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Had a Stroke? Talk to me!

Jp Enlarged

Those of you who have followed this blog since 2005 and my work for Drug Topics since 1989 (now  240 columns) know that my essential way of being is optimistic.  I do not see the doomsday scenario that so many of you cannot see beyond. 

My stroke has affected me in ways that I feel ill-equipped to handle.  I am bummed out and there is no blooming reason.  I walk okay, but use a cane to let me know when the way is about to get rocky.  I have discovered that the Occupational therapist was right.  I need help doing certain tasks and that includes walking on the uneven shell path.  When I fell last summer and broke a couple bones in my left hand, it was on the shell path.  I tripped on an exposed root.  Had I been using the cane, there would have been warning.

Physical therapy is really tough  My left hand is darn near useless.  An hour of working the fingers leaves me enervated.  Like an hour with no help at 7:00 PM on FRIDAY.

Still,  I am limited and that is unnatural for me.  I talk okay, but slur a bit when I am tired.  And… I am tired a lot.  People have suggested  Relax, Plagakis.  What do you expect?

My aorta is good.  The lesion on my thyroid is not cancer.

If you have advice, lay it on me.

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CVS AGAIN. KILLING OFF A QUALITY PHARMACIST BECAUSE SHE INSISTED ON HER RIGHT TO ACTUALLY PRACTICE PHARMACY,

Jp Enlarged

I WANT TO KNOW THE LONG VERSION OF STEVE’S THOUGHTS ABOUT THIS GOOD PHARMACIST BEING SACRIFICED TO THE WHIMS OF AN MBA MASTER OF THE UNIVERSE.

OH, I FORGOT. PRACTICING PHARMACY IS NOT IN THE JOB DESCRIPTION.  FAST, FASTER AND WAIT TIMES IS THE JOB.  A METRIC SATISFYING MANAGEMENT OF THE PRESCRIPTION MILL IS WHAT KEEPS CVS OFF YOUR BACK.  ‘PRACTICING PHARMACY’? WHAT AN OLD-FASHIONED IDEA.

 

CVS PHARMACISTS.  CAN YOU LET HER TWIST IN THE WIND, ALL ALONE?  DO YOU HAVE ANY SPINE AT ALL?

I read with great interest the article “The Political-Medical Complex “ by Robert L. Mabee, Rph, JD, MBA, published in Drug Topics on December 10, 2013. I have had the privilege of speaking with Mr. Mabee on several occasions in the past year, and consider his opinion to have particular weight and merit.  His unique qualifications as a pharmacist, a lawyer, and MBA, as well as his personal values and common sense approach were a great help to me and a sustaining voice of reason as I tried to make sense of a profession that has been hijacked by the chains, the insurance industry, the pharmaceutical companies, and indeed, even our once trusted academia and state boards.  In our profession, as in many other professions and occupations, those of us who do the actual work at ground level have no voice. We have never been able to organize, we are afraid for our livelihood, and we do not have the funds to influence and elect politicians who will represent us. We accepted the word of university faculty that promised that pharmacy would soon be elevated to going beyond count pour lick and stick. We kept thinking that if we just held on and kept increasing our skills and working hard, that this dream would eventually materialize. All we needed was time. Meanwhile, the chains and hospitals kept cutting back our support staff  and increasing our responsibility, ensuring that we remained exhausted and separated by virtue of our long hours, lack of breaks, and outlandish schedules. Our compliant and people- pleasing nature, our extreme sense of responsibility, and our self-destructive work ethic also took a toll on our energy and self-esteem. We became our own worst enemies.    Meanwhile, the big chains infiltrated our state boards of pharmacy, donated money to our colleges and universities, and accepted kickbacks from the pharmaceutical companies. Staff and professionals at local hospitals and doctor’s offices became employees of huge corporations as their hospitals and medical complexes were bought out and swallowed up. Medical decisions were increasingly dictated by insurance companies, P and T committees, and hospital administrators, as well as the CEO’s of the medical machine.  In reading a book entitled “How to Live…A Search for Wisdom from Old People while They are Still on This Earth, I came across the story of Granny D. At the age of 89, Doris Haddock, a.k.a. Granny D, walked 3,200 miles in 14 months to support the McCain-Feingold bill and its limiting of lobby-based or “soft” campaign financing. Two months after finishing her walk, she was arrested, handcuffed, and taken to the police station for reading the Declaration of Independence aloud under the Rotunda of the Capitol in Washington DC.  When she appeared before the judge two months later, she said:  “Your honor, the old woman who stands before you was arrested for reading the Declaration of Independence in America’s Capitol building. I did not raise my voice to do so, and I blocked no hall… Your honor, we would never seek to Abolish our dear United States. But alter it? Yes. It is our constant intention that it should be a government of, by, and for the People, not the special interests…In my 90 years, this is the first time I have been arrested. I risk my good name, for I do indeed Care what my neighbors think about me. But, your honor, some of us do not have much power, except to put our bodies in the Way of justice—to picket, to walk, or to just stand in the way. It will not change the world overnight, but it is all we can do.”    The time will come when those of us who know what is going on will have to stand up. Many of us are afraid, have been disrespected, harassed, and had our lives upended. Our self-esteem is in the toilet. Those who have not been “excised” have been forced to endure brutal working conditions, threats and ill treatment. District Managers, Store Managers, and even some of our technicians spy on us, second guess our decisions, and report us if we step out of line. The public and other health care professionals treat us with disrespect, and we grovel and apologize in fear that we will lose our jobs. We work on the ragged edge of control, hoping every day that we do not hurt or kill someone because of the pressure and stress.  And now there are rumors (and substantiated evidence) that our pay will be decreased and ourhours reduced so that our employers do not have to provide us with benefits.   If you have not been shaken up or forced to change , your time is coming. Those of us who have been forced to face the truth are out here. Our numbers are escalating. We are hurt and angry at what has happened to us. Maybe it is time to unlock the golden handcuffs and make a leap of faith.   Kimberly A. Ankenbruck Rph

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I HAD A STROKE AT4;00 AM, SATURDAY 1-11-14

Jp Enlarged

TISSUE PLASMINOGEN ACTIVATOR WORKS. 

I WOKE UP IN THE DARK.  I REACHED FOR MY SMALL ALARM CLOCK TO PRESS THE LIGHT.  MY LEFT HAND WOULD NOT WORK. I WENT TO PEE AND COULD NOT HOLD MY DICK WITH MY PREFERRED PEEING HAND, THE LEFT HAND,  WHAT NOW?  I WALKED TO THE KITCHEN AND TOOK THE “WHAT-TO-DO IF-YOU-ARE HAVING-A-STROKE REFRIGERATOR MAGNET  OFF THFRIDGE.  I RETURNED TO THE BEDROOM, WOKE VICTORIA, SHOWED HER THE  MAGNET AND POINTED TO MY CHEST.  HER EYES GOT BIG. NOT ONE WORD NEEDED TO BE SPOKEN.    SHE CALLED 911.  I WAS IN SOME ZONE WHILE WE WAITED.  A FIREMAN GUY WALKED ME DOWN THE STAIRS. THEY DROVE VERY FAST.  A NEUROLOGIST FROM INTERCOASTAL MEDICAL GROUP WAS IN THE TREATMENT ROOM WAITING.  INTERCOASTAL PROVIDES MY CARE.   THE NEUROLOGIST SAID, ‘YOU ARE STILL IN THE CLOT-BUSTER WINDOW.  IF WE GIVE YOU THE BOLUS NOW, CHANCES ARE THAT YOU WILL REGAIN ALL FUNCTION.  HE MOTIONED FOR VICTORIA TO COME OVER.  ‘IT COULD KILL HIM.  THAT IS A POSSIBILITY. SMALL, BUT POSSIBLE.’ 

I SAID, ‘DO IT.’  VICTORIA AGREED.  WITHIN SECONDS, IT SEEMED, TPA WAS ENTERING A VEIN.  30 MINUTES LATER, I COULD MOVE MY LEFT ARM.  WE ARE 7 DAYS OUT.  I WALK OKAY.  I AM WEAK AND TIRED. ,MY VOICE IS WEAK AND SOME VOWELS SOUND DIFFERENT.  MORE LATER.JAY PEE 

15 Comments

The Dumbing Down of Pharmacy Schools Produces Robo-Dispensers

Jp Enlarged

He is paid too much.  His benefits are too comprehensive.  He gets too much vacation.  He still gets a bonus even though we have eliminated bonuses.  He still works 40 hours a week.  He limps after 40 years on his feet.  He spends too much time talking with the customers.  He complained about the $12.00 an hour tech wages.  He called it a disgrace.  He told an intern that patient-centric pharmacy practice should be the goal.  He also told her to disregard the metrics when a patient was in need.  This guy is a trouble-maker.  I suggest that we trump up something out of the years of documentation we have on this guy and replace him with that kid who just graduated from Pine Leaf Veterinary School of Pharmacy.  

Those among you who read here regularly know that I have been harping about what I see is a conspiracy to “dumb down” the retail pharmacist corps to save money.  I don’t know if the schools are in collusion with the retail giants, but it looks that way when you observe the quality of the graduates from the new for-profit schools.  

 have been having their way with our profession. We cannot allow this. We cannot allow students from FOR-PROFIT SCHOOLS becoming registered with only two years in the class room.  They don’t even teach compounding.  It is not relevant, they say.  Soon, the profession’s memory of what an old-fashioned “Druggist” brings to the table will be lost… forever.  It is up to us to rattle the cage so hard that the vibrations are felt as far away as Washington, DC.

I worked for a few months with a very bright new graduate.  She got her education at the Feik School of Pharmacy, University of Incarnate Word, San Antonio, Texas.  Founded in 2006.  It looks as if she was in the first graduating class.

There were huge holes in her education.  I went on a mission to fill them.  I worked with her for about 15 hours a month.  We did compounding.  We did Rx counseling.  We did OTC counseling.  I gave her the “You da boss” talk.  When she was the pharmacist on duty, she was the Queen.  All professional issues were her call.  The Lead Tech (who is an ex floor manager believes that she runs the place).  We rattled that hard.  I drilled her with “Counseling defines what you are”.  If you do not counsel (Rx & OTC) you are just a robo-dispenser working in a dispensary.  If you can’t compound, you can’t call yourself a pharmacist.  

She was a sponge.  She sucked up everything I had to offer and I was at it from the minute I entered the pharmacy until she left for the day.  

You MUST step up you guys.  We are fighting for our existence and watching isn’t enough.  Get some steel for uour spine and DO IT.  I have plenty of astep-by-step advice as I am sure Steve and Goose do also.  Stand up.  Kick the non-pharmacist out of the pharmacy just once, if she disrupts the professional job.  Gotta go.  Victoria just said, “Are you coming or not?”
From Goose

Friends,

We haven’t talked in a while, so I thought I’d share a few things I heard yesterday. First a little background. I currently am a preceptor for 3 students, 2 of them on 6th year rotations just prior to graduation and 1 that is doing a 4 week rotation in the middle of her third year, first professional. All are from Purdue and as far as students go, they are okay, but nothing great. The younger student is in her last week and the two older ones are just starting this week, 2 days late because of the weather. I thought all 3 were kind of wimpy about the weather, but that’s another story.  Anyway, one of the older students shared her experience about the interview
process and the job she accepted with CVS and it confirms some of what JP has been hearing about hours, etc. She was hired in by CVS on a 30 hour/week base and was asked if she needed medical or could stay on her parents until she was 26. She didn’t share whether she took CVS medical or not but they did ask. That would be a reason to hire the youngsters, right? She also will be required to float indefinitely.
Another student stopped by that works park-time for us and is also ready to graduate. He was hired by Walgreens to work in South Bend, and he initially agreed to do that. Then he had a change of heart about going there and turned down that position, (unbelievable, right?) and asked for a position in Louisville. I thought that was interesting since Steve has been posting about Wags openings in L-ville. He has not been called or offered. We currently have 2 other students that I am not involved with but know, for a total of 6. Frankly, out of the 6, only one is any good and he’s not that good. Not sure what this all means long-term, but if the talent is this poor coming from a good school like Purdue, what are the others like? The students were also talking about Manchester College’s first graduating class in 2016. (the new pharmacy school in Indiana) Butler and Purdue are currently having a lot of trouble getting preceptors for their students, the Purdue kids think Manchester students will have placement problems. Maybe we’ll get paid now. Looks like more problems for the kids.Just wanted to verify some of the rumors.
Peace out,
Goose

From Steve

    I am hearing other “seasoned” RPH’s talking about the kids coming out of Sullivan U.. here in Louisville.. I hear the phrase that they are being “taught to pass the test” .. and few are very impressive.  From a business standpoint.. it makes sense to have 30 hr RPH’s.. If you have a 90 hr/wk store.. most likely you will have some non-overtime hrs.. when sick days, vacations come around… and since most of the chains have standardized their Rx dept layout… in the larger cities.. you just move bodies around from store to store and/or need a smaller float pool… to cover shifts and avoid overtime.

    I know, that I have a cousin that has a store in Scottsburg… and he was a preceptor .. for only one year.. and that was enough for him… he is no longer doing it.  I still say that we will see – as the surplus grows – PDM’s coming into stores and telling RPH’s .. I have a new RPH’s willing to do your job for xx,xxx.xx/yr and you have 24 hrs – or less – to make up your mind.. if you want to keep your job..  you will have to work for what they agree to work for and take a cut in benefits to match what a new hire would be entitled to. If corporate health insurance premiums are aged based – like everyone else – might have to pick up the cost of insurance over what the new hire
would cost.

    I still think that there is a possibility that we may have to “bid” to get a job… the chain does interviews… and selects half-dozen or so that they feel are good candidates … then get them to bid on how little they will take to get the job. As Obamacare kicks in… and tries to cut costs and the PBM’s & the chains fight over what is left… while trying to increase their profits annually… labor is normally the highest per-cent of a store’s overhead.. and since we are the highest paid… it could get real nasty..  on the positive side… the chains might increase the number of stores that a DM/PDM have to manage – shrink that labor pool cost – so more stores.. the less you have to personally see the asshole :-)

 

17 Comments

Cleaning E-Mail Files and Found This

Jp Enlarged

Can any of you verify this?  Jay Pee

Jim,

 I’m a frequent reader of your blog and want to pass on some new information I got.

 I just gave a copy to Rite Aid in Northern California.  After business, we discussed new happenings in Northern California and he said there are 2 more new pharmacy schools coming to California within next year or two. 

 He says Walgreens in San Francisco Bay Area is now (or will soon) be offering new graduates $40/hr, 30 hr weeks, with no benefits, that’s it.  For me that’d be a $20/hr pay cut, the pharmacist said that for him that’s almost $30/hr pay cut, not to mention the No Benefits provision.

 Just passing along this unverified info.  It’s not good news for pharmacy, if true.

 Tony in the Pacific Northwest

Not good for pharmacists, Tony.  This is the rate for new graduate ROBO-DISPENSERS from schools like Touro.  These newer for-profit pharmacy schools do not produce PHARMACISTS who know how to navigate the job, including compounding.  Can we do anything?  Is there value for Walgreens to want to hire a graduate of the University of  Calif0rnia San Francisco Pharmacy School before a graduate of Touro in Vallejo?  Probably not.  It really kis our job to show WAG that they will get more bang form their bucks to hire a pharmacist rather than the robo-dispenser.  Any ideas?  Goose?  Peon?  Steve?  Pharmacy Gal?

 

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