Being a pharmacist has always been an enormous source of pride and joy to me. As a community pharmacist, I get to help patients understand their medications, navigate their disease state, figure out the best possible over the counter medications for their day to day ailments, look out for possible drug interactions and essentially fill in counselling gaps left by other health providers. And, of course, who cannot succumb to the gratification of being able to consult your own friends and family so that are healthy and comfortable.
But, along with these fulfilments, there are many perils that a pharmacist faces as the most accessible health worker – the issue of abuse and violence from the very population that she serves. Abuse and violence against community pharmacist is a real issue that leaves a lot of pharmacist demotivated, burnt out, stressed, more prone to errors and develop unhealthy coping mechanisms including assuming a dispassionate or detached countenance.
Patients could get abusive because their medication was not in stock, or not enough to fill the whole order, they didn’t have refills on their prescriptions, insurance denials, long wait times or need to consult with the doctor before dispensing. With controlled substance prescriptions, it could escalate to threats or violence especially in cases where lengthy protocols are required prior to dispensing or when prescriptions cannot not be filled for legitimate issues including misuse and double doctoring.
Further, female pharmacists seem to face additional harassment. It ranges from the “usual” making passes, indecent to suggestive comments to pretty graphic or vulgar propositions. I will share some snippets:
At one time, our pharmacy phones did not have caller ID’s which made it easy for patients to harass you over the phone. We would have a male caller call in asking if we had a certain brand of condoms in stock. Then he would proceed to tell us that he was extra large and needed a really big one and ask if we had a fitting room and if you in particular would help him try it out.
Another male caller would call posing as the boyfriend/husband who had taken a Viagra and the intended partner did not come home and now he needed release and ask if you could tell him how to do it or could you hold while he did it. And he would start making suggestive noises. I still remember a newly licensed pharmacist who had recently been posted to our store and encountered this caller as well – she was completely thrown off balance. It affected her composure and her work.
Not only are such incidences offensive, demeaning and stressful but they are “lost time” which could have been spent on a genuine patient need/issue. With expanding pharmacist responsibilities, e.g. in providing immunizations, point of care testing, medication therapy management (MTM) reviews, coupled with continued budget cuts of support staff, these incidences become even more destructive as pharmacist have less time to recover.
As pharmacists also play a leadership role to support staff they work with, they can be very concerned on how they react to the situation with many normalizing such incidences in the hopes of not sounding judgmental, appearing in control of the situation or hoping not to alienate other patient who may be overhearing the conversation. This behavior is further internalized as there are no formal reporting guidelines, nor are they provided with on the job training which acknowledges these issues.
Therefore, to get the conversation started, I interviewed other pharmacists about their experiences and will be presenting it at the upcoming International Federation of Pharmacist World Congress. So, look out for our poster session on the 23rd and 24th of September. And, if you are a community pharmacist, share your thoughts with Health Law Institute’s global survey at http://bit.ly/2lHYmaR. It’s only through knowledge sharing and awareness raising that we can towards possible solutions and accountability measures to provide pharmacist with decent working conditions that they are entitled to.
About the Author
Soosmita Sinha holds a Pharmacy degree from Ahmadu Bello University, Zaria, Nigeria and a JD from University of Michigan, Ann Arbor, USA and is currently licensed as both a pharmacist and lawyer in Michigan, USA.