By Isabella Zarate
Phones are ringing.
Four antsy people sway left to right looking over the counter checking the time as they wait in line. Empty bottles scatter the counter, waiting to be filled.
The phones are ringing.
Fifteen cars inch along the drive-through.
Patients awaiting a COVID test grow eager; others awaiting prescriptions even more so.
The phone still rings.
The next person approaches the counter. What are they here for? Prescription? COVID test? No, they need a vaccine.
The bottles are still empty, a man in the drive-through grows agitated because he needs his medication, but the lady in line is demanding her vaccine before she is late to work.
It is only 8:30 A.M.
The phone rings.
This is retail pharmacy.
Dr. Bled Tanoe, a pharmacist from Oklahoma who recently left her job, was drawn towards pharmacy after bouts of childhood illness. Within pharmacies, she found her heroes, the people who would make her feel better and provide a sense of relief.
From then on, Dr. Tanoe knew she wanted to provide that same sense of safety and security for others. Graduating from the University of Oklahoma in 2016, Tanoe was well on her way.
As she began, quite literally the career of her dreams, she quickly came to notice some disparities.
At first, Dr. Tanoe thought “I will leave the business to somebody else. I want to be pretty much the heart of the profession, so I don’t have to worry about the numbers.”
Though, Dr. Tanoe found that her hope of helping patients seemed more like a business model than a doctor’s office.
“I was very quickly awakened, and it was very hard,” she said.
Within no time her “let the pharmacists be the heart of the profession and let the business be the businesspeople” ideology was wiped away.
And her medical degree felt as if it had turned business.
In what Tanoe referred to as the “company metrics,” it is understood that there are specific rules, guidelines, and quotas that retail pharmacists are expected to meet. Much of this is reliant on big companies making a profit, while for pharmacists, it is about serving the patients.
Dr. Tanoe explained how the mindset of “we need to meet those numbers” causes a lot of added pressure and has the ability to interrupt patient and customer safety.
Tanoe described the pressure with a metaphor of a surgeon. In an operating room, they would not be asking the surgeon to handle everything alone, there are nurses and other staff there to help, and each has an assigned role.
“In pharmacy we ask the surgeon to do the cutting, to do the padding, to do the suctioning at the same time,” she said. “Whoever is on the table is not going to survive.”
Whether it be a missed allergy, dispensing the wrong medication or even getting it out late, a lot of focus is taken away from the patients and put towards satisfying and aiming to make profits for the company.
While there are multiple risks for patient error on the line, Dr. Tanoe found it difficult to fight the balance of losing her job versus harming a patient.
“There are consequences for not meeting the goals,” Tanoe shared.
And according to her, this is common among a lot of retail pharmacists. Even though many have a team of technicians and other pharmacists to help, the pressure and stresses of the workplace are increasingly dangerous.
“We want to be here, we just cannot function in this environment,” said Tanoe.
After four years in the business, Dr. Tanoe was hit with a realization. While working yet another hectic shift, she thought to herself that her team deserved some sort of recognition or reward. “I will bring pizza,” she thought.
Her intuition told her what she already knew: pizza is not going to fix this; “nothing is going to fix this.”
After work, she shared the thought with a group of pharmacists online and the #PizzaIsNotWorking movement was born.
“It was never meant to be a movement,” claimed Tanoe. “At first, it was more of ‘a public plea’ that turned into much more overnight.
Tanoe’s hashtag gained even more attention in September of 2021 after #shewaited surfaced. This happened following the death of 41-year-old Indiana pharmacist Ashleigh Anderson. Anderson died from a heart attack during her shift at CVS.
Now, nearly four months later, Dr. Tanoe takes to social media to remind people of the life Anderson lived. The end of Anderson’s story was one that could have possibly been prevented, though according to Tanoe it was not the first time she had heard of technicians and pharmacists putting their own well-being on the back burner in order to prioritize the company’s metrics.
In Nov. CVS enthusiastically reported a 10-percent increase in earnings over the same time period in 2020 at $73.8 billion.
As for Dr. Tanoe, she ultimately came to leave her position as a pharmacist in the summer of 2021. Her decision to leave was made based on a slight error she made. The error involved a patient confronting Dr. Tanoe about incorrect direction printed on the prescription. This led her to realize she could have done much more harm – that was not something she wanted to risk.
The “error was so small that I should have caught it,” Tanoe shared. “What would happen if it was a different error.”
With the “line all the way through the end of the store, the drive-through [is] full, and the phone [is] ringing . . . I just told myself I’m not coming back.”
The choice was not one that she took lightly.
“I did struggle a lot with the decision to leave,” Dr. Tanoe said. “I personally felt very much as a failure to leave that profession so young.”
Though, now with the extra “free time” and the sparked passion for change, Tanoe is making strides in efforts to ameliorate working environments within the retail pharmacy.
Colleagues, friends, and pharmacists from across the country have assembled in teams to find ways to ameliorate the issue and re-instill a strong sense of patient safety. According to Tanoe, these teams serve as a voice for others who don’t speak up for fear of losing their jobs.
Meanwhile, Tanoe continues to meet with lawmakers in hopes of bringing changes to store and retail pharmacy policies. The ideal situation would be for more technicians and more pharmacists on a team to help alleviate stress and divide up the tasks.
Tanoe said there are plenty of workers available. Big corporations, though, need to invest in a team to properly fund their customer base.
She also mentioned how a shift in power could make all the difference.
Tanoe made the point that pharmacists can lose their licenses and get fired for errors, but that companies are often unaffected. If anything, they are charged a small fine. She believes that creating bigger and more meaningful consequences for retail or chain pharmacies may also lead to fewer errors and incidents, thus creating a better environment for the patients and the pharmacy teams.
“Health care needs to be about the patient first,” she said.
For Tanoe, this battle she is fighting spurred from her passion to help people.
“I believe so strongly in this. I want to make pharmacy better,” she said. “I want my patients to be safe.”
And just as she continues to make her best efforts at bettering the field and creating a safe environment, she does not lose hope for her future in pharmacy.
“I love community pharmacy,” she said. “If I had the opportunity, I would go back 100%. If the conditions were better, I would go back because this is what I wanted to do.”
Tanoe is not the only pharmacist to leave the profession. Pharmacists and technicians across the country are leaving the profession in search of manageable working hours and conditions and a livable wage.
Customers, though, don’t always see the 12 to 14-hour workday or the fact that someone behind the window may not have eaten lunch in hopes of getting everyone through the line. Pharmacists and technicians know, though, that they are quite literally putting their lives and their reputation on the line as they try to meet the demand.
