Behind the Pharmacy Counter: A Patient Advocate's Journey Through the Healthcare System
- nashadvocacy
- Sep 4, 2025
- 11 min read
In April, I did something I never thought I would do. I started working part-time as a pharmacy technician at _--- in Clover, South Carolina, on Bethel Street. It was necessary to keep my business going - a mission I deeply believe in. My patient advocacy business, my passion and my calling, was still in its infancy. I had started with absolutely no investors, no loans, no capital of any kind. But I did have one person at a time, and those people talked, and those people talked, and it has been a blessing.
I started working with a new business coach near the beginning of the year, who advised me that new businesses often require supplemental income, and he was right. Running a business without the constant fear of financial stress is truly enlightening, and people are rediscovering my services.
Initially, in January 2023, I juggled several part-time jobs to make ends meet. Once I noticed my business beginning to turn a profit, I decided to leave those part-time positions behind. People were astonished that a brand-new venture was already generating income before I even finalized my business plan; I was addressing challenges and making a positive impact on people's lives. In hindsight, I should have kept one part-time job to supplement my income.
However, I understood what I needed to do to survive and keep my business afloat. I put on blue scrubs for the first time and stepped behind the pharmacy counter at ---, working part-time with a demanding retail schedule that included four nights a week. By day, I was an advocate, and by night, I worked as a pharmacy technician. I wasn't abandoning what I knew was necessary; I was doing whatever it took to keep my dream alive. I cared deeply about my work and was willing to fight for it.
This is a story of my experiences, my lessons learned, and how they transformed me. It reflects the realities of entrepreneurship, the intricacies of our healthcare system, and the remarkable resilience of the human spirit. Although I was initially hesitant to share this story, fearing it might be perceived as a failure, the opposite has occurred. This journey has become a testament to the heart of the struggle. The healthcare machine has become one of my greatest strengths. And now, I'm ready to share it with you.
The Business Reality: Survival and Resilience
Starting a business is an act of faith. You pour your heart, your soul, and your savings into an idea you believe in. For me, that idea was patient advocacy. I recognized a critical need for people to have a guide—a knowledgeable and compassionate ally—as they faced the overwhelming challenges of our healthcare system. I knew I could make a difference. But I also knew that I was on my own. No investors, no safety net, just a fierce determination to succeed.
But determination, as I quickly learned, doesn't keep the lights on. My business was growing, but slowly. And time was a luxury I couldn't afford. The bills were piling up, and I was faced with a stark choice: give up on my dream or find a way to keep it afloat.
For me, giving up was never an option. So, I chose survival. I decided to take a job at ---, not as a patient advocate, but as an employee. It was a humbling experience, to put it mildly. I had moments of doubt, moments where I feared that people would see me as a failure—a patient advocate who couldn't even sustain her own business. The irony was not lost on me.
But what I discovered was something entirely different. The experience didn't break me; it fortified me. It gave me a new perspective, a deeper understanding of the very system I was trying to help people navigate. It reminded me that there is no shame in an honest day's work. In fact, there is immense dignity in it. And it taught me that sometimes, the path to our dreams is not a straight line, but a winding road with unexpected detours. This detour, this time behind the pharmacy counter, was not a step back; it was a crucial part of my journey forward.
The Corporate Monopoly: Understanding the System
One of the first things you learn when you work at --- is that you are not just working for a pharmacy. You are working for a massive, vertically integrated healthcare conglomerate. --- is owned by -----, one of the largest health insurance companies in the United States, and --------, a major pharmacy benefits manager. This isn't just a business partnership; it's a monopoly. And from my vantage point behind the counter, I could see the profound and often detrimental impact of this consolidation of power.
Corporate decisions, made in boardrooms far removed from the realities of a small-town pharmacy, would trickle down to us, often with little regard for the actual needs of our patients. The most glaring example of this was the installation of touch screens in the pharmacy lobby. Here we were, in the midst of flu season, with RSV, strep throat, various colds, COVID-19, stomach viruses, and numerous other illnesses circulating. Our elderly and often sick patients were being asked to navigate a technology that was not only unfamiliar to many of them but also a potential vector for disease.
In a small town like Clover, with a large population of farmers and others who choose family over learning to be technologically savvy, this creates a significant barrier to care. It was a classic case of a solution in search of a problem; a decision made without a shred of understanding of the real-world context in which it would be implemented. This disconnect between the corporate office and the "boots on the ground" was a constant source of frustration. Changes were implemented without consulting the very people who would be most affected by them: the patients and the pharmacists. It was a stark reminder that in this consolidated system, the bottom line often takes precedence over the well-being of the people it is supposed to serve.
The Pharmacy Environment: Chaos and Compassion
The pharmacy is a place of controlled chaos. The phones are ringing off the hook, the drive-thru is backed up, and a line of anxious patients is forming at the counter. The stress level is palpable, and it takes a special kind of person to thrive in that environment. What I discovered was that the pharmacy is filled with these special people, these unsung heroes of the healthcare system.
Despite the high-stress environment and the often-unreasonable demands placed upon them, the pharmacy staff I worked with were some of the most compassionate and dedicated people I have ever met. They were advocates in their own right, working tirelessly within the constraints of a broken system to help their patients. They would spend hours on the phone with insurance companies, search for coupons and discount cards like Saving Finders, and do everything in their power to ensure that their patients could obtain the medications they needed at a price they could afford. They did this not because they had to, but because they cared. And for their efforts, they are underpaid.
This experience gave me a profound appreciation for the vital role that pharmacy staff play in our healthcare system. They are the frontline, the first point of contact for so many patients, and they bear the brunt of a system that is often confusing, frustrating, and unforgiving. They are the human face of a system that can usually feel anything but human, and they deserve our respect, gratitude, and support. But more than that, they deserve so much more than what they are getting.
These individuals work tirelessly behind the counter, performing truly remarkable work. They juggle multiple responsibilities, navigate complex insurance systems, provide medication counseling, and serve as the bridge between patients and their healthcare providers. They do all of this while maintaining compassion and professionalism, even when faced with frustrated patients and impossible situations.
As a patient advocate, I have always felt the need to advocate for patients. But my time at --- opened my eyes to another critical need: the need to advocate for the people who serve people. These pharmacy staff members are not just employees; they are healthcare heroes who deserve recognition, respect, and most importantly, fair compensation for the vital work they do. The work they perform is skilled, demanding, and essential to our healthcare system, yet they are consistently undervalued and underpaid.
It's essential to recognize that the people in the stores are not the issue. The system is the problem. The dedicated individuals working behind that counter are doing everything they can within the constraints of a broken system. They taught me things I didn't know, showed me perspectives I hadn't considered, and demonstrated a level of dedication that was truly inspiring. Working alongside them was not a step back in my career; it was a step forward in my understanding of healthcare and my commitment to advocacy.
The Patient Reality: Knowledge Gaps and Barriers
People would come into the pharmacy with no idea what their drugs were for, yet they would make decisions about which medications they wanted and which ones they didn't like, often based on price rather than medical necessity. They would ask, "What is this for?" about prescriptions they had been taking for months. They would choose to skip medications they actually needed while keeping ones they didn't understand, all without consulting their doctors about these potentially dangerous decisions. They would often say, "My doctor did not explain anything to me. I was only given 1 to 5 minutes. Yes, I heard one minute."
This knowledge gap is a dangerous and pervasive problem in our healthcare system. This is exacerbated by a system that places the burden of navigating its complexities squarely on the patient's shoulders. Insurance is the ultimate decision-maker, and its rules and regulations often create insurmountable barriers to care. I saw this most acutely with the aging population, who are truly the backbone of the pharmacy. They consistently pay the highest amounts for their medications and often get the "worst end of the stick." They are frequently caught in Medicare's donut holes, and the medicines they need usually don't have generic alternatives, leaving them with impossible choices between their health and financial survival. For those on fixed incomes, the cost of a single medication can be the difference between solvency and destitution.
In this environment, the pharmacy becomes a place of difficult choices and heartbreaking compromises. And for me, as a patient advocate, it was a constant reminder of the urgent need for better patient education and a more patient-centered approach to care.
The Healthcare Crisis: Symptom Treatment vs. Root Causes
Our healthcare system is in crisis. And from my perspective behind the pharmacy counter, I could see the symptoms of this crisis everywhere I looked. Doctors, constrained by time and resources, have become "symptom treaters," prescribing medications to address the immediate problem without having the time to investigate the root cause. This has led to a culture of over-medication, where patients are taking a cocktail of drugs without fully understanding what they are for or how they interact with each other.
But my fear goes beyond just healthcare - I fear we are becoming a symptom-treating world, not a root cause-finding world. We're so focused on quick fixes and immediate relief that we've lost sight of the importance of understanding and addressing the underlying issues that create our problems in the first place.
The pharmacy staff are caught in the middle of this broken system. They're filling medications, following policies, while insurance dictates the terms, and large corporate practices prioritize profits over timely medication calls. The staff are the ones left standing, and they get the brunt of patient frustration when things go wrong. The number of drugs people take is something I cannot even explain - pills for symptoms that create more symptoms, and then more medications based on the side effects of those pills. It's a vicious cycle that I witnessed every single day.
In this system, the pharmacist is often the last line of defense against medication errors. They are the medication experts, the ones who can identify potential conflicts and contraindications, and provide patients with the information they need to make informed decisions about their health. They are an invaluable resource, and one that is too often overlooked and undervalued.
The truth is, pharmacists possess the most extensive knowledge about medications of any profession. They save lives every single day - you might not see it, but I do. It's the pharmacist who saves lives when doctors' offices make mistakes due to symptom-focused practices. The information they provide about medications is powerful: what not to take, when they catch dangerous allergies, how they educate patients about titration schedules, the medication conflicts they identify, and the life-threatening mistakes they catch that doctor offices make because many practitioners are just too busy focusing on time factors, treating symptoms rather than comprehensive care. Pharmacists are the unsung heroes of medication safety, and their expertise is absolutely critical to patient survival.
The Professional Conflict: Boundaries and Heart
I want to be clear that I always did the right thing. There was never a question in my mind about right or wrong—I remained firmly grounded in integrity. As a patient advocate, my mission has always been to help people, never to cause harm. While working at ---, I understood the limits of my role and respected those boundaries. I never used my position to promote my business or to steer anyone in that direction.
I also never gave medical or medication advice, which is not the role of a patient advocate. Instead, I encouraged patients to have conversations with their doctors and reminded them that they had options and a voice in their own care. Often, I would encourage patients to ask the pharmacist questions—even if that wasn't something they were used to doing. By doing so, I was able to shine a small light on their path, helping them feel empowered to take ownership of their health journey. It was never about me telling them what to do—it was about giving them the confidence to ask, clarify, and engage.
This balancing act was not always easy. Every part of me wanted to step in more deeply, but I knew I had to respect the boundaries of my employment. What I discovered, however, was that even within those limits, small acts of compassion and encouragement could make a meaningful difference. A kind word, a gentle reminder, or a moment of patience often helped patients feel more confident and less alone.
Through this experience, I learned an important lesson: advocacy is not always about taking significant steps on someone's behalf. Sometimes, it is about planting seeds that allow people to advocate for themselves. By working within the system while staying true to my values, I gained a deeper understanding of the challenges patients face. I developed a stronger appreciation for how mighty even small acts of guidance and kindness can be.
In the end, I left --- knowing that I had never crossed boundaries, never compromised my ethics, and always did what was right. I found ways to honor my calling as an advocate while still respecting my role as an employee—and that lesson has made me a stronger, more mindful advocate today. It was a challenging and often frustrating experience, but it was also incredibly valuable.
The Broader Experience: Building Advocacy Strength
My time at ---was not my first experience working within the healthcare system. I have worked for the VA and the state as a vocational rehabilitation counselor, job coach, and business development specialist, as well as a Medicaid social worker for a private Medicaid company that profited from Medicaid while people were barely getting by. Medicaid was making the company very profitable, although no innovative measures were being taken.
My journey behind the pharmacy counter was not what I expected, but it was exactly what I needed. It was a crash course in the realities of our healthcare system, a lesson in the importance of resilience, and a powerful reminder of the human cost of a system that often prioritizes profits over people.
One of the most meaningful compliments I received in quite some time occurred recently while I was at the grocery store in Clover, SC. Someone approached me and asked, "Aren't you the ---lady?" I replied, "Yes, that's me." This Friday marks the final day of my notice, and I am deeply grateful to the pharmacy manager/pharmacist for allowing me to pause, reflect, and move forward.
This story is a testament to the power of resilience, the importance of understanding the systems we seek to change, and the dignity found in honest work. Sometimes the path to our dreams requires unexpected detours, but every step teaches us something valuable about ourselves and the world we're trying to improve.