UPDATE: Local Florida News channel WCTV Tallahassee covered today’s press conference and testimony before the Florida House and Senate where I spoke out against the bills increasing the pharmacy tech to Pharmacist ratio.To read the full story and watch the video news coverage on the WCTV website click here.
On Tuesday April 2nd, I will be testifying before the Senate Health Policy Committee in Tallahassee to tell my daughter Emily’s tragic story and voice my strong opposition over SB818/HB671. If this ludicrous bill passes, it will increase the technician to pharmacist supervision ratio to six to one. If this happens, Florida residents will be put at a much greater risk of tragic medication errors similar to the one that heartbreakingly took Emily’s life.
What really upsets me about this horrible piece of legislation, is that the ONLY people and organizations who ultimately benefit from this type of legislation passing, are the big retail pharmacy chains PROFITS, like Walgreen’s, etc. Their underlying motivation for lobbying so hard for these increased pharmacy technician to pharmacist ratios, is simply due to the fact that it costs substantially less for them to staff their profit generating pharmacies with as few salaried pharmacists as possible, having them supervising as many, hourly paid, pharmacy technicians as the law will allow. What’s most disturbing to me is the fact that these retail pharmacy chains are constantly putting their profits before their customer’s safety. In doing so, they treat their pharmacy technicians as unskilled, hourly labor. Putting them into a high volume based production line type environment, where there is a propensity for catastrophic human error that ultimately results in medication errors occurring. Evidence of this is that over the past six years, Florida has been the site of several very well publicized and tragic pharmacy technician related errors, which resulted in patient deaths and injuries.
• From Jacksonville Florida – Inside a pharmacy where a fatal error occurred
• From Lakeland Florida – an ABC 20/20 news story describing this case: Walgreens Told to Pay $25.8 Million Over Teen Pharmacy Tech’s Error
• Other errors are detailed here
With all of this being said, I am appalled with the fact that the Florida State Pharmacy Board is actually supporting the passage of this ridiculous bill that will have tragic consequences for the residents of their state. Any state board of pharmacy’s primary mission is to protect the residents of their state from unsafe pharmacy practice. This raises an important question, do they really feel that by increasing the pharmacy technician to pharmacist ratio they are actually accomplishing their mission and adequately protecting their residents from this clearly unsafe pharmacy practice? Along those lines, I find it very hard to believe that Representative Travis Hutson (R), as well as, the members of the Florida Health & Human Services Committee who sponsored this horrible piece of legislation really DO NOT have their constituents best interest in mind. It really appears as though they are doing nothing more than lobbying for the retail pharmacy chains and their profits. I question why they have seem to have absolutely no compassion or empathy, at all, for the wellbeing and safety of the residents they all represent in the state of Florida. If they genuinely had the public’s safety in mind, and not the best interests of the retail pharmacy chains profits in mind, they might consider keeping pharmacy technician to pharmacist ratios where they currently are. Additionally, in my opinion, people like Representative Travis Hutson, would consider introducing legislation requiring retail pharmacy chains in the state of Florida to staff their pharmacies with more pharmacists, basing the number of required pharmacists on duty predicated on the volume of prescriptions being filled.
Some Additional Factors that Should Concern Florida Legislators and The Public They Serve
1) In 2011, California, New York, Florida, and Texas are the four leading states with the highest number of retail prescriptions filled. California has a 1:1 technician to pharmacist ratio, while New York and Texas have a 2:1 ratio. Florida is currently at 3:1. Currently, Indiana and Idaho are the only two states that allow a 6:1 ratio, with each state filling approximately 30% and 8% respectively, of Florida’s total number of prescriptions. The table below compares the ratios and volume done for each state. HB 671 allows increasing of the technician to pharmacist ratio, which will expand the workload on pharmacists with high volume stores, leading to an increased risk of medication errors and lack of patient safety.
If this legislation passes, Florida would become the only high volume prescription state (third leading) with a highest pharmacy technician to pharmacist ratio.
2) According to a report done in 2008 by the Institute of Medicine, medical errors in the United States range from $37-$50 billion. Of that total, $17-$29 billion could have been a preventable adverse event. A systematic observational analysis of pharmacies in six large cities (Chicago, Los Angeles, Dallas-Fort Worth, Philadelphia, Seattle, and Tampa) revealed an error rate of 1.7% meaning four errors per day with a daily volume of 250 prescriptions. By approving HB 671, this will increase the number of prescriptions a pharmacist must check daily, thereby escalating the error rate and preventable costs associated with the adverse drug event.
3) Studies done at Auburn University and Texas Tech documented that the risk of error rises along with the number of prescriptions filled per hour. These studies showed that pharmacist’s error rate is volume dependent. Pharmacists who are pushed beyond the limits also have less time to properly consult their patients. Consultation has been shown to decrease the risk of the patient leaving with the incorrect drug by 88%. .
Studies show that medication errors occur on a daily basis in the State of Florida and other states. HB 671 and SB 818 do not provide any benefit to the state or local governments in Florida. Both bills do nothing for the citizens or patients in the State of Florida except require that the pharmacist check the work of twice as many pharmacy technicians as before. This would cause greater medication errors affecting patient safety and lead to greater morbidity and mortality. So who does HB 671 and SB 818 benefit? Why would any legislator sponsor such bills? Unfortunately, it seems to benefit only the special interests and large chain pharmacies in Florida to increase their profits and bottom line. What does it do for the citizens in Florida? It creates a less safe environment to get their prescriptions filled and increases the risk of more medication errors.
The profession of pharmacy is often times referred to as the most trusted profession. This is because the public sees that the pharmacist is accessible, strives to provide the best care at the most responsible cost. The pharmacists of Florida are most concerned about this bill. Pharmacists have said in surveys that they will not be able to provide the care they were trained to do and the public expects of them safely.
Therefore, SB 818 is bad health care policy and should definitely be defeated!
Below you can see the Press Release regarding my announced testimony before the Florida Senate Health Policy Committee that was issued by the Florida Society of Health-System Pharmacists