The People's Perspective on Medicine

There’s an Easy Trick to Talk to the Pharmacist

Do you take time to talk to the pharmacist or do you grab and go? Most people skedaddle, bag in hand. BIG mistake. Errors are common. Here's a better idea.

There was a time when most of the pharmacies in America were owned and operated by a pharmacist. They were friendly gathering places. The pharmacist knew your name and probably everyone in your family. When I was growing up in New Hope, PA, the local pharmacy on Main Street was run by Benny (short for Benjamin) Sidon. Some people called him doc. In addition to filling prescriptions he also created medications. My mother loved his specially formulated cough remedy and diarrhea medicine. If you had questions, Benny was happy to hand you the bag of pills and provide answers. Nowadays, if you want to talk to the pharmacist it requires some effort and patience.

Where Have All the Pharmacists Gone?

There are still some independent (aka community) pharmacies out there. At last count about 35% of the 67,000 pharmacies in the U.S. are community drugstores. The number keeps shrinking.

Dr. Adam Fein is CEO of Drug Channels Institute. He offered the following insights on the future of the independent pharmacy (Drug Channels, Jan. 15, 2019):

“…we estimate that in 2017, the average pharmacy owner’s salary fell to a level comparable to that of an employed pharmacist. Owning a pharmacy, with all of its hassles and additional obligations, now brings the same reward as being an employee. I wonder how many owners will conclude that it’s barely worth the risk and effort.

“The pharmacy consolidation endgame is getting closer. The next time you see a pharmacy owner, offer your condolences.”

The Chains Are Taking Over:

The top five chains are:

  1. CVS with over 9,000 stores and 24% of the market
  2. Walgreens with nearly 8,000 stores and 16% of the market
  3. Walmart, with over 4,000 pharmacies and 5% of the market
  4. Rite Aid with over 4,000 stores and 4% of the market
  5. Kroger with nearly 2,000 pharmacies and 3.2% of the market

Harder to Talk to the Pharmacist:

Chains make money because they deal in volume. That means efficiently filling as many prescriptions as possible. Some busy stores report more than 1,000 prescriptions go out the door on a busy Monday.

The pharmacist relies on “techs” to help fill prescriptions and work the counter. They get paid a pittance compared to the pharmacist and are not trained to answer your drug questions. It is a rarity to actually get your medicine directly from a pharmacist and have a calm opportunity to talk with her.

One disenchanted pharmacist we know likens the dispensing process to flipping burgers. The drive-through window just adds to that impression.

Many pharmacists tell us they don’t have time to go to the bathroom or take a decent lunch break. It’s non-stop controlled chaos. And patients quickly get the idea that the pharmacist is super busy.

We have observed that most customers grab and go when it comes to their prescription medicine. They either don’t want to bother the pharmacist or they don’t want to wait for a break in the action. 

Why You SHOULD Talk to the Pharmacist:

Every medicine, Rx or OTC, has the potential to cause side effects. Would you know what symptoms to look out for if the acetaminophen you take for pain and/or the flu were damaging your liver? What about the metformin you take for diabetes? Do you know the signs of lactic acidosis? If not, you could end up in big trouble. Your pharmacist can tell you!

As important as learning about the side effects of your medicine you need to know precisely how to take your pills. Should they be swallowed with food or on an empty stomach? It matters. And what exactly is an empty stomach? Is that 20 minutes or two hours before a meal.

Finally, it is absolutely essential to ask the pharmacist to check for drug interactions. Many medications are incompatible with other compounds. That includes OTC remedies, vitamins and dietary supplements.

A Reader Has a Trick to Talk to the Pharmacist:

Q. You have written about using the pharmacist as an information resource. Unfortunately, in a lot of stores it is difficult to interact with the pharmacist face-to-face. Mostly, the person on the other side of the counter is a clerk or pharmacy technician.

Here is my solution: use your phone. I have done this several times and have always been able to speak with the pharmacist and get a response to my question. I may have to wait a few minutes, but it is worth my while.

A. We are glad to hear you take advantage of your pharmacist’s knowledge. Far too many people grab their prescriptions and speed off without taking the time to ask any questions. Pharmacists are well-equipped to answer questions about side effects, drug interactions and how to take your medicine.

Most pharmacies now have a space set aside for consultation, so people don’t have to ask embarrassing questions in front of other customers. Your suggestion is another good option.

The only downside to calling on the phone is the likelihood that you will be put on hold for 5, 10 or 15 minutes. Of course you will likely have to wait in the store as well. Pharmacists are way too busy these days to drop everything and consult with a patient at a moment’s notice. 

We do long for the days when pharmacists had time to chat with customers as if they were old friends. Nowadays, if you can get past the pharmacy tech and grab a few quality moments to talk with the pharmacist, whether in the store or by phone, consider yourself fortunate. 

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About the Author
Joe Graedon is a pharmacologist who has dedicated his career to making drug information understandable to consumers. His best-selling book, The People’s Pharmacy, was published in 1976 and led to a syndicated newspaper column, syndicated public radio show and web site. In 2006, Long Island University awarded him an honorary doctorate as “one of the country's leading drug experts for the consumer.” .
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I use my neighborhood Walmart pharmacy. My pharmacist knows my name and always says “Hi Carole, how are you today, nice to see you.” I NEVER leave the counter without opening my Meds and inspecting them. And remember, just because your med looks a different color or size, does not necessarily mean it’s the same med you are taking and just from a different manufacturer. I never let my Dr. e-mail a new med to my pharmacy. I ask my Dr. to write me a prescription and then come home and look up the med in my PC. That way I don’t pay the price only to decide that particular med has too many dangerous side effects. I return to my Dr., and we discuss what other drug would be better to take. Sorry folks but in this day and age, one has to be their own Dr.

I love my Rite-Aide Pharmacy. It is small and out of the way and there are always two pharmacists on duty, who are friendly and ready to answer questions. The support staff is also kind and friendly. This pharmacy doesn’t have a drive-thru, and I like that. They offer the best prices possible on medications and the other store products. There is a Consultation and Drop-off area separate from where you pick up your meds and I really appreciate that.
In the past, I’ve filled my scripts at CVS, Walgreens, Publix, and two other Rite-Aide Pharmacies and none have the set-up that this Rite-Aide Pharmacy does. The pharmacists are always relaxed and have time to answer questions in a friendly way. I feel so fortunate to have Miller’s Pharmacy in Vero Beach, Florida.

We must be lucky to live in “Podunk.” CVS is the only pharmacy in our nearest town, 11 miles away, & people grumble about their prices being much higher than Walmart’s, another 15 miles farther. But when I pick up a new med, I am asked if I wish to speak to a pharmacist, & any other time I want to, all I have to do is ask, & he will finish what he is doing & come over & give me his undivided attention.

Both Walmart and Walgreens in my area require that the pharmacist hand you your medication after someone has retrieved it and taken the payment. They always ask if anything is a new drug and if I have any questions. At times they volunteer information about the drug too.

In a recent Consumer Reports survey, people expressed extreme satisfaction with privately owned pharmacies, compared to chain stores. Places like Rite Aid, Walgreens, and CVS were at the bottom of the list in customer satisfaction.

As Molly from Myrtle Beach commented, our local big chain pharmacy always sends us to the pharmacist when we get a new prescription filled. What a blessing. And I have a friend who is the pharmacist at the other chain where I have most of my prescriptions filled. She will take the time to check things out. That chain does not automatically send you to a pharmacist. If my friend retires or changes job locations, I’m out of there.

Now I feel really lucky to buy from a good pharmacy (in a large grocery store) where the pharmacist promptly comes to the separate window to help the customer. When I complained that the eye drops I need were in a round bottle that hurt my arthritic fingers to use, they found a manufacturer that uses an oval bottle and now, with a note in my file, they dispense that bottle style without fail. They, or a tech, even comes from behind the counter to find an OTC I’ve been unable to find. I urge people to remember that you can always exercise your power (in a loud voice) to take your family’s business (even if you’re only a family of one) somewhere else. Then, if they don’t satisfy, do it.

I make it a point to know my two pharmacists at the same location by first name and they know me as well. Even though I might get an Rx a bit cheaper elsewhere, my first choice is “my” pharmacy, and I may even discuss the cheaper option with them. Most of the time they are ahead of the game and have already recognized that they can provide a less expensive alternative to my insurance. I trust these people very much and they are never too busy to talk to me. Loyalty, respect, and polite conversation will establish the trusted relationship needed for prescription drug service.

Usually pharmacy visits have become a huge stress factor. Disabled with 17 broken, collapsed, shifted, compressed vertebra osteoporosis and RA I am always in pain and stressed going to pharmacy.

BUT GUESS WHAT my CVS pharmacist (1 of them) looked out for me. He said ‘no you cant take that antibiotic you have a severe aneurysm and Afib.’

He called doc and changed med. I went to the doctor and he said ‘all humbug with the hype about fluoroquinolone antibiotics and Afib or aneurysms. HE DOESN’T help me. BUT THE PHARMACIST DID. Most other pharmacists say..go ask your doc. Sigh. Docs have no time.

I love pharmacists who still care.

As an RN of many years I have taught patients to ALWAYS make it a point to speak directly to the pharmacist when starting a new medication and to always question whether there are any side effects or interactions with current medications BEFORE starting your medication. Always look at your new refill bottle to see if the pill/capsule looks different from the last refill and, if so, ask why.
Patient sensitivities to medications are very common. Know when to call your physician about whether you should continue the medication, weighing the benefits vs the side effects.

Insurance companies bear much of the blame. I would love to deal with one or two of the independent pharmacies in my town, however they are not on the “preferred pharmacy” or “approved pharmacy” list, and it would cost me way too much out-of-pocket to use them. I particularly hate the fact that Aetna is in the process of being bought by CVS, and my choices are even more limited!

My brother-in-law was a Pharmacist who owned his own drugstore in Bayside Long Island. I remember him telling me if the RX says take 4 X a day, it means take every 6 hours round the clock. That means you have to set your alarm to wake you up for that dose when you are sleeping. The bacteria do not lie dormant when you are sleeping.

Thankfully I seldom visit the pharmacy at my big chain store. The last time I did I was required to talk with the pharmacist as I had never filled that prescription there before. It ended up that the cream prescribed was an NSAID, which I had told my doctor I don’t take. My doctor had said it was no problem because it was only applied to the skin. I was dubious but filled it anyway. The first thing the pharmacist said was “You know this is an NSAID and goes right into your system!” I shouldn’t have even purchased it but was so flabbergasted that I did, although I never used it. Glad the pharmacist was well informed!

Before I can check out my prescription at my big chain grocery store/pharmacy, I have to check a box on a screen asking whether or not I want to speak to the pharmacist. Since there has been no change in my medication for a long time, I haven’t had any questions, so I don’t know what would happen if I were to check “yes.” I assume I’d have to wait awhile.

We always use our local big chain pharmacy for our prescriptions. You might think that it would be very impersonal, but I have found the opposite to be true. While another employee fetches my phoned-in order, she always asks me to wait to talk with the pharmacist to be certain that I understand all the dosing, interactions, etc. They also give flu shots and other prescribed vaccinations and do a creditable job, with a small wait time. My pharmacist knows me and my husband and usually waves from behind the glass when he sees me come in. We have had several good conversations regarding various treatments, drug costs, etc.

Sad but true. I started practicing pharmacy in 1963, and the personal relationships with patients were the highlight of my day. What a change from then to now. Pharmacists are just hired guns; the number of fills is the game. You work for a big corporation where the bottom line is really what matters regardless of what is said. Gone are the days when I would see my dad fill an Rx for someone and let them pay with a catfish or some collard greens. The changing face of America. Would I go into the profession today? Probably not.

As a 3rd generation pharmacist, I have worked in the family pharmacy, then in a chain.

Like it or not, busy or not, we are required to do consultations on every prescription, by law. Unfortunately, that requirement is fulfilled by the clerk at the register asking “ Do you have any questions for the pharmacist?”. I have rarely seen anyone say “ yes”. Sometimes the clerk yells your question to the back to the area where prescriptions are being filled.

Go when the pharmacy is not busy.

Do you know of any web sites that provide correct information on drugs as to side affects and interaction with other drugs. I go to a Walgreens and it is almost impossible to talk to a pharmacist. Sometimes they even have gag orders on them.

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