I have always been fascinated by pharmacology and its related disciplines. If I did not become a doctor, I believe that I would have chosen to be a housewife or a pharmacist. I know that there are no connections between those two careers (I count being a housewife as a career) but those are my next two favourite jobs.
It is a known fact that most doctors have penmanship that leaves a lot to be desired. I can say with a huge smile on my face that I do not belong to that faction of the fraternity as my handwriting is completely legible. Pharmacists seem to be gifted in the area of sleuthing as they have to decipher what is written on a prescription from a doctor. I have to admit that I bemusedly shake my head on several occasions when I read referral letters from colleagues, and I use that word ‘read’ loosely, as I have to determine the words by contextual clues, shape and length. In some cases, I just pick up the phone and make a call to the colleague because I simply cannot read the note in its entirety.
These men and women have such a pivotal role to play in the care of patients that goes far beyond reading a script, counting tablets and sharing out pills. As specialists in their own right, they must ensure they adhere to the guidelines as specified by their governing body and not toe the line or step over that line. I am sure many of us have been in pharmacies seeing many pharmacists having animated conversations with patients, and we have also been on the receiving end of those conversations.
As with any group of professionals, there are those who adhere to the rules of the profession and others, usually for pecuniary purposes, who choose to ignore said restrictions. A classic example is the issuance of antibiotics. This particular class of drugs is supposed to be available by prescription only, yet on a regular basis, persons are able to get their hands on ‘five hundreds’. I was most surprised when a patient proudly proclaimed that she recently used some ‘five hundreds’ to purge her system. Another dangerous class of drugs that is sometimes handed over the counter or rather ‘under the counter’ is the abortifacients. These are drugs which cause abortion. There are so many things that can and have gone wrong when these medications are just taken ‘willy-nilly’ and without medical supervision. That, however, is another discussion for another day.
I believe pharmacists stand as the gate-keepers between the doctors and the patients. They scan for errors on the prescription; they are able to see whether a particular drug, whether prescribed or over-the-counter, would interact with what a patient is currently using; they are able to ascertain whether patients are ‘doctor or pharmacist shopping’ which is very prevalent in our country; they are able to determine if a previous allergy to a drug was overlooked by the doctor or perhaps even the patient.
Pharmacists are counsellors. Many persons go to a pharmacist before they go to a doctor especially if they have a good relationship with that pharmacist. Based on what is discussed and held in the strictest of confidence, a remedy might be suggested or the patient is directed to another health care professional. Any good healthcare professional must know when a particular situation is beyond his or her level of expertise and when to refer.
Are pharmacists becoming a thing of the past? With technology advancing the way it is, there are some who believe that pharmacists are like bank-tellers and gas attendants. These persons featured very prominently in our society and were part of our cultural fabric. However, right before our eyes we the see the role of the bank-teller unravelling as more and more banking institutes are closing their doors or reducing the complement of tellers.
Perhaps there will be a time, in the not too distant future, when persons in Barbados will be able to call a number and have an automated voice instruct them on how to upload their prescriptions to a particular warehouse ‘manned’ by computers, and when and where to pick up their prescriptions.
Maybe doctors will find themselves in this conundrum as well since patients will be able to use the internet to diagnose themselves. They would then be advised on which particular medications would be best suited for their particular ailments and maladies. No need for personal interaction at all.
I believe one should not simply do a job for the money but for the enjoyment of that vocation. Please do not get me wrong because I know that money (in one form or another) is a necessity. In the Bible it says that if a man does not work, he should not eat. So that if the ideal occupation is not yet available, you should not sit at home and do nothing. What I am referring to is that particular activity you would still do if you were not being paid to do it.
I do not believe that we can dispense with the pharmacists, but what we need to do is to ensure that those who put patients and colleagues at risk by their actions or inactions, should be reprimanded. We must consider that in the case of healthcare professionals, serious errors, even though they may appear to some to be insignificant, could lead to loss of life.
So, we celebrate another profession integral to the healthcare system of our nation. This is certainly a group of persons I believe truly do not get the recognition they deserve for all the work that they do on a daily basis. After all, they have to listen to patients say things such as ‘I cannot take genetic medication’ (instead of generic) and continue working with a straight face!
(Rénee Boyce is a medical doctor, a wife, a mother and a Christian, who is committed to Barbados’ development. Email:firstname.lastname@example.org)