ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Wednesday, August 28, 1996 TAG: 9608280063
SECTION: VIRGINIA PAGE: C-1 EDITION: METRO
SOURCE: SANDRA BROWN KELLY STAFF WRITER
A pharmacist at a Revco drugstore in Covington says he has to take the telephone off the hook to get the time and concentration to fill prescriptions.
"I don't know of any business that takes the phone off the hook," Charles Weber told the crowd at a state Board of Pharmacy public hearing Tuesday in Roanoke.
More than 50 people attended the hearing, which the board scheduled in response to complaints by pharmacists and board members' "gut feeling" that drug errors are increasing.
Weber said he is so busy answering phones and ringing up sales that he also has little time to counsel patients on use of the medications he sells them.
"Revco's a wonderful company, but I'm in a store that's doing too much business to do it in a safe manner," he said. "We get from 150 to 170 phone calls a day."
Weber said he might take as many as 28 prescription orders in one phone call from a doctor's office.
But when he looks to his supervisor for extra staffing, he said, he is told: "The money's not there to help."
A corporate spokesman for Revco said he could not respond to a hearing he didn't attend, but that Revco encourages its pharmacists to tell the company their problems and that it occasionally runs focus groups to get at the workplace issues.
The company would never compromise customer safety "for the sake of money," the spokesman said.
The 14 speakers represented a variety of companies, but expressed similar concerns. They said they fear that cost-cutting in the health-care industry has jeopardized consumer safety. Each speaker's comments brought applause. The Roanoke hearing was the last of a series and the most vocal, said the board's executive director, Elizabeth Scott Russell.
The pharmacists told of routine 12-hour shifts and of going as long as six hours without even a bathroom break. Meals, if eaten at all, were eaten while working, several said.
Others spoke of having night sweats caused by fear that they had given someone the wrong medicine.
With prescription orders coming in by telephone, fax and in person, a pharmacist's attention is fragmented, said Charlotte Teeter.
Teeter is retired and lives in Florida most of the year, but returns to the area in the summer and works as a relief pharmacist while full-time staff is on vacation.
A pharmacist has to focus, she said. Too many drug names sound alike, and filling a prescription with the wrong one means your license.
"Did the doctor say Ornade or Orinase?" Teeter said as an example. "Ornade is an antibiotic; Orinase is for diabetics, for blood sugar."
"I've been a pharmacist for a long time, and I can see my compatriots getting more stressed," she said.
The board hasn't compiled data on how many cases of prescription errors it gets, but it plans to do so, Russell said.
Pharmacist Emily Tomlin asked the board to regulate the number of prescriptions a pharmacist would be allowed to fill during a work shift. She said she has an average of three to four minutes per request because of the volume of business at her store.
"Many prescriptions don't take long," she said. "But there is so much to think about at once that your mind can get muddled."
The board should also set a maximum 60-hour workweek for pharmacists and make breaks mandatory, said Angela Warnick, who did not identify her place of employment.
"Our workload is not safe," she said.
Warnick suggested increasing the state-mandated limit of one technician per pharmacist. That likely would provide the pharmacists with more support because it would allow stores to increase staff without paying a professional's salary.
Pharmacists earn from $40,000 to $60,000 annually.
Other state restrictions also need reviewing, speakers said. For example, a doctor can designate an "authorized agent" in his office to call in a prescription, but it must be taken by a pharmacist.
Why not allow pharmacists to also designate an agent to take the order? asked Allison Lucas. "You want to do more patient care, but you're also asked to do more nonpatient business," Lucas said.
Doctors ought to be required to write legibly, and a prescription should include the diagnosis so that the pharmacist will know how to counsel the patient, she told the board.
She said she made as many as five calls a day to determine what a doctor has written. And medications are used for multiple purposes, so a pharmacist doesn't know what to tell a patient unless the pharmacist knows the patient's problem.
"If we're supposed to be the last catch before the patient gets the medicine, we need more information," she said.
Written comments on pharmacy workplace issues will be accepted by the board through Sept. 13 at 6606 W. Broad St., Suite 400, Richmond 23230-1717. The Board of Pharmacy can be reached at (804)662-9911.
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