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COVID-19: What's behind the ‘disgusting’ abuse of pharmacy teams?

Many pharmacy professionals say patients have verbally abused them
Many pharmacy professionals say patients have verbally abused them

Pharmacy teams reveal why abuse received from patients has soared during the COVID-19 outbreak

The deluge of demand for healthcare items following the outbreak of COVID-19 has loaded unprecedented pressure on community pharmacies. The impact of this was inevitable – increased waiting times, enforced social distancing, and reduced opening hours.

However, the consequential spike in reports of “disgusting” abuse from patients was unexpected. Pharmacy professionals say this includes patients spitting, coughing and screaming at them.

One told C+D they had to call the police after a patient, infuriated by social distancing measures, threatened to “rip the shop apart”. Another says their pharmacist was “in tears”, while one says the COVID-19 outbreak had made abuse upon pharmacy staff “routine”.

But why do these incidents happen? A C+D survey reveals the reasons behind patient anger during the pandemic. The survey, which ran from April 1 to May 10 and covered pharmacy teams in all four UK nations, received responses from 1,018 respondents on how their business has been affected by COVID-19.

Waiting times

Longer waiting times were the primary cause of patients becoming abusive. One third (33%) of the 545 survey respondents, who say they had received abuse, say it was primarily down to patients having to wait longer to be seen by a member of staff in the pharmacy. A further quarter (26%) say the main reason for patient abuse was having to wait longer to receive their prescriptions.

Social distancing measures have lengthened waiting times as they often lead to queues. Almost one in 10 (8%) of respondents say attempts to distance people in the pharmacy were the chief driver of patient abuse.

Pharmacy professionals say:

Our abuse has been related to increased waiting times to be served, the fact that only three people are allowed in the pharmacy to comply with social distancing results in a queue system outside the pharmacy. Repeat prescriptions are taking longer to come from the surgery – we get abuse for this as they’re not ready when patients want.”

“Patients seem to forget that everything has a supply chain. Just as they wait at supermarkets, they have to be patient at pharmacies too. They are happy to wait and buy bread and milk but seem to think their prescriptions should be at hand even when they are not urgent.”

“Most people come over as very reasonable until you tell them their prescription will take longer than usual, or they can’t get something, or we can’t deliver immediately. Then they can get quite abusive.”

“[Patients are] demanding same-day service for routine prescriptions. [They have] unrealistic expectations of a service under pressure.”

“Social distancing has led to verbal abuse – the company has employed a guard to assist us.”

“Patients are increasingly demanding. They get angry if they have to wait longer.”

“Patients are not happy with social distancing measures implemented by [the] pharmacy, in turn swearing at pharmacy staff and banging on our doors and windows because they're not happy.”

“The issue is that [patients] had such an excellent service in the past. This waiting longer and reduction in opening hours is alien to them.”

Medicine shortages

Waiting times at pharmacies are often made longer due to medicine shortages because pharmacists have to spend more time sourcing stock or calling the patient's GP to find an appropriate alternative. According to the survey, 77% of respondents say they had been affected by medicine shortages as a result of COVID-19.

This was the most-common impact of the pandemic felt by respondents. The other most pressing problems were a lack of personal protective equipment (55%), a need for COVID-19 tests for staff (50%), and reduced money from clinical services (48%).

A lack of certain products in pharmacies was also listed by respondents as a trigger for patient abuse.

Pharmacy professionals say:

“Initially, patients couldn't understand our lack of hand sanitiser, face masks and especially painkillers.”

“Patients are not happy that we restricted items, such as paracetamol and baby milk, to give everyone a fair chance! Some have been very verbal and just downright nasty.”

“The mad panic was almost unbearable from a pressure point of view. The medicine shortages and prices [issues] have compounded the issue massively.”

“Drug companies really need to sort out medicine supply issues, quotas and out-of-stocks as this is adding enormous pressure when we need to be focusing on COVID-19.”

“We are facing abuse due to medicine shortages, there is a total lack of awareness to the public or our plight.”

“Thankfully the abuse has eased but we are still getting complaints about medicine shortages.”

GP prescriptions

Many respondents have reported problems linked to GP surgeries. A common issue is patients becoming incensed after not being able to access a closed practice, before venting their frustration in the only primary care premises open to the pubic: pharmacies.

In addition, some GPs are trying to help patients by prescribing them up to three months’ worth of medicines, instead of the standard 28 days. This contravenes COVID-19 advice from the Royal College of General Practitioners that doctors should not increase the length of prescriptions as “this is likely to undermine the medicines supply chain”.

When there is a mistake with a prescription the blame falls again on the pharmacy team, who must spend time calling the GP surgery to try to fix the problem. Many respondents to C+D’s survey feel abandoned by their healthcare colleagues.

Pharmacy professionals say:

“GP surgeries appear to have increased the volume of prescriptions according to patient wishes, this knock-on effect has brought many more patients who are frustrated that medications are not available immediately.”

“GP surgeries have shut their doors and we are getting the blame for it. Patients are taking all their stress out on us.”

“GPs tell patients to go straight to the pharmacy and it will be ready – it will not.”

“GP surgeries have refused contact [with patients] leaving patients scared and confused as to how to order or manage their medication.”

“GPs have shuttered themselves in and left us to deal with everything.”

 “A lack of communication from surgeries means that patients, and ourselves, are not always clear where prescriptions are. Some scripts have been post-dated but there is no clear pattern and no advice to patients. Some patients have ended up having three months’ worth of medicines while others, maybe in the same household, are struggling to get what they need”

Although abuse of pharmacy staff has risen during the COVID-19 pandemic, it is usually a minority of patients. Many respondents to the survey noted that the rise in aggression was accompanied by an increase in gratitude – with patients gifting items ranging from chocolate to personal protective equipment. But it just takes one offensive patient to ruin the day of a member of a pharmacy team. 

20 Comments
Question: 
Would you leave your job in community pharmacy to work in a different sector?

Lucky Ex-Locum, Superintendent Pharmacist

The answer to the posed question is a big fat YES!!!!!!! and not just to another part of pharmacy. Pharmacy is becoming a rancid cesspool and anything would be better. Not that there will be pharmacy for much longer anyway. The pharmacist will be replaced by ACTs with one stroke of a ministerial pen and then we will go the way of Debenhams, BHS and Woolies into extinction.

Mark Boland, Pharmaceutical Adviser

It is often the case that the pharmacist is too cowardly to do anything about abusive customers.

Over the years I have seen pharmacists allow their staff to be abused by customers, only to then humiliate the staff member by apologising to the customer in front of them.

I have seen pharmacists blame locums for what was in fact egregious customer behaviour and then give them a negative rating to the locum board.

I have seen pharmacists castigate delivery drivers because an irate customer has missed their delivery.

When I think of community pharmacists, I generally think of a subservient wimp kowtowing to customers and GP surgeries. Nit pickers who blindly follow rules because they are too scared to use their own discretion. When staff are looking for leadership and strength from a pharmacist, they see a chaotic dispensary led by a disorganised alarmist more interested in ticking the right boxes than getting the job done with least amount of staff stress.

 

 

Lucky Ex-Locum, Superintendent Pharmacist

What utter cobblers. Most pharmacists stand up for themselves and their staff perfectly well. I have never in 30 years experienced anything like you talk about. What ACTUALLY are you anyway, Mr Boland? Your title states pharmaceutical adviser and yet in other posts you talk of 'your branch'. What is very clear though is that you have a high opinion of yourself and this post seems to firmly place you in an observational rather than patient interactive role. It's also obvious that the irony of your post is totally lost on your ego-driven self - responding to an article about abuse of pharmacists by abusing pharmacists - how very droll of you.

Mark Boland, Pharmaceutical Adviser

'It's also obvious that the irony of your post is totally lost on your ego-driven self - responding to an article about abuse of pharmacists by abusing pharmacists - how very droll of you'

There is no missed irony, just your incorrect use of a word. I am being highly critical of a certain number of pharmacists based on my experience, criticism is not abuse. If you would like to point out a single abusive statement in any of my post, I would be most obliged. I await your reponse.

Lucky Ex-Locum, Superintendent Pharmacist

I believe the words 'cowardly' and 'wimp' are most definitely, in the context you have used them, abusive. I also think you should look up the word 'irony' in a dictionary - in this case it applies to your use of abusive language when answering a post about abuse. I'm not saying the irony was deliberate, just you couldn't see it. I await YOUR response.

Mark Boland, Pharmaceutical Adviser

 

If you think that somebody reporting the cowardly/wimpish behaviour they have observed (and had reported to them) during their practice is abusive, then you truly do not understand the term 'abusive'. Uncomplimentary and critical, certainly. Abusive? Not even close. So again, no missed irony.

The behaviour I have seen tolerated by pharmacy staff is genuinely abusive. When I have dealt with it and asked the staff who that person was, more often than not I have been told it is a regular occurrence and the 'manager' doesn't do anything about them. I have it regularly reported to me that the 'manager' has castigated them for answering back. That the manager sticks up the customer before them. That the manager and area manager think accommodation of patient behaviour is best way of avoiding a customer complaint. 

Pharmacists who are willing to stand up to senior management have always been in the minority in my experience. Conference calls or in-person manager meetings, it is always a very small minority who offer up any resistance about the work conditions for themselves and their staff. The rest too petrified to say a word.

In my experience, the most spirited and gutsy people in pharmacy have nearly always been the shop and dispensary staff. They are the ones who offer the strongest response to abuse from customers and are ones who want the strongest penalties. Unfortunately, they are all too often forced to put up with it.

I hope you do not feel too 'abused' by me simply reporting my experience. And as it is against the site rules to be abusive, try reporting it to the moderators.
 

 

Lucky Ex-Locum, Superintendent Pharmacist

Abuse takes many forms, calling comeone a coward and a winp is abusive. Obviously you are such a tough-guy that you can handle anything. Good for you, but I'm glad I don't work within ten miles of you. If someone is so unsympathetic to others I'm afraid you have no place as a pharmacist, adviser or whatever the f. you are. What you have to remember, and I would have thought that as an adviser, you would realise this but again, one more thing lost on you, in a service industry such as pharmacy, the customer is king. Many pharmacists will also work for multiples with the area manager (you'd make a good one of those I'm sure) hanging over them ready to pounce on any little mistake so they can buff up their own credentials as a hard man (or woman). Therefore, however much it sticks in the craw, it is the lot of the pharmacist to placate the angry customer, to remove the threat of a complaint (and remember nowadays, complaints are anonymous, online and accessible to all) either to the company or the GPhC which could lose them their career. It seems obvious from your comment that you either don't work or have very limited experience of working in, community pharmacy. It has become a thoroughly unpleasant place where good people are being broken on the rack, not in the least helped by your attitude, insults and abuse.

Getting Shorter, Community pharmacist

Not all of us! Two patients have been barred (including one who then went on to get themselves removed from the surgery list), one retracted his complaint with an apology...and even now, 3 months in, we are just telling people how it is. On the other hand, I also apologised to a customer I was unduly short with in the first couple of days. But my staff know I will intervene to back them up when needed and it means everyone feels confident and safe. 

Lucky Ex-Locum, Superintendent Pharmacist

Exactly, and, unlike the opinion of Mr Boland, who, apparently, is only fit to 'advise' others, the vast majority of us would do the same. I have had NO abuse from customers EVER because the second they try to start I make it perfectly clear that I won't tolerate it, occasionally using words that they understand.

Mark Boland, Pharmaceutical Adviser

'I have had NO abuse from customers EVER because the second they try to start I make it perfectly clear that I won't tolerate it, occasionally using words that they understand'

A totally incredulous statement. Every single pharmacist faces abuse in their practice. It would be impossible for anybody to acquire a reputation for zero tolerance to the point in which nobody would dare attempt it. It would be similarly impossible for anybody to intervene so quickly (a fraction of a second) to stop it before it started.

To use 'words that they understand' would show a loss of control and a willingness to stoop to their level. I would not 'advise' anybody to respond in such an unprofessional way. Clearly and politely explain that you will not be tolerating the abuse and ask them to leave or end the call.

Lucky Ex-Locum, Superintendent Pharmacist

I'm not saying I haven't faced the possibility of abuse, just that I have never let it get beyond that stage. Firmness and a look is enough to nip it in the bud in every case so my statement is not incredulous, merely fact. I have never allowed myself to be abused and never will. I also have never had to resort to banning a patient and frankly, 'stooping to their level' in another context could be seen as defusing the situation. Perhaps that is why I don't face the abuse that you do, because I don't respond with superior pomposity, just a normal person response.

Adam Hall, Community pharmacist

Using words patients understand does not 'stoop to their level' or show 'unprofessional' behaviour. Good communications is the cornerstone of our profession. Just because the person understands you, does NOT mean you have used inappropriate language. Nor does it mean you have lost control. I am sure we alter our language according to our audience. That doesn't mean we've started effing & blinding!

Mark Boland, Pharmaceutical Adviser

Here is the quote in full context:

'I have had NO abuse from customers EVER because the second they try to start I make it perfectly clear that I won't tolerate it, occasionally using words that they understand'

Does he in the most part use words they don't understand and only occasionally uses words that they do? Or is he implying something else? I think you know exactly the context it was being used.

In any case, the answer is no, I don't change my language when I'm dealing with abusive customers. Why would I? If you are abusive (in the true sense of the word), you are leaving the premises and that can be explained in the same language I would use to explain anything else. I'm not getting into a debate about it, I am not trying to explain something subtle or sophisticated. You are being told to leave the premises or that the phonecall will no longer be continued.

 

 

Lucky Ex-Locum, Superintendent Pharmacist

Mr Boland doesn't seem to understand much, does he?

Mark Boland, Pharmaceutical Adviser

The fact that I do understand what happens on the ground, is what seems to have triggered your response.

The idea that community pharmacy is a place of zero tolerance to abuse, led by a profession known for it's stridency and zero tolerance to all things abusive, is laughable in the extreme. It is known for the exact opposite. 

Lucky Ex-Locum, Superintendent Pharmacist

Agreed, however, necessity dictates that we cannot throw people out willy-nilly and in fact, banning someone from a store is a minefield in terms of contract because you CANNOT for any reason refuse to dispense a prescription. You can ban someone from the premises but not from your services. And no, I have never sworn at a customer, but I do make it perfectly clear to the, for want of a better phrase, less intelligent members of the community exactly what will happen if they carry on, using words of one syllable, which they will understand, rather than trying the overbearing superior approach you try. In MY experience, it's worked every time, never had a complaint, always defused the situation, never had to throw anyone out, kept customer AND staff happy, so who is right and who is wrong?

Kevin Western, Community pharmacist

Its all about the corporate "the customer is always right, no matter what" policy so many companies adopt to stop them taking their business elsewhere or being told to... if they ran out of places who would serve them, it might give them a clue

Tim B, Locum pharmacist

Retired and have no intention of being exposed to it again. I cannot understand why people do that job anymore. A lot of [email protected]@@e for very little money.

Industry Pharmacist, Head/Senior Manager

Pharmacists are abused in most patient facing roles. Either by their patients, customers or superiors. I feel blessed to be away from all that nonsense.

ABC DEF, Primary care pharmacist

Straight outta community. Ain't no body get paid enough to take these craps. 

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