The Pharmaceutical Journal
Vol 268 No 7195 p568-572
27 April 2002

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  Prescribing
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Letters to the Editor

Community pharmacy

Patients will miss the service

From Mr R. B. A. Johns, MRPharmS

In the title and opening sentence of his Broad Spectrum article (PJ, 13 April, p494), J. D. Glassman poses two questions, both easily answered. Is community pharmacy in danger of disappearing? Unequivocally, yes: for reasons that he expresses with eloquence and precision. Is the Government in danger of killing it off? Emphatically, no.

Since the mid 1980s, the treatment of community pharmacy by successive administrations has been such that its demise has been entirely predictable and therefore presumably intentional, unless we are governed by morons. It follows that the question should be: "Is the Government on the verge of successfully concentrating all pharmaceutical services in the hands of the multiples and supermarkets?" And is the motive not obvious? Under existing remuneration arrangements, large-volume dispensing is cheaper.

As Mr Glassman makes clear, it is the patients who are in danger: in danger of losing a service which they may not always appear to value as highly as we might wish but which, as so often in life, they will miss when it has been permanently lost.

R. B. A. Johns
Boston, Lincolnshire

Patients deprived of confidentiality

From Concerned Pharmacist

In his letter (PJ, 23 March, p397), Chris Morris described his experience as a pharmacist working in two newly designed pharmacies that resemble goldfish bowls. He clearly pointed out the discomfort they have caused him, as a professional working in such surroundings. I would like to provide a patient's perspective.

My sister has been receiving fluoxetine for postnatal depression. Recently, she found that generic fluoxetine was causing her severe indigestion, which did not occur with the proprietary Prozac that had received once against a generic prescription.

She presented her latest prescription at a newly designed "goldfish bowl" pharmacy and politely requested that the "brand name drug" be dispensed as before. She carefully used this wording because she knew that the indications for Prozac are well known and that there were a number of other customers standing nearby.

The pharmacist said, in full hearing of these customers, that if she wanted Prozac she would have to get a prescription for Prozac and dispensed the prescription in full view of everyone present. This clearly breached my sister's confidentiality, left her deeply distressed and set her progress back months.

Although the embarrassment caused was largely due to the pharmacist's lack of professional judgement, my sister believed that the design of the dispensary area contributed to the situation. Bystanders could clearly see everything that was going on and even if the pharmacist had not drawn attention to the fact that she was receiving Prozac, they could have seen it being dispensed.

I agree with Mr Morris that these newly designed pharmacies, although they encourage "openness", deprive patients of the confidentiality of which we assure them in our code of ethics. Perhaps it is time to rethink their design to ensure that we are truly acting in the best interests of the patient in this age of well-publicised medicines.

Concerned Pharmacist

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