As a big fan of the original Twilight Zone series, one of my favorite episodes is “The Obsolete Man”. The plot revolves around a librarian named Romney Wordsworth being put on trial by the state. He is being “liquidated” due to the fact that books and literature have been eliminated, and therefore the state no longer considers his profession an asset to society. My friend Brian is a librarian, so naturally I have to give him hard time about this episode. With the advancement of technology and the internet, much of what you used to need at a library is now right at your fingertips. Google is the new Dewey Decimal System.
What is ironic about this story - and my smugness of making fun of librarians - is that this man on trial could very easily be a pharmacist. With the advancement of health information technology, much of the clinical aspects (allergy, dosage, drug interaction, and contraindication checks) could be done quickly and accurately by a computer. Couple that with accurate dispensing automation, and the thought of becoming obsolete becomes real and very frightening! Imagine a world where the patient goes to their personal physician for their healthcare. The physician electronically prescribes the medication and tells the patient they can pick up their prescription at any convenient store that has an “Rx Box”. At this “Rx Box” (similar to that ubiquitous RedBox vending machine), a 3D printer prints out the pills and dispenses them to the patient in one smooth interaction. No lines. No waiting. It’s just like getting a soda out of a vending machine. It will be touted as the newest innovation in cost effective healthcare. No worries about paying a pharmacist a six figure salary to dispense your drugs. Technology can do that.
Pretty scary, right??
So the real question is… Are we already becoming obsolete? What can we do to prevent it from happening? If we work together, I think we can make sure that our profession does not end up in its own Twilight Zone episode.
First, I believe we need to change the public’s perception of what pharmacists actually do. A recent article in the Topeka Capital Journal (http://cjonline.com/news/2014-07-07/pharmacists-say-collaboration-bill-will-improve-care) about the passage of our collaborative practice bill had a string of comments that sadly demonstrate some of the public’s negative perception of pharmacists in general. For example:
“No pharmacist is going to CHANGE the drug prescribed for me by my physician without my physician authorizing the change - I will insist that my doctors check the 'dispense only as written' EVERY time to avoid having inappropriate changes made in favor of profit margins.”
Or how about this comment: “My doctor went to college for many years plus doing an internship and a residency for two years. I trust him to prescribe my medication. I trust my pharmacist to tell me what to use if I have a sunburn. I do not think the pharmacist is trained to tell me what medication I should use for my IBS or high blood pressure.”
While these comments might only reflect a few, even that is too many. We cannot let those who misunderstand the role of the pharmacist to be the most vocal while we play defense. If we hide behind the scenes “just doing our job,” that misperception could swell and before you know it, an RxBox is doing our job and now we have become truly obsolete.
We need to take a proactive stance and invite the public to understand our critical role in the healthcare system. We must talk about what we do as clinical pharmacists. Invite legislators, your C-suite team, your health-systems board of directors, and even the media, for a tour of the pharmacy. Allow them to see firsthand how pharmacists improve patient outcomes, prevent medical errors, save costs, and provide a necessary ingredient to patient-centered care - the human touch. Remember: The time is NOW!
If we take action now, we can hope that the next new episode for the Twilight Zone doesn’t star an obsolete pharmacist by the name of Romney Fillmore.
And just for the record, I still believe I need a human librarian. It is important to be able to talk to someone face to face when it comes to researching your best and most credible resource for information. Just don’t tell my friend Brian I said that.