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How does a pharmacy work?

Updated on April 3, 2017
BYPharmD profile image

Brandon practices as a community pharmacist in MN. He started as a pharmacy tech in 2003 and received his PharmD in 2011 from the U of M.

Pharmacy operation is a well-oiled machine.
Pharmacy operation is a well-oiled machine.

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Despite the fact that everyone has used a pharmacy, few people know what actually goes on behind the counter. Read on get the inside scoop on how a pharmacy operates, and get the answers to these questions:

  • What does a pharmacist do? What about a pharmacy technician?
  • Why does it take 15 minutes to refill my prescription?
  • Are the pharmacy staff as busy as they always seem?
  • How does understanding my pharmacy help me?

As always, please comment or ask questions. The best information I can provide is that which is requested.

Thank for stopping by!

-Brandon Y, Pharm.D.

The pharmacist does not control when or how much work they have.

Pharmacists rarely work by appointment. They often work alone. Although they may not always be busy, each one can only focus on one task at a time. If a person walks up with a question and the phone rings, decisions have to be made.

Work may include

  • Prescriptions
  • Questions
  • Appointments
  • Meetings, conferences
  • Logistics, business

Work can come from

  • Faxes, phone calls, e-mails
  • People, doctors, nurses, caretakers
  • New, refill, or automatic prescriptions

There is no way to predict when it will be busy for sure, but some general tips are

  • Mondays are really busy
  • Late afternoons are busy when people leave work
  • Mornings have a lot of flexibility
  • Pharmacists like it when they have time to eat lunch
  • Mid to late evenings are usually open

How does understanding this help you?

If you need to talk with your pharmacist, plan ahead. Ask when a good time might be.

Some pharmacy's allow for appointments. Ask if you can schedule a sit-down.

Be consistent. Visit the pharmacy about the same time each month.

Give the pharmacist some time to work on your prescription, question, or whatever. Then they can prioritize it with their other tasks.

Steps to dispense a prescription
Receive prescription
Process prescription
Review the prescription
Fill the prescription
Verify the prescription
Sell the prescription
Details below.

Every single prescription goes through the same basic steps.

With hundreds of drugs being dispensed to hundreds of patients with virtually unlimited dosing, directions, and combinations it's necessary to have a standard process.

While a particular prescription may not need every step every time, exceptions would, and do, cause dangerous problems. There are no shortcuts.

The steps a prescription goes through

The prescription is received. Prescriptions are ordered in many ways. They can be faxed, phoned, e-mailed, automated, new, or refilled. Each prescription must be ensured to meet certain criteria. Some prescriptions required additional information be gathered before it can be processed.

The prescription is processed. Each prescription is computerized into a person's profile. Each detail is meticulously entered for 100% accuracy. The insurance company is billed and any requirements or discrepancies are reviewed and resolved.

The prescription is reviewed. Every prescription filled triggers a review of a persons medical and drug history. The prescription is reviewed for appropriateness, safety, and interactions. Talking points are noted so they can be reviewed when the prescription is sold.

The prescription is filled. The physical medication is measured and labeled. Specialty prescriptions are filled by the pharmacist. Any issues with the medication are reviewed, noted, and/or resolved.

The prescription is verified. The physical medication and final prescription is reviewed for accuracy and completeness. Good practice is ensured and any remaining requirements are met.

The prescription is sold. Final sale is completed. Conversations designed to improve a person's understanding of and success with their medication takes place. Pharmacy options, preferences, and services may be discussed. Questions are answered and problems resolved.

How does understanding this help you?

  • Order refills as soon as you know you need them.
  • Use whatever automation tools your pharmacy has. It helps them predict how much work they have.
  • Give the pharmacy time to process your prescription. They may need to take extra, unforeseen steps.
  • Be patient and understanding. If you have a concern, bring it up with the pharmacist and see if they have any suggestions or if they can makes changes.

Prescription orders that require more attention
Hospital discharge orders
First-time medicines for a person
Specialty, or compounded, medicines
High risk drugs
Unclear, incorrect, or incomplete prescriptions
Infrequently used, or unfamiliar medicines
Off-label uses, or prescription that do not follow guideline standards

Your prescription is not the only prescription the pharmacist is working on.

There are as many types of prescriptions as there are people. Some prescriptions are "easy" to dispense, where others are "hard." I use quotations because there are so many factors that affect each prescription. These may include:

  • A persons medical and drug history. The more there is to review, the more complicated the prescription.
  • The experiences and familiarity of the pharmacist. A pharmacist is tasked to ensure medicines are used safely. When they encounter a medicine unfamiliar to them, they may need to review some professional materials before they can dispense the prescription.
  • Available support staff, and their skill levels. A pharmacist working alone must complete each step by themselves. Well trained support staff allows the pharmacist to focus on particular steps.
  • Degree of complication of the prescription. Some medicines require specific, particular preparation. Sometimes additional information must be gathered.

Even if your prescription is "easy," there may be a "hard" one the pharmacy is working on right before it. While every effort is made to avoid backup due to more complicated orders, sometimes a single step in the process can take enough time to create a bit of slow-down. And you never know, your prescription may be the one that requires more attention.

How does understanding this help you? When you request a prescription, ask for a realistic time-frame. See if there is anything that would be expected to take more time. Offer up as much information about yourself and the prescription as you can to help the pharmacist meet their professional expectations.

Dispensing prescription is not the only thing your pharmacist is doing.

Although dispensing prescriptions is the backbone of a community pharmacy, there are many other things that your pharmacist must spend their time on. In fact, pharmacists are some of the best multitaskers around. Here are just a few things they may need to give their attention to.

Trust me, there are many more.

Inventory

  • Keeping medications in stock for the pharmacies unique needs
  • Assuring specialty items are available when a person needs them
  • Tracking controlled medication
  • Preparing for seasonal or other predictable needs

Laws and regulations

  • Avoiding and preventing fraud and abuse
  • Keeping up to date with licenses
  • Reviewing new laws and rules and putting them into practice
  • Completing audits and quality control

Clinical

  • Performing comprehensive medication reviews
  • Recommending new or changes to a persons drug therapy
  • Administering immunizations
  • Performing health screenings
  • Preparing educational or presentation materials

Every pharmacy, and pharmacist, is different.

Remember, pharmacist are professionals. They have the professional license to practice in whatever way they find necessary to fulfill the requirements of their license and their position.

Some pharmacists put in more work than others to ensure that people get and stay healthy, are on the best medications, and receive good instruction. Every pharmacist will emphasize different aspects of their job.

If you are using pharmacy services and products a lot, it is not a bad idea to "interview' the pharmacist. See if the way they run their pharmacy seems good to you. See if they emphasize the things you value.

And if it's just not a good fit, find a different pharmacist. That may mean finding an entirely different pharmacy. But as one of your healthcare providers, you should feel comfortable with your pharmacist.

You owe it to yourself to put in the effort to understand how your pharmacy works and how you can get the most out of your pharmacist.

Brandon Y is a community pharmacist working in Minnesota with over 10 years of experience in pharmacy. He welcomes comments and questions. Find more great pharmacy tips here.

Disclaimer

The information provided on this page is intended for general educational and informational use only. It is not specific, personalized healthcare advice for you. For healthcare advice regarding your particular situation, talk to members of your healthcare team. Contact this hubs author for more information.


Copyright BYPharm.D. (author) 2013. All rights reserved.

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