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Bitter Pill: How DC's Pharmacies Fail Women

Amanda Hess's picture

For most professionals, an acceptable excuse is required to miss work: a swollen appendix, ailing grandmother, whiplash, at the very least.

Pharmacists, on the other hand, may refuse to do their jobs for any old reason - or for none at all. We're talking about birth control, of course. In the District, for example, pharmacists are not required to provide such products, especially if their "personal views" won't allow it. According to NARAL Pro-Choice America, only six states bar pharmacists from withholding birth control prescriptions/doing their jobs: California, Illinois, Maine, Nevada, New Jersey, and Washington.

That means that D.C. is a hotbed of the ultimate bullshit defense for denying health care to women. Pharmacists here can refuse to provide women's health care based on such "personal views" as latent sexism, unsubstantiated medical opinion, or whim. Some other "personal views" local pharmacies have offered up:

It's private. A pharmacy's trust factor often relies on its adherence to privacy - its hushed consultations, the 3-foot courtesy bubble between customers, pills wrapped in nondescript white paper packaging. For contraception allies, these conventions help keep birth control a personal transaction not subject to political interference. But right across the counter, the "privacy" excuse allows pharmacists to deny you access to contraception at any time while shirking explanation and accountability-no questions asked. A flack for Wellington Pharmacy defers to the privacy excuse - "it's a relationship between a person and their physician" - as to why the pharmacy, affiliated with Catholic-leaning Providence Hospital, provides Viagra but no birth control.

This pharmacy is here to deny your rights. Those not interested in providing medications to humans can choose from a host of careers that are not involved in providing medications to humans. And yet, the D.C. area is home to several anti-contraception advocates that insist upon going the pharmaceutical route. For all these pharmacies gets wrong about women's health - namely, their positions on condoms, birth control, and the morning-after pill - they often get one thing right: At the most fanatical anti-contraception outfits, women at least know what they're not getting. America's latest pro-life pharmaceutical poster child, Chantilly's Divine Mercy Care Pharmacy, defied the tight-lipped industry standard with its grand opening last fall. Holy water slicked the shelves. A bishop blessed the operation. The AP took video. But though the DMC is the only local pharmacy affiliated with anti-contraception group Pharmacists for Life International, it's less dangerous than the other area pharmacies quietly denying access to birth control.

They've got inventory issues. On a recent Saturday, I contacted 10 local CVS pharmacies to see if they had the morning-after pill in stock. Nine did. The pharmacist at the one that didn't informed me that his store's Plan B shipments arrived on Tuesdays, so I would just have to wait 72 hours to get my hands on the pill. Never mind that the effectiveness of Plan B decreases with each hour after unprotected sex, and that after 72 hours, its chances of preventing pregnancy are kaput. The representative at another CVS that did have the pill informed me they only had two pill packs left on the shelf. They, too, received new shipments only once a week, on Tuesdays, so my chances of getting the morning after pill depend on a guessing game of how many condoms broke in the District of Columbia in any given week. Here's a tip, CVS shoppers: If you're going to need to use the morning-after pill, just make sure that morning falls on a Wednesday.

They're weirdos. Though it's not uncommon for pharmacists to operate behind a shield of privacy, some display a distaste for discussing women's health that borders on good old-fashioned sexism. When it comes to contraception, pharmacists are often skittish about discussing the most basic aspect of their business - which prescriptions they will fill and which they will not. And it's not just pharmacies with moral motivations against contraception that aren't talking. In a telephone interview, the proprietor at Dupont's Tschiffely Pharmacy refused to discuss whether the shop dispensed the morning-after pill. But when I stopped in to try to pick up a pill pack, Plan B was in stock and offered with a smile. Georgetown's Dumbarton Pharmacy, meanwhile, declined to discuss its contraceptive options at all. Playing coy with contraceptive options is less cute when women need to locate them instantly in order for them to work. No other common, FDA-approved, over-the-counter medication would receive such silent treatment from pharmacists.

Even chain stores like Rite Aid and CVS, which have national policies that adhere to the contraception-access requirement of the six aforementioned states, must draft elaborate plans by which to protect their pharmacists' idiosyncrasies. Sometimes, those quirks mean losing business. Take Rite Aid's policy, which outlines a three-step plan by which a pharmacist can avoid personally filling your birth control prescription: 1) Have another technician fill the prescription; 2) if there is no other technician on hand, contact the closest Rite Aid to dispense the medication, then have the prescription delivered back to the customer's preferred Rite Aid location; 3) if no other local Rite Aid pharmacist will consent to dispensing birth control, locate the nearest competitor that will fill the customer's need, then follow through until that need is met.

They don't trust you - or your doctor. Cathedral Pharmacy owner Paul Beringer, a Catholic, will not provide the morning-after pill. "I consider it abortion," he says. Non-emergency contraception is dispensed on a case-by-case basis - meaning that the pharmacist can nullify the decision of your medical doctor because he thinks a prescription might be faked, is uncomfortable dispensing contraception to women under the age of 18, or otherwise wishes to impose his "personal views" on your body.

They fear your vagina. Target Pharmacy provides prescription birth control as well as the morning-after pill. Other women's health products, however, aren't available even with a doctor's signature.

Parker, 27, who declined to give her full name, came to the pharmacy straight from work with a prescription from her gynecologist's office. It was 5:30 p.m. and raining, and she needed to fill the prescription that evening in order to prep for a procedure scheduled for the next morning.

But Target's pharmacist refused to fill the prescription because the doctor instructed that the pill was to be inserted vaginally. Parker's doctor had prescribed her Cytotec, an FDA-approved treatment for ulcers. The medication is also routinely prescribed off-label to dilate the cervix to induce labor in pregnant women, or, in Parker's case, to aid in the insertion of an IUD. Parker - who wasn't pregnant - learned later that the medication can also be used to induce abortion.

The pharmacist, who did not give her name, says she rebuffed Parker's prescription because she disagreed with the doctor's insistence on vaginal insertion."That's not how it's supposed to be prescribed," she says. "It's supposed to be taken orally."

The pharmacist says she tried to call Parker's doctor's office but wasn't able to reach anyone at the late hour. Parker says the pharmacist never picked up the phone while she was there and that she had to beg her to consult her doctor before she got an explanation - that the office would be closed and there was nothing she could do.

Parker left the pharmacy in tears. "I got a little hysterical," she says. "I couldn't believe that this pharmacist, who has less training than my doctor, would deny me this medication that I needed, because it was specified that it went in the vagina?"

After asking for the name of a supervisor, Parker took solace in Columbia Heights' other chain pharmacy. Still red-eyed, she crossed the street to the CVS. There, "a very nice, flirtatious Latino man filled my prescription, no questions asked."

This article was first published on The Sexist blog at the Washington City Paper.


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11 comments
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A pharmacist not dispensing Plan B to a patient has NOTHING whatsoever to do with a pharmacist not doing his or her job or not showing up for work. Pharmacists are often expected to show up at work when they are sick. There often isn't anyone to cover their shifts when they are ill. You are so way off base in saying that they can refuse to do their jobs for any old reason. And, apparently, quite ignorant. Now, to the point of dispensing Plan B. If one pharmacist doesn't want to carry Plan B in his or her store, there is always another pharmacist, if not many more pharmacists, in the area that will. That's what I got from your story! Why didn't you get that??? What is the freakin' big deal? Last time I checked, this is a free market capitalistic society that we live in. No one is required to stock or sell anything in his or her store. Welcome to the USA!

Submitted by Anonymous on December 23, 2008 - 10:32am.

The big deal is that Plan B is a legal over the counter drug. The effectiveness of the drug decreases as time goes on. A woman should NOT have to run around an entire city to find this medication when it is well within her rights to obtain it. The fact that you can find it in other places may seem moot in a place where there are lots of pharmacies, but what about suburbs or rural areas? I have used Plan B before and the place I went had it, but was shutting down for lunch and I almost had a panic attack in the middle of the store because I had to wait an hour before I could get it. It was a terrifying feeling, and no one should have to feel that way when they are trying to get Plan B. Pharmacists that refuse to give this out are denying the rights of women to make their own choices and that is a huge deal.

Submitted by Anonymous on December 23, 2008 - 12:33pm.

If you go into a movie theater or get on an airplane, note where the exits are. Before you jump in a pool, make sure it has water. Carry more than one kind of credit card. Be prepared. Arm yourself with if/then knowledge. If you are sexually active, know where you can buy Plan B. It's as simple as that. And no, it is NOT a big deal.

Submitted by Anonymous on December 23, 2008 - 5:24pm.

Oh, I forgot... Know what your pharmacy's hours are & when the staff takes its lunch break. Knowledge is power!

Submitted by Anonymous on December 23, 2008 - 5:29pm.

You'll have to excuse me for not considering that my pharmacist might have had a lunch break when I was trying NOT to have a baby that I didn't want. I get your point about being prepared, but Plan B is called emergency contraception for a reason. I was kind of having an emergency, and the emotions involved in that are hard to describe. I offered up that example because I KNEW I would be able to get it at that location, but hitting a speed bump was scary. I can't imagine going to a pharmacy and having someone tell me that they wouldn't give me what I needed and then having to go somewhere else, especially when time is important.

I was so, so grateful that I had that option when I needed it. Really - so glad for all of the people who, I'm sure, had to work very hard to get Plan B to be over the counter. I was happy that I knew about it and could take the situation into my own hands and make my own decision about what was right for me. I wish that all women could have that and not have to deal with BS from some pharmacist standing on some 'higher' moral ground.

Submitted by Anonymous on December 23, 2008 - 6:41pm.

"Know what your pharmacy's hours are & when the staff takes its lunch break."

You're being silly.

Submitted by colleen on December 23, 2008 - 7:15pm.

The point is it isn't up to the pharmacy to decide what medication a woman needs or should have. That decision is up to the woman and her doctor to decide. When pharmacists are required to go through years of medical school, and have the same kind of education required of an OBGYN I will accept that a pharmacist can decide what medication a woman needs or can be given. Pharmacists are in a unique position of providing needed medications to people who require them. They are not in any position to diagnose any illness, or decide treatment for such illness. Would we really be having this conversation if pharmacies were denying patients needed hemopheliac treatments (which can be made from blood and are considered blood products) for religious or "moral" reasons? Of course we wouldn't, because hemophelia, and such illnesses are not conditiones that are only suffered by women. Wheather society as a whole is willing to admit it or not, women are still considered second class citizens, particularly in the instance of health care. This point is no more obvious than in the case of women being denied needed health services while men are eagerly provided medications like viagra, which serve only to put women in need of those health services the religious right is so anxious to deny.

Submitted by Equalist on January 8, 2009 - 11:31am.

It'll be best if people just ask their own personal doctors to recommend trusted pharmacies for them. I don't buy the women-as-second-class-citizens. That kind of labeling is already extinct.

Submitted by Dr. D.C. Harrison - dentist on January 10, 2009 - 1:31pm.

That kind of labeling will never be extinct as long as there are those who can and would deny women the health care they need and deserve based on their own ideals and morals without regard to the needs or health of the women they are supposed to be serving.

Submitted by Equalist on January 25, 2009 - 3:53am.

Arm yourself with if/then knowledge. If you are sexually active, know where you can buy Plan B.

I would go one further and recommend that if you are sexually active, keep Plan B on hand. Remember to keep your supply current - the pills have a shelf life of 4 years. If you have a daughter living with you who is or may be sexually active, the same thing goes.

Of course, being able to defeat the attempts of small-minded individuals to deny you access to contraception in no way excuses those attempts. Still, until the day that women don't need the personal approval of their local neighbourhood zealot to obtain legally approved medication, secure your supply in advance.

Submitted by DaveL on January 25, 2009 - 9:19am.

I will say this is good advice, but it is sad that it's come to a point that it should have to be.

Submitted by Equalist on January 28, 2009 - 12:07am.