Why pharmacists are not good people

The other day I went to buy a prescription-only drug at one of the "cheapest" or rather, most affordable/cost-effective pharmacies in the city. I happened to have been in town early enough, and I decided to pop in, while mentally bracing myself for the long queues filled with bargain-hunters like myself, that are a permanent feature of this particular drug store and its sister stores.

With pleasure I noted that there was just a handful of clients, looking bored and impatient as they idled on the rather insufficient seat at the waiting bay of the cramped chemist. I made my way to the counter where I ordered a prescription-only anti-depressant, while simultaneously fumbling through my handbag for the prescription. Before I could fish it out, the attendant on the other side of the meshed counter had completed my order complete with a discount, without ever asking to see my prescription. He directed me to join the other clients/patients who were waiting impatiently on the bench, as a different pharmacist worked on filling my prescription and completing my order. A few minutes later, I was out and about with my prescription-only anti-depressant without having to show any prescription chit from a doctor.

In my years as a person suffering from depression, I have been to many pharmacies, but only a few ever insisted on a prescription before dispensing the prescription-only drugs I asked for. Musing about this later, a thought crossed my mind that pharmacists are not "good" people.

A pharmacist will never tell you, "You look/sound awfully sick or you've been coming here to get pills to relieve these symptoms for too long, don't you think you should see a doctor to get to the root of your symptoms?"

Instead, a pharmacist will ask  for your symptoms and give you something to relieve them. I guess the first rule of pharmacy is to take the money, always; never turn away a customer ( patient). Yet sometimes those seemingly little but niggling problems belie a serious underlying illness, that needs urgent attention, but a pharmacist will be happy to take your money and prescribe something to relieve the symptoms, even as the illness simmers and festers beneath the surface.

Banned drugs

I've seen pharmacists push anti-malarials on people who've not had their blood passed through a Malaria Rapid Diagnostic Test. A pharmacist will sell you the absolute prescription-only abortion pill without a prescription. A pharmacist will sell you morning after pills without throwing in a cautionary “you should consider ‘regular’ contraceptives or even the possibility of HIV.” A pharmacist will sell you the one-tenth dose of antibiotics that you asked for as long as you slip the money across the counter, never mind that the world is grappling with the effects of misuse of anti-biotics in the form of drug-resistant bugs.

I once had a person standing behind the pharmacy counter prescribe Metakelfin (long after it had been banned alongside other sulfa-based anti-malarials such as Fansidar) as a way to prevent malaria just before I traveled to a malaria-prone region. It made me feel so sick, I had to go to a doctor, who informed me that that taking anti-malarials as a preventive measure before traveling to a malaria hot-spot was no longer recommended, not forgetting that I had ingested a banned drug and one I was allergic to too (I'm allergic to sulfa drugs).

Maybe I require too much from pharmacists, much more than they are cut out to be. Maybe they didn't take the Hippocratic Oath or any oath on patient safety and public health interest being paramount. Maybe those attendants who man pharmacy counters are not even real pharmacists, not even pharm-techs. Maybe they're just salespersons, placed there complete with sales targets. Maybe pharmacists are taught that the interests of the bottom line come above everything else.

Lastly, the self-medicating customer is also a fool who is easily parted with her/his money at the pharmacy and later in the hospital which s/he thought s/he'd dodged by bypassing the doctor and going straight to the pharmacy, after consulting Dr Google and/or a couple of strangers and friends.

Still, pharmacists are part of our health problems.