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