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Comments and FEAR

Jp Enlarged

From Rx Steve
A tired Pharmacists is a DANGEROUS PHARMACIST ?

http://consumer.healthday.com/encyclopedia/drug-center-16/misc-drugs-news-218/avoiding-pharmacy-errors-646512.html

The little girl sank into a coma and suffered permanent brain damage.
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From Rx Goose.

I think that you always need some leverage and if the people you work for or with do something stupid or illegal, don’t turn a blind eye, document it and save it for later.

I don’t really think you would have to do much else if you save and document information and when confronted, just say: “I know more than you think I know.” (From Jay Pee… Then, Shut Up)

I’ll bet most retail pharmacists, without trying very hard, could accumulate some damaging data on just about any DM or Pharmacy Supervisor in a month or two.

Keep in mind that chains push pharmacy metrics and the NABP is on record against them. Send a letter to your NABP every time your metrics are posted and you are reprimanded for not meeting them.

Worried about your job? You’re just a speed bump to them. They’ll fire you anyway. Plenty of new grads out there with heavy duty loans.
Talk about leverage. Watch Your Back.
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FEAR
From Jay Pee
The discussion in Edition #3 of THE GUERRILLA PHARMACIST is “FEAR”. Twelve essays well written by the most progressive pharmacist Guerrillas in our industry. If you want in, you will just have to subscribe, won’t you. If you want to take guerrilla action short
of damaging property (Not recommended ever) you will have to contribute toward production costs. If you want to be a leader,
you can write “The Guerrilla Letter”. If you want to take revolutionary action, all you have to do is start practicing pharmacy in compliance with the law. COUNSELING IS A REVOLUTIONARY ACT.

I want to know why women pharmacists are so easily intimidated, especially by non-pharmacists. This MUST be changed or the profession is done for.

Here are a few paragraphs from “The Rebels of Comfort:

The Great Motivator
Fear is instilled in us at an early age. It affects our perceptions throughout our lives. For me, the world was a very dangerous place, according to my mother. The dangerous things I did were behind her back and I was still scared. Fear was a primary motivator in my life. The essential result was that I didn’t feel very good about myself. I brought much of that to my career as an employee pharmacist.
Your mid-level boss is a master at using fear to manipulate and control his pharmacists. The store managers have been tutored on how to use the dreaded write-up. I had a pharmacist complain to me that his wait time was thirty minutes and that he had been written up twice.
“I don’t have time for transfers” he complained. “I have a family to support.”
“Do you really believe that you will lose your job because of your wait time?”
“I can’t take that chance.” It was fear that controlled his life at work. A man this fearful most likely is dominated by unexamined demons.
You are afraid of crime so you work only in “safe” stores, in the suburbs.
You are single and you are afraid of AIDS so you don’t have sex even if you are really attracted to that person from the book club.
You are so afraid of immigrants that you tell a man with dark skin wearing a turban that you don’t carry losartan. You just want him to leave and never come back. You find out that he is a doctor and excuse your behavior by making the excuse that even doctors can be terrorists.
You are terrified of making a mistake. You work too fast and get distracted easily. You wake up and night reviewing prescriptions and suddenly think that Mrs. De Marco got the wrong drug.
You are frozen by fear that you could lose your license. The company sent out a memo. Company policy is to triple-check every prescription. How is that possible? Who has the time? You are not stupid. You know that the company will leave you twisting in the wind if there is legal trouble.
You are afraid that your District Manager will send you to a store 60 miles from your home if you don’t behave yourself. The life of a floater is precarious.
You are so afraid of failure that you never take chances. You have been passed over for promotions and you wonder why.
When it is time for your annual job performance assessment, you expect the worse. That fear of losing your job is always lingering in your mind. The company is very skillful at planting doubts. The MBAs have the idea that employees who are worried will work harder for their security, including working extra, off the clock.
You really want that vacation in July this year. You are afraid they won’t give it to you so you work extra shifts to cover other pharmacist vacations just to look good. You follow every rule. Your spouse has the time off and there is a family reunion.
You are always afraid that you will have to miss your daughter’s plays or your son’s games because you have not earned the time off.
Fear limits our freedom and creativity. It prevents us from thriving because fear will not allow us to takes chances. You are just plain afraid. You learned when you were young that you better obey. You obey the company without examining why.
The company takes the place of a church for many of us. We follow the company’s rules to the letter because, if we don’t, we’ll go to some kind of drug store hell.
Fear can be the reason we do things and it can be the reason we don’t. We come to work early because we want the pharmacy to be ready for the morning rush. We are afraid of what the store manager will say when there is a mob at the register.
We don’t complain about not having a technician for the first hour because we are afraid of being accused of not being a team player. The company rewards team players. The pharmacist who wins “Team Player of the Year” gets a Hawaii vacation for two. You have met the winner from last year. He had a nervous breakdown a few weeks after he and his wife returned from Honolulu. He pulled down his pants and mooned Mr. Fullovit when the CEO showed up with a cheery smile and, “Terrific job, Jimmy.” The pharmacist’s name is Jerry.
When you are fearful, it is impossible to not be totally oblivious of the power that a pharmacist has. You have immense power. You are not a clerk in the camera department. You are a medical professional with the discretion to engage in professional acts any time you feel it is appropriate.

From Jay Pee. Grow up!

1 Comment

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Jp Enlarged

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Yellow Propaganda Bullshit. They must Think that Jay Pee is an Idiot.

Jp Enlarged

Customers = Profit

I get these often. Offers to make an author available for interview. JP
This one is a veiled attempt to get you to say, “Oh No, Poor Pharma. And they try so hard.” Drugs approved quicker will make money faster.

FOR IMMEDIATE RELEASE: Friday, April 17, 2015
CONTACT: Erin Humiston, (972) 874-5139, or erin@IPI.org

Merrill Matthews, Ph.D. is resident scholar with the Institute for Policy Innovation (IPI), an independent, nonprofit public policy organization. He is available for interview by contacting Erin Humiston at (972) 874-5139, or erin@ipi.org.

The Institute for Policy Innovation (IPI) is a non-profit, non-partisan public policy “think tank” based in Irving, Texas and founded in 1987 to research, develop and promote innovative and non-partisan solutions to today’s public policy problems.

IPI’s focus is on approaches to governing that harness the strengths of individual liberty, limited government, and free markets. IPI emphasizes getting its studies into the hands of the press and policy makers so that the ideas they contain can be applied to the challenges facing us today.

In other words, “IPI gives NO SHIT about saving lives. They just want to promote PROFIT. JP

Drug R&D Costs: $1.7 Billion And Rising
Growing Costs Due to Slow FDA, Drug Complexity, Short Patent Life

DALLAS – The significant costs of developing new, life-saving drugs and treatments has reached over $1.7 billion per drug over a span of 10-12 years. The mounting costs can be attributed not only to the growing complexity of drugs, but also due to bureaucratic red tape and the short length of a drug’s patent life, two issues which can be mitigated by legislative reforms.
“While drug companies are proceeding with research to create new and innovative drugs, drug development remains very expensive—and likely to grow even more so,” says Institute for Policy Innovation (IPI) resident scholar Merrill Matthews, Ph.D. in a new publication, “The High Costs of Inventing New Drugs – And Of Not Inventing Them.”
Matthews says in addition to the cumbersome FDA approval process that lacks incentives to expediently get drugs to market, manufacturers are increasingly developing far more complex biologic drugs, treatments, and even cures, as opposed to simpler pill therapies of the past. And while price controls are critics’ primary solution to the high cost of drugs, price controls would simply halt the R&D process altogether.
Matthews explains that economist Joe DiMasi of the Tufts Center for the Study of Drug Development recently pegged the total out-of-pocket cost to develop and approve a new drug at about $1.707 billion, a figure that nearly matches his own “back of the envelope” approach of $1.756 billion, found by simply dividing the drug manufacturers’ reported R&D by the number of newly approved drugs. “Whichever method is used, it’s clear that drug development is very expensive,” writes Matthews.
“There are ways to make new drugs less expensive—i.e., cut down on some of the bureaucratic oversight or lengthening the patent life, which means the manufacturers would have more time to recoup their investment—but both efforts would require a major legislative push,” said Matthews.
“Drug manufacturers plowed millions of dollars into finding a treatment for AIDS once it became clear the disease would take thousands of lives. The research and development was costly and didn’t emerge overnight, but being diagnosed with AIDS is no longer a death sentence,” said Matthews. “If the cost of creating new drugs is high, the cost of not having any new drugs is immeasurable.”

2 Comments

Seriously. What is Wrong With You People? Is It FEAR? You OWN Pharmacy if You Would Only Act Like it. Why can a European Pharamcist Stand Up, But You Just Whine?

Jp Enlarged

I had a long telephone conversation with Paula Zorek (Mrs. Whistleblower). CVS is openly at WAR against pharmacists and others. I was appalled at the stories. More coming up. CVS is, indeed, BIG EVIL.>

Pharmacists?

The following essay was the lead offering in the Premier Edition of THE GUERRILLA PHARMACIST. Read it carefully and you will think, “Hell, this is nothing new.” Read it to the end and you will think, “I could do that.” But..Do you have the courage? Or, are you waiting for the gas to be turned on, a bar of fake soap in your hand?

Make no mistake. This pharmacist was scared to death. He was not a native American. He was in Oregon because he was fascinated with America and wanted to try it out. He applied for and got a work Visa. He brought his young wife and they were on their own for quite awhile. Clearly English is not a second language to him. When we talked, I believe I identified his accent, but that is not important. What is important is that he knew when he was being worked over. He refused to tolerate shabby treatment. He said, “I’m a pharmacist. They can’t do this.” In, May, 2015, he, his wife and their 15 month old. born in Oregon, baby girl (An American, by the way, just as American as your kids) will head back to live where the overjoyed grand parents can dote on the child. He is going back with his dignity intact, his pride emblazoned on his chest. He confronted the dragon and destroyed it. How about you?

The following is his first person account. NEXT, YOUR TURN! You RAD pharmacists, especially, here is precedent.

I was working at a major chain for more than three years. I came here from the European Union and was licensed in the US in 2010.
I was the pharmacy manager in one of the Oregon Rite Aid stores. I have always experienced the working conditions as very poor in this company’s stores. The company provided very little or no training. The company does not give the pharmacists enough time to perform the tasks that we are required to perform, ethically & legally. When I talked to my store manager, he claimed that I spent too much time serving customers, something another staff member is capable of doing and it was silly not to have a Technician complete these duties. In fact, I spend 80 to 90 percent of my time performing menial tasks, such as answering the telephone, which are not appropriate for a pharmacist to perform. The company forces pharmacists to perform these tasks because the store is so badly understaffed that the pharmacist has to perform the work that others should be doing. This results in the pharmacists such not having enough time to fill prescriptions properly. In the Spring of 2011, I addressed the lack of staffing and pharmacists not having enough time to fill prescriptions in a letter. I later met with the Regional Vice President of the Pharmacy (Mr. X). I reiterated that I was not going to jeopardize patient safety, and that I was spending almost 1/3 of the time in my working day as a cashier and did not have enough time to do the prescriptions properly. He told me that I should concentrate on the prescriptions, and let the customers wait a little longer, if necessary In May 2011, the company required the pharmacists to fill all prescriptions in 15 minutes, if the customer came into the store in person. If the prescription is not ready in 15 minutes the patient receives a $5 gift card.
In the Summer of 2011, one of the criteria that the district manager used to evaluate our performance were the number of prescriptions that the company verified were filled in 15 minutes. At a later time, Rite Aid withdrew the 15 minute guarantee with a 15 minute pledge that the pharmacist will try to fill the prescription within 15 minutes. The latter change was made “orally”. Another criterion that the company uses to evaluate pharmacists is the number of loyalty cards or Wellness Cards customers have through Rite Aid. I told my manager that I could not force somebody to have a loyalty card. I wrote a second letter complaining about these requirements on July 2012. I described how in the Fall of 2011. I received a verbal warning for not giving enough flu vaccines as the goal for all stores was 500. Despite my best efforts, I was less than 100 vaccines short of my goal by the end of the flu season. I felt that the goal of 500 vaccines was too high for my store since we have a lower than average prescription volume compared to other stores. My store does very well during the flu season as a result of the prescriptions due to the flu, but the company and District Manager did not appreciate this work. In January 2012, the company gave me a written counseling letter, that stated that I was not performing well enough on certain metrics, such as courtesy refills, customer satisfaction, wellness plus and workflow. I had encouraged customers to enroll in courtesy refills and wellness plus, but cannot force them to do so, and believe that trying to force them to enroll is unprofessional. I also believe that it is difficult if not impossible to have patients use their wellness card when a large percentage of our customers are elderly and on Medicare, and therefore not eligible to receive points on the Rite Aid wellness card. I was also given a verbal warning because I insist on checking when a patient has a suspicious prescription, especially if it is for a narcotic drug such as oxycodone. I received an appraisal of “need development” in 2012. The negative comments relate to my not filling prescriptions fast enough. In my appraisal, my manager said expressly that my failure to meet the company’s metrics would lead to disciplinary action against me. As many other pharmacists, I have made mistakes because I am forced to work with low technician staffing levels, a fear of customer complaints, and the required metrics that the company has imposed. The pressure to rush has caused me to make errors. The company was surveying Express scripts patients that came to Rite Aid from Walgreens. A number of patients said that they were returning to Walgreens because the service time in the Rite Aid pharmacy was slower. However the reason the service time is slower is because we do not have the assistance we need to fill the prescriptions carefully and in a timely manner. I also stated in my letter that Rite Aid may be breaching the State Board of Pharmacy regulations if it requires pharmacists to work under time pressure and immediately serve customers in a manner that leads to prescription errors. Two weeks later, I refused to dispense a muscle relaxant to a patient who wanted to pay in cash. I believed that the prescription called for too high a dose and a refill too soon. This was at the time when on the news Michael Jackson’s doctor was under investigation for giving a muscle Relaxer eventually leading to his death so I was very uncomfortable dispensing the medication without Doctor clarification. I told the patient that I needed to contact the doctor to verify the prescription. Because the doctor did not get back in for a few days, the customer filed a complaint. Ms Y, the District Manager attempted to discipline me for that complaint and two others.

    About this time, this pharmacist telephoned Jim Plagakis. He asked if The Pharmacy Alliance could help him. The answer was YES. Within 2 hours, he became a member. Jim and Steve Ariens counseled him to simply practice pharmacy. He was advised to write a letter to Ms. Y certifying that he would comply with all state and federal pharmacy laws & regulations. With copies to the Oregon Board of Pharmacy, RAD’s corporate compliance officer (HR), RAD’s top pharmacy executive and the non-pharmacist store manager. He followed this advice. Soon, an HR officer flew from Pennsylvania to Oregon for a meeting. After ordering coffee at a coffee shop at the Portland Airport, the pharmacist immediately said, “You understand that Ms. Y ordered me to break the law.” Then he shut up. Last report.
    “They offered $15,000 for not talking about my experience to any agency, but I declined.”

At that point, I made a complaint to the Oregon Board of Pharmacy that I did not believe I should be disciplined for carrying out my duties responsibly. When more than three patients filed complaints, the store is fined $2,000, which means $2,000 is taken out of the P & L for the store. In late 2012, The State Board of Pharmacy gave me a letter that stated that I had acted in accordance with the State Rules, and it was inappropriate for Ms Y to tell me that I should have filled the prescription. After the Board wrote that letter I received a last and final warning from Ms Y based on my alleged deficiencies. In that form, she stated that any future action could lead to immediate termination. I believed that this “last and final warning” was retaliation for my having reported problems to the Board of Pharmacy, which had backed me up. At that point, I decided I needed legal representation. The company did not terminate my employment, after my attorney wrote a letter, but I also have not resolved the issue with the company over the retaliation. I have learned that Ms Y has been firing pharmacists all over the region. I shall refer to one as Ms Z who is one of the pharmacists who Ms Y fired because she complained about staffing issues, and that there were not enough staff to do the work properly. In Ms Z’s case, she stood up to Ms Y when Ms Y grew increasingly confrontational, demanding that the goal number of prescriptions needed to be filled. Ms Z was fired when she gave a different generic brand to a patient who came in with a prescription, when the pharmacy did not have the brand that was stated in the prescription. Ms Y saw the opportunity to get rid of her and terminated her. Ms Y then pressured the staff to file false statements against Ms Z. Right now I am working for a rival pharmacy chain who sponsored a temporary work visa for me. I cannot believe the difference in working conditions moving on from Rite Aid. No more 12-13 hour days without a break, no more coming in on days off without pay to complete managerial tasks. I realized working 12-13 hours a day was burning me out. I would just spend my days off sleeping. Now I just work 8-10 hour days with a break and I am still full of energy when I get home. Also, I lodged complaints about the wellness card and gift cards given to Medicare/Medicaid patients to the CMS. I got a few phone calls from investigators but was told that they may not get back to me regarding the outcome but I did hear from a colleague who is still at Rite Aid that they may have been fined by CMS in 2014 and also they were fined by the Oregon Board of Pharmacy for early refills on prescriptions in 2013.
Ms Y is no longer with Rite Aid. She claims to have left voluntarily but many of her pharmacists suspect she was eventually fired.

Appropriate Comments Will Be Pasted here.

7 Comments

All GUERRILLA, All The Time. If You Have a Better Way to get Pharmacy Back, Tell Me About It. Please Don’t Say APhA. I May Hurt Myself Laughing

Jp Enlarged

Forbidden Words
“Words That Managers Are Forbidden to use in your evaluation”

If YOU don’t have your own back, nobody does.

“What can dumb and fearful people always be counted on to do?”

Answer: TO TRY TO CONTROL AND MANIPULATE EVERYONE IN THEIR ENVIRONMENT

“What is the tactic used by these same dumb people as they try to control others?”

Answer: THEY LIE

Those ‘dumb’ people may even be intelligent. They may be very well educated. PICs have to be licensed pharmacists. Disrtrict Pharmacy Managers usually are pharmacists. Managers one step above your RxDM may have a degree. You know all about the ones who have, all by themselves, ruined the retail pharmacy industry… the non-pharmacist Masters of the Universe. They learned sophisticated bean-counting methods earning an MBA. The non-pharmacist store manager is unlikely to have a degree beyond the Associates Degree that is
earned in a 2 year Community College.

All of these people are DUNB. They take staffing away from your pharmacy (Usually Technician hours) and still expect superior customer service. Why am I telling you this? You know it all.

THE PROBLEM IS WHAT THE PEOPLE WHO HAVE SWAY IN YOUR PHARMACY HAVE DONE (I DO NOT INCLUDE STAFF PHARMACISTS OR TECHNICIANS).
Again, you know what they have done. I do not have to make a list for you. I can however outline how to retaliate AND
SAVE RETAIL PHARMACY.

    cREATE AND KEEP A SECRET FILE ON ALL OF THE IDIOTS. YOUR DISTRICT MANAGER FILE MAY BE VERY SKINNY, but, if you have evidence
    on him or her, put it in the file.

    You will get a lot of dirt on your P.I.C. She/he may be a great person, but this is a war. If they do anything illegal or even unethical, the Board of Pharmacy may want to know. A Court of Law may want to know and you will be happy that you recorded information if you ever get fired, for any reason.

    Your RxDM. If you have damning proof regarding their behavior, start a dossier.

    This next one is low-hanging fruit. Your non-pharmacist store manager. You will get something every single week. Record it, DOCUMENT
    DOCUMENT DOCUMENT DOCUMENT DOCUMENT.

    I will tell you something true. You say something like this, very casually, to your non pharmacist store manager: “JOHN, YOU REMEMBER THE TIMES YOU TOOK JANET (The bookkeeper) TO THE HOLIDAY INN BEFORE SHE GOT WORRIED ABOUT HER HUSBAND?” You smile a Penthouse grin. “YOU LUCKY DEVIL.” Then you just look at him for awhile and go back to work. If he responds, just say, “COME ON, JOHN. EVERYBODY KNOWS”.

    Later, if he EVER acts like an asshole about you, the technicians or the pharmacy, you, privately say, “John, you would be very wise to just leave the pharmacy alone.”

    If you have to, say, “Who has taken Janet’s place at the Holiday Inn?” If he gets really stupid and tries to intimidate you, ask him if he likes his job.

I know that every one of you can do this.

Tell what you thin about this. I know that Goose and Steve and K the “A” are gonna say, “Go for it.” I want to her the weak spine reasons why you can’t, why you are afraid.

TRUST ME. THEY HAVE A FULL AND COMPLETE DOSSIER ON YOU.

3 Comments
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