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Published on Wednesday, October 1, 2008 by the Concord Monitor (New Hampshire)

Big Chain Pharmacy Can't Fill the Prescription

by Deborah Stone

We were lucky to have a small, pharmacist-owned drug store in Newport for 10 years, until Rite Aid bought out Scarlett Drug this summer. The big chain took the pharmacist and some of his staff into its employ, along with many of the drugstore's devoted customers.

By all accounts, the little pharmacy was thriving in a Main Street storefront, even though it had opened its doors long after Rite Aid had staked out one corner of the town's major intersection. The Little Druggist That Could filled almost three times as many prescriptions per month as the big chain.

Any of its customers could explain why.

When you walked into Scarlett Drug, you were greeted by name by anyone who happened to be behind the counter. You made small talk about each other's families and caught up on the news. Often people waiting for their prescriptions sat in chairs, two against each side wall, out of the way but still close enough to partake of the chitchat. If you had questions about a prescription, Kevin Scarlett would come out from behind his lectern, take you off to a quiet corner, and talk with you warmly, patiently and discreetly.

When you walk into Rite Aid, you can't even see the pharmacy counter, it's so far back behind mounds of consumer goods, most of which have little or nothing to do with health. To reach the pharmacy, you have to wend your way between beach chairs and boogie boards, kitchen gadgets and cookware sets, Homer Simpson pillows and SpongeBob SquarePants dolls, panty hose and stick-on eyelashes, auto vacuums and 130-piece ratchet sets, or, if you choose that route, an entire aisle of beer, including a few of the "healthy" lite varieties.
Scarlett Drug didn't try to be K-Mart. It carried just enough choices of anything you might reasonably expect to find in a drug store - remember that quaint name, when drug stores sold pretty much nothing but drugs? Oh, the one in the town where I grew up also had a lunch counter with spinning stools where we'd go after school for ice cream, but other than that, Garb Drug was where you went for thermometers, bandages, medicines and, eventually, the dreaded sanitary napkins. A sixth- or seventh-grade girl would sooner be caught sharing ice cream with a boy than buying those things. That's what mothers were for.

'Can you take Sudafed?'

But back to Newport. Today's teenagers probably appreciate the anonymity of being able to select from hundreds of enhancements for their intimate lives while they dart to the school-supplies aisle for cover and always remain hidden by tall shelves. No evil eyeballs from the pharmacist or his wife in a big-box store, though even here, there's no escaping the moment of truth at the cashier.

As an adult, it's not anonymity I crave when I fill a prescription. I'm looking for some compassion and wise counseling. On one occasion, I had my mother-in-law with me as I was about to buy some Sudafed. Kevin overheard me ask for it, then ever so nonchalantly stepped forward and asked, "Can you take Sudafed?"

I must have looked puzzled. He took me aside to explain that some people with glaucoma (he knew because he had been filling my prescription for eye drops) can't take Sudafed. My ophthalmologist had never warned me off Sudafed, so I figured I'd buy it and call the doctor later.

But what really endeared Kevin to me was that on top of being hyper-observant, he found a way to counsel me without disclosing anything to the person with me - as it happens, someone who didn't know about my problem, and who I didn't want to know about it either, worry-wart that she is.

Counseling is not on the agenda at Rite Aid. The first time I filled a prescription there, it was for a drug I'd never taken. When I picked it up, a woman I know who used to work at Scarlett Drug helped me. She directed me to sign the little black box acknowledging that I'd received the medication, just as we always used to do at Scarlett.

Thinking I was done, I said goodbye and started to walk away, but the woman asked me to wait. She took the pen from my hand, clicked on "Next," handed me back the pen, and then, before I could even read the screen, said, "Now hit 'I decline counseling.' " She was friendly and only trying to help me through the new procedure, but I was taken aback because I hadn't declined counseling - nobody had offered it to me. I got a creepy feeling that I had just unwittingly waived some right.

When I got home, I read Rite Aid's patient information brochure that came with the prescription and discovered two-thirds of the way into the second page of small print that the new drug may interact badly with a drug I already take. I called my doctor, of course, but wondered what happens to the vast majority of patients who don't make a habit of reading fine print.

In my next Rite Aid encounter, when the clerk instructed me to say I had declined counseling, I took time to read the screen. It gave me two choices: "I decline counseling by a pharmacist," or "I have been counseled by a pharmacist concerning the medication I received." There was no possibility to say, "I would like counseling" or to state the truth: "I wasn't offered counseling."

Discouraging conversation

In fact, the way Rite Aid is set up, customers pick up their prescriptions at one end of a long counter, about 15 feet away from where the pharmacists work. The geography discourages conversation with the pharmacists. One time, just to test the system, I told the clerk I wanted to ask the pharmacist a question. She told me to step out of the (long) cash line and "go down there to that window." I was clearly disrupting the flow of things.

Kevin was one of several pharmacists on duty, and after some catching up and fooling around, he answered my questions thoroughly and pleasantly. He's doing his best to recreate the Scarlett feel inside Rite Aid, but now a customer has to be pretty assertive to have any contact with a pharmacist.

Gone are the days when the pharmacist took the initiative and asked you questions such as, "Have you ever taken this drug before?" or "Do you have any questions about it?" It's hard not to feel that Rite Aid deliberately minimizes contact between customers and pharmacists, then pushes the customers to say they have "declined counseling" - a routine meant to cover Rite-Aid's you-know-what rather than help patients.

This is what happens when large corporate chains replace small, locally owned businesses. In a chain, the local store personnel have to worry first and foremost about pleasing the corporation's lawyers and investors. For Rite Aid, it seems, we townspeople are no longer friends and neighbors, but impulse buyers and potential lawsuits.

That's a sad day for Main Street.

Copyright 1997-2008 Concord Monitor
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