PharmD, salaries going down (used to get hired at $60+/hr as a new grad, now as low as $40-44/hr), everyone scared they'll be replaced so they put up with the terrible and unsafe conditions. Takes kids a year to find a job floating then fellow pharmacy managers are unkind to them, can't get out of retail unless you have connections elsewhere. We work in fast food but with medication. Miserable all around. Most errors go unreported. I had a medical assistant ask to speak to me because a tech had called the office to help fix an insurance issue for a patient's RX and the she belittled me when I wasn't familiar with the situation saying the pharmacist should know about everything going on. Doctors, nurses, medical assistants all have no idea how a retail pharmacy is run, which adds to the pressure and unrealistic expectations.
28
My employer's health insurance pushed us into a mail order prescription program- - no choice to opt out. After a number of calls complaining about medications that arrived late or not at all, I was told by one of the techs that their workload had more than doubled. She said some employees had quit because of the increase, which made things worse. The last few months that we were on that insurance, we just had prescriptions sent to a local pharmacy, and paid out of pocket. I still work for the same company, but dropped their insurance and went with a different provider so that we can now pick up our meds a day or two after they're ordered. With the first refill that we received, the copay was about 20% less than we'd been paying with the employer's awful mail order program.
7
@Al D I mde a math error. Actually the refill price with the new insurance was 20% of the mail order cost, so 80% less.
1
This article is spot on. Fortunately, I rarely have prescriptions, but when I do, I use an independent pharmacy. I stopped using CVS and supermarket pharmacies 20 years ago, when needing post-surgery meds took more time than the drive to an independent and a wait of 10 minutes. Another bonus is the independent pharmacist will take time to answer questions & give advice and there is no line of people buying toiletries, food, etc. On a good day, CVS would take 2+ hrs to fill an RX. Pharmacists are medical professionals and requiring them to ring up sales is absurd.
10
The famous paper Goals Gone Wild should be required reading for management. In it, the Harvard Business School authors found that "the beneficial effects of goal setting have been overstated and that systematic harm caused by goal setting has been largely ignored."
Effects associated with goal setting included "a narrow focus that neglects non-goal areas, a rise in unethical behavior, distorted risk preferences, corrosion of organizational culture, and reduced intrinsic motivation."
9
Absolutely. This is especially true for so called SMART goals that only recognize a goal that is measurable. Many of the most important goals in business, and life, cannot be quantified or measured. But, hey, as long as the corporations are making record profits who cares if someone dies - whether from a pharmacy error, depression, or simply worked to death.
1
Thank you for writing this article. I have been telling my wife, a pharmacist at a chain pharmacy, that the New York Times or New Yorker needed to profile chain pharmacies and the work conditions they have created for pharmacists and technicians, which obviously is bad for the public as well.
I also appreciate the comments supporting pharmacists here. My wife has had patients call her every name in the book and questions "why did I get a doctorate for this?" She will work 13 hour shifts with zero pharmacist overlap, no lunch break, or any other type of break. She won't drink water so she doesn't have to use the bathroom and can use bathroom breaks to rest her feet for a couple of minutes. She also worked under these conditions for the duration of her pregnancies. Pharmacists make decent money but should make even more for this mentally and physically taxing job.
30
@John
Thank you to your wife. Further I would suggest that, instead of more money, she deserves the same money but they should give her more of her life back.
3
Keep barking up this tree nyt. Working for a major pharmacy chain isn't about the customers anymore. It's about making money hand over fist for the executives. Have been working for one of these companies for over fifteen years and I've seen the shift happening. It's not going to get better until someone holds them to account. The pharmacists are the easy target when mistakes happen but they truly are doing the best they can with what they have, and the workload keeps increasing while the labor allowed to them dwindles to almost nothing.
30
I am going to switch any prescriptions to an independent pharmacy l. The only thing corporations understand is money. Reduce their money and maybe they’ll start hearing
11
It would be interesting to know who actually has controlling ownership of these chains. It might give us insight into what we ought to expect the controlling owners to want from their pharmacies.
1
We live in a society that values profit alone. Today the stock market is crashing because airlines have to cancel a few flights! Thankfully, the executives will still receive their inflated compensation. And I am sure the executives at the pharmacies will get the correct medication, and their inflated compensation. Money, Money, Money!
8
I am mystified why I am sent to pharmacies to get flu shots and other vaccinations instead of getting them at my doctor's office. When my son needed a booster shot for one of his vaccines, I was told to take him to a pharmacy, not the doctor's office where he had had all his shots as a younger child. The pharmacy we went to was not especially busy at the time, but the pharmacist had to leave his post to administer the shot. I feel a lot better about qualified medical personnel at a doctor's office getting a shot right for a kid than an overworked pharmacist (the man looked exhausted and admitted he was) doing it. At the time I wondered, how do I know that's even the right shot? Afterwards I was given no record of the shot (a receipt is not the same as a vaccination record) so unlike the doctor's office I had no "proof" my son had even had the shot. Then I fill out the school paperwork which also does not require any proof of vaccination, just a blank where anyone could fill in the date.
What is going on? This country is a mess.
28
@sunandrain I ended up taking my kids to Walgreens for their flu shots this season because the military clinic where we usually go did not have a flu vaccine for everyone, only for the priority groups. It also Made me uncomfortable to have the pharmacy administer the shots without any record of which vaccine was used. But I ran out of time, it was almost Thanksgiving and no hope the military facility would get enough vaccine to cover every patient. It is a mess!
6
@sunandrain Possibly because your insurance company will not pay the charge the doctor's office wants to get for giving the injection.
Also, some immunizations may require specialized storage and/or have short use-by dates.
1
For the first time ever (and last time) I got my flu shot at a pharmacy. I left concerned also. The pharmacist was busy and had to come out into the customer area to give the shot. I got a slip showing a flu vaccine but did not see the bottle the syringe was drawn from. I thought ‘how do I know this is right?’ I don’t.
1
Greed.
15
The CEO of CVS "earned" $22 million last year.
https://www1.salary.com/CVS-HEALTH-CORP-Executive-Salaries.html
38
America is a joke. A sad, sad joke.
17
We have the best health care system in the world!
FAKE NEWS!!
-- Any Republican
16
If the state and federal governments/boards seem unable or unwilling to take action on this dangerous situation, the pharmacists should unionize. Then they would be able to negotiate working conditions in their pharmacies. That would solve a lot of these problems.
10
Pharmacists have floated this idea for a long time but are unfortunately in no position to do so. The market is saturated with new graduates due to the colleges pumping out degrees, and without the backing of a strong org, are susceptible to termination at the mere thought of a union.
6
Pharmacists are too scared to unionize, a failed attempt would paint a target on their back. This would be ideal though, for store managers as well, as neither group has any ability to improve their working conditions. I often work ten to twelve hour shifts 6 days a week without any chance to take a meal break, and barely a minute to take a bathroom break.
5
Pharmacists should not be involved in metrics. Like almost any employment issue, this needs more employees and/or less metrics. Most of the tasks seem a nuisance to everyone involved, so whoever set these metrics needs to change them or change the metric makers.
7
Pharmacists should not be involved in metrics. Like almost any employment issue, this needs more employees and/or less metrics. Most of the tasks seem a nuisance to everyone involved, so whoever set these metrics needs to change them or change the metric makers.
2
Perhaps Iam lacking in the protocol....due to not taking any prescription drugs.. my Father had to go see a Doctor I believe every thirty days for a refil...this is impossible due to his being 97 yrs old..so I ask how does one get a ninety day refil.?Only when I switched my fathers care to the Veterans administration did I find out about the tremendous pharmacy overnite,fast delivery system of the Va and ninety day ..my Dads pills were not serious meds either...…..Hope you all can get enough information if you should die that the little white pill was the cause...…….people die everyday and no one really knows what they die of..former caretaker of two people who died without any understanding of how it happened only the mysterious Septic shock for my father who was in NH at 98,and sadly my brother who fell to Brain absess and infection in his body that went thru blood..which I still consider a major mistake for no LABS for infectious desease..
1
Our RiteAid, which we used for many years, was taken over by Walgreen's--first the pharmacy and then the whole store. It is filled with overworked, unhappy people and the computer system is crap.
Unlike Axis genocide, which was focussed on particular victim groups, this can be seen as a profit-generating Amercan form of killing people by withholding care, botching care, and putting in layers of middlemen whose sole purpose is to get their "taste." EVERYONE except the wealthiest Americans are the victim classes--the elderly, the poor, people of color, LGBTQ people, Muslims, "illegal" immigrants.
8
I use a Walgreens pharmacy in Oakland, Ca. I have seen pharmacists behind the counter looking frazzled, literally running from task to task. Walgreens is a huge chain. They can afford to hire more pharmacists. There's a sign saying that on Saturdays and Sundays the pharmacy will be closed from 1:30pm to 2:00pm for a lunch break. Walgreens can't give their employees who are on their feet all day an hour for lunch? I've thought of writing complaints to the manager. It was so gratifying to see this piece published in the Times!
22
This is frightening -- I had no idea. My insurance company makes me use CVS (last year and this, anyway -- it has shifted around). I guess I got off easy when my recurring prescription for a tablet beginning with H was instead filled with a cream also beginning with H last summer.
It was not hard to determine that they had given me the wrong thing -- much more difficult if you have to differentiate between two similar forms of medication (e.g., two tablets), or if you are getting the medication for the first time. It's even harder if you have little medical knowledge but do have a trusting nature and don't double-check.
Was CVS working from the Wells Fargo playbook?
7
We need to have a "best practices" study conducted on all of the chain pharmacies. It should be conducted by an independent auditor and guaranteed full and unfettered access to all of the chains and every aspect of their operation. The audit should be made a compulsory legal requirement for all of the chains to participate in. And all the results should be made public. The same should be compulsory for the drug manufacturers as well. There should be a recommendation for universal, industry wide business requirements that provide safety for all prescription drug users, hospitals, doctors, pharmacists and other technical employees of the pharmaceutical chains. Simply adding more pharmacists will not solve the myriad of complex and overwhelming existing problems. There is already a public and private outcry. Now we need compulsory action and solving of problems.
4
In 2018 we hospitalized my sister several times when she was collapsing for no reasons. We finally found out that CVS had been dispensing to her a narcotic, "Clonazapam" instead of the anti psychotic medicine "Clozaril". We now check the numbered imprint on every pill.
10
My Rite Aid was bought out by Walgreens and the transition has been a complete and unmitigated disaster. I honestly don't know how you could do something so bad, unless it was intentional. I feel bad for the remaining staff that have served my family for over 20 years. They don't deserve it. I was going to find a new pharmacy, but it seems the situation is not unique to my store. Thanks for the head up. I'll be carefully checking my refills. Toxic corporations, everywhere. It's so disheartening.
321
@Lisa The same here and I did find another pharmacy - a small mom/pop with terrific! pricing, sweet customer service and a well stocked store with many natural products, not far from my home. I have looked at all my prescriptions closely for years and actually have counted pills while at the store as I was short changed many times.
35
@Zarda " a small mom/pop with terrific! pricing, sweet customer service and a well stocked store"
Must be the last one left in America.
25
@Lisa ......how about a couple of specifics of what you're talking about? Your Walgreens is not just a disaster, but a complete and unmitigated one? So bad must be intentional? What do you mean? Were your prescriptions filled wrong? How?
How is it different from the Rite Aid?
Write a few sentences of explanation.
16
I worked as a pharmacy tech at CVS for 3 years. The disconnect between corporate demands vs actually working in the pharmacy resulted in grueling work conditions and constant turnover among pharmacists.
Also rolled my eyes at this statement: “When a pharmacist has a legitimate concern about working conditions, we make every effort to address that concern in good faith,” CVS said in a statement." I agree with the pharmacists who expressed concern about being fired if they ever spoke up.
One last point -- while it's totally understandable that nobody is exactly happy to have to make a trip to the pharmacy, the lack of civility from customers on a daily basis was astonishing. It ranged from screaming at us about what could possibly take so long to "just count pills and put them in a bottle" to being told "I HOPE YOU GO BURN TO DEATH" over a shampoo coupon that wasn't picked up by the pharmacy registers/that we asked him to take up front so that we could address the long line of patients behind him. At bare minimum, I hope that this article helps the public understand that you cannot expect a pharmacy to function as quickly as a McDonalds, and that patient safety really is at stake.
70
Thank you for addressing some of the rude and inconsiderate behavior I have witnessed.
9
Lynn, when I visit my CVS pharmacy I would never dream of bringing other items from the general store area to the pharmacy area for checkout although the technician says it’s okay to do so; I deliberately take any items not specially ordered as a prescription to the front checkout where any discrepancies can be handled by the regular employees; not fair to bring gobs of stuff to the pharmacy checkout that can be handled up front.
4
I am a retired pharmacist and former chain pharmacy supervisor. This article is spot on. There is no need to blame one chain pharmacy over another because they are all the same. You can interchange company names in most of the statements. The chains have created a workplace
environment defined by metrics which do not allow the pharmacist to control how they practice pharmacy. The public is being grossly shortchanged. Pharmacists have a doctorate which took them eight years to earn. Studies include advanced knowledge of infectious diseases, oncology, cardiovascular systems, inflammatory disorders, general medicine, endocrine systems, chemistry, mathematics and genetics. The chain pharmacy workplace severely limits a pharmacists interaction with the public.
62
I wish I could vote for the NY Times.
I am so grateful that someone is exposing the forces that drive these companies and the mechanisms applying those forces to the people at work and the customers they should be serving.
The confidentiality to hide and privilege to fire are toxic to humane influence in corporations.
By converting previously-independent professionals to employees, health care has lost its self-control and delegated its authority to financiers.
There is no need for profit incentive in health care, and no reason for for-profit health care corporations. All health care should be non-profit organizations, and they must transparently track their achievement of health-care goals.
30
My CVS is top notch.Rarely a line at the drive through. I switched from Walgreens directly across the street where cars were usually 3 deep in line.
I’ve experienced several things you mention. Although I love my CVS, a 30 minute wait on the phone is not uncommon. One time I received 30 pills when it should be sixty. Sometimes they tell me that they have run out of their controlled substance supply and I would have to find another store. I completely agree that the utter chaos could make it easy to make mistakes. There is a pill identifier site on the web where you type in the number or letters stamped on the pill to see if it is accurate. If the label says the correct medication, look up the number imprinted on the site to confirm. Count your pills too. Since no one seems to be double checking at the pharmacies, then we must do it ourselves til they get their act together.
1
I got a notice from my insurance company and it showed that CVS had billed them for a prescription I no longer use. The insurance company told me that 1. the charge had been reversed (though I have never gotten any notice of that) and 2. they are billed and pay when the prescription is filled, not when it is picked up.
Of course they are pushing for 90 day prescriptions if they can bill for the whole prescription when they fill it. And they fill my prescriptions automatically, despite my telling them repeatedly not to.
Our long-time (20 years) pharmacist quit recently because of the working conditions.
Something is very wrong here.
8
Corporatization is a problem that plagues the entire health care field, not just pharmacies. Doctors, nurses, physical therapists etc. increasingly work for large organizations that apply constant pressure to do more with less. Not only does the quality of care and service suffer, but health care workers find their jobs demoralizing rather than rewarding and uplifting.
I am a physician, and I know whereof I speak.
18
Interestingly, I have had many of my patients describe that if a prescription is sent in to the pharmacy, and authorization obtained from the insurance company, the pharmacy is paid for the prescription even if the patient never comes in to pick up the medication. Another driver of the increasing cost of health care.
3
@EJDIII that is not true. If a prescription is not picked up within a set amount of days then the claim to the insurance company gets reversed and the pharmacy does not collect any money.
3
Concerned about what is in that little plastic bottle you just brought home from the pharmacy? Go to Drugs.com and use their "pill identifier" It is easy to use. Want to know more about the medication and is proper use. Check out a website such as Mayoclinic.org which has clear, concise descriptions of medications and their proper use as well as possible side effects and interactions with other drugs. Still confused - just contact the pharmacist or the prescribing health care provider.
4
If you need a "compounded" prescription the chain pharmacies can't help you. You're out of luck. Seniors stand in lines to pick up their prescriptions at counters manned by a "Pharmacy Technician" while only one licensed pharmacist is on duty and that pharmacist is overworked and underpaid. We get repeated emails to pick up prescriptions that have 2 weeks to go or just 2 days and the chain pharmacies can't get their computers straightened out. Prescriptions are filled incorrectly and computer information is often wrong, out of date or simply not entered. Communications between doctors who make electronic submissions is lost, not received, or somewhere in cyber space but not ready for any action at the pharmacy. It's time to break up the chain pharmacies or at least monitor them and hold them accountable. The chains relationship with drug companies also needs to be investigated and strictly monitored in an open business model that give patients, doctors and other healthcare providers the best services at the best prices. Start by creating better working conditions for pharmacists and stop putting them into situations where they cannot monitor and supervise the filling of all prescriptions. So-called pharmacy technicians need far better training too. Don't just pull drugs off the shelf and put potentially dangerous or the wrong drugs into a bag for a customer. Congress and the states need to act.
4
I just wanted to let you know how much those “pharmacy technicians “ make an hour. Those hard working technicians who run around endlessly helping me fill your prescriptions accurately while taking verbal abuse from customers who are either angry that their prescription are not ready or disputing how much it costs make on average $11.25 an hour. I have rallied numerous times to get corporate to give them more money. My latest response from my DM was I’m sorry. We really tried. We do not make as much profit from prescription sales that you think we do. The best that they could do was give a .25 raise. I kid you not. This is a NYS chain drug store.
Oh did I also mention that we all get complaints that we don’t smile enough?
6
This is one of the more dangerous examples of the trend in all areas of health care to treat medical professionals as assembly line workers.
14
CVS has taken the noble pharmacy profession, and inserted it into the relentless vise of unbridled capitalism.
The CVS pharmacists have become disposable cannon fodder for the Ayn Rand-styled capitalists running CVS.
While I am not a proponent for sprawling government regulation, this is an instance which clearly shows the need for swift and robust regulatory oversight.
With the aging population, more and and more prescriptions will be needed to maintain quality of life for many. The implications of medication error are horrific, particularly so when on a wide-scale.
Make no mistake, what we are witnessing with CVS is just as bad, scandalous and corrupt as Boeing's actions in the Max 737 debacle.
15
@Raphael As a pharmacist, I watched a story about Boeing, the crashes, and their corporate culture last month and immediately made the link of similarities between them and CVS
6
We as members of the public demand CVS (the most egregious practices named here) to change toxic workplace practices, change practice to stifle customer compliants, and report update to us.
i am switching to Riteaid - less egregious...it seems, or an online pharmacy.
2
Rite aid is the same. If not worse. Go find a mom and pop shop that doesn’t fill 400 prescriptions a day.
4
This is another example of the necessary role of organized labor not only to protect workers, but also the public.
Nurses have enough sense to not sneer at unions - they still fight a continuous, and I am sure exhausting, battle with hospital administration (the tenacity of the capitalist overlords never ceases to amaze), but in the end they can stage a walkout that gets everyone's attention. That power mitigates the quest for brutal efficiency that is everything to the corporate managers, and hopefully maintains some minimum standard for patient care.
Pharmacists are as brainwashed as physicians - they have long been convinced that they are 'professionals', standing apart from the common worker, then suffer abuse like any high school dropout who works in an Amazon fulfillment center!
6
I think CVS may be creating too many metrics and rewarding managers for meeting them. For a patient to feel free to use or not use a medicine they cannot be made to feel responsible for the welfare of a pharmacist.
The metric should be that the pharmacist asked the patient is they would like something, like having a refill. The patients have their own reasons for refusing. Many prescriptions, even when written with refills, are no longer needed.
I use HMO or Walgreens pharmacies. The Walgreens pharmacy usually has three or four busy people, one is a pharmacist. There is no reason to waste a highly skilled pharmacist's time on simple tasks.
Errors resulting in death absolutely should be reportable. Medication filling errors should be reportable. The pharmacy is still free to negotiate a settlement with the patient or family when needed.
1
All to appease the lords with the almighty dollar. Ever wonder why you don't hear about such issues in universal managed care countries? Pharmacy is part of the universal model, with appropriate skilled resource engaged to manage and deliver.
6
CVS pharmacy, located in my neighborhood Target, is completely dysfunctional. They don’t even answer their phone calls. Long lines, prescriptions not filled, angry customers. Target is a good company. They should cut their ties w CVS and return to operating the pharmacies themselves.
6
Sadly this is happening for many reasons and often self inflicted. Whenever I hear laments about brick and mortar stores or taxis I remind people of the issues they had. Similar issues existed with Mom and Pop pharmacies. Failure to upgrade, bad management, lack of inventory and discrimination. Yes I am old enough to remember local pharmacies that catered to whites only just like taxis or other businesses.
Then there is the reliance of these chains on cheap labor. Often foreign born and/or young believers that labor laws or unionizing was synonymous with devil worship. We need changes but we also need a reality check that everything in the past wasn't like Mayberry or life isn't a Friends episode where your corporate overlords are your friends. Being a worker, no matter how well paid or skilled means they are always looking for ways to decrease your cost or make you expendable.
1
How would you like to complete the education required to become a pharmacist only to end up working in this environment?!
17
@MAM I did not like it all - affected my health enough that I had to quit. Still over 150,000 of student loans left....
2
I always have to laugh when I see a Walgreens ad with a pharmacist chatting with a patient in an otherwise empty pharmacy. It’s certainly not the typical Walgreens experience of mass chaos.
8
One can speculate that this may get worse as the population ages and needs more meds. Patients need to check their own meds if in doubt. You can find pictures of pills, capsules, etc on the internet.
2
I'm a pharmacist that used to work for RiteAid in the northern New Jersey area. The way chain pharmacies put profits above everything is disgusting, it impacts patient care and leads to great harm. Very happy you published this -- a big curtain has been pulled off the shameless and harmful way these giants operate. The CEOs should be held criminally accountable.
24
This is what privatization and no regulation produces. There is no end and no one will stop it.
Bernie 2020
10
In addition to the issues cited, I believe there is pressure on the pharmacists to keep low inventories. On more than one occasion, my CVS pharmacy has been out of stock on my medication. I was most surprised being told that my daughter's anti-seizure medication was out of stock. This is just another ugly byproduct of healthcare for profit.
12
As long as the shareholders are making money nothing else matters.
14
The chains and state boards seem to be the very definition of 'moral hazard'.
7
CVS has become convenience store pricing with Home Depot level service. You’re on your own.
9
As an attorney representing employees I know this is true. Pharmacists are overworked, bullied and stressed beyond repair and leaving in large numbers due to the dangers they are forced to partake in. If we had a real administration that cared, I’d feel hopeful. Until then we will have to learn by serious mistakes caused by corporate greed.
10
I’ve been a retail pharmacist for 30 years working the busiest locations. No question the state of retail pharmacy is a complete disaster, and the way it is managed by both corporations and state boards should be a crime. The number of mistakes doesn’t remotely reflect the magnitude of errors I witness on a daily basis, many of which go unreported and those that do get no attention of state boards during pharmacy audits. Understaffing is at epidemic proportions while competence of technicians is at a career low. Customers don’t give a rip about anyone but themselves, management offers zero support for pharmacy, moral has been bludgeoned by the 900 pound gorilla of greed. No more bonuses, no pay raises (including cost of living) for years, workload has increased exponentially. New graduates coming out of school with hundreds of thousands in student loan debt (financial suicide). Opioid crises is showing no signs of abating, prescribing of stimulants has exploded. At the same time we are required to document every detail, override every controlled substance prescription as if pharmacists are responsible for massive overprescribing. We live in a culture in which anything goes, people are never told no and pharmacists are on the front line of all the nonsense. Countless prescriptions are filled and never picked-up. Customers constantly transferring prescriptions between locations and chains increasing the workload. Enormous volumes of E-prescribing, duplications and autofills.
17
You nailed it! If I may add, how about dealing with the new recalled drug of the day. Not fun to have to apologize to customers on behalf of drug manufacturers who outsource their drugs from overseas worried that the cancer they have could come from the drugs you gave them.
3
I recently got a flu shot from my neighborhood chain-store pharmacy, and after keeping me waiting, the pharmacist politely vented to me about major staffing shortages at her location. When I inquired as to the reason, she cited the inability of the industry to attract technicians, who are paid little more than grocery store cashiers. She then proceeded to list all of the resulting negative impacts on pharmacists, which precisely match those described in this article. It was pretty depressing to see how such bright, talented, hard-working professionals are so poorly supported in such intense work environments.
38
It is easy to state particular cases of errors. The bigger question is to measure the errors. How may errors per 100,000 prescriptions? Everybody makes mistakes. People who write articles also make mistakes. The author points out long shifts and says nothing about availability of pharmacists in different regional markets. What companies should do if pool of pharmacists is small and demand is high? Blaming companies is easy, understanding problems is much more difficult.
1
As a former pharmacist at a top retail chain, I am so glad to read this article. I left that role because of this exact reason. I was killing myself. I couldn’t sleep at night and if I did it was accompanied with a dream of me back at the pharmacy. Unrealistic expectations determined by those at the top who may have never even stepped foot in the back of a pharmacy. I always make sure to treat all my local pharmacies with respect and kindness. It is truly a nightmare behind that counter most of the time.
And lunch breaks? Bathroom breaks? LOL!
I could go on and on but sadly this has been going on for so long and nothing has or will be done. Pharmacists are afraid to speak up and understandably so. It’s unfortunate. Doesn’t matter if you’re killing yourself or making mistakes. Just meet your goals and metrics.
For those looking into pharmacy as a career, please reconsider. Too many pharmacists, not enough jobs which creates the sweatshop like environment.
22
Read this story early this morning. Noontime i went to Walgreens to pick up a prescription i get every 30 days. It needed to be
renewed. I was told it wasn't ready because they were waiting for the doctor to call to let them fill it for 90 days not 30. I told them to leave it at 30. Second time they tried this. Last time it was a pain killer of 30 prescribed pills they wanted to have the doctor increase to 90.
8
I am an RN who has worked closely with Pharmacists throughout my 20 year career. If Pharmacists are speaking out we had better listen.
27
I use a great independent neighborhood pharmacy, and am always worried about the cost pressure they are under.
3
I left pharmacy (CVS pharmacy manager) by own choice last year due to work stress related health problems. They asked me to stay, but I was constantly worried about misfilling a RX due to under-staffing issues.
Constant pleading with district/corporate managers led to nothing. At one point, I instructed my staff to ignore the metrics and focus on patient safety. That earned me a 'needs improvement' write-up for not meeting metrics. It is well known at CVS, that starting this type of 'paper trail' with write-ups is the process of terminating an employee. So, after that, I met my metrics by coming in early, working 10-12 hour shifts with no breaks (including bathroom many days),staying late, and still had to sacrifice the diligence I thought was needed to safely fill prescriptions - this earned me very good performance reviews, however it had quite a negative impact on my mental and physical health.
Leaving pharmacy was devastating to me financially, but I am slowly regaining my health and am much happier at my $14/hour job. I wish I could find a place of employment that needed a pharmacist whose main goal is patient safety, but no luck yet - not even sure I want to be a part of that profession anymore....we'll see what the future brings
75
A word to prescribers - stop using abbreviations on your prescriptions. Dr. Denby's lithium carbonate prescription shows directions for "i q AM, ii QHS," (1 every morning and 2 at bedtime) but the way he wrote "QHS" is a textbook example of an abbreviation that could easily be misread as "QID" or 4 times a day. Patient safety experts also have for well over 2 decades opposed using chemical formulas (Li2CO3) because they are also often the source of errors.
This is not to say that Ms. Gabler's excellent article is not on point regarding the role of metrics and inadequate staffing ratios that lead to danger for patients. I am aware of 2 other methotrexate cases in the US in the last 3 years that were similar to Ms. Scheurman's case, and where any competent pharmacist should have known that methotrexate is never given on a daily basis in outpatient treatment. Sadly, in one Missouri case, the patient also died and in the other case the patient suffers from permanent lung damage.
2
Though there are drawbacks to the French system, too, pharmacists there never count out pills, put them in little containers, and slap a label on. The medications are dispensed in the original boxes they came in from the manufacturer. And chain pharmacies are against the law--each one is individually owned. (And yes, one of the imperfections of the medication-dispensing is that sometimes you wind up with a few more pills than prescribed, but people are expected to exercise common sense and dispose of them responsibly. Which may not always happen, admittedly, but this still makes more sense to me.) Finally, in any given neighborhood, there will always be a pharmacy that is open all night for emergencies--they take turns; the location of the "night duty" pharmacy that's open is posted on the door of the ones that have closed at their usual time.
8
As a physician , I can tell you I have been on hold > 60min to speak with a CVS pharmacist about a patient. And I have seen errors in prescriptions for my patients. Also as a busy physician my self, we all rely on the pharmacist to catch our occasional errors l! This turning of medicine into a conveyor belt has had no good out come.
15
After an insanely unhelpful, multi-day back and forth about trying to get an epipen filled at Walgreens, I recently switched to a locally owned, non-chain pharmacy. Sure, it was handy to be able to pull up my prescription records online. But the local is faster, provides much better service, and best of all - is almost always significantly cheaper to fill the same prescription! I'm never going back if I can avoid it, but I wonder how many parts of the country still have a local pharmacy within an easy walk or drive? Hopefully one upside to these problems will be a renewed effort to "fill local."
9
@DSL
There is a pharmacy attached to the multi-doctor practice I patronize (the practice is attached to a teaching hospital). I always use that pharmacy rather than a CVS that is closer to my house. The pharmacists at the practice are always attentive; the pharmacists at the CVS always seem like they have something else to do and want to get rid of me.
3
@Chris as a former CVS pharmacist, I can tell you that nearly all of us wish we had the time to serve you better
10
The key is for consumers and patients to support local pharmacies and leave the big chains behind. I have been using my local pharmacy for over 20 years and would never consider going elsewhere. They know my name, my family members' names and, more importantly, the medications each person takes. Yes, you might have to pay a few pennies more for some prescriptions than what the big chains charge but you get what you pay for. With the damage wrong meds can cause the few extra pennies are worth it. And with the plethora of prescription discount cards readily available you may be able to get quality safe local service for the very same price as the big business chains.
6
At my Walgreen's, although no major problems, I have received antibiotic prescriptions with the wrong number of pills. Now I make sure the count is correct. Also, although this probably is legal, I have seen the store manager filling prescriptions.
2
A very well written article. One thing the article fails to mention is the saturation of pharmacists in the market. Many new pharmacists are coming out of school unable to find a job and willing to work for much cheaper than the pharmacists already employed. Thus, the currently employed pharmacists feel the need to work longer hours without breaks (some staying hours after their shift's end) in order to meet those quotas so they are not replaced by the debt laden unemployed pharmacist.
12
@Tyler This is very accurate
3
Goodness, this is so true and getting worse; and they are required to answer phone calls, speak to customers, check people out, explain medications, etc.. Seems to me this is where automation could be used not to replace the pharmacist but to aid him or her. Standing on their feet all day and with grumpy customers who want their prescription immediately, so by the end of the day they should be exhausted, dazed and in need of restorative medication themselves.
3
@jaxcat As a former CVS pharmacist, I can tell you that CVS is constantly coming up with new ideas of how automation can help in the pharmacy. The problem is, every time they find something that works and implement it, they use that opportunity to cut staff hours
7
Recently after my husband’s surgery, I had to fill some prescriptions at the Walgreen’s. I joined the long line waiting; people were clearly annoyed at the long wait. Behind the counter, one pharmacist was trying to keep up with filling bottles, answering questions, talking on phone, counsel customers, read the computer, etc. The two techs were vaulting back and forth between the drive-thru, phone, looking for rx’s, answering questions, patiently explaining to a few people who clearly were confused about what they were picking up and what it cost, ringing up the register, etc. etc. It was insane. I remember thinking, check my husband’s bottle carefully to make sure I got the right stuff. Pharmacies are important, staff them properly!
12
Standardizing pill colors/shapes would also help. Every time I fill a one of my maintenance drugs it is from a different generics manufacturer that puts their own spin on the appearance. I've had it in ovals and circles, fat and thin, white and green. Sure would be easier to catch mistakes if I knew what to expect each time.
7
Pharmacists are "information workers" and professionals. They ought to be treated like professionals for their sake, and that of the customers.
How did we get to this level of exploitation in drugstores, and where does it end in doctors offices, grocery stores, department stores, and on-line tech help?
Meanwhile, the profits for those at the top of companies (and in our mutual funds) keep going up.
Elizabeth Warren, do you have a plan for this? I am all ears.
10
Yes, I got a automated CVS pharmacy call for a refill of an antibiotic in which neither the doctor nor my wife requested for it. Over usage of any medications will definitely cause many untoward side effects such as the " Opioid crisis ".
One of the means to address the problem for all these greedy corporation is to file a multi-billions class action law suit aim at where it hurts.
10
@SK
The independent pharmacy I use never bombards me with robocalls.
2
@Chris
You are lucky. In the area that we live, not that many mama/papa shops survived. They are eliminated by big corp and chains store like CVS, Walgreen, Targets, Vons/Albertson super market etc etc..
2
This article says it all. Thank you. A reality we face about our health system (opting out the word care intentionally) as there is no care. Focus on money, trying to max on profit by understaffing which leads to patient harm should not in any way be part of it.
State Boards of Pharmacy exist to ensure patient safety, and clearly this is a patient safety issue, and yet...nothing is done, or if they do something there is no follow up.
Obviously it's a complicated issue and involves (PBM's, insurance companies, prescription drug prices etc.) as mentioned above, but an issue like this, that involves public health and patient well being is not an issue to be delayed.
7
CVS has replaced most local pharmacies in our area with its chain of novelty stores that sell prescriptions in the back. There's always a line, they always want your email address and like most stores, paper you with coupons for iiems you just bought. Discounts are only offered to captured customers.
There are no other choices in most towns and it shows in the prices and annoyances that shopping at CVS presents.
The pharmacies seem well run, since most of the people there learned their experience at the drug stores disappeared by CVS monopoly.
3
The risk of medical errors is always compounded when any part of our Heath care becomes a profit center. Shareholder demand for increased profits ultimately results in cheaper goods, downsized workforce, and constant pressure for more sales. This may work when your selling hardware or furniture, but it’s a deadly combination when someone’s life is on the line!
11
No surprise. Just like nursing, more tasks to increase payments with the end result compromising patient care. Do everything you can to avoid prescription medications and if you must take them protect yourself by knowing the name, dose, potential side effects.
7
Wish lawyers would file a class action lawsuit against CVS for forcing horrible working conditions and exploiting their workers.
Yes, productivity is very important, but forcing the staff to do more without providing the supporting tools is inhumane.
4
@Zor
There is no law forbidding employers from treating their employees the way CVS treats their pharmacists; hence, no class action.
1
@Chris Are there no labor laws that would force CVS to provide bio breaks and not force the staff to stand for hours on end?
2
We need market-based, profit-driven solutions. Just kidding.
The "speed-up" described in the article has been used relentlessly in manufacturing... with results of injury and death to workers. In the retail pharmacy industry, exploitation of pharmacists and harm to patients. Ugh.
Unions are one possible solution.
The article describes one aspect of our stupid health care system. Even the most capitalist/free-market economies, according to the Heritage Foundation, have universal, health care for all systems which are highly regulated.
13
The chains must be broken up. They have monopolized the business by driving out independents, unlike Rexall, which was a chain of independents.
5
I do NOT refill prescription requests that the patient her or himself does not confirm as needing a refill.
Please ask your patients - all of us personally as well - to “opt out” of automatic renewals at every encounter with a live person in a pharmacy.
If you are notified that a prescription is waiting that you did not order, just don’t pick it up (it is resuelves in 7-14 days according to the store’s policy or state law), or call the pharmacy and choose “speak with the pharmacy staff” or leave a clear voice message that ONLY THE RENEWAL, NOT THE BALANCE OF THE REFILLS, needs to be CANCELED as it was not requested and will not be retrieved.
A travesty!
2
I waited 10 minutes on hold with CVS, listening to their audio message about how CVS cares and will find the best price for the customer. When the pharmacist finally picked up the call and heard my question about meds and prices, he exclaimed, "I'm too busy for this! Call your insurer!" He hung up on me. When I switched pharmacies that day, the staff told me that poor man was taking a leave of absence for burnout. Sad!
5
All of this is scary and true, and then even if the prescription is filled properly, you have to worry about the contamination and actual efficacy of the drugs inside.
7
My local Walgreens has started to refill my three-month prescriptions without me making any such request or giving consent. They (figuratively) push the pills down peoples’ throats.
Time to move our account to the local pharmacy.
4
@LIChef Many insurance companies are now mandating dispensing three month’s supply.
2
Profit first rules the US. Each month I see the terribly overworked CVS pharmacists doing their best though it reminds me of Lucy and Ethel trying to keep up with an escalation conveyor belt of. chocolates. While Wall St proudly announces ever higher “earnings” reports.
13
If we re-elect Trump and the corporate sponsored, profits before people, Republican Party, this problem will only get worse. That is what I expect to happen - unfortunately.
11
I am married to a pharmacist who works for one of the chains and I am so glad you published this article!! I also hope that you can CONTINUE to write about this to pressure the chains to recognize the need to increase and not reduce staffing in their pharmacies and to change the inhumane working conditions these professionals are subjected to. The general public has no idea of the unrealistic expectations these chains put on their pharmacy staff.
540
@Terrry Howard I am in the same boat you are in. It is unbelievable what my wife is subjected to on a daily basis. The pay is good but should be much higher. My wife is in excellent physical shape and the physical toll the job puts on her is ridiculous. Standing 13 hours straight, no lunch break, or any other type of breaks other than using the bathroom.
46
@Terrry Howard..these chains are trying to reach a bottom line that may not be tenable...maybe its time there are more private and dr office pharmacies ...and let the chains fall
29
The problem with using profits to motivate Healthcare providers, is that bad care is more profitable than good care, in the short run, and markets don't really care about anything past the next quarter.
Markets do many things well. Healthcare is not one of them. A smart democracy figures out the difference and fixes bad markets.
That is what economists used to do, before Right-wing economists announced that markets are always right and Government is always wrong, ignoring all evidence.
15
This is standard large corporate business practices applied to the pharmacy business.
Standard large corporate business practices in order of priority are:
1. Maximize profits
2. through Infinity. (crickets)
4
I graduated from pharmacy school in 2014, and completed most of my intern hours at a Kaiser outpatient pharmacy, where I saw how difficult it can be to balance speed, efficiency, quality customer service, and patient safety. But Kaiser's working conditions were heaven compared to those of the large retail chain pharmacies, which push their pharmacists, technicians, and clerks to the brink of insanity. This is why I chose to work in a non-retail setting after graduation (I currently work in managed care). There are so many options out there for pharmacists beyond the Walgreens and CVS's of the world. Send the chains a message and move on.
12
We are increasingly in an era, especially with current “leadership” ,and the basic philosophy of the GOP, that profits and stock prices are the only thing that’s important. The average person and consumers are just commodities. These chains have probably made a conscious decision that setting some lawsuits is cheaper than hiring more employees.
3
I so appreciate this article for its robust reporting -- I have witnessed or experienced much of what is described here in my neighborhood CVS, through fortunately have not received any incorrect prescriptions. My heart goes out to those poor patients. I am fortunate to have two independent pharmacists within walking distance, one of whom greets me by name when I walk in, and offers valuable advice about alternative treatments. And now I know not to be angry at the CVS staff; they are doing their best within a broken, metric-driven system. I don't know if Medicaire for all is the solution, but something surely needs to happen.
5
In error, my HMO pharmacy dispensed an anti-depressant in the bottle labeled for the antipsychotic my son takes to manage his bipolar disorder. Had we not paid attention to the change in drug shape/size, he would have missed one or more of his critical doses and potentially wound up in a police confrontation if not an inpatient psych admission. The pharmacy is always busy with too few people to support patients. Appreciated this article bringing the challenges and real risks to our health and lives forward.
4
I always wondered why prescription pills need to be counted and relabeled by hand. Why don't more manufacturers package more of their prescription drugs like z-paks, in sealed ready-for-the-consumer packaging prefilled with the most common dosages and quantities. Sure, there will be some prescriptions that must be dosed by hand in order to fulfill doctor requests but in lots of cases people are picking up 30- or 90-day supplies of maintenance drugs. Let the reliable robots back at the factory handle the dispensing and cut out the opportunity for many errors.
3
You can't have 2 Pharmacists checking your medications and counseling patients for extending time without adding extra cost as simple as that. Just imagine a Government run system, how much it would cost the tax payers to fund such system. Considering the large number of medications dispensed in the US, it is very impressive errors outcome and it should improve further with more technology application but it will cost more.
1
Instead of extra cost to the consumer, how about less profit for the chain ?
10
There are also pharmacy techs who fill the meds and then the pharmacist checks them. In some states, techs can even check each other's work if it's a refill. The problem is the companies are cutting everyone's hours, often to the point where the pharmacist is alone and has to check their own work while often multi-tasking and in a rush.
2
And yet the countries that have government-run healthcare have lower costs and better outcomes than our expensive private system. Funny how it works out that way. If your ideology isn't matched by reality, it's time to change your ideology.
6
The best way to protect yourself is to use a drug ID app which you can get free on iTunes. It allows you to input the shape, color and ID number inscribed on the pill. It then tells you the name of the drug and gives you a photo of the pill. If the pill looks different than the pills you usually get, this is one way to protect yourself. As a nurse practitioner, I use it all the time.
3
For years I’ve gotten all my prescriptions refilled online through Kaiser Permanente’s own pharmacies which they mail to my house for free without a problem. I read this article and wonder why it has to otherwise be so complicated.
1
When you are on medications that cannot be started or stopped abruptly, mail order pharmacies are one more thing to worry about. A delay in the processing or shipping of the package has significant medical consequences.
I literally thanked God when my employer's insurance plan let us fill prescriptions locally for chronic conditions again. I had several medical setbacks from late mail-order prescriptions.
6
@JulieABQ, I've been on seizure meds for over 40 years that I have to take everyday regardless, on the off occasion my meds don't arrive on time I can just take my empty pill bottle to any Kaiser pharmacy at any clinic anywhere and they'll give me a carry over supply to last until they do. If anything the inconvenience of that makes me more sure to get my online refill order in sooner the next time.
Practiced pharmacy for 35+ yrs, retired now, for the reasons noted in the article. Fear of causing harm to patients I have serviced for years became too much a worry. A profession I once woke up to each morning anxious to work another day, then became a stress filled, accident waiting to happen. The reasons for the change in working conditions over the past 20 yrs are complicated but money and profits certainly play a large role, as in any business. Our state and federal governments needed to enact levels of staffing, and patient safety, then enforce them. Corporate pharmacy chains will claim there are not enough profits to hire adequate/safe staffing levels. Insurance companies will not reimburse pharmacy chains enough to allow profits that allow fair staffing levels. The market supply and demand forces that can repair much of this problem is hampered by federal laws preventing pharmacists from forming a professional bargaining group. The pharmacy chains and hospitals should be allowed to negotiate with insurance companies as groups also. Everyone needs each other, but a single pharmacist will never have the power to demand better conditions from a corporate chain. State pharmacy boards should have a more active role regulating the job sites, and boards should be represented from all facets of pharmacy specialties. The current situation is sad, and unfortunately leads me to consider socialized medicine as a lessor of two evils.
15
@Donald Lew A registered nurse for 30 years at my local “nonprofit “ hospital and resigned. The horrible patient care kept me up at nights.But our CEO is now making about 2 million a year. Make America Great Again, by taking advantage of all the workers.
3
"Regulating the chains ... has proved difficult for state pharmacy boards, which oversee the industry but sometimes allow company representatives to hold seats. Florida’s nine-member board, for instance, includes a lawyer for CVS and a director of pharmacy affairs at Walgreens."
...
"Errors, the companies said, were regrettable but rare; they declined to provide data about mistakes."
I am almost shaking with rage. Everyone who opposes M4A should read this.
Profit-driven private enterprise will always be anathema to good health. Period.
13
@JJ -- Florida is really good at getting the foxes to guard the henhouses and then paying no attent
2
My CVS ignores what my doctors have written and have told me they do that. Has been this way for years. State law now says they can substitute and they do in spite of the prescription and instructions in my file. I always know/research before I even go to the doc. I finally contacted CVS corporate. A regional mgr called me and we had a pleasant conversation. I thought things would improve. No they didn't. Doesn't refilling errors cost them $?
Good article.
4
I have gone to the same pharmacy for 15+ years. Initially, they were kind & caring, knew me by name, and never made a mistake. In the past 3 years, the old staff vanished. The new staff neither knows nor cares. They've made 3 mistakes in the past 6 months, none of them terribly dangerous, but mistakes nonetheless. They make sure I get one drug every single month that I don't really need, while missing two vital medicines. Neglecting to fill my blood pressure medicine could be very dangerous, & it keeps happening (does that count as an error? then they've made 7 mistakes in the past 6 months).
1
The last prescription I received had 3 errors; wrong dose, wrong quantity, and wrong MD listed. The pharmacist was nonchalant about it even though I had been taking the medication for several days. I have refused to sign up for automatic refills for years, ever since receiving a refill of a controlled substance narcotic I did not request. Like most people I assumed automatic refills were to fill the prescriptions I actually had refills listed for. What actually happened was that the pharmacy also sent a refill request to my doctors office for a narcotic medication that had been given one time temporarily. Since the pharmacy represented to the doctor’s office that I had requested this refill, which I had not, the refill was authorized and my husband was given the prescription with another medication he was picking up for me. That is how easy it is to end up with a controlled substance prescription that you didn’t even ask for.
Since the automatic refill incident I have worked for several medical clinics and spent a large portion of my time dealing with prescription prior auths and refill requests. It is absurd the number of requests received daily for inappropriate refills. Directed to MDs who haven’t been at there for years and for medications patients are no longer taking. These requests invariably come from the pharmacy without the patients knowledge. Automated refill programs not only waste patient’s and doctor’s time and money but are too dangerous to justify.
3
When I've been in my local Walgreens looks like the pharmacy is the only area that is turning a profit. The rest of the store is devoid of customers. They need to rethink their business model. They aren't selling anything that I can't find at Walmart during my local grocery run, and for less $$. If they're supposedly having a sale it's usually "buy 2 to get a special price" forcing you buy more. Walgreens is within walking distance of my house but I seldom go in there.
Feds need to change the law to mandate automation in the healthcare industry. This can apply to making appointments online, checking in at your doctor, processing payments, accessing patient's health records, but also as it relates to dispensing drugs. A distribution center can then use robots to fill prescriptions, package them, and send them out for overnight delivery. This way the healthcare provider has better control over refills, etc.
2
Corporate companies need to provide better work-life balances for their pharmacy staff. They need to care for their employees so their employees can care for their customers. It's always been all about the money and numbers. They don't seem to care about their staff or their patients. My pharmacist friends at CVS and Walgreens have medical issues themselves and struggle from the day to day. I've seen staffing models where permanent pharmacists are turned to floaters and struggle with their schedules on a regular basis. There's a ton of turnover with district managers and schedulers because the work environment is unreasonable. They have to plan their PTO a year in advance and most of the time is not granted, denying them time off a much needed break. The pharmacists have been overlooked and am so glad New York Times posted this article. The risk is too high to ignore. Corporations need to be responsible and accountable for their business model and restructure to find that balance. These companies have been flying under the radar for way too long, it's time to change.
8
I had terrible service locally for years from both CVS and Rite Aid, the only nearby chains. CVS would sometimes not fill my scripts and not bother to call. Rite Aid had a drive up service they would shut down whenever the pharmacist was overloaded with inside cashier work. This really hurt bad after my two back surgeries, having to park and gingerly walk with a cane the full length of the store twice to pickup my pain meds, which only they seemed to stock. Finally, Giant, a supermarket chain, has been absolutely wonderful. They transferred everything and fixed any errors in my seven prescriptions for my diabetes, my prostate cancer aftereffects, my sleep apnea, my high blood pressure, and my chronic pain. You can see my Coopersburg Giant Pharmacy staff is busy, but friendly, well trained and organized, even empathetic. Their computers are effective, and doctor call-ins are filled in short order, so the short walk inside the front of the store is not objectionable. Also, I have made it a habit to learn by heart every single one of my drug names, both brand and generic, the dosage prescribed, and always check my scripts closely before leaving. I caught several mistakes by both CVS and Rite Aid, but not Giant. Pharmacies are a crap shoot, no doubt about it, so I'd strongly encourage more investigations like this and sadly, more regulation with streamlined pharmacy systems. The goal here is perfection, no mistakes, and the stakes are high.
2
This is a very difficult conversation to have, as someone who worked in this environment for quite some time. I have seen it go from customer oriented to quotas. While a primary concern was financial based, the one staff had to be concerned about was time management. As years went by the focus become more on how much can we do at a lesser cost. This all got placed onto the staff. I cannot say it is the same at every type of pharmacuetical facility or chain.
The bottomline is you are dealing with people and their medications, tensions flair on just about everything and people get upset easily especially in the climate we are in today. It's a tough job and not many can handle it which is why being understaffed is a problem. Throw in asking about surveys and things that we offer along with menial tasks that have no business being handled by pharmacy staff and it's a no win situation. It's about time and staff, of which neither are available.
4
The employees on the front line know what's going wrong. But the only channel they have is to try to get things fixed is to go directly to management, and if they do that they know they get a black mark in their files. So they are reluctant to do it, and the problems fester. There needs to be an intermediary to whom they can bring the fact to and who in turn can take it up the chain without jeopardizing anybody's livelihood. In a case where mistakes cost lives, some sort of on-going ombudsman-like function is surely appropriate, and ought to be mandatory. Unions used to fulfill that role. This is another example of how their loss has worked against the interest of the public in the face of faceless corporate power.
3
@John Binkley
"some sort of on-going ombudsman-like function is surely appropriate, and ought to be mandatory. "
This is the job that the state boards are supposed to fill, but they are corrupt as described in the article.
5
As virtually all Medicare patients whose drug coverage is through Part D or through an advantage plan are required to deal with one pharmacy chain, they have limited ways to change if the encounter an error.
The insurance companies that are issuing the insurance should be held responsible if patients if the pharmacies they force them to use make mistakes.
5
I must live in an alternate universe --
For the past fifteen years, we have lived around the corner from our local CVS - literally - I could stop typing right here in mid-sentence and be standing at the pharmacy counter i less than ten minutes --
There are two full-time pharmacists - along with a staff of about six tech assistants - and I am on a first-name basis with all of them --
They are all courteous, efficient and patient - even on those days of stress - like on a Monday when everyone who didn't plan ahead suddenly all need their prescriptions filled "RIGHT NOW!" --
There are a couple of techs who have moved away for a few years and then returned to the area - only to come back to this particular CVS and reclaim their job - and - in each case - we reconnected like old friends --
The pharmacists there fill prescription for both my wife and myself - like many commenters - critical monthly medication for health issues --
They have never made a mistake in fifteen years on any of our scripts - and are careful to make sure we understand any new meds we are about to take --
I've had flu shots from my CVS for the past five years - and recently she reminded me I could come in some time for a Shingles vaccination --
I feel bad for all the people here who seem to hate their pharmacies - and I guess perhaps I should consider myself to be one of the fortunate few --
Yes - the staff at my local CVS can be stressed at times - they just seem to handle it like professionals...
2
I too have always had good results with CVS, they’ve always gone above and beyond. Not so much with the others ie.. grocery chain stores.
Our CVS has reduced staff by at least half, while seemingly doubling their number of customers. They regularly run out of common medications. Wait times are very excessive, sometimes standing in line for half an hour. All this and my co-pays keep going up.
6
There's an old adage,"Nothing matters but the Almighty dollar." Stockholders in corporations, their executives, and the politicians who take their donations are the people who matter in this country. Bernie Sanders and Elizabeth Warren are too "scary" for Democrats because they do things like calling out the pharmaceutical industry for sacrificing the needs of people to profits. Go figure.
8
This article is accurate and scary. I’ve worked in pharmacy for 25 years and it’s gotten so bad that pharmacists regularly leave the job crying or need therapy due to the stress.
One thing that could be done would be to eliminate auto refills. Make it illegal to fill a prescription unless the patient asks for it to be refilled. This would also cut down on refill requests to physicians for drugs the patient is no longer taking. It would cut down on excess work freeing up the pharmacist for other things. The only reason chains push auto refill is to drive up sales. Many times patients don’t even know what medications they are getting.
7
@Frau Greta: I suggest you check your prescriptions before you leave the premises, not in your car. This protects you from being suspected of tampering with the meds, which could affect whether you are charged for the wrong meds, or not.
I opened my meds the next day, and found that the bottle was completely empty. Fortunately, it was not a controlled substance. It took a while to convince the manager it was dispensed empty.
1
Thank you to the New York Times and to the authors for reporting and publishing this important and compelling story. This piece is award-worthy and I hope that the Times is recognized for it.
My insurer has a contract with CVS Caremark, so I have experienced some of the difficulties mentioned by the Times:
-The offering of unneeded refills (which I have declined.)
-Significant understaffing at my local CVS pharmacy.
Although Caremark has generally done a good job in auto-filling my recurring medications, the entire global pharma industry needs heightened regulation. While the error was not Caremark’s, I did receive through Caremark— and in part ingest— a bottle of a Chinese-manufactured generic that was belatedly found to be contaminated by a carcinogen.
For another generic prescription, I now specify my preferred manufacturer, as an alternative Caremark-provided generic did not work well for me.
In general, I recommend that consumers:
1. Have their physicians specify their preferred brands or generic manufacturers when they have their prescriptions written.
2. Scrutinize labels and pills before the medication is taken, as an additional safeguard against pharmacy error.
3. Use independent pharmacies, if a choice is possible.
4
The headline would be more accurate if it read, "How Capitalism at Chain Pharmacies is Putting Patients at Risk." The practices detailed aren't "chaotic"--they're the result of putting profits first.
13
Exactly! Putting costs before people inevitably follows from capitalism's profit motive and, especially, capitalism's insatiable need to expand. The fundamental structure of the socioeconomic system is the problem. Capitalism (that is to say, private ownership and non-democratic control of industry) necessarily leads to unbridled corporate greed not because those companies are run by bad people but because the system demands it.
4
As usual this labor management issue in the era of American corporate capitalism is dictated by bottom line
concerns to keep distant investors happy. So, we get the inevitable stream of egregious and stupid management decisions to minimize cost and maximize profit, which push employees way beyond what is good for patients, and even tempt some to act unethically via bonus rewards.
In addition there is the inevitable ineffectual
pushback from employees who are simply not organized to defend their (and their patients') interests.
Well, how surprising that any of what this article reports occurs!
The question is what is an appropriately uniform and effective response to these systemic threats to the well being of patients by oversight state boards of pharmacists AND physicians, as well as labor relations boards (for all the good they actually can do), and what is
a comparable response by consumer and patient rights defenders who can at least shine focused shaming lights at the bad guys from corporate HQs.
Since chains control so much of this business, we
need to define policies of good practice everywhere with the help of pharmacists behind the counters and
require ALL pharmacies to follow them.
And for those ideologues who pooh pooh by
referring to small percentages of bad outcomes, lest we get government oversight involved in the sacred practices of private industry... let's hope they get their own prescriptions incorrectly filled.
1
Article after article about how broke out healthcare system is while viable candidates run to fix it...but Republicans continue pulling the wool over the eyes of Americans who stand to benefit most from socialized medicine. When it becomes hopeless and too many are suffering, then what? What will the Republicans and their billionaire opioid peddler friends say then?
5
It doesn't surprise me to see the top 2 examples in your report. Because of past problems w/ both I now decline to enter their retail facilities.
1. CVS is the Pharmacy Benefit Manager for my health insurance. Unacceptable experiences from that management led me to try to find a different insurer, but was dismayed to learn that CVS was contracted as PBM for every plan offered. The company has expanded far beyond pharmacies and retail, apparently attempting to become themselves the behemoth they fear from Amazon entering the med dispensary market.
2. In July 2017, I went to a Walgreen's to purchase consumer items on sale. I use in-store carts in lieu of my walker while shopping at retail stores. I contracted bronchitis & was severely ill for over a month. Because that single trip to Walgreen's was the only time I'd been away from home, there was no other conclusion but that I'd picked it up from their cart's handlebar. Walgreen's did not respond to my complaint about the lack of sanitary wipes in their stores. I haven't gone back there since, & am also now fanatic about using sanitary wipes on shopping carts at every store I enter.
Both companies seem more interested in market share than in safety and service for their professional staff as well as for their customers.
1
Unfortunately , as a pharmacist for the last 42 years , everything stated is true . It is a profession in crisis with others making decisions for pharmacy that are not pharmacists . One element missing from the article is the variation in technician training . If my techs have worked in the field for years and are knowledgeable it can make my day much smoother and i feel I can focus more on my work. When the technicians are new or poorly trained I find myself pulled away and much more distracted . I have complained to the pharmacy board, as well . Hopefully this article will be the impetus for change .
11
I love my local Walgreen's here in Peoria, AZ, but wow, that pharmacy counter is a really busy place.
3
This article makes me glad to have an independent pharmacy so close. But, of course, no one should have to worry that they are risking their health or life simply based on their pharmacy of convenience.
About five years ago, a family friend passed away due to a mix-up in medication. She was otherwise quite healthy. One of my favorite artists, Tom Petty, died from an accidental overdose. Mistakes happen, and the patients and pharmacists alike should take extra care to avoid them.
The conditions described in this article are so unbelievably far from how the important job of dispensing medication should be done! I, for one, had no idea it was this bad; the pharmacists have unnecessarily stressful working conditions and the patients are at risk. I can only recommend that patients get the details of their prescription from their doctor and verify the details at the pharmacy, including prescription length and any possible drug interactions. This could---and I regret that this is not hyperbolic---save their lives.
Thank you for this informative article. I hope that this problem is fixed quickly, but given what I know of similar problems with nursing, I am not optimistic.
6
We’ve handed ourselves over to the tender mercies of the corporate bottom line.
17
Pure capitalism merged with unfettered greed; the greatest profit for the fewest pigs. It is another example of American “culture” and no surprise in a country led by such soulless narcissists as Trump, McConnell and, yes, Pelosi.
1
PBMs like CVS/Caremark are putting pressure on independent pharmacies that are the direct competitors of their retail branches, too. If we had a Justice Department that actually cared about the law, antitrust actions would put a stop to this vertical monopolization of the pharmacies in this country.
States that care about patients getting the right amount of the right drugs should sue these pharmacies for practicing medicine without a license for dispensing more pills than a licensed doctor has prescribed.
And pharmacists need to unionize to get their corporate overlords to obey state labor laws on work hours and required breaks.
3
If these Pharmacies are so good at metrics, why aren't they collecting metrics that track their compliance with the laws and regulations mandated by State Boards and Legislatures?
4
I am a retired pharmacist. I retired in 1998 The situations described have existed for many years and have apparently gotten much worse. The errors are definitely a result of pressure to fill more and more Rxs. Corporate managements consider the cost of settlements as part of the cost of doing business. I have no idea as to the solution as pharmacy boards really have little actual power. However I do not do business with chain pharmacies including my prior employer. There are still a number of independents available to provide good and safe service.
7
This is no surprise to me as the tension & stress of those behind the pharmacy counter has been palpable for some time. My recommendation is to seek a small, privately owned pharmacy if you can find one. There are several in my area one of which will even deliver.
3
Recently, a veteran Kroger employee remarked that the ONLY reason Kroger existed was to maximize investor share price. We are all sacrificial lambs at the altar of greed. But, then, you already knew that.
1
@Cody McCall
That is the only reason that any corporation exists. There is no other reason.
Nothing about this article surprises me because this has become the American way over the past 30 years in many industries. Cut staff and benefits to boost corporate profits and C-suite salaries. The implication is that the remaining employees should feel grateful to have a job even if it's a murderous workload. It's all about greed.
13
This article is greatly disturbing, especially in light of the fact that employees of CVS who take their insurance don't have the choice to get prescriptions through anywhere other than CVS.
5
This is why you don't want unfettered capitalism. It only benefits the few at the top and throws everyone else under the bus.
13
I live in a small town with a very good independent pharmacy. They are very considerate and careful, and I am very grateful for their care. The pharmacist takes the time to explain medications and answer my questions. I could travel 50 miles to a CVS, Walgreens or Walmart but after reading this am grateful I do not have to.
6
A good rule is always to look at pills (they have identifying information on them) and consult the on-line Physicians Desk Reference to see if they are what they are supposed to be.
And check all labels, both the pharmacy's and the manufacturer's too.
2
I use a local pharmacy and I always check the medication name and the look of the pill. Pills have numbers on them and a specific shape. and color. Pills appearances have been easy to google. I have a pill tray with seven chambers and I take them throughout the day. I have forgot to take meds at times but never had an extra dosing accident.
The power of the dollar- shop local and independent.
Love my easy to navigate, consult with and trust independent pharmacy.
3
Spot on. Went to Walgreen last January after CVS made so many mistakes. All was well for a year. However, it is happening at Walgreen now and the Pharmacist is nasty when I call her attention to the problem.
What is a patient to do?
5
@Joan
As a pharmacist I hate to suggest it but you need to call your state board of pharmacy. Take names! Your your state board of pharmacy will have a complaint process. Usually a simple phone call does it. It’s cruel. It’s tough. And it’s the only way things will change.
Simply mentioning to the pharmacist, not the tech mind you, that you are aware of the state board of pharmacy will change the tone of things.
3
While I can clearly see there's a problem with staffing at my CVS pharmacy, my pharmacist is a spectacular example of what paying attention and doing your best can achieve. He goes the extra mile for his customers and I value that kind of service.
The problem is how CVS is attempting to force customers to buy or refill prescriptions they might not need. Each time I refill my prescriptions, there's always additional drugs they try to throw in and it's despicable.
There's also a problem with Express Scripts and how they manipulate the drugs they cover, or don't cover, and try to get you to use their online pharmacy.
By allowing all the mergers we've recently witnessed, we're aiding these corporations in manipulating the marketplace and their customers.
We need to break up these monopolies.
15
This situation has far-reaching consequences and can be traced to several sources.
The entire pharmaceutical industry has, through its greed and pervasive influence on both the public and health care management, created unnecessarily dangerous confusion.
Both state and federal oversight of medical and pharmaceutical activity are seemingly unsuccessful in their function.
There is obviously poor communication among physicians and pharmacies who are working from different perspectives and interests.
Patients are often left out of the loop or do not know about the pressures on pharmacists, becoming frustrated with a process that should be (once was) much easier.
Finally, we, as individuals, have long had the choice of practicing a healthy lifestyle in order to minimize dependence on drugs or of turning our care over to the frightening mess this article reveals.
2
If it’s any comfort to the pharmacists out there, I’ve found the pharmacists at my local Walgreen’s to be infinitely more helpful than anyone at my health insurer, and everyone but the doctors at my and my son’s doctors offices.
.
Insurers play games with me. They talk down to me. The girls handling billing and appointments at the doctors office do the same. But when I go to the pharmacy I can typically expect to be treated with courteously, and helped if there are problems. It’s a breath of fresh air.
4
Welcome to what happens when this becomes a commodity, not a profession. We really need to get the accountancy out of these types of businesses as it is causing great harm. Performance metrics? As if the human doing the work is simply a cog in a wheel to be made more efficient by simply removing resources? Just because something is "cheap and efficient" does not mean it should be that way. Yes, I pay more for prescriptions from an independent and I am happy to do it.
6
Even hospitals are not perfect. I went with my wife to the ER recently and after giving a breakdown of her medications, the NP put in for a prescription for the triaged issue that would have severely interacted with one of the medications my wife had previously stated. After reminding the NP of this, she thanked me and edited the request before sending....
1
After having numerous issues with our local Walgreens, we changed to a "mom and pop" pharmacy. While prescription costs have risen slightly the quality of care has risen dramatically. For certain meds we no longer get 90 day refills, indeed refill requests are denied if submitted more than two days before the one month refill date for certain meds. Walgreens were constantly changing generic suppliers, noting the change on the bottle in the tiniest possible print. While collective wisdom says all generics are the same this is not true. I started experiencing arm pain after Walgreens changed suppliers of my statin. When changed back at the direction of my doctor the pain went away.
Not all people may have available a local such as ours and may not like inconveniences such as having to call in monthly for renewals, not having a drive through window or paying a bit more but what price is the right price for control over one's healthcare?
3
Similar to how hospital systems evolved into unregulated corporations chasing profits, drug stores are even less connected to any health care model. Executives in suits are reaping rewards, not patients...once again in America.
1
I am so happy to be able to use the small, local pharmacy that has been here for decades. Very attentive to their customers, they also serve up some great milkshakes, too.
2
CVS has managed to turn medicine into fast food- you won't see any other medical professionals with a drive-through window in their office. No other medical professionals are asked to do so much with so few resources. I enrolled at a pharmacy school for my first year of college. It took me 3 months to realize how terrible retail pharmacy was, and I changed my major immediately. It was one of the best decisions I've ever made. I am still friends with several pharmacists that I met at that school, and they all agree that retail pharmacy is a terrible job.
5
@Greg
Well yeah retail pharmacy does suck. However, there’s always hospital pharmacy. Good career choice to avoid pharmacy though.
1
This is my 32nd year in the pharmacy profession. THANK YOU for this very important article regarding patient safety. It is long overdue as these business practices to increase "efficiencies" and arbitrary productivity goals (profits) have compromised the integrity of the pharmacy profession and more importantly have placed patients at risk. With the constant threat of discipline or losing their jobs, pharmacists must meet increasing productivity metrics or quotas. We are pressured to work faster and faster. Do you want your pharmacist to work in fear? This is antithetical to our first duty: do no harm. A fast pharmacist does not a good pharmacist make
12
Stand in the usual long lines at any CVS pharmacy and you will observe the harried pharmacists and their assistants trying to keep up with the demands of the job. The phone never stops ringing. The pick up tacks overflow with orders pending customer pick up. Add to this the nerve wracking exchanges between pharmacists and irate customers who cannot understand why their prescriptions are not filled because of doctor and/or government red tape, and you have a recipe for chaos.
7
@paul Add in the urgant cares that keep starting up, especially when they tell someone their medication will be ready upon arrival to the pharmacy. You now have people expecting it done and ready to argue you...and they want it expedited which pushes everything else back a good 15 or so minuets. Those people, who got pushed back, turn up and want their expected medication and it's not done - cause of all those expedites. It's a mess and no one wants to listen to us on why it's happening...no one wants to complain to corporate to help us. We need a better situation. Add to it old computers and registers that freeze and crash and we're left with sub par technology to do the job.
5
How do mail order prescription services compare to the large chain stores? I use one that is owned by a chain and I have noticed that I collect a lot of extra medication. I use a pill organizer so I rarely miss a dose. It seems that they send me more than I should use.
4
@Terri Ferrari : File a complaint with your state authorities. This is fraud.
I do not take any regular medication and have low blood pressure. Once, when I needed an antibiotic for something, CVS gave me pills for high blood pressure. Luckily, I check prescriptions very carefully and was able to figure it out.
My spouse needs regular medication. Recent changes in insurance require that the medication be purchased through an online pharmacy or a place like Walgreens or CVS. We would like to use our independent pharmacy but the insurance prevents that.
Back before the millennium, the pharmacy my family used closed, and the pharmacist went to work for a local CVS. He thought it would be a nice change from running his own business. He hated it and soon retired earlier than he had intended.
8
As long as the medical industry is regarded by business and stockholders from the cash-register vantage point, they'll continue missing the real point -- to treat and care for suffering, needy people. The plight says a lot about our U.S. priorities as a society.
3
Walgreens ,CVS, and other major pharmacy chains need to do background research on generic manufactures. When small pill manufactures have a series of recalls ,red flags warning! Use another manufacture with less potential liability. People with chronic issues don't need bad/tainted meds to worsen their health. Especially medications produced in India ,which appear to have less regulatory conditions.
1
@Carole
Walgreens, CVS etc don't care in the slightest bit about the quality from the generic manufacturers.
They do whatever they are permitted to do to maximize their profits.
7
Big Drug Stores make things worse for pharmacists and patients by cutting the number of pharmacy assistants and paying them so little that many leave after a few months.
The lead pharmacist who's served me for 12 years broke his silence to share that he can't hold onto assistants after the 6 months it takes to get them trained and up to speed. That suggests 200% turnover -- and we're in an area with relatively low living costs and a rising minimum wage standard.
Mindless cost cutting on the backs of workers has horrific costs. Worker turnover has high costs for employers who need to refill slots. That creates an incentive to slash training and overwork those remaining. No surprise that overworked, undertrained, unsupported workers leave their jobs. But at pharmacies the results can be deadly.
Shame on Big Drug Stores!
5
Kudos to the NYT for their investigative journalism. I'm relieved to hear that our family is not the only one faced with these issues. My wife recently picked up a refill of her heart medicine at CVS, took the first dose and then realized that she had been given a stronger dose than had been prescribed by her doctor. Fortunately, she looked at the container afterwards and realized the error. She called the pharmacy immediately and was told that taking the single dose would "probably" not be harmful. They said to come in the next day and pick up the correct strength. I also had an incident not that long ago where my doctor was out of town and I saw a covering physician. Despite having a list of my medications, she prescribed a medication which had the potential of being fatal when taken with a medication I was also on, which had been previously filled at the same CVS. I picked up the new medication but fortunately read about the side effects and realized the the potential danger. I went back to CVS, received an apology and was told a pharmacy tech had ignored a computer warning of the incompatibility. They refused to refund my money, though, until I threatened to lodge a complaint with the State of NJ, at which point they provided a refund. At this CVS, they are so busy that they are all falling all over themselves. They are always calling to get approval to get refill approvals for drugs we have enough of or no longer take. Something needs to be done!!!!
5
I can’t be the only one that made it halfway through this article and found a local independent pharmacy to replace the chain one we’ve been using, right? We get 4 monthly prescriptions and two are for one of my children...I’m not taking any more chances just for the sake of convenience.
4
There are three adults in our household who all regularly take more than one Rx med. We have used CVS to fill our prescriptions for many years now. They have, so far as we can tell, not made big mistakes on our Rxs, although their oversight of medicines interacting seems to be lacking. But CVS has become increasingly annoying and intrusive - via calls, texts, voice mails, and counter staff trying to get us signed up for one thing or another - and meanwhile: repeatedly reverting to 90 day fills despite our stated wishes not to, refilling way earlier than necessary, and asking us in several ways per month to add on these “services”! I would like to change pharmacies but all the ones our health insurance allows are chains, including the online one the insurer constantly pushes. Any suggestions out there?
4
Um, I know what pill my pharmacy is giving to me by name, shape and color. CVS has never let me down.
The calls from CVS were getting so frequent that I finally called 1-800-SHOPCVS and ask them for no more calls. Then followed up with no more texts.
I have set my account to NOT have auto refill, yet every time I fill a prescription they ask if I would like auto-refill "just this once".
5
The last time I picked up a script at CVS, I made a comment about being asked all the time if I want to auto refill even though I keep saying no. The pharmacist gave me a long spiel trying to change my mind,how even if they refill it I don't have to pick it up blah blah blah. As I walked away he picked up the phone and said "thanks for holding." He left another customer ON HOLD to try to get a convert to Auto Refill. This article shows its not just my CVS.
1
This is why Bernie is surging. We are all so SICK AND TIRED of being Capitalist Cannon Fodder.
11
The friendly CVS folks of years past have been replaced with dead eyed stressed out zombies just trying to make it to the end of their shift.
4
I always laugh when I see an ad where a white-jacketed pharmacist is cheerfully roaming the aisles, answering questions about some OTC medication. In my life, I don't ever believe I've seen a pharmacist who wasn't behind the counter. Maybe they roam the aisles on their day off.
8
Thank you for this story NYTIMES. I have been getting my medication filled at a CVS in Harlem for two years and always feel so bad for the pharmacist. The lines are extremely long, the orders are stacked high and the crew behind the counter anxiously moves around. This is an important topic worthy of coverage.
8
Dear CVS, Walgreens etc.
I will no longer fill my prescriptions with you, and I asked my account manager to sell any related holdings.
Good luck you greedy vultures!
10
Have you ever tried to shut off "auto-refill" at CVS?
Impossible!
When you get a one-time drug from a doctor, they keep refilling it and harrassing you with text messages. If you accidently purchase said drug and walk out of the store with it, you are stuck with it. They won't take it back, even if the bag it comes in has never been opened.
Try shutting off the automatic text messages. They keep turning them back on.
I would like to know the percent of drugs that people inadvertently buy because of CVS" "system".
A total racket.
8
My fellow citizens... Reread this article before you vote.
5
If these people actually cared they would form a union. Until then it’s all idle talk.
@Andy : Which people are you talking about? The over-worked, over-stressed pharmacists who don't have the time or energy or knowledge to start a union?
1
Pharmacy schools are turning out so many graduates these days that there are more pharmacists than jobs. Everyone is too scared of losing their jobs and being unable to repay their loans to fight back against the big chains.
1
@Andy There are unions for pharmacists, but many of the chains take the walmart anti-union approach, and just the mention of a union is enough to get you fired. And with a massive over-supply of pharmacists, you will be replaced in 20 minutes, and it will be nearly impossible to find another job because openings are filled instantly and there aren't many to go around.
1
Where are the union organizers when you need them! Stand up for your rights and to correct what’s wrong!
2
Patients receiving drugs from any source can turn to websites such as https://www.drugs.com/ to determine what the pill's name, its strenght, and what it is normally prescribed for.
The information designating the pill are always imprinted on the pills themselves. Owing to the pill size it may not be easy to read for elderly people but by using a magnifying glass and a strong light source the imprinted information is quite easy to see.
These websites not only allow the identification of the pill but also provide a picture so the shape and color of the pill can be confirmed. In addition, these websites also provide drug interaction information with which to determine the effect of the interaction of all drugs and supplements one is taking along with common side effects and warnings.
We all have the means now of determining what has been prescribed to us and what its impact is. We are our own best Quality Inspector with the tools available on the internet.
2
The people’s laws are not being followed...laws meant to protect against abuse and misuse of prescription drugs. OBRA-90 is on the books and has been for years. It’s only a matter of time before the people realize this. https://m.youtube.com/watch?v=Gy39oipikvE
As with so many things today, patients should double check! There are many websites that have pill identifiers. Also, check the medication website for dosing and side effects. Pharmacies provide medication information with each prescription, but if the prescription has not been filled accurately the information packet may also be incorrect. A website search for “identity this pill” will produce many options; this government site is one.
https://pillbox.nlm.nih.gov/
CJSorlFL
Perfect time to switch to Pillpack from Amazon.
I worked for Walgreens the last 12 years of my 45 year pharmacist career. It went from doable in 2003 to chaotic to the point where I fell asleep driving home one day cuz I had less than 6 hours of sleep between my 12 hour shifts. The last 6 years there was nothing I could do right. My sexist supervisor Jason G told me “You need to smile!!”—like you would have ever said that to a man, fool. Then I retired!!!! Hallelujah. I have never been happier. My blood pressure is down, the headaches are down 90%, and my hands don’t shake any more. I saw these “kids” coming behind me and said to myself “dude, don’t do it.”
6
Understand that these are "system" and QA problems, like many in the health care delivery systems. They can be solved, but they have many negative driving pressures from the administrative and financial side. The professionals would much rather go slower and deliberate, and be more accurate.
2
@Carl As a professional inside the medical "industry" (where the product is a human being), it is very obvious what effects the top-down insurance - reimbursement system has had on the employed physician, nurse, physical therapist, physician assistant, nurse practitioner, pharmacist and other allied professionals. This occurs in all corporate hospital and clinic and pharmacy systems, and has major effects, also, on independent medical practices. It is passed downward in punitive ways via hospital and clinic administrations. Its ongoing deterioration is related to corruption at the federal regulatory level (of health insurance, pharmaceutical, hospital systems) and many medical professionals now find themselves in "high demand, low control" situations with low morale and burnout being prevalent.
1
As a Psychiatrist I've experienced most of the issues described. But why are humans still doing the physical dispensing of routine prescriptions? Automated robotic dispensing systems exist and are currently in use in academic medical centers. Robots don't get tired or bored, and free up pharmacists for tasks that require judgement and communication. Studies show significantly reduced dispensing error rates. A follow up article describing the pros and cons of automatic dispensing would be helpful.
3
At the supermarket pharmacy I use, your order is in a sealed plastic bag, and it is hard to see through. I will tear each bag open while the clerk huffs and puffs and check everything on the labels, hold up the containers and look at the pills, then read the headers on the inserts to be sure they agree with the labels. When I am satisfied, I will put it all back in the bags, complete my transaction, thank the impatient clerk and smile at the steaming, sullen customers behind me. If everyone did the same, line would be twice as long, and the store would hire a second clerk so half the customers wouldn't go to the independent pharmacy down the block.
307
@David mcgrath
I pay & then check the meds while in the store - no need to hold up everyone else.
66
@David mcgrath It a good idea to always check your medicines as you said.
America is overdosed on way too many drugs they don't need and as the pharmacists have stated, it's all about the money not safety or health care. Everything in America now is all about the money unless you go with small, independent folks.
https://www.goodreads.com/book/show/220314.Overdosed_America
20
@David mcgrath It's pretty easy to go online and get an image of what the pills of any prescription look like. Maybe we all need to pull up these images while standing in that long line at the CVS and check what's in the bottle before we leave the register.
24
Just this past summer I started catching medication errors that were made by my local pharmacy when filling my prescriptions. They ranged from only giving me half the amount that I was prescribed, and charging me for the full prescription, to filling the prescription with a much lower dose of medication than my doctor had prescribed. Now, with this article, I wonder how many errors I have not caught over the years, and how much my health has suffered as a result.
2
I have noted that my local Walgreens pharmacy’s staff are increasingly rude and unprofessional.
On occasions hostile.
If one is overworked and stressed, sometimes being pleasant is difficult.
2
This is just a reflection of American style capitalism, profits and greed always before people. Bernie Sanders is right, they need to be reined in.
8
This is what Senator Sanders is talking about -- for profit medicine is killing people daily -- in more ways than one. If you think it is wild-eyed radicalism to want this malpractice to stop, I ask you -- how much worse do you want this to get?
7
This is but one example of the race to the bottom that has infected all aspects of health care putting profits over patient care. Who do you complain to? Boards stacked with representatives of the profit industry and health care providers who have sold their soul for leadership positions? Quality of care seems a nostalgic memory of a not so distant past.
4
Several years ago I remember my Walgreens always asking me to confirm that they gave me the right medicine. They stopped doing that in last two years and now they just ask me to confirm my birth date and address (I assume to prevent some kind of fraud?) and never ask if the pills are what I was prescribed or not. Even when they rush you over to the consult window, it’s just, “any questions” and then out the door.
@Elle : Please note that they now won't LET you check your meds before you sign and pay. HUGE shift in culture and approach.
2
You might wonder why a patient wouldn't recognize that their drug looks different.
The problem is that the same generic drug from different manufacturers can look entirely different. They don't have a standard appearance, and if the pharmacy changes suppliers, the drug will look different. Since the pharmacy can change the source of generic drugs, without notice, patients get used to these changes and aren't alarmed by a drug that looks unfamiliar.
In contrast, brand name drugs that come from one manufacturer never change appearance.
One partial solution would be legislation that standardizes the appearance of generic drugs.
4
Very true. Although Walgreens has never done so without telling me and putting them in separate bottles, sometimes I even get two different manufactures for the same monthly refill because they’re running low.
Now understand some things about CVS. Recently the Walgreens I was using closed. Since CVS was across the street I began using it. First thing I noticed were the computer instituted calls of my prescription being ready for pick-up. I had not ordered any refills. I also sensed a lack of staff when I went to the drive-up window for a pick-up. Was the pharmacist rather than a clerk . I also understand why my doctor will not entertain faxes or telephone calls from pharmacists for refills, patients only. While I usually check my prescriptions for accuracy, I will surely now.
2
Please, America, tell me how a self-regulated private sector works better than good regulation or publicly owned utilities? I mean America has the highest life expectancy in the developed wor... opps, I mean health care in the US is really afford.... oops, I mean poor gun control means you have the lowest gun dea...oops. Move on NYT, why do you even report this stuff, clearly Americans enjoy dying younger for their “freedom”.
5
Larry Merlo should resign. He is a menace to public health.
1
The free market is doing nothing for people below the C-Suite.
4
Please do not forget many, many locations are also very hostile environments from own employees. Staff becomes so jaded, cliques form. I've rwas about technicians who have attempted suicide because they could not bear to go into work again. I myself had severe anxiety about going into work and seeing what pharmacist was there because 1 in particular would bully me for my disability. Let's also add that some stores have unethical health hazards going on behind the scenes that they do not fix because it costs too much money... I'm talking about human feces in places it shouldn't be. If you ever keep having prescriptions put on AUTOMATIC refill without asking, it's because we have a quota for that as well.
2
I have been using the same Walgreen's for 30 years. The hours have changed a few times, to what it is today. I understand why the hours have gotten less. Over the years the pharmacists who filled my scripts are always courteous to me. As well as the techs. I know them by name, as they know who I am. I am patient with them, understanding the nature of the customers that are rude, demanding, which I have empathy for them.
I see how understaffed they are. Always drop off scripts, return for pick up when I get notified it is ready.
Having worked customer service where there is little to no time to take a break. The big stores contribute to overworked, understaffed areas of the stores, because they can. The culture will not change as long as the stock holders, investors scrape every bit they can for their need to be in the high wealth bracket, damn those that are making the profits for them.
4
I wish I were surprised, but having watched firsthand the devolution of our health system, my reaction to these deaths is “sounds about right.” It is not an assembly line even when it looks like one ! The corporate calculus is speed*profit minus deaths*litigation expense. That is all. The only solution that will fix the underlying problem is this : End the corporate practice of medicine (in every way, shape, and form). Only those trained to diagnose and treat should be doing these things. Our current system is focused on “customer” satisfaction and profit as if we are making cars with the same parts on an assembly line moving the same speed. The conveyer belt of medicine moves at many speeds and directions, often unpredictably, and more importantly, people are NOT cars. So, the fundamental fix is to recognize that the services of health care professionals like pharmacists are crucial to our society and the people who select these careers have historically been 99.9% motivated to help others. They should be treated with respect and made secure in their positions as they were already dedicated, motivated, and hard-working. Worse, when they are pushed to increase profit for shareholders and someone gets hurt, the forces driving the system deflect blame onto the caregivers rather than the corporate influences (especially insurance companies) whose greed is the root cause. While profits are being made off the backs of those working to care for others, this will continue.
7
Why not regulate it on a federal level? If a pharmacist is only allowed to fill say 200 prescriptions per eight hour shift it would force chains to hire more pharmacists, thereby solving the problem, no? Seems like a pretty simple fix.
@Kristine : Agree with the principle, but wonder if 200 prescriptions in 8 hours is a lot. Would love to hear pharmacists weigh in on what is realistic, especially so they have time to dispense advice to patients, answer questions, use the bathroom, take breaks, and eat lunch or dinner.
2
@Kristine
Because CVS, Walgreens etc are multi-billion dollar corporations with powerful political lobbying to maximize their profits
The pharmacists, assistants at my local CVS are harried, hurried, running around like crazy - not the kind of atmosphere that gives you confidence that all is well in the Rx business. Ever since Aetna and CVS formed their "marriage" I've seen fewer people working, at superhuman speeds. It's like Amazon took over a shipping line production - or Lucy boxing candies on the conveyor belt! They must all have to BE ON SPEED to work AT SPEEDS NOW MANDATED BY THIS UNHOLY ALLIANCE. Any time big Pharma teams with ANYONE you can be sure NO good will come of it! I really feel bad for the people behind the counter measuring out pills, bagging meds. They don't stay at CVS very long - either the pharmacists or assistants! BAD MOVE, GUYS!!
5
I have seen these staffing shortages at 2 different local Walgreens in the last month. Both locations had floor staff filling in at the pharmacy. Neither of these employees were adequately trained causing significant delays.
One did not know how to reliably use the speaker for customers in the 2nd drive through pickup lane. The other had trouble locating medications and could not answer basic questions about what scripts were ready.
After my last 2 visits where previous visits had been fine I am looking at moving our medications to a local grocery store instead.
3
once again corporate greed reigns over the needs of the consumer.
4
BOTH of my parents are pharmacists aged 59 and 61. Years ago, there were multiple pharmacists in each shift, now they have an obscene ratio of technicians to pharmacists, impossible metrics, and sleepless nights. I’m so sad for them. The career they were proud of is now an embarrassment to healthcare, and shame on the chain drugstores in this article who refused to take responsibility for their part in these mistakes.
4
By the way CVS also owns Aetna Insurance. Isn't that cozy!
My local CVS looks rather like a field of white prescription envelopes erupting from alphabetically labelled cubbies. Picking up a scrip takes much longer because the folks behind the counter can't easily find YOUR meds in all those piles of pills. But they still have to ask if you want a 90 supply.
5
Scary! And no excuse. I had silver nitrate for my warts in my bottle instead of glycerol for my ear drops. I put it in my left ear.
Fortunately I had so much ear wax and the draining silver nitrate was burning my visible ear black that we were able to save my ear drums, although my left ear has ever since (50 years) produced far more ear wax than the right ear.
3
Can we imagine what will happen, as these behemoth prescription chains expand into the diagnosis and treatment arenas?
It'll be the same thing that they are, as the prescription "pushers", when there are mistaken diagnoses!
With the billions of obscene dollars that they are making, there should be federal legislation passed, and there should be a federal preclusion to disallow campaign contributions for both Congress and the Executive Branches of our federal government!
It's time for us to take and have our government represent us.
PS: And no mandatory arbitration provisions will be allowed for their life threatening greed!
3
I will never have a prescription filled at a drugstore chain that gives you a 3 foot long cash register tape when you purchase a single item.
1
I’m also concerned about these Goodrx coupon policies! Those discounts have to be eating into their salaries! The pharmacists can’t be happy about that! Put that together with the Coronavirus building hysteria and I think all consumers are in trouble!!!
3
Yet another example of the absolute lunacy of medicine for profit. As if we
needed more. There's a reason every other industrialized country has nationalized healthcare.
5
Maybe the chains like CVS could dispense (get it?) with the mandatory greetings for each and every person approaching the counter. Just walking up, you get a chorus of employees saying, "welcome" and "we'll be with you in a moment!" Why do companies feel that these perfunctory greetings are necessary? Let the people handling my medicine pay attention to my medicine. I won't have hurt feelings if they don't say hello.
3
Well, our pharmacy is at Giant Food Markets. They are a great bunch of people. My wife has Parkinson’s and dementia. We depend on them and I cannot say enough good things about them!
1
Does anyone want to hear my story of being given an abortifacient after asking the CVS pharmacist if the prescribed medicine was safe in pregnancy?
4
THANK YOU. Boards of Pharmacy have been listening, but not providing enough solutions. How many pharmacists and techs must complain before someone steps in? Patient Safety is #1!!!
2
Oh, this is a problem that is not confined to pharmacies. The whole of healthcare has been under pressure to do more with less for at least 30 years. Understaffing, efficiency-based decision making, pressure to hurry so the next victim can be worked on, emphasis on churning money out of every corner possible are extreme. Make an unannounced visit to a nursing home and the smell of urine will knock you off your feet. A hospital is a dangerous place to be for everyone involved, but especially for the intended target of the ministrations from the ‘caregivers’. Talk about a dehumanizing experience, try getting well in an ICU! That is a torture chamber. Perhaps one may think my perspective radical, but it is based on experience (35 years of it). If one is elderly, then one’s decision making is null & void, especially if one has given healthcare power of attorney over to a clueless person. The whole system needs to take a deep breath and ask, What is my purpose here? Am I truly allowed to make decisions based upon the patient’s best interest? Is there ever enough time to both satisfy the needs of the patient and the priority of speed and documentation? Try doing that in an eight or twelve hour shift when your patient load is greater than 5. The staffing ratios are woefully skewed in the wrong direction. So much attention is being put on access to healthcare, but the real danger is in the model itself.
6
BlueinRed - with over 40 years of Nursing experience I wholeheartedly concur with your observations.
This is what happens when you vote for the de-regulatory, protect corporate profits at all costs, agenda of the GOP.
9
Capitalism and monopolies do this.
4
Why don’t pharmacists unionize?
Fast food workers have it better.
3
@Larry Dickman Because joining a union likely means losing your job. Most of the chains follow the walmart anti-union approach, and just mentioning them in a positive manner can be enough to get you the boot. There are isolated places that do allow pharmacists to unionize, but they tend to be smaller chains that don't carry the same amount of policy weight.
CVS keeps calling to refill my deceased dog's prescriptions. The automated calls do not allow me to leave the comment that Maggie is dead.
4
I am a pharmacist and owned an independent pharmacy for 29 years. These issues started when CVS purchased Caremark, a pharmacy benefit manager (PBM) in 2006. This acquisition should have been halted by the FTC. In 2018, CVS squired Aetna.
Again the FTC allowed the acquisition. The FTC reasoned that these acquisitions will create vertical integration that will in-turn create savings in healthcare dollars. What we have seen is constant increases in healthcare costs. These mergers have created mini monopolies . I closed my pharmacy because of constant reimbursements below my cost from PBMs, and being locked out of PBM networks. PBMs now constantly drive as many prescriptions as they can to mail-order, retail, and specialty pharmacies that the PBM themselves own. As a result of all this, many independent, small chain and grocery store pharmacies are closing all over the country. 3 PMBs basically control most of the Rx's processed in this country. Each of these either own or are owned by a major insurance carrier. Most retail Rx's are now steered to a favored pharmacy chain of each of these carriers.
The answer to all this is the need for regulation to break up these monopolies and create more competition which will result in lower pricing and better service. Of course this will never happen. The healthcare industry and Pharma control congress with the bribes from their lobbyists. The only way to fix this is term limits for congress. Again, never gonna happen.
16
How is it that CVS is owned by Aetna, an insurance company with massive prescription drug plans for people on Medicare? What happened to anti-trust laws? CVS is the “preferred” pharmacy for Aetna plans.
4
CVS owns Aetna.
I have been with Walgreens for 30 years now with my chronic medical condition at several stores in different states. They have been a pleasure to work with, are always prompt and courteous, and if there is a problem they have taken care of it quickly.
59
@steve
You're in the minority
31
@steve That's fine; as a customer that's the experience they want you have. What this article does is pull back the curtain on the insanity and poor practices that go into you getting your prescriptions filled at a place like Walgreens. It is not safe, it is not sustainable and it's all in the name of making large companies money.
51
@Steve
Please tell me where you live and count me a new neighbor
15
Not all pharmacies are so harried. Pick one that is not as crazy. I gave up on Walmart for that reason. On the other hand, there is no real excuse for a trained pharmacist not to take a quick second look. Just do it. These are totally preventable mistakes.
3
@Wilmington EDTsion
"there is no real excuse for a trained pharmacist not to take a quick second look."
The point of the article is that there isn't time to do this due to pressure from the corporate overlords
Consumer Reports did a reader survey that confirms this information. The big chains are (mostly) at the bottom of the rankings. Use filters feature to narrow choices. I was surprised to see some were cheap (if you have to pay because insurance does not cover it), accurate, and clean (my preferred factors). But none as convenient as CVS or Giant Foods to my home.
BTW: I recently had to buy a drug not covered by my lousy insurance. CVS gave a discount (always ask) but I realized, I should have called around to all the pharmacies and maybe got an even better price!
www.consumerreports.org/products/walk-in-pharmacies/ratings-overview/
2
Yes, I only realized recently it is worth it to shop around on drug prices. Walmart charged me $170 for my first Shingrex shot. Public charged $20 less. My stupid prescription drug plan didn’t cover any of it, but at least Publix was not gouging like Walmart.
The disingenuousness of the chains' responses to criticism is to be expected. Another reason why we need to restructure our health care system. Heath care should be for people, not corporate profits.
4
As an Ex CVS and Walgreens employee I can concur. Not an easy environment and never enough hours.
1
Every day we read about a new shocking risk to Americans’ health, money, privacy and free time. Capitalism in the United States has devolved into a dystopian Hunger Games, where corporations are predators and we the people are the prey.
We are left to choose between spending every waking minute nervously flinching as we stand guard against these predators, or offering up our pints of blood and pounds of flesh to the predators in order to take a quiet moment with our family, reading a book or enjoying nature. We will go to our graves broke and addicted to pills to help us sleep at night and get up in the morning without bursting into tears.
It is not like this everywhere on Earth. I love my country and weep for it, but this year I am selling all my possessions and moving to Europe, where you can live life without corporate-induced PTSD.
5
I wish you well, Kevin. We have unethical business leaders in the US, corrupt and ignorant politicians, and, yes, many stupid citizens. The same people who are being treated so badly will readily elect politicians too corrupt to take these issues on and solve them. Such as much of the Republicans in Congress and their most ignorant king....Trump. MAGA indeed.
My spouse works for Walgreens. This article is spot on - 12 and 13-hr shifts with no break for lunch, dinner, or even the bathroom. Walgreens even has a timer on its computer screens to show that you should have filled another prescription within the allotted time. Ceiling cameras monitor all movements. The pharmacists are not expected to step out from their areas unless they are administering a flu shot (so much for counseling a customer/patient). It is an assembly line environment. My spouse's job is constantly threatened if prescription numbers are not met. Don't believe the smiling "neighborhood Walgreens" commercials. It and other retail pharmacies only care about the bottom line. An injury to a patient caused by a mis-fill is considered a cost of business.
5
Endless thanks, NYYTimes, for this excellent guide to helping us insure that we get accurate prescriptions (and refills). I am aware of the fact that whenever I do have a question, the pharmacist is often on the phone with a patient or doctor and it is important to stand back and wait patiently for your turn so they can concentrate. I also receive occasional notices of recalled batches....but am assured by my pharmacy that they screen the relevant individual prescriptions before dispensing. Wonderful guidelines and thank you again!
2
Could the staff shortages and low net profits of the large pharmacy chains have anything to do with the fact that in many American cities - including mine - a Walgreens has been built near every CVS, or vice versa? The direct competition between these two companies may be what is hurting their profitability, but more importantly, the resulting depleted staffing may endanger public health. Is it time for CVS and Walgreens to call off the ‘feud’ and consolidate stores? Which one will do it?
1
@Dee
"Low net profit"?!? Where on earth did you get that idea?!?
2019: CVS reported revenue of $64.8 billion for the three months ended Sept. 30, up almost 37% year over year, and profit was up 10% year over year to $1.5 billion.
The US is, probably, the only country in the world where pharmacies dispense regular prescriptions by manually (or automatically) filling a plastic bottle with the patient's name.
In all the countries I lived and visited, pharmacies only dispense pre-packed medicines, unless they are "compounds", and not every pharmacy is allowed to dispense those.
I cannot think of any argument to justify the way pharmacies dispense medicines in the US other than pure greed. Even if using automatic dispensers, like those found in large hospitals (where individual dosages are necessary), dispensing pre-packed medicines should be safer (and perhaps even cheaper) than having a pharmacist taking care of each prescription.
4
Until a few years ago, I never had a need to get medications regularly. The last few years, our family needs have changed and I've visited Walgreens, Walmart, and CVS.
I encourage anyone who wants to see what is wrong with American healthcare up close and personal to go and observe a CVS or Walgreens for one hour. It will blow your mind.
I've found CVS, by far, to be the most negligent and downright dangerous. TWICE I have been given the wrong medication for my KIDS. Each time, I caught it.
Walgreens is so-so. I find the staff to be less stressed and kind but the lines are so incredibly long.
I've actually never shopped at a Walmart but I do get prescriptions there because Walmart seems to have reliable systems and its staff doesn't seem quite as overworked. I cannot believe I'm typing it, but it is true.
4
In Fall of 2019 my local CVS was taking a week to fill refills. There were times I had to ration my meds because my refill didn't get filled on time.
When I asked, the pharmacist said "this is their business model, we might get some additional staff in the new year."
They have added staff, and refills are coming on time.
Meanwhile, nobody ever told the robocall system that everything was messed up. It would always offer next day fulfillment when I knew full well the actual humans would not be able to do that. Usually I ordered the refill ASAP b/c it gave me a strange satisfaction to mess with the automatic system.
2
My wife, a retired Pharmacist and Pharmacy Manager at a major chain pharmacy read this article and said:
"My reason for retiring was that I had not made a mistake resulting in someone's death. However, I felt that if I had to keep up the increased demands of the corporation that nightmare situation might happen."
6
@Bobcb It is interesting that one of the first things written in this article is this:
"The people least surprised by such mistakes are pharmacists working in some of the nation’s biggest retail chains." WOW!
2
This article so completely described my time at CVS that I started to tear up while reading. 12 hour shifts are the norm but I would come in 2 hours early to start verifying orders to make sure I could work at a safe pace through out the day. However, inevitably, I would fall behind and would stay 2 hours late finishing tasks that I couldn’t during the day. Of course I wouldn’t take lunch - if I’m already 30 orders behind in the queue, have 3 patients on hold, and a line of customers waiting, taking a 15 minute break is not going to make me feel refreshed.
When my manager asked me why I wasn’t hitting my quota for patient outreach calls, I told her I couldn’t fit it along with verifying prescriptions, answering patient questions, counseling, giving flu shots, calling on transfers, taking new prescriptions, resolving insurance issues, answering tech questions, etc. She said that I should check prescriptions while on the phone. It was non negotiable. When I didn’t improve on this metric, I was written up and started on the process for termination. This is only one example of the extraneous tasks that pharmacists are required to complete at CVS.
After pushing myself to work faster to meet my quotas, I started making mistakes. It was at that point I knew I couldn’t safely do this job and I quit. CVS made me feel like I was a bad pharmacist but I was set up to fail.
44
I've been going to the same location for pharmaceutical needs for nearly 35 years. When it was individually owned and managed, the owner/pharmacist knew my name, my medical history, my doctor's name and phone number by heart, and would even call me by name on the telephone on hearing my voice before I said who I was. There was a never a prescription mixup in decades. I enjoyed the genuine smile I got when I walked in his shop.
Since Duane Reade ran him out of business and bought the location, I have been given other patients' orders or the wrong prescription FIVE times in as many years. The pharmacists rotate and have no clue who I am, when they need to call my doctor for a re-order they don't do it, and it can take weeks to get a prescription when before it took hours, and on top of it all the staff is sullen, sour and the pharmacists glare at you from behind their newly installed plexiglass wall for giving them another order to fill. It must be a horrible place to work.
And let's not even discuss the street blight of having yet more Duane Reade signage on the street when there are three other locations within two blocks of this one.
4
Have absolutely seen all this at both CVS and Walgreens. Since CVS-Aetna deal, the competition has become cut-throat. Walgreens absorbed Rite-Aid poorly; I had several Rx mix-ups. CVS pharmacists aggressively push refills, bugging you weekly to get a refill you don't yet need as soon as your insurer will pay for it (resulting in potential stock-piling of drugs in homes). Both CVS and Walgreens are having inventory problems (I assume cost-reduction efforts and/or overworked managers) resulting in delayed refills, sometime by up to a week. I've been in health care administration for 30 years, and you can't miss the chaos in the back and the obvious understaffing for the workload. For someone experienced in health care administration, you can feel the mistakes about to happen.
12
i have two choices for filling scripts where i live: walgreens, cvs or rite aid
OR
an "independent" pharmacy which is code for medicaid fraud and/or an opioid pill mill. utterly easy to spot as there is little if anything on their store shelves and all the action is at the pharmacy counter. what to choose?
3
@heisenberg : Ugh, those independent pharmacies don't have a lot on their shelves because they are pharmacies, not stores the way the chains are.
Personally, I have never seen an independent that is an opioid pill mill -- and I think it's somewhere between a big stretch and an outright lie to say that it's a pill-mill because it focuses its business on the prescription market instead of having a robust store front of bandaids, candy, notebooks, and ace bandages.
1
I always hand my patients a list of their medications and instructions, and remind them to take the medication out of the bag before they leave the pharmacy to make sure it's the right medication with the right name on the bottle. I also have a pharmacy that I work with more than others. I have introduced myself and make sure that they know that they can call me with any question about dosing, medication choice, interactions, etc.
5
Are you accepting new patients?
:-)
1
One solution is to go to your local independent pharmacies. They need you and they can provide more than big chain pharmacies.
4
When one of the chains bought our local pharmacist’s business, only to close it, he told me he was close to retirement age and said he had made more with the deal than if he continued to work two more years. The lovely vintage neon signage was replaced and another business took over the spot. His customers were sent to Walgreen’s. A personal touch pharmacist is going the way of dial phones.
2
There’s no mention of supermarket pharmacies. While they may be convenient, I stopped having my prescriptions filled at the local chain supermarket when, more than once, I saw register checkers substituting for “Pharmacy Technicians” and dispensing prescription information. I also saw Pharmacists checking out groceries along with prescriptions. I’m sure this was not what the pharmacist had in mind when she spent four years in pharmacy school.
7
@Molly Bloom Actually, 5 years in pharmacy school.
1
Pharmacy school is 6-7 years
1
This is terrifying since we generally have no way of knowing whether the meds we received are the right one, unless it’s a marked packaged product from the vendor.
CVS went from being just a pharmacy to being a health provider, and part of our health plan (ie I am not sure whether I can obtain the same prices if I went to a different pharmacy).
They indeed do all to encourage consumption, whether by selling 3 months’ worth at a discount, or nagging you with refill reminders (which I had to stop altogether). Considering how busy they are, it’s a wonder they have the time to call me with these reminders.
Locally I am guessing that they are not overwhelmed, based on my experiences, but that surely depends in the ratio of pharmacists to patients.
3
I was once almost given the wrong drug for a patient with the same last name, (but a different first name). When the pharmacist handed me the drug, I didn't recognize the name of it. I was picking up a prescription for an antibiotic. The pharmacist then caught the error. I was being handed birth control pills. I was trying to conceive then. If I had taken the medicine, believing it to be an antibiotic, no wonder I wouldn't have been conceiving. I would have been taking a drug to prevent it! I think it's up to pharmacist and patient alike to double check.
2
What particularly concerns me is the monopolization of the big pharmacies and health insurance companies. A lot of patients have no choice but to go to CVS and pay whatever CVS wants to charge them that day.
I always try to encourage my patients to go to smaller pharmacies, where I have more faith that the pharmacist is focusing on the patient and will call me with legitimate questions, not requests for more pills.
One day, all our prescriptions will be exclusively through the Walgreens/CVS Megaconglomerate. You think drugs are expensive now, wait until there's no competition.
7
@Mark
So true
1
It is also the insurance companies that push for 90 day refills on maintenance meds, and only through selected providers. Cigna would not pay for maintenance medications filled by my local ShopRite pharmacy, even if they filled the prescriptions for 90 day supply. This pharmacy goes a step beyond in taking care of my medication needs, and I've been going to them for over 20 years. I am not going to stop now, no matter what Cigna says.
5
Same thing happened to us, but we couldn’t afford to stick with Shop Rite.
1
Everyone reading this who has the ability to do so needs to help put an end to this by spending their dollars at pharmacies that have adequate staffing and treat their staff humanely. Look for local, independent pharmacies and check to see if your hospital has an outpatient pharmacy. Hospital jobs are usually the most coveted by pharmacists, even though they often pay less. But the better working conditions are a worthwhile trade off.
9
The practice of metrics tied to evaluations of staff, which include turnover & volume have been applied to most healthcare settings. As a retired RN in a surgery department for 23 years I left feeling like I had failed my patients and disgusted with the administration that had put that pressure on me.
5
My daughter is a pharmacy technician in a grocery chain pharmacy in a grocery store. Violations of labor laws are common: often she and her coworkers are too busy to take the two fifteen minute breaks and half hour lunch they are due during nine hour shifts for techs and twelve hour shifts for pharmacists. She has to go nine hours without even being able to use a rest room.
She has been working there for five years, so her pay has increased from barely over minimum wage to 14 dollars per hour. If she tried switching to a less hectic and understaffed pharmacy (if such a thing exists), she'd probably have to start out at the bottom of the pay scale again, so she feels trapped.
Pharmacy techs are much more than pill counters: they do most of the face to face with the public and deal with the numerous insurance issues, juggling the details of the various plans. Worked to exhaustion and taking the brunt of customer ire, they are paid a pittance. It would not be too expensive to hire additional techs in a pharmacy, but the corporate office won't consider it.
9
I use one of the few remaining independent pharmacies in town. I've never once been prodded to sign up for automatic refills, 90-day supplies or anything like that. But when I called my doctor's office for renewal of a prescription, I was told to call the pharmacy instead and have them make the request!
3
This is absolutely correct. Two of my scientist colleagues at the NIH were skilled pharmacists whose career paths changed because of how dangerous, difficult an unprofessional it was to work in chain pharmacies. The pharmacists in the local CVS which I use is complete chaos, and I had to block their phone number because of robocalls for unnecessary refills for asthma drugs I use only as needed. I would never take anything they dispense without carefully reading the label and verifying the drug description- I am not comfortable with the system.
10
Years ago, I used the Target pharmacy. Wait times for a prescription were about 15-20 minutes. There were plenty of employees assisting the pharmacist and sometimes even two pharmacists were on duty. The Target sold out to CVS. Employees complained to me about how much they hated it. Staff was cut. Wait times for a prescription were 2-4 hours. Lines were long. I can remember when there was only one employee working with the pharmacist. America, where the bottom line rules.
13
Watching the video of the pharmacist counting pills is a bit mesmerizing, but this could be done much more quickly and accurately with a scale.
Thirty years ago, a friend started working at Pitney Bowes and showed me a scale made for a mail room where you could place one sheet of paper on it, set the weight, and then it would tell you precisely the number of sheets in a large stack. The same could be done for pills.
Perhaps a little technology could help.
@Chris
There are hundreds of medications in any pharmacy, with multiple brands all pill sizes for every different medication. Being able to assess them all by weight is unlikely
1
Cvs does not allow robots. They do not want anything that improves safety or helps their staff. They are a deranged company.
Thank you NYT for this article. Please follow up with more investigative journalism on how the companies are following through on their promises to do better. They are using the preferred corporate sound bites we so frequently hear these days.
6
At least some pharmacy chains no more tend to staff, safety and work conditions than do fast-food chains. At least with the burger chains, you know you're getting a hamburger when you order a hamburger.
Based on my own lengthy and sometimes lamentable experience, this Times' story and the comments, I'd say that maybe we're getting prescribed the wrong kind of medicine altogether.
7
I have worked in the pharmacy and medical profession for over 30 years. This article is spot on. I currently teach pharmacology at a medical school and always include information about pharmacy errors that constantly occur and why, just like what's written about in the article. All medical providers need to know about this, doctors, physician assistants, nurse practitioners, physical therapist, so they can double check their patient's medications and do the job that pharmacists no longer have time to do when working for chain pharmacies
7
I am absolutely against corporates using their front line employees as patsies to cover for organisational failings. But, pharmacy dispensing errors in the UK are very uncommon. That's in large part because, unusually, dispensing errors are a criminal offence here. Just these; medical, nursing, administrative errors causing patient harm are not automatically criminalised. And, yes, some pharmacists have ended up with serious jail time. These are easy 'crimes' to investigate, so the police pursue them with gusto.
The consequence of this draconian and somewhat unfair legal anomaly is that pharmacies in the UK are very, very careful to avoid errors. Prescriptions and dispensings out are checked, checked again. And again. By multiple people. Every staff shift has a legally responsible 'in-command' pharmacist to supervise everything.
I'm not suggesting this a 'good system'. Just one that worlks.
16
As a licensed pharmacist, with 50+ years experience before retiring, and my admonition would be to simply "follow the money!"
I asked my employer in the early 1960's why he accepted the generous reimbursement offered by the first prescription insurance plan in our area. I remember clearly saying that, however generous the offer was, it was not negotiated.
Now sixty years later, it IS largely negotiated by a few huge insurance entities holding near monopolistic power, and the few large surviving retail pharmacy chains. One chain, CVS is both a retail pharmacy chain and a Pharmacy Benefits Manager... a foot in both waters, providing undue leverage to lower retail reimbursement for competing chains, while scooping up its cash as a PBM. How can that be allowed?
• Corporate chain pharmacy sees the bottom-line, not public safety, as its main priority, despite protestations to the contrary.
• State Boards of Pharmacy are largely funded by fees of retail pharmacies owned disproportionately by chains in most states.
• There is NOBODY looking out for your medication safety except for that overworked pharmacist has lost control of his profession to corporate financial expediency!
Now retired I sleep better, not waking mid-night in a sweat wondering if I gave Ms. Smith the correct medication, strength, dose, or instructions.
I feel sorry seeing my local pharmacists who are harried and overworked, but most importantly, I double-check all my family's medications MYSELF!
24
How many times have I dropped off a prescription at 8am and returned at 7pm to find the same pharmacist behind the counter.
It's crazy to work the person handing out meds 12 hours a day 5 days a week.
20
I have watched my overworked pharmacists with increasing concern. At the same time, I have had to fend off efforts by CVS to text me to death; they keep changing the rules of the game and I'm constantly having to opt out. I got the worst shot of my life from a pharmacist who should have had more practice before giving shots to customers. My wife had the automatic fill option with Rite Aid and we realized one day that she had accumulated three months of a drug.
The profit motive works to a point and then it doesn't. That's where we are now. We need to get the health industry under control.
13
I received a flu vaccine early this fall from a top chain. Big deal, so what? Shortly after, I found I could barely move the shoulder joint on the same arm without screeching in pain. It turns out there's a painful and sometimes-lasting condition that can occur if a vaccine is administered too high up on the arm. The needle can go into the shoulder capsule instead of muscle and cause damage. I commented about how I felt little from the shot. The pharmacist joked about being good with a needle. But is administration of that vaccine why I've had the pain and limitations for the past four months? Was it due to one of the Times and commenters cited problems, like inexperience or understaffing or overworking? I can't say. But at the least I've learned yet another potential deficiency in this pharmacy system that can hurt and hound me and everyone else. I've learned that the stakes in yet another aspect of our for-profit, and even for-every-shed-of-profit, health care web are too high to keep going as we have been.
1
This isn’t a new phenomenon, maybe it’s getting worse but I constantly fight with my pharmacy benefit manager (which is owned by CVS) to use an independent local pharmacy where I am a person rather than a number.
The current system sacrifices patients health for profit and they are aided by the money they spread around state capitals and DC. The Democrats and Republicans are indebted to the PBM industry which is dominated by CVS/Caremark, best exemplified by Governor Cuomo vetoing a bipartisan effort to put small checks on the industry. A veto he issued in the middle of the weekend between Christmas and New Year’s Day.
11
There should be 2 pharmacists at each of these chain pharmacies, to cross-check and assist each other, particularly because of the long-shift and fatigue issues. It is common sense.
10
Why have these processed become more automated? I go into my local CVS and it is compete chaos; phones ringing, bags everywhere....this is one are of the economy (Retail Pharmacies) that could benefit tremendously from automation and more intelligent software. Everyone seems over-worked and stressed and the turnover for technicians seems very high. Of course, it's the Retailers unbridled pursuit of profits that make it an unsafe workplace for workers and customers. Retail pharmacies need to invest in more automation and software to reduce mistakes, theft and stress for employees.
4
From the article:
"The benefit managers charge fees to pharmacies, and have been widely criticized for a lack of transparency and applying fees inconsistently. In a letter to the Department of Health and Human Services in September, a bipartisan group of senators noted an “extraordinary 45,000 percent increase” in fees paid by pharmacies from 2010 to 2017."
Can readers here think of any other industry that has enjoyed even close o a 45,000% percent increase in fees over a seven year period?
This harkens back to the almighty dollar, i.e., how to increase corporate profits, safety be damned. Press pharmacists with unrealistic metrics to increase sales at any cost--including at the cost of safety and the health of patients/consumers.
In a word, reprehensible.
9
To use the word ‘chaos’ in this headline seems irresponsible. Please return to a more neutral journalistic approach, New York Times.
1
As a happily retired pharmacy tech -- THANK YOU -- 14 hour shifts and never eating, sitting or peeing is EVERYDAY for CVS pharmacists and staff. It is inhumane and needs to stop.
766
@MaryAnnK My wife is a retired chain store Pharmacist and Pharmacy Manager who agrees with you 100%.
46
@MaryAnnK I interviewed at a CVS for a pharmacy tech position, and all the pharmacist cared about was, "Can you work fast? We're timed! We work fast, fast, fast!"
I was surprised. I thought when you hired someone in a pharmacy that you wanted accuracy above all else. Because I was older, she recommended I look for a job in a retirement home.
47
@MaryAnnK
I also refuse to use automatic check out. That was someone's job, and now I'm doing it for free?!
Self service is a scam.
28
I just wish more news outlets would shed light on this nonsense. I work as a tech and yeah I'm under preasure for the metrics. I just automatically put down for people to have us call the doctor for refills. In part cause customers don't want to call themselves and in part because I've been scolded once for it not being a high enough number. So yeah - part of the problem...but forced into it. I'm new and don't need another scolding for it. Also, we are understaffed and with cut hours, especially around the holidays, it's intense. I wish customers understood just what is going on and why the lines are so damn long. It's frustrating to have customers screaming and yelling, about things not being done, long lines, ect...and I can't explain to them what's going on. I had one customer threaten to come in the next time he got one of those phone calls, that we're forced to do, and ring someones neck. He was shouting and yelling for over ten minuets. It happens and it's not a way to work. Our pharmacists have gone without eating, without bathroom breaks for hours (I got a UTI cause of it myself) and will work 13 hours if they can...and take an hour long drive home tired and yawning. It's not safe. I heard, from another tech, that years ago a pharmacist had a miscarriage because she was under too much stress and not eating right/at all.
16
Congratulations on your excellent coverage of an issue affecting so many people. I have been the target excess solicitousness of my pharmacy about setting up refill plans that are irrelevant to my situation. Now I better understand the cause. I fear for those unable to take personally protective measures (including my future elderly self).
7
The Wal Mart pharmacy does a great job at keeping the lines short and the service excellent. The prices are much lower and I have never had an error. Too bad that this admirable profession has turned into a fiasco for so many,
1
Instead of reporting on the anecdotes, I would respectfully request NYT journalism to focus on the systemic problem- the clash of basically 19th century technics (the 18th century clinical model, the entire chain of action from diagnosis to cure, of which contemporary pharmacy practice is only a small, obsolete part of, and the economics as well) with 21st century demographics (the number of patients treated, and their expectations, most importantly modern disease etiology and variety.) Once the systemic conflicts are resolved, there will be no anecdotal evidence as you reveal here. We live in a post-capitalist world, and medicine is still mired in the pre-capitalist malaise.
Sorry Robert, but it’s not clear what you are trying to articulate here?
1
Surely (1) checking the label, which features the name of the medication prominently, against the discharge form, and (2) checking the actual pills against the description given on the bottle and bags label, are elementary steps that patients can be educated about. Errors cannot be eliminated, and the current computerized systems now catch many prescription problems that would not have been flagged before. Unfortunately the working conditions you describe make up for this... nevertheless the responsibility for what is ingested is what was prescribed rests squarely with the patient.
I disagree. We depend on professional who have the training to pick the correct medication from the shelf and dispense. Could an elderly our impaired patient know or be expected to know a 5mg later from 10 mg one? How are we to know in the case of a liquid what was actually actually in the container, Our what color or shape the pool is supposed to be.
If you had your vehicle repaired and the wrong fan belt was installed would that be your responsibility to check the mechanics work? So I really don't get your logic, perhaps I'm missing something
7
My local Rite-Aid recently finished its transition to Walgreen's. The changeover of the store's pharmacy was chaotic. Pharmacy staff are nice and helpful and seem knowledgeable, but they are overwhelmed. Lines are long, nerves are frazzled (on both sides of the counter), and my confidence that they are getting things done right is low.
2
It doesn’t help that chain pharmacy often change generic suppliers - and the tabs aren’t necessarily the same color/shape..
I am reminded of a time I was at a CVS pharmacy...it was incredibly busy at the exact time “management” came to visit....or rather inspect.
What did they do? Ask the harried pharmacist to put on her white coat.
4
"A majority of state boards do not require pharmacies to report errors, ..."
Without an accurate, effective monitoring system failures are not an opportunity for needed corrective learning.
What enables state boards to be negligent, and in this process, to foster "failure blindness?"
2
Follow the money. There should be an investigation as to who sits on these state boards and their ties to corporate chain pharmacies
This is why I try to fill my prescriptions at a local independently-owned pharmacy whenever possible.
7
I've recently found one I like too, but a few months later I got a letter from my insurance who contracts with CVS that it would not cover a particular perscription if I filled it through the independent pharmacy. So much for the argument that our current health system limits choices.
4
There is no standard size, color or shape for generic drugs among generic manufacturers and pharmacies switch frequently between manufacturers. As a result my script might be a pink oval pill on one refill, and a white round pill the next, making it hard to recognize my medication. The FDA should standardize this aspect.
5
Bravo. Great reporting. Yet another example of how the obsessive drive for efficiency and productivity (i.e., profits), aided by technology, have overwhelmed not only safety, but common decency.
6
Not surprising. I noticed this at the local Walgreens, quite a while ago. I had a medication that was supposed to be refrigerated and ordered it in advance. When I went to pick it up it was sitting out on a shelf. Who knows for how long, since I'd order it the day before? Other small and sloppy things were apparent before that and the "culture" seemed off, frantic, understaffed. The refrigerator incident was the last straw, when then tried to make me feel that it was no big deal. Even though it's more convenient, I no longer get my medication there.
3
It’s anecdotal but the pharmacist and staff at my local chain pharmacy are always incredibly swamped and stressed out. It can’t be a healthy work environment and I can easily how mistakes can happen.
2
Welcome to corporate Medical Care 2020 style. It won’t get better until we start jailing some corporate bigwigs
22
The pharmacist at my local Walgreen’s gave me incorrect advice in my new, injectable medication yesterday. Dangerously incorrect, which I found out when I opened the auto-injector box and read a tablecloth sized information sheet.
The pharmacy was nearly empty when this happened. No “chaos” or overwork, to blame for the error. In this case it was simply arrogance and laziness. I had asked the clerk, who rang up my prescription, a question about medication handling. He went over to the pharmacist, who was about six feet away from me — fully visible — and who made the clerk stand there for a time and wait to be acknowledged. Then she, without looking at me or him, spouted a curt answer that was absolutely wrong.
Incompetence and bad attitude should not be blamed on the employer or the working conditions. The failure in this case was with the person.
6
A pharmacist can be extremely busy and stressed without a single person in the pharmacy. When I worked for a chain there were days that my brain was barely functioning, especially towards the end of a 12 hour day with no break, no lunch, no sitting, sometimes no time to even use the bathroom. Most people cannot even relate to the level of stress and exhaustion that pharmacists in these chains are experiencing
2
@Jay Quinn, so? Plenty of people work under pressure every day, and don’t kill people though their carelessness. Time pressure is no excuse for tossing out any answer that pops into your head. The pharmacist simply did not care. She should not be in that job, with that attitude.
Ah yes, capitalism racing to the bottom. Anyone who has been to a pharmacy has seen this themselves. One pharmacist, working alone, rushing, behind, etc.
I have taught my family to never put a pill into their mouths until they have carefully read the label, and compared the identification on the pill to the published description of the medication and that the med matches the indication.
Just like self-checkout, we have to do this work ourselves that someone used to do for us. This is not efficiency, this is a lowering of standards.
14
Overworked, understaffed, intolerable working conditions. Those are the problems. The answer? Unionize! Good old unions who ensure that Joe and Jane Worker had a safe and reasonable work environment and a wage (salary in this case) commensurate with their jobs and education were what built a solid middle class in this country.
10
You’re right but I can assure you that if a chain pharmacist made so much as even a comment on social media in support of unionizing they would be fired shortly thereafter for failing to meet the impossible metrics. There is extreme fear of retaliation because there is currently an over supply of pharmacists and if you won’t do their dirty work they way they want you to there are 30 people waiting in line to take your job.
1
I was already mad at CVS for selling worthless homeopathic drugs, one of which I almost bought by mistake instead of an FDA-approved OTC remedy (recommended by her physician) for dry eyes for my very ill mother. They put the quack drugs right next to the real ones on the shelf, so it's easy to get mixed up. I called corporate HQ about this but they never did a thing. (Because, profit.) Then one of my physicians told me I should switch from CVS because it makes too many errors. Thanks for this article, as now I am definitely switching to another pharmacy.
9
Our neighborhood pharmacy went under last year. The pharmacist, struggling for years to stay in business against corporate entities, gave individualized advice, knew his customers and their needs and often caught mistakes made by physicians who were too busy to notice the other medications we were prescribed by other physicians. One of the most important bits of advice he gave me was that sometimes it is actually cheaper to buy your medication off of your insurance plan. It helped me save about $100 a month and now I always ask to compare the price of my medications with and without using my insurance. This independent pharmacist employed six or eight local people who now have to look for non-existent work elsewhere. 
7
This story is just another data point in the overwhelmingly obvious conclusion that PROFIT MOTIVES IN HEALTHCARE ARE A PUBLIC HEALTH CRISIS.
Sociopathic greed is the greatest threat the United States has ever faced, and it has infected this every facet of this country from top to bottom.
44
This is another deadly consequence of a medical system which primarily focuses on profits.
13
You can get your prescriptions filled at Costco even if you are not a member.
I have always had good service there.
The pharmacy is shut down for lunch so they can get a rest. Costco provides good benefits to their workers, even part-timers, so they seem happier than other places I shop. And there are generally two or three staff at the registers so you don’t have to wait as long. Plus, their prices are often better.
7
With the lack of antitrust and monopolies laws not being enforced or even remembered, this problem and healthcare in general will continue to get worse. CVS was allowed to purchase Aetna's Medicare part D plan. Unfortunately I have never been a CVS fan for many reasons. I was a Aetna Part D member and very nervous CVS has taken over.
Their stores are staffed just like their pharmacies. Most of the time when one wants to check out and buy something there's one or none employees to check out. The stores are carpeted and have low ceilings in our part of the country. Dirty carpet, unattractive stores, no checkers or pharmacists and lines of sick people in the back and front of stores. My advice is don't give them the opportunity to fill your prescription wrong. Transfer to an independent pharmacy or a smaller chain. I have used a Kroger pharmacy for years and am very pleased. I won't buy groceries at a Kroger because they expect customers to do their job - self-check. but I haven't been forced to find n fill my own scripts yet so I can say I do love my Kroger pharmacy - but waiting for the day CVS says you must now use CVS pharmacy at which point I will find another Part D provider.
2
I use CVS inside of a local Target. I don’t try calling because there is usually a long wait. I do know that a few of the workers were Target employees who are now working in the CVS pharmacy in Target. My experience has been mixed. I have seen some of these employees filling prescriptions because there were more of them than there were actual pharmacists. I actually use an independent pharmacy for some medications because for me they do a better more personal job. The pharmacy in Target is convenient.
1
I once got a kind of critical medicine that pharmacists are required to double-count because mistakes with it cost dearly and they're heavily regulated. The bottle felt a little light so when I got home, I counted. I was missing 50 pills out of 180. Fifty. If I hadn't noticed until next day, the top-chain drugstore would not have filled the rest. As it was, when I called for the pharmacist to check the count of what he had left, he said, "Ok. Come on back and I'll fill the rest. But I can't do this if it happens again." When I complained, He offered to count these in front of me each month when I used to take them but by the second month, he was so busy he tried to put me off.
Since then, I've gotten 15 pills too few of one thing and double of another. Both errors were caught but only because they agreed to count them in front of me. Last year, I had a chain pharmacist take offense when I just opened the bottle to look before paying. (So much for your suggestion in the sidebar on safety tips.)
During a big holiday recently, I went to my chain pharmacy to pick up some something and the frazzled pharmacist was the only drugstore employee of any kind that entire day. He was doing everything -- from answering phones to counting pills from giant bottles into little bottles to running the cash register. The turnover of chief pharmacists at this top-chain is alarming. They barely get to know you and your meds before they vanish. Counting in front of me became a must.
8
Follow the money. It's all about driving sales at any cost. As a retired executive at a major grocery retailer, I can tell you this is the main subject at most staff meetings. I take 4 meds (common scripts for seniors) per day with a monthly retail of value of $1006. I have been forced to use Walgreens or CVS as a preferred pharmacy for preferential pricing. Both companies have inundated me with text messages and phone calls for refills (90 day) despite my instructions that I will request them when needed. Thanks for the story and keep probing.
13
This is the essence of good journalism. The Times could do a public service by sharing how reporters came to realize this was a story.
18
This is what happens when companies are controlled by private equity, guided by outside consultants and obsessed with constantly increasing profitability, and are under-regulated by the government. But of course, regulation is bad, private equity is wonderful, profit is more important than lives and this is just fake news from the “failing New York Times.” I get it.
19
The majority shareholder of NYT is a private equity company.
1
Our local, Winston-Salem, NC, CVS is understaffed and almost dysfunctional.
7
Every CVS and Walgreens in the country is dangerously understaffed and dysfunctional. This is their business model.
3
These chains are an oligopoly and have been working hand in hand with big pharma.....all that matters is how much profit is earned year over year.....that’s it! Basically, a legalized crime syndicate is what we have. And, the best part is the consulting firms that collude with these jackals to “help companies manage their prescription costs”. How many times has the benefits office brought in the “professionals”, who are all too happy to take their cut while pretending that the entire prescription drug market is not rigged against the actual purpose of saving lives at an affordable price!
6
If you have ever been to a CVS, you KNOW those pharmacists are incredibly overworked. You can see it with your own eyes.
15
This is what happens when the public has let Wall Street take over healthcare
5
Excellent article. Thank you.
2
A spokesman for CVS said it had created a system to address the issue, but Dr. Schwartz said complaints persisted.
Keep those lies coming, CVS.
As always, The Times is ahead of the curve.
15
Where is little George Bailey when you need him? Is it still a wonderful life?
9
@Stefan great comment, perfectly correct. It will take big George Bailey to solve this problem, and we’ll all have a wonderful life in Bedford Falls, not Pottersville!
2
The healthcare system is broken. It's based on greed. Time to stop the television ads for drugs, discontinue marketing reps visiting doctors, and everything else that drives up the cost of prescriptions. My pharmacy at a big box is a sweat shop. They are always understaffed; the pharmacist was ill with the flu and filling scripts - in between blowing her nose and wiping her eyes. This isn't working and it hasn't been working. Why is this okay with us?
8
Corporate America ruling this country. The politicians are afraid of them or work for them Elizabeth Warren is a perfect example of the revolving door. In a less obvious manner so are the Clintons and Biden and Barack Obama. Follow the money. This country has become a disgrace.
1
@Marie Seton : What a bizarre comment! Elizabeth Warren worked for "Corporate America" a long time ago. Based on what she saw, she joined the other side and started fighting for regular people.
I consider this to be an asset because she understands how the game works and how things are rigged.
6
@Marie Seton yes, and Bernie is George Bailey!
Her words are too bizarre to believe that they are genuine. We should expect the degree and number of disingenuous and agent provocateur type postings to increase exponentially as we get closer to November 3rd.
1
Another win for capitalism! Someday all the humans will be dead and robots will carry on making money, money, money.
5
Thanks so much to the NYT and the journalist which wrote this investigative article. My daughter has been a pharmacist at CVS for over 15 years and she do not have lunch time or brake and the famous metric are really a burden for her performance. Every day she work over 1 hour extra without pay, in order to fullfill the metrics. The root of all these corporative greed is that only money and profit is what count. Neoliberalism and market without regulation, when it deal with health are a deadly mixture. I apolagized for my broken english and welcome the NYT to make the appropiate correction to these lines.
45
This article couldn’t have been more accurate. Thank you for alerting the public to what goes on “ behind the scenes”. I have been in this business for over 30 years and nothing has changed and nothing will.
The public has no idea about the poor working conditions we endure. I also refrain from drinking because I don’t have time to use the restroom. Breaks? Oh that’s non existent. I work 13 hour shifts with no breaks. Is that really comprehended? Have I complained? Yes. The answer I get is simple. Just take a break they tell me. Right! The minute I try to sit down the phone rings. It’s a doctor calling in a script. I sit back down. Now it’s a question from a patient “ oh what can I take for my stuffy nose”. Next.. red basket customer doesn’t want to wait. Sit back down again. Shingles shot now. It’s never ending and I only come back to an overload of prescription to fill because I sat down for 5 minutes. I fill over 400 prescriptions a day with no pharmacist overlap. Think about that people and make sure you double check everything. Oh and please don’t yell at me and call corporate because you didn’t get the service you deserve. We only get reprimanded and written up. I’m hanging on a thread now just waiting to get fired.
676
This is even mire horrific when you think about the few chain pharmacies that control most of the market and work conditions. Pleas hang on - to your sanity and yourself and your voice. Most of us patients understand enough to know staff didn't create these conditions and is suffering right along with so many of us.
69
@Tired My wife, a retired chain store Pharmacist and Pharmacy Manager says she can relate to ALL of this!
43
@Tired Thank you for this. Now, can we discuss getting corporate profit out of our health care system?
93
What's missing from this article is the fact that we, the health care "consumers", are compelled to use these pharmacies and to demand 90 day prescriptions or else be financially penalized, in the name of saving money, and yet, the very corporations we are compelled to do business with are on a mission to upsell us at every turn. Then, to add insult to injury, we, the health care consumers, are blamed for out of control health care costs. Is it any wonder more and more "consumers" turn to Dr. Google?
9
Excellently researched and written article. The United States of America has the costliest medical “system” in the world, period. At all levels of this “system” providers are being squeezed to perform more with less.
When short term profit is the primary motivation this is the natural outcome. When hedge funds own drug companies and healthcare providers this is the natural outcome. At some point one would hope the American people rise up against this monster which fleeces them from cradle to grave.
Medical care for the population of America SHOULD NOT be a profit center for anyone. Remove politicians, lobbying money, and large tech companies who mine your medical data for profit from the medical care equation.
Patronize and support your local pharmacies. Your dollars stay in your neighborhood and generally the pharmacists will be familiar with you as an individual not just a customer number in their system.
15
Ellen’s article on pharmacies abuses is fantastic. PLEASE Send it to every STATE and Congressional legislator. It documents a serious abuse of our health system! Keep up the great work Ellen. You are doing a fantastic reporting.
10
As a retired nurse I know mistakes can happen whether it’s in the pharmacy or the hospital. I fill my prescriptions in a small pharmacy in Riverdale which so far has been pretty good. With that being said, before taking my meds I always empty the bottle on a table, spread them out looking for uniformity in color, size and the numbers and/or letters on them. I then google the information and get an image of the pill. I know some pharmacies, including mine, have at times given me a prescription with different colored pills and differed shapes. I’m sure this is done only because they have run out of one and have to supplement with another manufacturer. Don’t be afraid to question the pharmacist even if he is a grumpy old man like mine. It’s your body, your life.
10
This is what US-style virulent capitalism produces. When will Republicans realize that they take prescriptions, too?
2
Is there anything in this country that is more important than money? Apparently not.
4
These chain pharmacies value money more than your life. If they make a mistake and you die, it’s cheaper for them to settle the lawsuit with your family out of court than it is for them to properly staff their pharmacies nationwide. They do not care about you at all and they care about their employees even less. It is truly a disgusting state of affairs and a sad indictment of what happens when we mix capitalism and healthcare
1
Similar deal, different system, in Canada.
My pharmacist, a sweet middle-aged lady from Europe, and a Shoppers Drug Mart franchisee in Toronto, told me she's losing her hair, getting fat and can't sleep--plus her husband left her for a twenty-year younger woman.
I responded, "Wow, patients driving you nuts?"
She said, "No, my patients are wonderful. It's the corporation. The quotas, the demands, the insurance, the break-ins and security costs (to keep out opioid-seeking burglars), plus the skyrocketing rent for the store... The stress is killing me. I just want to run away, buy a little cottage in the country and plant a garden."
I asked why she doesn't do that.
She replied, "I'm broke!"
14
My experiences with CVS have been horrible. The parking lot is jammed. No drive-up window. The pharmacy is always crowded with lines. Sick people sitting right by the counter waiting for their prescriptions. Then when their prescription is filled, they have to go to the back of the line. The pharmacists and techs are never smiling and look harassed. They never look up or smile. They automatically fill prescriptions I have asked them not to fill. They have called me so many times with each prescription that I have had to block their number! I’ve called to see if my prescription dropped off the day before is ready and told it would be ready in 3 hours. When I arrived 5 hours later, it hadn’t been filled. I blame the corporation for this. It’s obvious they don’t have enough help. The work culture obviously makes CVS the worst. I’m looking for another drug store now.
9
Thank you for understanding that this is not the fault of the pharmacist or their staff. Pharmacists became pharmacists to help and interact with people about their healthcare needs. This is no longer possible with the corporate, profit driven model of pharmacy. Those pharmacists are 100 times more miserable than they look.
1
This is yet another example of the toxic system of capitalism so revered in the U.S. The idea that the only purpose of a corporation is to make money for the owners has poisoned our economic system. Technocrats, bean counters and algorithms dictate practice and policy. Equity funds worsen the system because the bean counters who own the funds don't give 2 cents for the industry they are in. They just want to squeeze every dime out of the paying public and pad their offshore bank accounts before either sending the company to a third world country or bankrupting it. This is why we need progressive democrats in government. Don't vote for more Neo liberal democrats or for any republicans.
6
WHISTLE BLOWERS NEEDED at US pharmacies. Interesting.
4
Is it known how many lobbyists are crawling around congress setting policy.... not to worry all is under control.
It will only get worse with this no corporation regulation administration!
6
Reading the article and the comments leaves one rightfully worried about needing to take any medication. Our for profit system clearly jeopardizes Americans’ lives to a great degree— all in the name of greed.
Add to the disturbing reports sited here, the fact that the bulk of our medications are manufactured in China. THINK about that. China— with no oversight & no incentive to provide a pure & accurately dosed product.
A BP med I was on for years was found to be contaminated with a known carcinogen. Oops. But no repercussions to the manufacturers or distributors. Just us patients.
How many meds that you or your loved ones are taking are similarly contaminated? Anybody’s guess. How many of the pills our pharmacies are dispensing are fake, substandard, incorrectly dosed or contaminated? Again, anybody’s guess.
And during Hurricane Maria Americans learned that I.V. bags are not produced in the continental US. They are produced in & must be imported from Puerto Rico. (A territory we won’t even help keep reliable electrical service.) —As are the large majority of our needed medical supplies. The greed of the profiteers currently running our healthcare systems has effectively eliminated the US production of these items.
We desperately need to remove the profiteers from our healthcare system. We need a single-payer system dedicated to rendering comprehensive, safe & affordable care. Unnecessary American deaths is the price we pay for failing to do so.
21
And conversely, insurance can require 30-day refills only, instead of the more convenient 90-day, for maintenance drugs. Scamming medicare by pushing seniors to refill expired prescriptions already mentioned. Ultimately, much of this behavior by corporate disserves the patients, and creates a miserable workplace.
3
I stopped shopping at Walgreen's when they centralized their Rx filling. You'd drop off a Rx, get a part of it, and have to come back the next day. Or they didn't have the medicine in the store at all, but you didn't hear that until after they took your Rx and stamped it. This caused two trips to get one Rx. No skin off their nose. They got the business and made the $.
I learned at a young age the best thing to do was to find a pharmacy I liked and keep all medicines at one, so there were no interactions. Of course, now, all that messy interaction stuff is done by computer. But no one knows more about drugs than a good pharmacist. It's your health. You have to go to the best providers, not merely the most convenient.(Which holds true across the board to all medical and dental providers!)
5
Your lead-in video says it all...
Aside from the 20th-century meds in the pills, things haven't changed much since the age of leeches and blood-letting...
Can remember when Walmart tried to get a bank charter – and Congress blocked it because they were afraid of how WM might abuse the banking system...
Though our pols were quite comfortable with how our banks abuse the banking system…
Probably the same reaction today, if Amazon goes too big and too fast into this business...
The fragmented and compartmentalized and secretive pharma supply chain has been an embarrassing step backward – for both computers and for supply chains…
The US supply chain for pharma is as opaque and subject to mischief as are the global supply chains for crude and cobalt…
At least there, you have some idea of what you’re going to pay for the stuff, going in…
5
Sounds like another Wells Fargo “metric” issue. Executives on high imposing impossible metrics to achieve their own maximum bonuses with no regard the consequences.
11
Non disclosure agreements, often part of forced arbitration agreements prevent early detection of these dangerous practices in corporate America. Corporate America hides behind these practices to the detriment of us all - both employees and customers.
12
Yesterday at a hospital based pharmacy, when I requested to verify my prescriptions were accurate before signing and paying for them, a pharmacy tech grabbed them out of my hands and refused to show them to me until I signed for them. I am an RN and have seen pharmacy errors first hand and was appalled by this.
19
@Sara : We have had the same experience at a chain pharmacy. There should be a law that patients are allowed to look at their prescriptions -- read the label, look at the pills, count them if they wish -- before they sign for them.
In fact, the computer systems you sign off on could be a step to ask you if you want to look at the prescription before you sign off on accepting. There could be little check boxes: I read the label (yes/no), I looked at the pills (yes/no), I counted the pills (yes/no).
2
I work for one of the companies mentioned and can attest the working conditions — no meal breaks, long shifts, woefully understaffed to cut costs — is absolutely true and extremely dangerous. The refill requests are built into the register system and go thru automatically. It is an extremely dangerous situation for staff and employees and it is driven by profit incentives alone. This article is spot on.
34
I take 8 medications twice a day for ischemic heart disease. I get them through the mail with 90 day supplies. My co-pays are five dollars or less per drug. They have all become generic over time. Any additional perscriptions I need I get at a local pharmacy that is affiliated with one of the giants who have their own store about 2 tenths of a mile down the road ! The local store is never crowded. When I have gone to the big chain store for my shingles and flu shots sitting in the pharmacy section I have observed a chaotic continually moving group of pharmacists working in a small crowded space and in addition to that, there is a continual recorded voice saying there is a call to the pharmacy. I am amazed these folks can work in such conditions day after day. Oh, this giant store also has a drive up window !
7
Whoa. Frightening. As a prescriber, I am starting to think I have to teach all my patients how to look up their dispensed medication on one of the pill identifier websites, and have them do that each and every time they pick up an Rx. Generic drugs in particular are concerning. (Generic drugs from different manufacturers can look very different from one another, even for the same strength medication. Pharmacies routinely dispense a different generic brand each time.) Unfortunately, not all patients have the wherewithal to do that.
10
The instant and most relevant question is, "what can we do to fix this inadequate patient care by pharmacies"?
5
@Bob : Require that pharmacies do the following:
1. Hire enough pharmacists that each pharmacist is only filling, at most, a certain number of scripts per hour.
2. Give their staff adequate breaks for food, bathroom, and just mentally recharging.
3. Slow down the pickup process a bit so patients gets prompted by the computer to look at the label and at the pills -- and even count them if they wish. They can decline that if they wish, but the prompting may encourage them to look more closely -- and it will prevent the huge problem of the chains not allowing you to see what you're picking up before you sign for it.
3
Many prescription programs require 90 day supplies for them to pay. That is one reason for the 90 day thing. And I have noticed that some prescriptions now come in 90 pill containers so the pharmacist doesn’t have to count. Just pop a container in your bag and you are good to go. Tail wagging the dog.
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They are now suffering the sorts of torments that we doctors have had to endure for many years. Such odious impedimenta were the reasons I retired from solo private practice after 40 years.
Being a doctor and treating patients was always magnificent and wonderful; the hoops I eventually had to jump through were increasingly malignant and burdensome.
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Just this week CVS called my doctor for a refill on a medication that I did not request, and the prescription had expired at least 6 months ago. The doctor ok'd it but called me to tell me to come in for a recheck. Otherwise I would never have known. This caused him to think I was trying to get medication that I should not have had without a recheck, which was not the case. This aggressive behavior is not unusual with CVS. Last month they called me at least 5 times to refill a different medication that I did not need, and with each call I clearly told them that I did not need it and would call if I needed a refill. But they kept up the calls.This has been going on for years with so called "automatic refills" that I did not request to be placed on automatic refill status. I now plan to transfer all my prescriptions to a private pharmacy.
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At most Chain Pharmacies the majority of the Prescriptions are filled by "Pharmacy Technicians" who have zero formal pharmaceutical education. Many are doing this job on a part-time basis. They bring the medication up on a computer monitor and verify that the pill that they are dispensing looks like the picture on the screen.
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@alan: The pharmacist still has to perform a final check on the prescription before releasing it for pick up.
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@retnavybrat Have you ever watched? I have, not all are verified. One Pharmacist, multiple Tech's.
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@alan There is no computer system in any of the big chains that will print out a finalized receipt that can actually scan at the register without a pharmacist verifying it. You are correct in that most scripts are filled by a technician who pulls the drug and scans it into the computer which then prints the label for the bottle. Before that script can go to the patient it passes through the pharmacist's hands to be checked against the images in the computer. Mistakes can still happen during these steps, but the errors mentioned in this article likely happened before it even got to the filling station.
Let's not forget that today's Pharmacists spend 6 years in College to earn a Pharm D degree. Some go into research, sales or these "Wells Fargo" pharmacy chains. My father owned his won pharmacy for over 35 years in a small town, that also supported 3 other privately owned stores. CVS/RiteAid/Walgreen's moved in and killed them all off after a few years by eroding their customer base and eventually buying their prescription book of business. One of the owners reopened his own small store several years later and had immense success as his client's were sick and tired of long waits, assembly line production and uncaring/overwhelmed staff at the chain store next door. If you can- find an independent pharmacy, they care.
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@steve
Amen, after bad experiences at CVS I found a wonderful independent just like the ones I grew up with before there was a CVS, Walgreens ,Rite Aid
I went to a private pharmacy and have been happy for years.
March with your pocket books, pay a little more but be secure that your family is safe
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The local pharmacy in my locale is a CVS, and there are always long lines and the pharmacists work nonstop, with seemingly never an opportunity to take a deep breath.
I found that the only way to ensure my prescription gets filled properly or at all is to walk in a hand written prescription rather than having it called in.
I recently had a raging infection and after several days of them not filling the prescription, I checked with CVS and was told they were out and wouldn't get any in til the next week. I had to call the doc and have him call another pharmacy on the other end of town so I could get my much needed antibiotic.
The price of my heart meds has been ticking up this past year for the first time in five. A dollar or two more, twice already.
Here's all we need to know: CVS revenue rose 35% to $61.65 billion in 2019.
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Walmart is on some kind of “inventory on demand” in this area anyway, and are out of medicines frequently—many that people need in large numbers or for sustaining their lives. Patients should be aware, as of many other burdens business is laying on customers, and seek your refills early.
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When you run healthcare just for profit, then there’s nothing shocking in an article like this. The incentives are all financial, to sell as much “product” as possible, deceptively if necessary, and cut overheads wherever you can to maximize revenue, please Wall Street and pay outrageous CEO and executive salaries. One pharmacy executive got a billion dollar bonus recently during a merger.
Like with every other facet of our healthcare system, we are paying insane prices for a statistically below average level of service. Other countries have adequately staffed pharmacies and humanely priced drugs. We don’t.
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I appreciate the NYTimes publishing this excellent piece of reportage that reveals one of the many serious structural flaws in how healthcare is delivered to Americans. According to research out of Boston University, 82 percent of American adults take at least one medication and 29 percent take five or more - most of the latter are elderly. Each year more drugs come on the market, many of which are are not demonstrably better than existing drugs, but do generate higher profits. These facts alone contribute to an extraordinarily complex and expensive situation in our attempts to maintain population health. Effective coordination of care among physicians, patients, and insurance companies, especially in the realm of prescription medications, is virtually absent. Health information technology solutions to the problem of the safe and effective managment of patients’ medications are at hand, but the will to implement these solutions fall victim to the short-sightedness of the pharmaceutical and health information technology industries’ focus on near-term gain. Part of the Affordable Care Act included a mandate that healthcare providers implement computerized health records systems. Unfortunately, the resulting systems are designed more to cater to the needs of billing departments and less to the needs of patients.
When, according to Johns Hopkins University, the third leading cause of US mortality is medical error (which includes medication error), this is urgent.
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First, don’t blame the Pharmacists. They are highly trained experts and I’m my experience extremely concerned about Patient welfare. In these chain stores, they barely TOUCH the medications, usually just glancing at the bottle and verifying the Name. That’s it. The “ Work “is done by a “ pharmacy technician” often training in the Store, on the Job. Few States require any Exams or certification. It’s all about Cost Control.
Just last month, I was sold two separate Prescriptions, from the same Physician, for the same Drug, in the same Dosage. At the very same time. This was a powerful blood pressure medication, I’ve been taking for years. Now, of course I discovered all this at Home, the next day. However, if I was careless, in a hurry, very, very elderly or confused, chances are I certainly might have started taking BOTH sets of pills. DISASTER. My pulse is already in the 50’s. This was absolutely, potentially FATAL.
I returned both bottles the next day, and spoke with the on-Duty Pharmacist. He was very apologetic and admitted the “ error “.
The place was a madhouse, as usual. I will NOT be pursing this further. Just be very careful, and check all your medications, and those of your Family members. Then, check them again.
Good luck.
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As a supermarket pharmacist, nothing in this article surprises me. I am working alone about 50% of the time and hope I don’t hurt anyone. I work 12 hour shifts (with no formal breaks). We must legislate on a national level to increase staffing! We can do more with more!
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Thanks for an important article. One thing not addressed in the article is whether anyone is doing things right. I have been impressed by the pharmacy and staff at Costco. They are also busy, but manage to work well with local physicians, have prices that are extremely competitive, and they seem well staffed and professional in all their interactions.
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I worked as a pharmacist for CVS for 20 Years until 2008 when I had enough. The company cut our technician hours and told us no matter how busy we were we had to meet labor hours even if it meant working alone. One Saturday my supervisor handed me a list of 150 calls I had to make that weekend to ask patients if they wanted their medication filled. I was lucky enough to find another job within a week.i have nothing but sympathy for my colleagues who work for CVS and Walgreens.
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I am a pharmacist who works in a health care system specializing in medication safety and my job is to prevent and reduce medication errors and improve patient safety. Firstly, I have to give kudos to this article and investigation because it is spot on.
Over the last few years, I've seen an increase in the trend of prescription renewal and refill request related medication errors being reported by our primary care practices. The providers, nurses, and MA's are so inundated with requests that the downstream effect is more medication errors happening in these practices that may authorize inappropriate requests. Being on the receiving end of these requests, we have to develop strategies to manage handling these requests in a safer and more standardized manner, which is taking more resources.
I'd also like to address some of the comments made regarding reporting of medication errors to state boards of pharmacy. Not all state medical boards are of the mindset to hold chain pharmacies accountable. In fact, many boards still punish individual pharmacists for human errors made under abhorrent working conditions. We can't learn from our mistakes until all pharmacies and medical boards understand Just Culture and process improvement. Just Culture to hold both individuals and organizations accountable for behavioral choices, and process/systems/working conditions, respectively. Then, there will be value in reporting errors that lead to meaningful changes in the pharmacies.
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No state board in the United States holds chain pharmacies accountable for anything. Their response to pharmacists is to either quit your job or complain to your employer if you feel conditions are unsafe. If you complain about unsafe conditions you will be fired and there are 20 pharmacists waiting to take your job. What exactly are the boards of pharmacy doing if not protecting the public from pharmacists working in dangerously unsafe conditions? A good follow up article to this would examine who sits on these boards of pharmacy and their ties to the corporate chains
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I receive my prescription medication via Express Scripts, a mail order pharmacy. Has there been any investigation of mail order pharmacy working conditions and procedures?
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@Russell Prystash -- I don't know about working conditions, but there are a number of complaints about late, damaged or temperature-compromised prescriptions by consumers.
Isn't Express Scripts one of the biggie PBMs?
So true. In my area most of the independent pharmacies have been rubbed out. As a prescribing doctor, I have heard many stories from patients. One of my own really got me fried: I needed to call a CVS with a prescription and was asked to call back in 15 minutes because the pharmacist was "giving flu shots". Not only is that my job, but they should have been able to take a message, not needing me to call back. I also have a few patients who work as pharmacy "technicians". Their stories will make your skin crawl. AND-what business did CVS buying Aetna-a venerable insurance company?
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@Eric : I'm with you -- CVS buying Aetna was a total conflict of interest. Still not quite sure how this was legal ...
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I’m part of my husband’s Union prescription plan and last year we were forced to go to CVS to fill any prescription for an ongoing condition or to fill the prescription by mail. I greatly resent being told where I must do business and also resent that this may help put the two pharmacies I try to still patronize out of business.
This article just makes me more outraged that in spite of the increased money the CVS chain takes in, the bottom line is all that matters. Patient’s health doesn’t matter as long as the money keeps rolling in. On a personal level I hope the Union reads this article and rethinks their drug policy. But on a another level I hope that if we mange to get rid of Trump, things like drug safety and the crushing of small businesses and anti trust lawswill once again be of some concern to the government.
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