Pharmacies in New York City have become quite the consistent experience:

~ open 24 hours and available every three blocks

~ a vast selection of merchandise, but few of the exact products you seek

~ astoundingly filthy floors that rival a movie theater for cleanliness

~ indifferent employees, including the managers

~ understaffed cash registers and six-deep lines to pay

The whole business has become a big morass of saturation and lowballing. Not ten years ago, pharmacies were still wonderful local institutions in New York, a city that brimmed with apothecaries and helpful staff. Even the chains were lovingly local, from Duane Reade, which once upon a time was a basic New York staple store, to the dozen Love Discount outlets around Manhattan (most of which are Duane Reades now). Pharmacists were helpful and stores were clean.

Today, that experience is all but gone. To walk into any city pharmacy (particularly in the winter) is to wish one’s delicate pharmaceutical products could be kept in a clean environment somewhere else. Floors are full of grime and, in the snow, wet cardboard. Shelves are either overflowing or understocked. The pharmacy counter invariably has a long line of patients shifting their feet while a lone technician tries to process orders and deal with a litany of customer service complaints. Checkout counters at the front of the store reveal a long row of cash registers manned by one or two cashiers who have zero concept of expediency. Paying within five minutes of getting on line is a dream.

This isn’t just a function of big business muscling in; debating the merits of chain stores that underprice local ones is a completely separate issue. The bigger problem now is how the chain stores have come to run their businesses.

This is a funny topic to consider until you’ve bounced around a handful of stores in Manhattan, as I did this past week. Duane Reade, CVS, Rite-Aid, Walgreens: all of them ubiquitous, all identical in their shortcomings. It’s a big, ugly mess, and no one is even mildly attempting to do anything better. The shame is that just a few years ago, this wasn’t the case. The Duane Reade by my old apartment was a well-stocked, well-staffed store with friendly pharmacists and only moderate job stress; the Walgreens on 14th Street and 4th Avenue was a gleaming, smooth-operating shop when it opened in 2002. Now they’re both sad reflections of the undermanning and laziness inherent in the business today.

Visualizing the meetings and budget memos that created this mess is easy. Chains are expanding every which way in oder to claim market share and muscle out competitors—I want to meet the strategy genius who opened three Ricky’s outlets within walking distance of my apartment—and all that floor space creates significant overhead. Sales are plentiful enough, but the multitude of store options forces prices down, which keeps margins low. This makes staff the one area with a flexible cost base. As a result, stores have pushed to find the minimum personnel necessary to operate the store without alienating consumers.

Let the record show: I am officially alienated. And I’m doing something about it. As of this month, I’m shifting my prescriptions to Bigelow, the Greenwich Village pharmacy that hasn’t opened fourteen local outlets or cut its staff to an unmanageable level. It’s not the greatest pharmacy in the world, and it’s too far for me to stop in on errands, but they deliver prescriptions, have the right amount of personnel, and keep their floors clean.

My local Walgreens, meanwhile, is almost always out of Kleenex tissues. Really.

That I have to differentiate my pharmacies on such trivial matters speaks volumes about the industry as it stands. What a mess.