Well, it’s finally happened.
My neighborhood pharmacy, my primary pharmacy for decades, is closing next month. The pharmacists and pharmacy techs — who I know by name and who know me on sight — are scattering. I’m unlikely to see any of them again.
I’ve been dreading this possibility for years. You can’t write about pharmacy benefit managers (PBMs) and falling reimbursement rates as I do without worrying. But I kept hoping my pharmacy would survive, because the alternative was so awful.
You might be wondering what is so special about my particular pharmacy, especially if your medications arrive through the mail, or if your pharmacy is a big-box type that also sells vanilla-scented candles, mascara, and packages of orange-colored circus peanuts.
My pharmacy was special because of the people who worked there. They knew my name and remembered I am allergic to Biaxin (and asked if I was allergic to anything else, just to be sure). The pharmacists not only talked about medication dosages, but also offered practical tips, such as “Take this with a full meal. Not just with a yogurt.”
They kept me current on my vaccinations and gave me an updated printout after I took each one. When those vaccinations happened on weekends, they would also wink and say, “I can write you a note to get you out of work the rest of the day. It’s probably best to take it easy and watch a movie.”
In turn, I told them I was hearing more and more about PBMs’ stranglehold on which pharmacies can stock which medications, and the increasing physical and mental stressors on pharmacy professionals serving in understaffed locations. I worried about their physical safety and mental health, given the growing numbers of verbally and physically abusive customers, as well as increasing numbers of customers stealing from pharmacies.
My pharmacy saw me through two major surgeries, pneumonia, and more sinus and ear infections (my specialty) than I can count. I worried about them on the front lines during the COVID-19 pandemic, during flu outbreaks, and during resurgences of once-thought-defunct diseases such as measles.
Now I worry that my pharmacy friends, with their extraordinary professionalism and compassion, are becoming rarer and rarer. A 2018 study from the National Institutes of Health (NIH) confirmed that most of us patients interact with pharmacists more often than with any other health-care provider. And a 2020 NIH study confirmed that the relationships between patients and their health-care providers make a difference in patient knowledge and outcomes.
“Health literacy may improve by the communication and connection with a specific provider because patients better understand the care and/or medications that are being prescribed,” the 2020 study said. “Seeing the same provider helps patients develop a better relationship and make clinical decisions in a way that they prefer. Improving the patient–provider relationship can potentially change health outcomes positively for vulnerable patients.”
But now my friends are finding jobs in other cities’ pharmacies, if they choose to stay in the profession at all.
I worry about how many other neighborhood pharmacies are facing this same future, their face-to-face, personalized care replaced by medications and drug-interaction pamphlets tossed into the mail. I fear the consequences, especially for those living in rural areas, of patients having less and less face-to-face access to pharmacy professionals.
My pharmacy will probably become a Starbucks, and I worry that this future awaits many more neighborhood pharmacies and their patients.
