For most of us, the pharmacist is that somewhat unapproachable person in the back of the drugstore, standing behind a counter and usually on a raised floor, looking down at us. We hand the pharmacist our prescription, answer a few cursory questions, and come back later to pick up our pills.
Pharmacists actually do a lot more than that impression might suggest, and most of them are willing, even eager, to become more active in their customers' health care.
Anthony Wolfinbarger has been a pharmacist for 28 years, and he currently works at the Compounding Shop in St. Petersburg. He spoke to the Times about what pharmacists do and what more pharmacists will do for the cooperative consumer.
What are the biggest misconceptions about what pharmacists do?
One is that we take pills out of one bottle, count them and put them in a another bottle, that what we do could be done by a lay person.
The other is that we make a huge profit on prescriptions. It's very expensive to develop new drugs and get them approved and the drug companies have to make their money back. That's where the high cost comes in. We don't make any more money on prescriptions than on anything else we sell.
So if the pharmacist isn't a mere pill-counter as some people believe, what else does he or she do?
Behind the scenes, the pharmacist will be looking for allergies, for possible interactions with other drugs you're taking.
It's not unusual for the pharmacist to call the doctor and suggest a possible alternative to the prescribed medication. The doctor probably doesn't know how much the drug he prescribed costs. He shouldn't be expected to know. We're the drug experts. If a patient doesn't have insurance and there's another drug that will do the same thing for less money, I'll call the doctor and ask if it's all right to make the change. The consumer might not even know I've done that.
How would the pharmacist know about allergies or interactions with other drugs you're taking?
When you first go to a pharmacy as a patient, you have to fill out a form that asks about other medications you are taking. It's important to be as comprehensive as you can. We need your medical history, we need to know about conditions like hypertension or hyperthyroid and we need to know your allergy profile. You definitely need to include over-the-counter medications and even vitamins. If they're not asking you about what other medications you're taking or about allergies, I would find another pharmacy.
Your pharmacist will have a record of all the prescriptions you've filled there. You may forget to tell your doctor about something you're taking, but your pharmacist will have a record of it and will know about possible interactions.
Prices on many drugs vary so much from one pharmacy to another. Is there a danger in getting each prescription filled at the pharmacy that offers the best price?
We're all aware of comparison shopping. We've all done it. I've done it. But for prescription medications, ideally you should have a single pharmacist you go to who knows you and knows your medical history and knows what prescription and nonprescription drugs you're taking.
What else can I do to let my pharmacist take a more active role in my health care?
When you receive your prescription, by law you should be asked if you have any questions for the pharmacist. Always say yes. If you don't have any specific questions, just ask if there's anything else you need to know about the prescriptions, about when you should take it, about interactions with food, about side effects. And if you're not asked whether you have questions for the pharmacist, find another pharmacy.
You call your specialty "compounding." What is that?
In compounding, we do what the old apothecaries did. We make everything ourselves from the component chemicals. It may be a medication in a form or dosage that is not commercially available. Or sometimes a doctor may want to prescribe a medication that, for commercial reasons, is no longer manufactured, and we'll make it if we can get the chemicals.