Diary of a Neighborhood Pharmacist, Entry #15

The company put in yet another fail-safe mechanism. Now we have to enter the bar code from the drug package into the computer to verify the product – this in addition to a visual identification. (The challenge with visual identification is those things that are wrapped. How can I see things like a suppository that's foil-wrapped unless I unwrap it? If I dispense one with the foil removed, do I get to explain that it was unwrapped for patient safety?)

I'm sure that at some level, this protects the company from lawsuits, but it doesn't do a thing for the pharmacist. The more checks they put into the system, the more we're pressured to rush through them, and the less likely we are to spend enough time on the relevant stuff, like checking the dose, and reviewing allergies and drug interactions. One really careful check of the product is a lot more useful than a dozen quick reviews that are simply blown through.

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The downside of generic dispensing is that it eliminates the final check on dispensing errors. I don't know if anybody ever did a cost-benefit analysis on that. I'm a strong advocate of generics myself, and don't have many nice things to say about the pricing policies of the brand name manufacturers, but at least in the old days, if we made a mistake, the patient could tell because the drugs looked different. Now they're so used to seeing a blue tablet one month, and a red one the next, that they never ask questions. Our job is to protect the patient from mistakes by the prescribers, but who is protecting the patient from our mistakes?

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