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Hospitals
(Patient’s View)

In the last few weeks I have spent time in a couple of hospitals. Once for me and a couple of times accompanying others who needed help understanding hospital-English words, phrases, and abbreviations. While there, I observed.

The main observation was that all of the professional staff and just about all of the nonprofessional staff knew and acted in a manner respecting the patient and making sure that all of the patient’s needs were met. Every issue was addressed. Every question was answered. All of the ancillary services (labs, EKGs, scans of one type or another) were easily scheduled and had as few problems as possible.

One of the primary reasons for things being so well managed is that the professional staff waltzed in with a computer mounted on a rolling platform. It gave them full access to the patient’s information and enabled real-time entries on the chart. Orders could be added, observations recorded, and any other important information entered in real time.

Hospital gowns: They still tie in the back. It is awkward for patients, physicians, and nurses. Patients are walking in the corridors holding their IV pole in one hand and the back of their gown with the other, hoping they are staying decent. I asked Google why gowns are still tied in the back and received answers that were far from satisfactory. (Most answers were of the “that’s the way we have always done it” variety.) Someone needs to design a better gown and have that design standardized so it gets used in every hospital.

Sleep interruptions: Just when the patient gets comfortable and starts getting a good night’s sleep; someone pops in to do something. Most of those somethings can be done at some other time (e.g., emptying the trash) or done automatically (e.g, blood pressure readings). I understand that a patient needs observation, but it still seems to be a bit too much at times.

Anxiety and Stress Relief for You and Me

Today’s news cycle is no longer cyclical. It is continuous. It goes on 24 hours a day, seven days a week, for 52 weeks a year. We used to get news once a day, from newspapers or evening TV. Now your “phone” or the radio is constantly streaming it to you.

That was creating stress for me. I strongly felt that I needed to know what was going on. However, I was getting into a sort of constantly worried, depressed state. I went to my bookshelves searching for something to occupy my mind more pleasantly.

I discovered Sir Arthur Conan Doyle. The Adventures of Sherlock Holmes is a book full of stress relief. Read one or two of those excellently crafted stories to put your mind in a better place. (Sometimes it takes three.) The stories are complicated and demand your concentration. They are also fun, set in the fantasy world of England more than a century ago.

Put a copy of The Adventures of Sherlock Holmes next to your comfy chair. Read it prn. It has helped to put my life back to normal. Get a copy from Amazon for $18.72. Or go to your local bookstore — if you still have one.

Amazon

Amazon now has a prescription delivery service. !! Code Orange: Anxiety Alert!!

(Have your copy of Sherlock Holmes ready to read after this one.)

Jeff Bezos recently bought (for $1 billion) a mail-order pharmacy service that has some interesting packaging systems that are a bit difficult to replicate in a retail pharmacy setting. We all know that Amazon knows how to get stuff to you accurately and quickly. Just ask my wife and our UPS driver, Tony, who stops here several times a week.

Jeff Bezos does not advertise the new service as an Amazon service. He uses the name of the mail-order pharmacy that he bought (PillPack).

Amazon has already rattled, shook up, and/or destroyed and replaced product sales and distribution in many industries. Now the whole world of pharmaceuticals, from the manufacturer shipping pallets, to patients swallowing their pills, will change.

I expect that soon PillPack will be negotiating drug prices to determine which products it will favor.

There is an interesting principle to understand. Whenever someone who knows what he or she is doing puts together an enterprise that others will not like (usually because their business will be harmed), the new enterprise will be squeaky clean, very legal, and very difficult to challenge in public or private venues.

I believe that we all have to accept that the prescription drug distribution system at the patient level will change soon and significantly. The only drugs that will be difficult to change will be Schedule II drugs and antibiotics that can’t wait until tomorrow. It will be interesting to see what happens to them. Maybe Amazon drones will deliver them to the patient’s doorstep.

The BIG Bothersome Side Effect

Sometimes side effects can be huge. Patients seldom understand the drugs they are taking. Pharmacists have been in a position to provide that understanding. It used to be  “You can’t have the pills until you talk to me.”  The loss of that essential communication will degrade healthcare. It is not replaced with multipage fine-print brochures that rapidly go into the wastebasket. It is not replaced with phone numbers to call “if you have any questions.” A face-to-face conversation is the ultimate communication tool.

The thing that has to happen is to have pharmacists in places where they can counsel the patient. I believe that a pharmacist needs to be one of the full-time people in the primary care setting. Pharmacists need to be in the physician’s office. There are places where this is being tried, developed, and made permanent. It is working.

All of the above is anxiety inducing. Grab your copy of Sherlock Holmes. Stave off the orange alert.  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.