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Be Careful What You Wish For

12/14/2017

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DISCLAIMER: We received our first guest opinion piece, and it's controversial. 
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DISCLAIMER FROM THE BLOG:
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This was sent to Behind The Counter from a pharmacist I know. I advised this person to publish this without their name so you (the reader) can focus on the opinion and not the author.

After the initial essay, I asked this person four follow-up questions. 

If you would like to formally respond, please click "Share Your Story"

Here is some background reading: 
http://www.behindthecounter.ca/opinion/the-government-wants-to-know-if-you-deserve-a-lunch-and-more 

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Anonymous

​There has been a largely positive response from naïve staff pharmacists that believe that removing pharmacists from the exemptions and exclusions of the Employment Standards Act in Ontario will be a good thing for staff pharmacists. They say that the big corporate drug stores and chains are making them suffer, and are putting them through harsh working conditions and 8-12 hour shifts with no breaks.

Here’s the thing: if you mandate breaks, full-time staff pharmacists’ hours will get cut and you will lose money. There is no way around it. Yes, you may have bemoaned your 8-hour shift, but how happy will you be when your shifts and hours are cut?
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I don’t think people truly realize the impact of removing these exclusions and exemptions. They believe that the pharmacy will just close for half an hour while they eat their steak dinner and read magazines. These people have not thought this through.

​Let’s look at the ESA for a moment:

​“An employee must not work for more than five hours in a row without getting a 30-minute eating period (meal break) free from work.” 

​Do you think the pharmacy chains (Shoppers Drug Mart, Rexall, etc., who the majority of us work for) will just roll over and close the pharmacy for half an hour? You have to be truly naïve if you believe that they will close the pharmacy to give us a break. Did anyone forget a certain pharmacy chain adding in self-checkout kiosks in anticipation of the minimum wage increase?The same principle will apply here. They will not close the pharmacy and lose potential customers to the competitor; they will just circumvent the system.They will get around this with either one of two ways: Schedule multiple pharmacists for 4-hour shifts instead of having a pharmacist for an 8-hour shift (and before you argue “THEY WOULD NEVER DO THIS”, think about the oversupply of pharmacists, and then think again). The other alternative is having the business owner cover for a half-hour break for each pharmacist’s shift, which is patently absurd and unrealistic, especially in midnight and 24-hour stores.
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However, let’s say that pharmacies do close for half an hour (and pigs fly, and the Leafs win the Stanley Cup). This will have an impact both on the patients at the pharmacy, and on the business of the pharmacy. Patients who have their refills at a pharmacy will be unable to get them in the half-hour that the pharmacist is on break. If it is the only free half-hour that the patient has during their day, then I guess they are s*** out of luck. The other impact of this is that patients with new prescriptions will simply go to another pharmacy because their pharmacy is closed. This will be greatly detrimental to lower volume pharmacies that can’t afford overlap pharmacists, putting them at a competitive disadvantage. 

​Here’s the other thing: “Meal breaks are unpaid unless the employee’s employment contract requires payment. Even if the employer pays for meal breaks, the employee must be free from work in order for the time to be considered a meal break.”

​This break from the ESA is unpaid, which means this is yet another half-hour cut from pharmacists who are already suffering fromrecord-low wages. For a full-time pharmacist, that works 40 hours a week, their 40-hour work week becomes 37.5, and they lose 2.5 hours of work a week, which becomes 130 hours a year. Do the math – that is quite a bit of income lost.
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Lifting the exemptions and exclusions on the ESA for pharmacists will have nothing but a negative impact on pharmacist compensation and hours. This is in addition to the inconveniences placed onpatients, and the major difficulties for pharmacy owners, which I didn’t even touch upon. Fellow pharmacists, I am asking you to look beyond the allure of a half hour break and see the true impact that lifting these exemptions and exclusions will have on us. Be careful what you wish for. 

Follow-Up Question #1 

Let’s assume a pharmacy is open 9am to 7pm (total of 10 hours). It is currently legal for one pharmacist to complete the entire shift of 10 hours without a break. You believe that some pharmacy owners will simply hire two pharmacists for 5 hour shifts each instead. Do you believe there is a strong appetite for pharmacy owners to do this? How do you think a staff pharmacist would reply to this proposal from the owner?
Response: ​I believe that pharmacy owners and chains will do, and should do, what is best for their own business and what is best for their patients. Is closing the pharmacy for half an hour break best for the business, and best for the patients? Absolutely not. A staff pharmacist would obviously be opposed to this proposal from the owner, but here’s the thing: if these laws pass, these WILL be the proposals from the owners, and there is enough of a surplus of pharmacists to meet these proposals. Don’t be naïve to think otherwise. 

Follow-Up Question #2

You assert that patients who notice that their local pharmacist is on a meal break may simply choose another pharmacy whose pharmacist is available instead of waiting for one-half hour. We all have a few patients who expect something to be filled within a minute. Do you believe the general public would not be sympathetic if it was explained that the pharmacist was on a meal break?
Response: Sure, the patient may have sympathy for the pharmacist, but the patient also has their own life to worry about (as they should). In downtown Toronto, you could find 15 pharmacies within a 10-minute walk; if they find that the pharmacy they go to is closed, they will simply go somewhere else. On the flip side, if there isn’t another pharmacy close by, you could argue this is even worse for the patient. If a patient comes with a discharge prescription from the hospital and finds the pharmacy is closed, they then have to wait until the pharmacy reopens to get their prescription. Is this in the patient’s best interest? Absolutely not.

I’ve seen remarks from pharmacists about how “there is no medication that can’t wait half an hour for the pharmacist to take a break.” My response is: How inconsiderate are you? Do you really treat your patients that way? Do you have that much disrespect for their time that you think that making them wait until the pharmacy is open is in their best interests? You can’t argue that the patient should be sympathetic for the pharmacist, when you don’t show sympathy for your patient. As pharmacists we are there to serve our patients, and that is the job we should be striving to accomplish. 

Follow-Up Question #3

You mentioned that a theoretical 40-hour work week might become 37.5 hours assuming an unpaid 30 minute break, and lost wages of 2.5 hours per week. Let’s assume this pharmacist currently works 9 am to 5 pm without a break Monday to Friday. If the pharmacy’s business hours permitted it, do you think a typical pharmacist would prefer to work (for example) 9 am to 5:30pm with a 30 minute unpaid break? This way their overall paid work hours per week stays the same. 
Response: ​9 am to 5 pm certainly sounds like an idealistic community pharmacy schedule to me! But let’s go ahead with that. I would absolutely prefer to work longer to keep the same number of hours, but this solution doesn’t solve the problem of closing the pharmacy, which means that pharmacy owners have no incentive to do it. What incentive does a pharmacy owner have to keep overall paid work hours the same? Even if you have a grandfather clause to keep pharmacists from getting their hours cut, this doesn’t protect the potential hours and schedule for new grads. Keep the schedules the way they are, and this won’t be an issue. 

Follow-Up Question #4

[This question was copied verbatim from an OPA Survey] A potential solution to removing the exemptions for pharmacists is to allow registered pharmacy technicians to dispense and/or provide refill prescriptions while the pharmacist is on a meal break. With this proposed solution, registered pharmacy technicians would still not be allowed to provide new prescriptions. Do you support or oppose this? 
Response: First of all, not every pharmacy can afford a registered pharmacy technician. This is a luxury only few pharmacies can afford. Secondly, the pharmacy might as well be closed – the pharmacist won’t be there to answer OTC questions, and you can’t take in new prescriptions. This handcuffs business owners and is actually quite dangerous. If a patient decides they don’t want to wait for the pharmacist and just takes an OTC without asking the pharmacist, is that in the patient’s best interest? What about a patient that comes to the pharmacy to pick up their prescription but the pharmacist is unavailable for counselling – do we tell them to wait until the pharmacist comes back from break? Even if every pharmacy had a registered pharmacy technician, this would apply to so few pharmacies, and even if every pharmacy had one, it would not come close to offsetting the problems caused by lifting the exemptions from the ESA. 
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DISCLAIMER FROM THE BLOG:

The above was sent to Behind The Counter from a pharmacist I know. I advised this person to publish this without their name so you (the reader) can focus on the opinion and not the author.

If you would like to formally respond, please click "Share Your Story" 

share your story

You can also submit a formal response to Ontario College of Pharmacists: 

http://www.ocpinfo.com/library/news/open-feedback-exemptions-under-esa/

The deadline for feedback is December 15, 2017.
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