I would like to point out a few points that are overlooked in the report that aired on 20/20 regarding pharmacy errors. First of all, the pharmacists have the final say on prescriptions. They are the ones responsible for verifying that the work the technicians have done is correct. Now think of all the interruptions that other people have written about. Secondly, one of the primary interruptions comes from patients who believe that the Burger King mantra "have it your way" applies to pharmacy. This is just not true. This is your health. Patients should never pressure pharmacists to get their prescriptions filled in less than 15 minutes. It is unrealistic and adds another dimension of unnecessary stress to the already-strapped pharmacist. Thirdly, many states, do, in fact, require internal error reporting in the form of Quality Assurance programs, which are aimed at examining each and every error that occurs and using that to implement necessary changes in work flow so as to prevent prospetive errors. Yes, in this report, the cashiers are mis-informed as to what patients are actually signing when they pick up prescriptions. That can't be denied. But it is imperative to look at the entire picture before automatically writing off all community pharmacies. Pharmacists, now required to have Doctor of Pharmacy degrees at entry level, are a great resource for pharmacologic therapies, medication profile examination, and a wealth of other information about patient health from diet modifications for diabetic patients, to herbal and supplement counseling for patients interested in alternative medicines. Don't discount your pharmacist. Make him/her your friend. I promise you, you won't regret it.

The R.Ph. are "dictated" by non-professional "store-managers" to get Rx done in 10 minutes or less or "else".Interruptions are biggest problem.Working long hours hours without qualified help & no breaks other problem.Not getting "sick" time is othr problem.I have worked "sick" many times.Language barrier,"accent" all leads to "mis-fil".Being R.Ph. for more than 30 years, going through all changes( from manual typewiter to computers),and with more modernization & computerization ,the problems & stress level for R.Ph. are at the highest level.In fact, most computer programs for pharmacy chains are developed by " hight tech computer gurus" who are not Pharmacists. And most of the time even the brilliant R.Ph. & qualified techs. don't understand them,as there is never proper training for new technology.

20/20,

I am a pharmacist and was highly disgusted by your report. You need to do a story on the flip side of the coin. It seems that a lot of pharmacists are blaming the lack of breaks for errors. Fortunately, I work for a chain drug store that allows us a 30 minute lunch break. We actually shut down the pharmacy for this. You would not believe how many complaints we get about this. Apparently this is a big 'inconvenience' for our patients who are too impatient to wait. Mind you, they just came from a doctor's office that sometimes has a 2+ hour wait to be seen and the doctor's office closes for at least 1 hour for lunch. They can wait patiently there, but will not accept a half-hour break for the pharmacist.

I work a 10 hour shift, this is the only break I get! A bigger topic should be 'customer impatience' and/or 'customer ignorance' when it comes to pharmacy. You would not believe how many times I am on the phone with a doctor's office and a customer walks by and yells out out to me "where are the q-tips?" and other various store related questions. They stand there waiting for an answer, they do not care how busy I am or the fact they just interrupted me. The perception of retail pharmacy it that we just dump the pills from the big bottle and put them in a little bottle. This perception needs to be changed. We are not fast-food pharmacy (even though some retail stores have drive-thurs) America expects everything now, now, now. Errors happen when we are rushed. Pharmacists have a very important role.

I would like to address the 22% error rate that the investigators incurred. First, the 'error' of ringing up aspirin along with purchasing Coumadin is flawed. A lot of times people pick up medication for others. I could see an error occurring if the individual actually spoke with the pharmacist and specifically asked if they can take aspirin along with coumadin and the pharmacist saying that is ok to take. However, that would not provide shocking statistics for your investigation. The fact is, pharmacists do not have time to ring up medications.

I am writing in response to the news segment that aired regarding pharmacy errors. First of all, I am a pharmacist that no longer practices as a pharmacist due to the very issues that others have written in about. As a pharmacist, you hold yourself to a very high standard to care for your patients and be there for them. However, the corporation you work for dictates the environment that you work in and unfortunately for both pharmacists and patients, they are motivated by profit and that comes from high volume script fills. Based on this fact, the corporation works pharmacist for long hours with no breaks, usually standing on your feet all day, and does not promote counseling of patients as it does take time to counsel properly.

Pharmacists are at three times the risk of the average population to have heart attacks and commit suicide. I went to pharmacy school because I wanted to care for my community but upon graduation I realized that it was not possible to give the high level of care that patients deserve so I left the full time practice of pharmacy in 2000 and never looked back. I now work as a pharmaceutical sales rep where my expertise is valued. If the government and patients themselves don't care about their health and wants their prescriptions rushed and are always looking for the "cheapest" place to get their prescrition then you will continue to reinforce to the large chain drug stores that this is the best business model....and yes continue to put yourself and your family at risk of serious injury and even death from misfilled prescription errors.

If you want better service, then pay the extra few dollars and go to an independently owned pharmacy where you will get personalized service, a pharmacist who knows you and your family and who really cares about your well being. Support the independents!!!

Dele Obaitan, R.Ph., MBA

As a registered Pharmacist for 25 years, I felt your news story was fairly accurate. However, Walgreen seemed to to singled out. I do not work for Walgreen, but I feel they are no better or worse than any other Pharmacy. Mail order is even worse, at least if there are questions concerning the medication a retail store has immediate access to a pharmacist to clear up any confusion. Sure, you can call the mail order pharmacy, but be very patient. Pharmacists are not in control of their professional practice. How can a person work 8 to 15 hour shifts without a scheduled break or lunch, answer the phone, manage a drive thru, ring register, counsel patients, figure out an insurance card that is incomplete while talking to a helpdesk in a third world country, have unqualified techs helping you and not make errors.

I want to know where the State Board of Pharmacy is? Could it be, pharmacists employed by CVS, Rite Aid, Walgreen and other chains that are members of the Stae Board of Pharmacy look out for corporate affairs. In most states they will not initiate laws limiting Pharmacist /tech ratio, manditory tech liscences, drive thru pharmacy, manditory counseling ext. In My State the Board will not handle issues involving employee/employer relations. Only when a law is broken or consumer complaint will they intervene. I can have 25 sixteen year old high school drop outs working under one pharmacist and fill 1500 pescriptions and still be legal in this state. Then if there is a law requiring manditory counseling for every new prescriptions is required, how does the UPS/FedEx/mailman counsel on mail order prescriptions.

Pharmacy is big bussines. How can CVS tender 27 Billion dollars for a mail order/third party claims administrater and cut help in their Pharmacy's.

I am a pharmacist at a large grocery chain pharmacy. I try to be very conscientious about performing my duties and avoiding errors. I think it is extremely important for patients (customers) to be aware of several things. #1: if this is a new prescription, do not decline counseling. It always annoys me when problems occur on prescriptions, when they may have been caught by the pharmacist at counseling, but the patient was in too big of a hurry to wait for cousnel. I frequently hear nurses say, "I don't need counseling, I'm a nurse." No offense to nurses, but there are things the pharmacists can tell even other health professionals about the correct usage of prescriptions that they may be unaware. The patient should always try to be aware of why the drug is prescribed.

We don't always have that information and have to make assumptions. #2: if this is a refill, look at the drug in the vial and if it looks different, ask the pharmacist why.
#3: if you send someone else in to buy your prescription, make sure they know the names of the drugs they are being sent for.

Many of the errors our pharmacy have experienced is when the wrong person's medication is sold to a patient. And sometimes, the person takes that medication without noticing that the name on the prescription label is not their own. So, for God's sake, read the label and the stickers on the vial and the information that comes with the prescription. It might just save your life.

I would like to address the 20/20 story with the Coumadin error. The patient received 10 mg Coumadin when it should have been for 1 mg. One of the reasons for medication errors is the use of dangerous abbreviation and leading/trailing zeros along with poor doctor's hand writing. I would like to see the actual prescription on that one. Maybe the doctor wrote Coumadin 1.0 mg, thus, appearing as 10 mg.

I am a licensed pharmacy technician for the state of California. I have been so since 1999. I am now a pharmacy technician program director for a vocational school. I think the story that aired on Friday was extremely biased.

In California a ptech must attend 720 hours of an accredited school, have a high school diploma, be over the age of 18, and submit to a background and drug test prior to employment prior to even being able to handle medication.

Dispensing medication is an extremely important job that must be done with a precise knowledge and practice. I take my professional seriously and it was unfair and inadequate presentation of the pharmacy technician.

"Chain drugstores are spending millions of dollars on new technology that will prevent medication errors...." The bottom line is that nothing will replace properly trained personnel. I have been an intern at a large chain pharmacy for 4 years, and if you don't have knowledge of the drugs that you are working with on a daily basis, no amount of technology will save you. Many techinicians are young because the starting salary - usually around $8.50 per hour (Taco Bell starts over $9.00 per hour) is more appealing to a high school student than to an older person with perhaps a mortgage, car payment, and family to support. Pharmacy technicians are improperly trained, and pharmacists face the task of catching and correcting multiple errors per day. It is imperative that a standard program be implemented for education of pharmacy technicians, such as a required 2-year associates degree.

The resounding conclusion is that the profession of pharmacy is not yet respected as part of a patient's overall healthcare. Chain pharmacies and patients expect too much of their pharmacists and pharmacy technicians. We constantly multi-task, and are over-worked. This is a bad recipe for a medication error to occur. It could happen to anyone at anytime. It is important for patients to be just that - patient! Don't expect things done yesterday, and understand that we are working to improve your health. If you want to be sure that your prescription is filled properly and that you receive all of the important accompanying information and counseling, just give us adequate time to do our job properly.

20/20,
I have been working in this profession for 12 years. I started out as a pharmacy cashier/technician and then as an pharmacy intern until I completed pharmacy school with a Doctorate in Pharmacy. Yes, the hours can be grueling. Thankfully, I work for Walgreens, who does not have long hours. Most shifts are 8 hours and we do get lunch breaks. I have never worked for any other retailer in the pharmacy business. So I don't have any comparisons to go upon other than heresay, which is usually not good.

I was extremely upset at the so-called "investigative reporting" that was done about errors in the pharmacy. Yes, errors are made, that is to be human. But errors are made by everyone, from doctors,nurses, technicians, pharmacists and even patients themselves.

I think it's high time that patient take responsibility for themselves. They need to ask their doctors the names of their medication they will be getting and what they are used for before coming to the pharmacy. This is your health we're talking about. If patients want to don't take care of themselves, then who does the blame ultimately fall on?

You recently did an investigation of the major retail pharmacies and mistakes. You focused on Pharmacy technicians and how poorly educated they are at certain retailers. I work for a Midwest chain pharmacy and I have a national certification AKA CPhT. There is a national test for both retail and hospital techs. It is the National Board of Pharmacy Technicians. I think you should do a story on how properly trained techs can actually help the RPh and help catch mistakes. We have a "triple check system" for RX's. There is a lot of info we could give you. Pharmacy techs are the biggest help for an RPh. I have been one for 14 years. I also am a college graduate, not a 16 yr. old high school student. Also the laws vary from state to state on who can work behind that counter. That is what the NPTB is trying to do....maintain a standard of quality in the pharmacy! Wow, there is so much more to talk about on the subject, especially the catching of errors and being a patient advocate.
Please consider this subject for a future story.

I see the pharmacists are upset and complain of long hours no breaks etc,please there is lots of jobs allot more stressful then putting a pill in a bottle,try hanging off a side of a building with foreman yell hurry,or landing a plane or hundreds of planes. And of not having breaks or lunch,that is on the worker,speak up. one mistake was too much in that kids life,it was very good story,if your gonna give excuses maybe go to another job to fit your level of stress.

I am a patient that takes 12 different meds a day. I have never encountered a mistake at any pharmacy that has provided important medications such as Prograft, Cellcept and prednisone. Immuno suppressants vital to retain a transplanted kidney. The bottom line is that the patient is responsible for their health. Take notes of your doctors orders on how and when to take your medication. A large part of prolonged health problems is the misconception that your doctor is 100% responsible for your health. You are in charge. My advice. Always follow your doctors orders.

As a Nurse I can empathize with the Pharmacists. Having your environment controlled by a corporate body puts money ahead of people. Our liscences serve as a convienent buffer for the corporation so that when mistakes happen, the corporate body can conviently fry the liscensed provider and move on.
I trust my unit pharmacist and the advice he gives. He helps me keep my patients safe and ensures they have accurate drug information.
Until we have more political will than capital, I don't see the problem going away in the near future.

I was extremely disgusted by your misleading report on 20/20 and have been fielding angry questions from our customers ever since. First of all, I am a nationally certified technician but I started out in this business as a "high-school kid". All pharmacies that I have worked for run this way and have run with their help for as long as I can remember. Remember that these "kids" are where a majority of new pharmacists come from. We need to stop blaming technicians and realize the truth. You should have made it clear that although we physically fill the prescription, no prescription leaves the pharmacy without first being thoroughly checked by a registered pharmacist for errors. Any mistakes then become their responsibility. Without these "kids" pharmacies would not be able to function. As a news reporting authority, I am disgusted by your disregard for the truth and will no longer go to you for information. Telling half of the truth is not reporting the news. You are no more than shock jocks trying to create ratings by scaring people. As pharmacists and technicians, we are not out to kill our patients. You should do a report on how many lives we have saved by catching errors by doctors. These happen 10 times more often than miss-fills.

I work for a retail pharmacy as a technician and was disgusted that there are actually states out there that allow high school students to fill prescriptions who are not certified. If myself I am unsure even a little bit on how the doctor wrote it or what exactly the medicine is I go directly to the pharmacist to verify. I know alot of technicians who do not do this and i also know alot of pharmacists who seem to be bugged by you when you constatly ask, as if you are unable to do your job. Myself, I ask all the time and I feel that my pharmacists get annoyed with me, but I rather be safe than sorry. In the state of California you may not ask if they have any questions for the pharmacist, you are to just simply say, "I see this is a new prescription I will hav the pharmacist come over and go over this with you". If they decline then we have them sign in the appropriate area. CVS is really making alot of changes with their system and training is extensive. I am still going through training to be certified as technician in CVS pharmacy and I am PTCB certified.
I agree that there are unrealistic expectations from employers and the customers. If it is in the middle of the day they need to be more realistic and give half an hour min. I dont have to many problems with patients wanting thier medicines now, but more of a problem with co workers complaining all the time and all the negative attitude in the back. It can be stressful at times and I feel that everyone needs to just relax and stop worrying about time.
I do believe that the registers should help out at the check out when it comes to interactions. I myself am not aware of all the interactions with OTC's and prescriptions and I know that there are alot of "clerks" or cashiers that are at the pick up area. If we were able to scan their prescriptions and their items at the register and it say something about that interaction, then we will be able to fight that battle there. However that is just to much money to invest in something that no one wants to take the time to do. This is an eye opener that was well over due.

As a pharmacist of 30 years:
What you should do is an investigation of who is actually doing the prescribing in the doctors' offices. I think it will be more shocking than the story on phramacy

1. PATIENTS need to understand that pharmacy drive through windows and pharmacy counters are not fast-food equivalents.

2. Correct interpretation by the NEWS MEDIA about the flow of a prescription through a pharmacy. The pharmacist has the ultimate verification of the prescription. Many chain computer systems require that the pharmacist. not tech, verify the prescription twice before it is ready for sale.
If there are pharmacy chains out there that do not do this, then they need to upgrade their software and workflow.

3. Pharmacy TECHNICIANS do alot of work for little pay. Their pay should at least increase so that pharmacies can atrract more mature and teachable people.

Brian,

Your report states that customers are waving their legal right to counsultation when signing form picking up prescription. Technically, this is only true for medicare/medicaid patients, not the general public. You need to state the law right if you are going to advise the general public. The adoption on the forms for the language is there to cover medicare/medicaid customers when also signing for prescription pickup.

Things are busy in the pharmacy, no doubt, so signature forms have pretty much universally adopted doing both on one form rather than keeping two logs for that. If you check on this you will find that this is exactly what is going on. The errors, on the other hand, involve what is actually going on with patients whom the law is designed for, the medicare customers. Your investigators need to check on that error. Also, if people wish, in most cases the forms they sign specifically state what they are signing unless they are signing a log book. In the case of a log book they can not sign away legal rights to counsultation, so in that case they are just signing to pick up, and many stores do just that.

In your report it was clear that your video was taken of just a log book being signed while you reported on signing of forms. You need to report on what is actually happening, and not get confused about the complexities that you are not fully understanding. In this case a blinket statement like you made seems to be designed to upset people and make the issues appear worse. You really are over reporting this error.

Mike
PharmD Intern

I have worked as a pharmacy technician for 9 years and I am a valuable member of the staff at our pharmacy. The problem does not lie with the technicians filling prescriptions as the report suggests. The main problem is the large chain pharmacies pressuring speedy service. Your health care is not something to be handled swiftly.

To patients, please give your pharmacy more time to fill your prescription accurately and efficiently.