Decoupling from the dispensary: boldly pursuing the path of service-based pharmacy

Learn more on this topic from Ashwin Juneja at Pharmacy U Vancouver on October 22, 2022

Over the past few years, one of my guilty pleasures has been turning to YouTube to watch street food tours throughout the world. I suppose after a few years of lockdown, living vicariously through the taste buds of others is the closest thing I have been able to get to an exotic adventure.

The thing that always stands out is the way the street food vendors prepare the orders as clients line up.

There is so much precision in the way they handle the tools of their trade, whether it be a wok, ladle, spatula, skewer, grill or some sort of combination of these things. There is not a single wasted movement as they pile high a stack of sumptuous fried noodles high onto a plate, much to the mouth-watering delight of the onlookers.

Of course, we all know that the phenomenon I am describing is muscle memory. But it’s far easier to recognize in others than in ourselves. And depending on the context, it may not always be as positive as I may have made it seem.

You see, as a profession, we collectively lean into our muscle memory every day. We find our spot at the end of the dispensary assembly line, and we check and sign (and intervene where appropriate). Of course, we counsel and dabble in other services, but these all feed into the drug distribution juggernaut. We provide so many services for free, or for inadequate direct or indirect remuneration because we are simply trying to feed more volume into script counts.

Yet dispensing fees remain static. Drug price deflation is hacking away at mark-ups, which were never meant to be a profit centre in the first place. Our business model is decaying slowly and insidiously.

So insidiously, in fact, that our muscle memory keeps us moving along with robotic-like consistency.

Wait a minute!

If we’re basically pseudo-bots, why aren’t we just using real robots to manage most of the drug distribution in the first place?

Actually, studies have shown that robots do a better job anyways. As a matter of fact, so do registered pharmacy technicians when it comes to accuracy in performing technical verifications of prescriptions. Silly muscle memory is making us do things that other sentient and (so far) non-sentient beings are better at.

Now let’s reframe this slightly. What if we viewed dispensing robots and RPhTs as a launching pad for a cognitive-service-based future for our profession?

By freeing up our time, we can do more of what we do a better job at. You know, being the pharmacotherapy experts within the healthcare system. This is our core competency. Just like dentists and oral health, or optometrists and eye health. Doing work that is outside of where we provide the most value equates to a misallocation of resources or an inefficient system. Many of you will recognize this as an opportunity cost.

Cognitive-services-based practice needs to be the norm. It needs to become synonymous with the profession of pharmacy itself. But developing new muscle memory can only develop if we start getting our reps in.

Interested in learning more? Learn more from Ashwin Juneja at Pharmacy U Vancouver on October 22, 2022

Ashwin Juneja graduated from the University of Toronto in 2007 with his bachelor's degree in pharmacy. Since then, he has completed an MBA through Queen's University and a PharmD through the University of Toronto. He has spent much of his time managing community pharmacies, while simultaneously pushing for deeper pharmacist involvement in patient care. He has also been a peer reviewer with the Pharmacist's Letter Canada and spent time helping lead the Champlain Regional Pharmacist Committee in the Ottawa region. He became a published author for the first time in 2022, with original work in travel health pharmacy services. He has most recently been working to help champion innovative approaches within pharmacy, with a particular focus on cognitive services, disruption of conventional dispensary operations and greater uptake of emerging technologies, including pharmacogenetics.