Pharmacies across the nation are in crisis. Labor shortages are rife in nearly all retail settings and inadvertently putting patients’ lives on the line. The shortage of pharmacists has reached such a crescendo that some large healthcare organizations are offering sign-on bonuses approaching, and sometimes exceeding $100,000. The downstream effects of these shortages are staggering — pharmacists are spread so thin that patient education and consultations on life-saving medications are nearly non-existent. The result? Adverse drug events are becoming an increasing – and justifiable – concern.
We often consider the leading causes of death in the U.S. to be heart disease, cancer, and strokes — but there’s a not-so-silent killer among us. Each year, adverse drug events cost the American healthcare system approximately 1.3 million ER visits, $30B in additional costs, and is considered by epidemiologists to be the 4th leading cause of death.
As a pharmacist and healthcare consumer what frustrates me the most is that many ADEs are preventable. So why, as the most industrialized and wealthiest nation on the planet, have we accepted this fate to be true?
Early in my career, my grandmother – like millions of elderly patients around the nation – entered a long-term care facility. As a family, we expected that the facility would better manage her daily care than she, or we, could. Not long after, we received reports of her repeated falls and subsequent injuries. Despite being a young pharmacist, I took it upon myself to thoroughly cull through her extensive medication list. What I discovered left me shocked. One of her physicians improperly prescribed a prostate medication (why is still unclear, decades later) which knowingly had a side effect of lowering her blood pressure, causing dizziness upon standing, resulting in her consistent falls. Only after proactively contacting the care facility was the error corrected. She never fell again, thankfully.
Yet all these years later, I still wonder what would have happened to my grandmother’s fate if not for the medication review and remediation. How many other loved ones are unknowingly experiencing unnecessary side effects from their medications? How many patients are taking dangerous combinations without a caregiver or family member to intervene? Far too many, the data suggests.
The bright light in this otherwise challenging time is that there is an untapped resource available to help solve this epidemic. Today in America, we have an underutilized workforce of over 300,000 pharmacists who haven’t been empowered to reach their full potential. They are, in my humble opinion, healthcare’s unsung heroes. Medication experts go through extensive education and training to understand medications better than any other healthcare discipline and are positioned to directly improve patient lives.
Many pharmacists, however, find themselves stuck in a field in which they’re consumed with taking inventory, putting pills in bottles and bottles in bags, and managing a team of pharmacy technicians in environments that often lend little to no time to spend with patients. Think of yourself. When was the last time you received a true consultation when filling a prescription? Not the standard “any questions” remark you hear when swiping your card at the register. Pharmacists are only being spread thinner, and as the field progresses toward automation, now is the time to reallocate our pharmacist workforce toward more meaningful work—both for them and the patients they serve. Pharmacists have been burnt out for a long time. Never have they been able to choose their own hours, run their own practice, and work from the comfort of home.
I know that my grandmother was not alone. And there are millions of patients since her that prove patients deserve a better way to ensure they’re taking the right medication, in the right dose, at the right time.
Building a marketplace for pharmacists to offer their expertise in a gig economy is a design that quite frankly, should have been developed long ago. It provides a practical solution to this dilemma. Gig economies are working for other industries at scale, and should be considered for the pharmacy industry, too. With the ongoing pharmacy labor shortages happening across the country, doesn’t it make sense to have another way for patients to access a qualified pharmacist to provide counsel on how to administer a new drug, potential side effects, or prevent a drug interaction? These are life-saving conversations that require a reliable solution in real-time to prevent catastrophic outcomes.
An extensive marketplace of clinical pharmacists can – with relative ease – provide patient consultations solely focused on optimizing the use of medications, developing pharmacist-patient relationships meant for the long-term, and better health outcomes. Imagine the lives that could be saved if all patients prescribed medication had a medication expert at their fingertips anytime they had a question or concern. Clearly, this antiquated pharmacy industry is hungry and arguably desperate for change.
And the gig economy? It’s here to stay. According to a recent McKinsey report, more Americans are turning to the gig economy than ever before. The nature of it offers flexibility and autonomy that the workforce at large has never experienced before. A newly energized and enthusiastic workforce leans in and initiates a virtuous cycle where everyone benefits. Modernizing an outdated profession allows pharmacists to address one of our nation’s largest crises and save many more lives.
Elderly patients or those with chronic conditions often have a care team consisting of a primary care physician and a slew of specialists. Patients often receive prescriptions (often multiple) from their cardiologist, rheumatologist, gastroenterologist, and more. It makes sense to create space on the patient’s care team for a dedicated medication expert to stay connected to the patient, driving their medication comprehension and adherence; a role upstream and separated from medication dispensing.
While it’s scary to think about the numbers of ADEs affecting patients like my grandmother every day and the pharmacy closures that are prohibiting patients from obtaining lifesaving consultations that could help to prevent them, it’s simultaneously comforting and rewarding to know there is a solution; a community of highly trained and passionate pharmacists ready, willing, and able to improve our broken healthcare system and drive powerful change in reducing avoidable adverse drug events. Because we know better, so we must do better. Let’s innovate and bring meaningful change.
David Medvedeff is CEO of Aspen RxHealth.
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