George’s Corner

Blink and Everything Changes ––>



Blink and everything changes. I can only add to that: Blink twice and it has probably passed you by.

I am writing this on June 28. It has been an eventful week. Several times in this last week everything changed in the blink of an eye. The three biggies last week were the massacre in Charleston, the Supreme Court’s decision on Obamacare, and the Supreme Court’s decision on same-sex marriage.

I am not going to talk about the rightness or wrongness of the decisions or the causes of the massacre. I believe it is important for everyone to stop for a moment (several blinks) and think about the largeness, the impact, and the immediacy of each of these things and the many others that occur to us individually and collectively — in the blink of an eye.

What happened to me, and me only, last week is that my “smart” phone all of a sudden became very dumb. It could not find stuff. It could not take pictures. Email went bonkers — starting to work and then disappearing. It could not display my calendar. That calendar thing was really bad. I did not know what I was supposed to do that day, or any following day.

I became very upset. I had not realized how dependent I had become on that little pocket-everything computer.

So I took it to the place where I bought it. The store manager said he would try something that would take more than two hours. I gave it to him and went on some other errands (feeling naked and incomplete). I came back, and he said it hadn’t worked, and that I would have to: make a backup of the phone; erase everything on the phone; then copy the backup back onto the phone. My old computer experiences said no way. Copy bad stuff, then copy it back? Bad idea. But I had no alternative, so I did it — worrying all of the time about all of the data that phone had been collecting over the last few years.

It worked. My phone is now fully functional. No data or programs lost. What’s the point? In just a few blinks I went from copacetic to panic to copacetic. (However, I now do backups automatically every night.)

I believe the message that needs to be heeded is that no matter how big or small the happening is, we need to stop and thoughtfully implement changes. Knee jerk reactions are dangerous. How does all of the above pontificating relate to pharmacists, pharmacies, and computers? Some examples:

Track and trace: The feds are putting together a huge system to keep track of the location of every drug that is manufactured. It probably won’t work. It’s mandated. That blink is going to happen pretty soon. Now is the time to think about how to fix it.


Pharmacist provider status:
This will soon happen nationwide. The big problem is how to compensate pharmacists for patient care (instead of pill care). Important people in D.C. are working on this right now. The system needs to be crafted in such a way that pharmacists are appropriately compensated and without creating opportunities for fraud and/or excess use.


Drug prices:
Something has to happen to get some kind of control over drug prices. It is likely to be a big change. Maybe even allowing the federal government (the biggest purchaser of drugs) to bargain with the manufacturers. What will be the impact on pharmacies?


The CURES (Controlled Substances Utilization Review and Evaluation System) program:
This is California’s system for keeping track of users of controlled drugs and enabling pharmacists to access that data to check on new prescriptions to determine if the patient is an excessive user. Other states have similar programs. Hopefully, they are working better than ours. In any case, things that don’t work well are avoided by the users whenever possible.

I believe the message that needs to be heeded is that no matter how big or small the happening is, we need to stop and thoughtfully implement changes. Knee jerk reactions are dangerous.


Computer vulnerabilities:
Every week there is a major hacking of computers with significant factual data storage. I don’t know of any major pharmacy system data breaches. That’s probably because I missed the news (I blinked) that day or those who have had them are not talking about it.


Pharmacist employment:
There are now twice as many pharmacy schools as we had just a few years ago. Maybe there will be too many pharmacists. Maybe there will not be enough to fill the new roles and responsibilities. Maybe some of those new roles need to be filled by a different kind of pharmacist.


Gadgets galore:
The number and variety of health-related gadgets is already large and growing exponentially. How many are needed, functional, manageable, and desirable? Does everyone need to have his or her blood pressure checked every 30 minutes, like they do in the ICU? Some of these gadgets seem to be related to snake oil from the 1800s.


Education:
Everything from preschool through professional and Ph.D. education is also going to change. Probably a bit slower than other things, but faster than education usually changes. My pharmacy school is contemplating huge changes in its curriculum and requirements. I keep reminding myself that a professional school is supposed to prepare its graduates for a 40–50 year career. At the rate change is happening, that is quite an assignment. How can one hazard a guess about what a pharmacist will be doing in 10–20 years, much less 40–50?

Blink and everything changes. I can only add to that: Blink twice and it has probably passed you by. CT


George Pennebaker, Pharm.D., is a consultant and past president of the California Pharmacists Association. The author can be reached at george.pennebaker@sbcglobal.net; 916/501-6541; and PO Box 25, Esparto, CA 95627.