Prescription APPROVED for Implicit Bias

i remember my time

as a pharmacy intern

one day during cough and cold season i

was working at one of my favorite stores

it was in a black neighborhood and a lot

of my buddies from high school

and members from my church came there

marvin get the counter the pharmacist

said

sure i replied this pharmacist

never waited on any of the patients at

this store

so as i’m looking at the computer

looking at the patient’s order she’s

here to pick up a prescription for her

son his cough syrup one second ma’am

i’ll go to the back and finish it up

so i went to the back of the pharmacy to

finish up the patient’s order

and realize we didn’t have enough to

fill it

so i went to tell the pharmacist and

the pharmacist seemed very annoyed

he then said to me just put some water

in it

my eyes grew wide and i said what

he then replied again voice a little

lower

still calm just put some water in it

it’ll be fine no big deal

oh he was actually

serious now the proper procedure in the

pharmacy

is when you don’t have enough to fill a

patient’s order you give them a partial

or a portion and then when you order it

and you give them the remainder when it

comes in

to make a long story short i did not put

water

in that child’s prescription that day

but later on that night i struggled

with why the pharmacist felt so

comfortable

making such a request of me

first off he never waited on any of the

patients at that store

second he was extremely annoyed it

seemed while working at that store as

well

third he wasn’t as helpful at this store

as he was at other stores i worked with

him at that did not compose

of black and brown people but then

he never treated me poorly

what was it

was it the fact that i was a pharmacy

intern and he saw some portion of

himself in me

what was it bias although this is an

extreme example

implicit bias is real it can show up

indirectly or

operate subconsciously

furthermore implicit bias are feelings

feelings we have against a certain

culture or group of people

but unlike feelings we cannot hide these

biases

because they operate subconsciously

an article in time magazine by jennifer

eberhardt asked the question

why is it implicit bias just not racism

when we think about racism we think

about bigots

and you don’t have to have a moral

failing in order to have

an implicit bias

now let’s fast forward years later

i am now a pharmacist

on the weekends i played semi-pro

football with the local team

i knew i was getting too old to be out

there but you couldn’t tell me anything

back then

and i was a beast

well one weekend i ended up dislocating

my shoulder

i actually worked that next day armin

sling and all

and i had the doctor calling my pain

prescription to another pharmacy

so when i got off work for that day i

went to the pharmacy to pick up my pain

prescription

and as the pharmacist is ringing me up

i’m looking at my bottle

and i notice the day’s supply is wrong

the doctor said he was going to call in

a quantity of 30. there was only 10 in

this bottle

so i had the pharmacist go check the

prescription

he went and looked at and said that’s

what your doctor wrote for

and as he starts to come back to the

counter he starts to smile

and says you won’t need that full

prescription

you people take pain well my eyes grew

wide and i

said again excuse me i

actually think that pharmacist thought

he was giving me a compliment

when he realized my reaction he tried to

backpedal and say

you’re a big guy you won’t need that

full prescription

so the next day i got my prescription

taken care of i called my doctor

got it all straightened out but it

wasn’t until later on that i realized

there is this belief between

african americans and assume pain

tolerance

in our 2015 article in jama

looks at 1 million emergency room visits

these emergency room visits are children

admitted for appendicitis

the study goes on to say that

only one-fourth of the black children

actually received

opioid painkillers compared to the white

children admitted for the same reason

the article also goes on to say that

health care providers

can contribute to unequal treatment to

minorities

as well so let’s look at this picture

can you see the physician let’s say

diagnosing the patient for pain

do you think this doctor can clinically

or effectively manage this patient’s

pain

with this invisible wall of implicit

bias in front of him

now let’s look at from the patient’s

perspective what kind of negative

experience

what kind of emotional toll what kind of

distrust now

does this patient have for this doctor

or health care

professionals in general

so what is society doing

to fix this issue with extreme examples

such as the death of george floyd

there has been an increase in education

specifically around diversity equity and

inclusion

implicit bias is one aspect of that

training

this education has forced government

systems to look more closely at policy

racism as a public health crisis was a

resolution or an announcement

that looked at the disparities in the

education criminal justice

and health care systems

now let’s look at our pharmacist that i

discussed earlier

could they benefit from some education

and diversity equity and inclusion

some may actually say let the employers

handle diversity equity inclusion

training on their own watch

well let’s see what that may look like

emily’s law

is 2009 legislation in the name of emily

jerry a two-year-old that died from a

pharmacy technician

error before this law a pharmacy

technician

could work in anybody’s pharmacy without

any mandated training

what this law did is it took the

training away from the employer

and made a pharmacy technician have to

pass a board

approved competency exam

2017 journal

in the journal of psychiatric and

neurologic pharmacist

states that healthcare professionals

exhibit about the same amount of

implicit bias as the general

population does this implicit bias could

affect

diagnosis and treatment the same

implicit bias that took the lives of

brianna taylor

and george floyd that shows up in law

enforcement systems

can show up in our health care systems

so what can we do

currently in ohio a pharmacist must

report

ceu every two years this cu

eu is composed or continuing education

is composed of pharmacy law

and pharmacy practice well what if it

was created some diversity equity

inclusion training as well

a 2019 article 2019 article in the

journal of

infectious disease states that just as

health care professionals are expected

to stay up to date

on medical techniques and clinical

guidelines

we expect them to be up-to-date on

cultural competencies as well

to make sure that they’re able to treat

people that may not always look like

them

so with that

i believe that it is time

go to your pharmacy board organization

and suggest diversity equity inclusion

training for

pharmacists every two years how just go

to the website

they welcome your comments and questions

i believe that it is time

to go to your state representative and

propose a bill that would mandate

a pharmacist to have diversity equity

inclusion training every two years

i believe that it is time

to all my fellow pharmacists

reach out to your local pharmacy

organization and have them support

legislation they would demand

diversity equity inclusion training for

a pharmacist every two years

and the next time you go to one of your

pharmacy organization meetings

and there’s some type of implicit bias

training there

make sure you take it be a part

make a change thank you