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.
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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!
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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
Posted: July 3, 2013 by ejfadmin
New Mexico Eliminates Pharmacy Technician Ratio Mandate Putting Thousands of Residents at Risk of Deadly Medication Errors
MEDIA RELEASE
FOR IMMEDIATE RELEASE
June 17th 2013
Media Contacts:
The Emily Jerry Foundation
Christopher S. Jerry
440-289-8662
[email protected]
www.emilyjerryfoundation.org
Traveling to New Mexico to Find out Why New Mexico State Pharmacy Board Member Was a “Driving Force” in Getting Pharmacy Technician Ratio Eliminated, Putting Tens of Thousands of Residents at Risk for Medication Errors!
CLEVELAND, OHIO- Last week, it was brought to my attention by a number of concerned pharmacists from the state of New Mexico that their state was now one of the few states in our nation to recently eliminate their pharmacy technician ratio mandate. If I understand correctly, under the new terms, the pharmacy technician ratio will now be determined by the pharmacist-in-charge (PIC). With this particular scenario, my primary concern from a patient safety standpoint is shared with many pharmacists themselves around the nation. It is NOT that the pharmacists themselves are not capable of making this very important determination. It’s quite the contrary, pharmacists are very qualified to determine safe ratios in their pharmacies. The primary concern, lies in the fact that in retail pharmacy especially, the large retail pharmacy chains treat their pharmacy workflow in their retail pharmacies too much as a volume based production line. If you live in New Mexico then you may want to take out health insurance with someone like New Mexico Insurance Services to protect yourself from these changes because with that type of mentality, through the corporate policies and procedures they implement, they put their core emphasis on quantity over quality, often at the expense of their customer’s safety. With that being said, my trepidation is due to the fact that pharmacy technician ratios are so closely tied to retail pharmacy’s PROFITS that the large retail pharmacy chains like Walgreens, CVS, Rite-Aid, etc., will now start to dictate and put pressure on their pharmacists in New Mexico to staff their pharmacies with as many pharmacy technicians as they so choose, throwing customer safety by the wayside, in an effort to maximize their profits. With that in mind, if a pharmacist employed by one of these large retail chains refuses to sign off on, or approve, a ratio in their pharmacy that they feel is clearly unsafe, the retail pharmacy will simply tell them to resign and find another job elsewhere.
As I have mentioned many times previously, the primary mission of any state board of pharmacy, is to protect the resident’s of their state from unsafe pharmacy practices. It is not clear to me how the New Mexico State Board of Pharmacy’s recent approval of the elimination of their pharmacy technician ratio will improve the safety, or benefit the residents of their state in any way, whatsoever. Again, the only people that stand to benefit from the elimination of the pharmacy technician ratio are the large retail pharmacy chains, as well as, the owners of the small independent retail pharmacies in New Mexico. They stand to benefit greatly by substantially increasing their PROFITS by now being able to legally staff their retail pharmacies with as many low cost, hourly, pharmacy technicians as they want, while simultaneously, lowering the number of registered pharmacists supervising and double checking these technicians work. Furthermore, by increasing the number of pharmacy technicians in any given pharmacy, you increase the overall number and volume of prescriptions that must be checked by the supervising pharmacist, thus, increasing the probability for “human error” and subsequent medication errors with catastrophic results. The following are just a few very relevant and well publicized pharmacy technician errors that really hit home with me, as I was lobbying in opposition of Senate Bill 818 in Florida earlier this year.
http://usatoday30.usatoday.com/money/industries/health/2008-02-12-pharmacy-errors_N.htm
http://abcnews.go.com/Blotter/walgreens-told-pay-285-mil-teen-pharmacy-%20%20%20techs/story?id=9977262#.UbyaxBaM_A0
As everyone is probably already aware, The Emily Jerry Foundation has been working very closely with several experts in safe pharmacy practice, the American Society for Health System Pharmacists (ASHP), the Institute of Safe Medication Practices (ISMP), and numerous state boards of pharmacy all over the United States, to keep the large retail pharmacy giants from lobbying to increase pharmacy technician ratios. Having worked so closely with these pharmacy professionals over the past few years, I have learned that the only reason the retail pharmacy chains lobby so hard to increase the ratios, or eliminate them entirely, is because it is in the best interest of improving their profits. When profit maximization strategies by retail pharmacy come at the expense of overall customer safety, I find it quite appalling!
What I found even more disturbing was learning that a New Mexico State Pharmacy Board member, Danny Cross, may have been a “driving force” behind the elimination of the pharmacy technician ratio in New Mexico. This is alarming, if true, given the potential conflict of interest, given that Mr. Cross is the owner of a retail pharmacy establishment called Southwest Pharmacy in Carlsbad, New Mexico.
I have made flight arrangements and will be departing for New Mexico on Wednesday, June 19th. During this trip, I have meetings scheduled with Larry Lorens, the Executive Director of the New Mexico State Pharmacy Board and will be attending their meeting on Thursday, June 20th, which I found it ironic that The Emily Jerry Foundation was already on their agenda (click here to see the agenda, particularly section 12c).
Also, during my trip, I hope to meet with the Governor, Susana Martinez, to discuss this very important issue and will also be trying to schedule a meeting with Danny Cross to discuss the underlying logic behind this ludicrous decision to eliminate the pharmacy technician ratio. I am extremely concerned about the safety of the residents of the state of New Mexico and will be doing everything I possibly can, with respect to my advocacy efforts and those of The Emily Jerry Foundation, to get their pharmacy technician ratios, not only reinstated, but lowered in their state.