For the past ten years, I, along with most others, have assumed that the answer was (or a variation) that pharmacists viewed the advancement of pharmacy technicians as a direct, or implied, threat to their own job security. I’ve always known that it was a weak response to the question; pharmacists, after all, are very intelligent individuals…how could they accept such an absurd notion as “if pharmacy technicians are required to complete standardized education and take on more responsibilities in the pharmacy, they eventually won’t need me….the chains will realize that they can replace my $100k+ salary with a $30K salary…”? This is as ridiculous as pharmacy technicians opposing pharmacy automation for the same reasoning.

The logic of this explanation completely breaks down when you witness the chain pharmacies offering the fiercest opposition to increasing the standards for pharmacy technicians. If they felt that they would be able to do away with the pharmacist eventually (and the liability of their payroll burden), the chains would be rushing to get such standards in place.

Pharmacists see the action of the chains, so why do they remain in opposition, including the younger/newer pharmacists? One would think that pharmacists would want the most competent, educated and trained staff as possible. Then I came across the results of a 2007 study published in the American Journal of Pharmaceutical Education, and suddenly I’m beginning to understand.

In the study, 3rd year pharmacy students underwent personality assessments for a correlation on how to improve patient consultations and communication skills. The results, in my opinion, provide great insight to the million dollar question. According to the study, two out of three pharmacy students (66%) were assessed to be introverts.

…and?….so?….what does that have to do with anything?

Think about it. One of the main reasons provided for advancing the standards and education of pharmacy technicians is to free the pharmacists up from the routine, non-clinical, aspects of dispensing….thus allowing pharmacists to use their clinical expertise and spend the majority of their time consulting with patients and/or prescribers. Subconsciously, if not consciously, pharmacists are scared of this change in practice, because as introverts they would prefer to stay behind the counter, under the hood or in the basement preparing and dispensing medications. 

Introverts are wired in such a way as to avoid social interaction whenever possible. Think about it – how many of the pharmacists you have worked with are introverts by nature. Now, think about nurses, whose job is completely focused on interacting with patients…the vast majority of nurses are extroverts by nature.

The thought of technicians “freeing them up” to spend more time with patients is hitting a deep seeded fear. It’s not about the validity and necessity of increasing standards for technicians, it is about maintaining the status quo and not having to get out of their comfort zone.

I plan to look further into this theory, because if this proves accurate – we will need to do a few things.
1. Reframe the argument for increasing the standards for pharmacy technicians
2. Provide extensive training/resources for pharmacists to become more professionally extroverted
3. Reconsider the ideal traits for admission of  future pharmacy students 

Disclaimer: Yes, I realize that every pharmacist does not oppose such standards. NPTA works with numerous pharmacists who are among our strongest supporters/allies. I also realize that every pharmacist is not an introvert, nor is this theory the reason why every challenger opposes such standards. This post uses mass generalizations, which can illustrate trends, which in turn can provide significant insight.

Study: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1959225 

I welcome your thoughts!

NPTA Board Member, Wendy Meigs, attended this hearing on Monday and testified in support of the proposed legislation.

A House bill to require two-thirds of the state’s pharmacy technicians to meet new education and training requirements has stalled.

Bill proponents say more training and education are needed to prevent prescription and medicine errors.

“In two weeks time, I went from working, folding linens in a linen store to making IVs at a pharmacy,” said Natasha Nicols, who has since become a pharmacist. She’s now president-elect of the S.C. Society of Health-System Pharmacists, which backed the bill.

It could be next session before a compromise could be brokered and a subcommittee of lawmakers takes the bill back up, said its sponsor, Rep. Kit Spires, a pharmacist and Lexington County Republican.

At issue is that nearly 5,000 of the state’s more than 7,400 technicians are not certified pharmacy technicians even though they work behind pharmacy counters, preparing medicines and filling prescriptions.

Instead, would-be techs pay a $40 registration fee. They are required to work under the supervision of a pharmacist and take 10 hours of continuing education annually.

No state agency tracks the number of prescription errors that occur in the state’s pharmacies. One is too many, said Kathy Darragh, of Greenwood, who told lawmakers Tuesday her granddaughter died after receiving an overdose of intravenous medicine in a hospital in South Carolina in 2002.

A tech and pharmacist failed to catch the error when filling an IV prescription, she said.

“My granddaughter fought many battles in her life and survived,” Darragh said. Complications from a surgery meant the child relied on IV injections to receive drugs and nutrition.

“But human error is not one you can fight against,” said Darragh, who became an IV pharmacy tech after the tragedy.

Opponents of the bill, including the S.C. Association of Chain Drug Stores, said the bill would hinder pharmacies’ abilities to recruit technicians.

“The real danger is an overwhelmed pharmacist with no help,” said Kevin Floyd, a Charleston pharmacist and president of the association. “It’s about a yearlong process to gain state certification.”

Floyd said rural areas and small pharmacies would suffer the most if the bill passed because they would not be able to fill technician positions.

“The cost of education and the time commitment is a barrier to lots of folks,” he said.

Under the bill, starting in 2012, pharmacy techs would be required to complete a certification program at a technical school, log 1,000 hours of work experience under a pharmacist and pass an exam.

Spires said the bill’s educational requirements are too stiff for the economic times and he will work on a compromise.
(Source: The State)

The South Carolina Society of Health-System Pharmacists, which assisted in drafting the legislation, is in full support, whereas the South Carolina Pharmacy Association intends to see the bill overturned.

NPTA has been invited to review the current draft of the legislation and participate in upcoming House Subcomittee Hearings; it appears that South Carolina has become the next battleground for NPTA and pharmacy technicians.

The law requiring pharmacy technicians to be certified, passed in 2006, was backed by the Iowa Board of Pharmacy and requires pharmacy technicians to be certified before working in any Iowa pharmacy. Currently, registered pharmacy technicians must be certified no later than July 1, 2010. The controversy began after the adoption of the rules established after the bill’s passage, said Terry Witkowski, executive officer with the Iowa Board of Pharmacy.

Now a separate piece of legislation, House Study Bill 51 is expected to redefine who must be certified as a pharmacy technician. “There has been a request that the [Iowa pharmacy] board move to recognize individuals who are not involved in the more complex practices relating to pharmacy technicians,” Witkowski said. “People who may be working at a pharmacy and assisting a pharmacist, but not really directly handling the drugs, would be defined as a pharmacy support person.”

The new legislation would still require pharmacy support staff to be certified, but there would be no establishment of competency and no minimum age requirement as there are for pharmacy technicians.
(Drug Topics)

ICPT’s ExCPT certification exam has been added to the list of recognized certification exams for pharmacy technicians in the state of Nevada.

SB 203, known as Emily’s Law, has received Governor Ted Strickland’s signature today, making the law official in the state of Ohio. Named after Emily Jerry, Emily’s Law will provide strict requirements and regulations for pharmacy technicians. The law, which was originally sponsored by Senator Tim Grendell, was drafted with assistance of the National Pharmacy Technician Association.

Emily’s Story
Emily Jerry died at the age of two as the result of a medication error caused by a pharmacy technician. On the day that Emily was to have her final chemo treatment and received an excellent prognosis from physicians, she was given a fatal dosage of chemotherapy. The pharmacy technician who prepared Emily’s chemotherapy had opted to compound her own normal saline base solution, as opposed to using a commercially manufactured (prepacked) IV solution bag.
Standard IV bags contain a base solution of 0.9% NaCL (sodium chloride); the base solution prepared for Emily contained approximately 20x the standard concentration of sodium chloride. Prior to entering a coma, Emily grabbed her head, screamed and cried as she experienced a fatal overdose of sodium chloride.

Although pharmacy technicians practice under the supervision of a licensed pharmacist, the public assumes that these individuals are still required to be properly trained and demonstrate competency to work within a pharmacy setting. While controversy still remains over the specific circumstances of what occurred that day in the pharmacy, the fact remains that a major medication error occurred, went uncaught and ultimately cost Emily Jerry her life. In the aftermath, local and national media attention exposed the gross inadequacies of pharmacy technician standards and regulations in Ohio (as well as across most of the United States).

Emily’s Law
Kelly Jerry, the mother of Emily, became resolved to ensure that another family would never have to encounter such a tragic and preventable loss. In 2006, the National Pharmacy Technician Association (NPTA), based out of Houston, reached out to Kelly offering support, guidance and lobbying assistance. In 2008, with the support of Senator Tim Grendell (R), SB 203, now known as Emily’s Law, was introduced in the Ohio State Senate.

NPTA’s Chairman and CEO, Mike Johnston, CPhT, traveled on numerous occasions to Ohio to support Kelly Jerry and work with Senator Grendell in overcoming powerful, opposing lobbyist efforts and a few petty politicians. In a unique and unlikely series of circumstances, Grendell and Johnston were not only able to get all opposing parties on board with SB 203, but they were able to revise the bill, making it even stronger than the original draft.

“I am thankful for the assistance of the National Pharmacy Technician Association with the passage of Emily’s Law in Ohio,” explained Kelly Jerry, “due to their expertise, persistence and hard work, Ohio now has the most thorough and stringent laws regarding pharmacy technicians in the United States.”

The primary provisions of Emily’s Law will require that pharmacy technicians be at least 18 years of age, register with the State Board of Pharmacy and pass a Board-approved competency exam; the legislation also includes specific provisions related to technician training/education, criminal records and approved disciplinary actions.

“Governor Strickland, Senator Grendell and the Ohio State Legislature have taken a significant step in protecting the citizens of Ohio from preventable medication errors today,” explained Johnston, “and the National Pharmacy Technician Association is proud to have played a role in it.”
While pharmacy technicians currently practicing in Ohio will have 210 days from the law’s effective date to become in compliance with the new regulations, they will not be exempt from the statutes – a common practice known as “grandfathering.”

Ultimately, Emily’s Law has become a reality due to the strength, courage and perseverance of Kelly Jerry and her family, as well as Senator Tim Grendell, the Ohio State Board of Pharmacy and the National Pharmacy Technician Association.

Governor Ted Strickland held an official Signing Ceremony of Emily’s Law today in Columbus. Invited guests included Kelly Jerry and family, Senator Grendell and Mike Johnston.

For more information or media resources, go to www.pharmacytechnician.org
For more information on Mike Johnston, CPhT, go to www.rxmike.com

###
About NPTA
The National Pharmacy Technician Association (NPTA), which was founded in 1999, is the largest non-profit trade association for pharmacy technicians in the world. The association represents over 30,000 individuals practicing in a variety of settings, such as retail pharmacy, health-system pharmacy, independent pharmacy, federal pharmacy services, purchasing, education and management. NPTA is the leading provider of accredited continuing education programs for Certified Pharmacy Technicians and offers advanced certifications in Sterile Products and Compounding. The association is committed to advancing the roles of pharmacy technicians to reduce medication errors and advocates for mandatory/standardized technician education, certification and registration. For more information on NPTA, call 888-247-8700 or visit www.pharmacytechnician.org

For the full story go to http://www.usatoday.com/money/industries/health/2008-12-30-pharmacies-boards-mistakes-prescriptions_N.htm 

As a matter of full disclosure… I have (or had) working relationships with several of the chain managers mentioned in the story.