Pharmacy dispensing volumes spike at the start of each month, because of the timing of government assistance payments . This leads to a spike in medication errors, resulting in a spike in mortality.
Thus trust goes in cycles. At some times of the month you get a rushed service, with little opportunity for personal (authentic) interaction. At other times, the pharmacist may be able to spend a little more time on each item, not just checking the technical correctness of the medication but also relating to the patient as a person.
There are three types of risk that may be affected by this cycle.
- Implementation risk - is this correctly dispensing what was prescribed?
- Composition risk - how does this medication interact with anything else the patient is doing/taking?
- Intention risk - is this the right prescription for this patient?
POSIWID thinkers may note that the negative impact of this phenomenon falls disproportionately on those dependent on government assistance, thus effecting a kind of triage. God forbid there is any purpose in here.