The lines and frustration at Massachusetts pharmacies are growing for some patients.
After years of pharmacies slashing hours, shuttering stories and cutting staff, patients are starting to get impacted.
Viewers told 7 Investigates that their pharmacies have randomly been closed, prescriptions have taken weeks to get filled and vaccination appointments were suddenly canceled.
“It’s not fair to the patients certainly and it’s not fair to the pharmacist,” said Joanne Doyle, the secretary of the Massachusetts Pharmacy Association.
Doyle has been a pharmacist for over 25 years. She said she’s heard of the challenges patients are facing. She isn’t surprised because the long wait times are a symptom of a much larger problem that has been mounting in the industry for years.
“Twenty years ago we would have had more staffing for certain areas and especially since COVID-19, the staffing has really dropped off and made it really challenging for a lot of pharmacists,” Doyle said.
The decrease in staff came at the same time many pharmacies reduced hours and locations, leaving more work for less staff.
“Hours were dwindling. More work was being handed out and it got very stressful to the point where I ended up having a nervous breakdown at work,” confessed Melissa Gordon, a Massachusetts pharmacy technician.
After working 16 years in retail pharmacy, Gordon left in October 2020 due to the increasing demands and concerns for patient safety.
“You have a bunch of brand new people and a bunch of really tired, broken people and it’s a recipe for disaster,” she said.
Gordon said she would catch mistakes in patients’ prescriptions a decade ago, but during the last few years of working in retail pharmacy the mistakes started increasing.
“We had the time and the care and the attention to do our jobs properly. Now it’s just I hope I don’t kill anyone today and that’s just absolutely terrifying,” Gordon said.
She said the increased demands paired with a diminishing workforce meant fewer opportunities to catch errors.
“These little things that are human error are now multiple because you have one person doing everything,” she said.
7 Investigates found multiple pharmacies were reprimanded by the Massachusetts Board of Registration in Pharmacy. The Board found multiple issues at sites that could have had a big impact. Many of the issues related to pharmacy technicians working and administering vaccines without an active license. The Board also found pharmacies were randomly closed and “failed to provide adequate continuity of care” and even processed a prescription wrong.
Gordon is now a pharmacy technician with a hospital system and said she believes the conditions in the retail pharmacy realm have only gotten worse since she left in 2020.
“It’s not just Massachusetts, it’s not just New England; it’s everywhere,” Gordon said.
Doyle agreed and said pharmacists nationwide are “at their breaking point.”
More than 90% of pharmacists surveyed in California stated that they did not believe their staffing was appropriate to ensure adequate patient care, according to a 2021 survey from the California Board of Pharmacy.
The industry-wide problems have been in the national spotlight recently as retail pharmacists associated with major drugstore chains have walked out in protest.
“They are afraid they are hurting the patients. They are afraid they can’t do their jobs. They are trying to save lives, they are trying to better lives and the strikes are about that,” Gordon said.
Massachusetts has lost 60 pharmacies in the last decade, according to data from the Massachusetts Department of Health and Human Services.
“It’s not surprising why it’s occurring. It’s occurring because of under reimbursements to pharmacies. You can’t continue to stay in business if you are losing money when you dispense prescriptions to patients,” said Seth Freedman, the pharmacy manager at Gary Drug in Beacon Hill.
Improving support and resources for pharmacies is a multifaceted issue, but both Freedman and Doyle point to the impact of pharmacy benefit managers (PBM). PBMs work between pharmacies, drug manufacturers and insurance agencies to set reimbursement rates for pharmacies. These rates hit independent pharmacies particularly hard.
Nationwide, 41% of independent community pharmacies said their business’ financial health was poor or somewhat poor in a 2021 National Community Pharmacist Association survey.
Freedman said state lawmakers could take action to help pharmacies.
“If the state of Massachusetts would enact certain bills then I think that would better serve patients and better serve pharmacists in the region,” he said. A bill is currently in the statehouse that would increase transparency in the pharmaceutical industry; a measure if approved would begin to allow lawmakers to rein in excessive costs. The bill would also add some restrictions to PBMs.
Freedman said he believes workforce challenges could also be helped if pharmacies were better reimbursed.
Other states like Virginia and Ohio have proposed or passed changes to improve working conditions. Some of these changes include eliminating production quotas and efforts to enforce adequate staffing ratios.
Doyle said if changes don’t start, pharmacies will not have enough people in the future.
As pharmacists, lawmakers and companies come together, Doyle recommended patients have a little patience. Pharmacists recommend ordering prescriptions at least a week before you run out and trying to make vaccination appointments in person instead of online.
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