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Vol 273 No 7310 p162
31 July 2004

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Off the record

Improving pharmacy's image well overdue

Off the record series


I have just been reading Lynn Truss's book on punctuation ‘Eats, shoots and leaves’. Correct punctuation is vital if misunderstandings are to be avoided. For this reason it reminded me of pharmaceutical labelling, and how bad that can be.

I used to think that “Keep out of the reach of children” was just good advice, until I had a couple of kids and realised they could be quite fun. Surely, “Keep medicines, or this medicine, or something(!) out of the reach of children” is the correct expression.

Now it is easy to blame software. A few keystrokes and the process of label production is automated and control is relinquished. This may be preferable to those handwritten labels we once had to write, and it does provide a degree of standardisation. But sometimes I wonder whether the standard of labelling is yet another reason pharmacy has such a poor image.

One skill I was taught at university in the late 1960s was how to wrap a medicine bottle in white demi paper, with the seam exactly down the front, and finally sealed with red wax. I never used that skill, except to wrap that special present, but it is a link to an age when pharmacists realised that presentation is so important. Humans make judgements based on something’s visual appearance out of all proportion to its true importance. Perhaps a bit of psychology should be crammed into that fourth year too.

Pharmacists are not entirely to blame for poor presentation, since the decision often has to be made as to where to stick the label on a pack already covered in manufacturer’s small print, bar codes, expiry dates, etc. Why do so many manufacturers not leave enough label space on product packs, knowing full well that a dispensing label will be applied? On original packs appropriate warnings may already exist and yet a computer inevitably generates a label with the same warnings appropriate for that drug. So, we have either duplication, which could, arguably, be message reinforcement, or more likely, the dispensing label obliterates some of the appropriate wording already on the pack. The net result may meet legal requirements, but professional looking? It certainly is not.

Equally bad is the outsized label, obviously designed big enough to accept every additional warning that may ever be required, but it just does not fit on a 32ml tablet bottle. So, whatever you do it just looks a mess. Is this an appropriate image for a profession that wants to be taken seriously? I think not.

My car’s MOT test certificate is now better presented than most dispensed medicines. It comes in a neat plastic wallet, highlighting the date when the next test is due. My most recent MOT test took less than half an hour and cost over £40. This recommended cost is determined by a government department, so, in relative terms, that shows exactly what our masters really think we are worth, despite all the lip-service. Decisions made during dispensing and MOT testing can both have life or death consequences, so it could be argued they are comparable. But is this what you expect after spending four years studying pharmacy at university? Improving pharmacy’s image is well overdue.
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