It’s about patience, not speed

I got an email from a pharmacist that said a column I had written for an issue of PharmacyTech News (Winter 2007) had gotten his “blood boiling.” My column in that issue was about a young pharmacy technician named David Bol. We featured David on the cover of that issue, the subject of a very poignant feature story written by senior editor Antoinette Alexander. David, in addition to being a pharmacy tech at a Rite Aid store in the Seattle area, is also one of the thousands of displaced young people the world has come to know as “The Lost Boys of Sudan.”

David, like so many other kids from his generation and from that part of the world, was forced to flee his family and friends, with whatever he could carry on his back one horrible night, as guerilla fighters raped and murdered their way through the Sudanese village his family called home. He was 8 years old, and he never knew if his family lived or died that night.

Fast-forward 20 years later, from the Sudanese killing fields to the refugee camps of Ethiopia, to a Red Cross hospital in Kenya, and all the way to Seattle, the U.S. Job Corps’ pharmacy tech training program, and the Rite Aid store in quiet Moses Falls, Wash., where he works today, and David Bol has emerged with one extremely critical takeaway from the personal ordeals and amazing suffering that he encountered along the way. David doesn’t like to see people waiting for medicine; you see, it reminds him too much of that time when he was a teenager and he was shot in the shoulder with a high-powered rifle and he just laid there, with a hole the size of a quarter in his shoulder. First, he prayed not to bleed to death; then, he prayed for someone to come along and help ease his suffering; and for a time when he was most desperate that evening, he actually prayed for his own death. David Bol prayed for death that night because he thought it was easier than waiting any longer for his medicine.

So when David Bol sees sick people waiting for medicine, he does the one thing he knows he can do: he doesn’t cop an attitude and try to educate customers about the strain of life behind the pharmacy counter, or the intricacies of dealing with third-party adjudication; he works a little bit faster. Not so fast that he gets sloppy and risks making an error; just as fast as he realistically can.

One pharmacist didn’t like what I had to say, or maybe it was just the way I said it. “I was appalled at your implication that it is all about speed,” the reader noted.

I won’t identify him for a couple of reasons. First, I am not looking to embarrass anybody. Moreover, though, I firmly believe that his frustration was driven by a rather common disconnect that exists between many bench pharmacists, their management and most importantly, payers as it relates to the subject of compensation and the proper alignment of incentives: Is the pharmacist’s job to crank scripts or improve health outcomes? And that is a much more complex question to answer than many would ever admit. On one hand there is x amount of volume and y number of pharmacists in America; those scripts have to get filled one way or another. On the other hand, how is retail pharmacy compensated for its services? By patient outcomes or scripts filled?

To be sure, this industry is making great strides to change that equation. The latest example of that is NACDS’ recently unveiled million-dollar ad campaign aimed at educating Beltway-area influentials of the true value of retail pharmacy through a common message, “Pharmacies—the face of neighborhood healthcare.”

In the meantime, David Bol is one of those faces this industry desperately needs customers, payers, politicians and policy makers to see at the drug store. That is the point of the David Bol story: it’s not about speed; it’s about patience.

So in the course of David Bol’s amazing journey from Sudan to Seattle, he found something even more precious than the blood he spilled along the way. He found a career in pharmacy, and this profession is lucky to have him.

There—I said it again.