We all know the story of the Emperor’s new clothes, where someone had to state the obvious and for obvious reasons.The situation in Ontario for the practice of pharmacy has clearly taken a turn for the worse. It is as much pharmacy’s own doing as anyone else's.There are some who long for the old way, but that system is clearly broken because what happened COULD happen. It happened because of government structures to be sure, but also because of structures in the business of pharmacy and in the profession itself.The failures of pharmacy to grapple with the payment and practice models over the last 25 years is endemic to the component of pharmacy that has had the greatest impact on pharmacy business: pharmacy owners and particularly pharmacy chains because they are the ones who have the resources to put people in place who’s sole role is to create and modify business models. It should be of no surprise that these models have been designed to work for these owners, both independent and corporate. What is surprising, however, is the failure to adapt to the new realities and the choice to fight them instead.What has been lacking is the self-efficacy assessment of these groups. Pharmacy’s business model has been under attack for decades, and failure after failure in solving the problem has not changed the fact that the same structures, and in many cases the same people, have set themselves as the guides for the future business and practice of pharmacy. They say that the definition of insanity is doing the same thing over and over and expecting a different result. Perhaps it is time for a sea change.No doubt pharmacy business has been profitable, but over the past several years it has pinned its hopes primarily in one area: the increasing size of the generic drug market. It was only a matter of time before someone on the payer side asked what they were getting for their investment. Pharmacy’s answer was a hollow response. How many of us would be satisfied with the question “What value are you giving me?” being answered with “Just be glad you aren’t paying more."Our business should always have been about payment for what the pharmacist does and any extensions of that service that the business can provide. People wanting to be healthy and needing medications to do it, and needing help with those medications, is something that won’t change anytime soon.We need leadership in ownership that recognizes the pharmacist’s true role in this. We also need a business model that reflects that role. It’s as obvious as the clothes on your back.
