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THE GUERRILLA PHARMACIST

Jp Enlarged

OREGON IS OUR ONE GRST HOPE. The BOP is on our side.

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A little imagination and you will get it.

A little imagination and you will get it.

FROM GOOSE: I am putting all my writing efforts into this new publication and supporting it financially. I am also urging others to do so. We need to get this rolling folks, while we have the advantage of seasoned writers who know the real issues in pharmacy.
Even if it just a few bucks, support The Pharmacy Alliance in this or subscribe. $30.00 for a year is nothing.
That’s a few days of coffee for some of you.
Peace out,
Goose

“The Guerrilla Pharmacist” is the best bet to get you to stop sitting on your hands. FIRST ISSUE WILL BE MAILED EARLY IN MARCH, 2015. Those of you who make a dollar contribution of $50.00 or more will receive “The Comfort Trilogy”. A Thank You gift from THE PHARMACY ALLIANCE”.

send CONTRBUTIONS OR SUBSCRIBE BY PayPal to: tpafund@hotmail.com

There were PayPal subscriptions there this morning. You Rock.
Contributors of $50.00 or more will receive a Thank You gift. THE COMFORT TRILOGY. This volume contains three books. “The Prisoners of Comfort” “The Comfort Demands” and “The Dangerous Book for Pharmacists”. Amazon price is $26.99.

WE can now accept major credit cards using the SQUARE technology. $$$ are sent to the TPA account in Galveston.

Please tell us what the $$$ are for. SEnd Account #, Expiration date & Security code. Name on card.

Checks (will be deposited to a TPA checking account in Galveston) Make Payable to: Guyerrilla C/o Plagakis
Send to:
Guerrilla C/o PLAGAKIS
1609 BAYHOUSE PT. DR. BA229
Sarasota, FL 34231

941-281-9096

WE CAN DO THIS YOU GUYS. If “The Guerrilla Pharmacists” inspires only 20 out of 100 Pharmacists to engage in battle (even small battles) WE WILL WIN. You get your dignity and self respect back. Pharmacy will be ours again. Fuck the MBA Masters of the Universe.
They can run the variety store out front.

The Pharmacy Alliance will publish the first The Guerrilla Pharmacist in a few weeks. It will be a magazine with the essays written by stud activist writers like Goose, David Stanley, me and others.

We want to kick start the revolution to get our profession back. And, well, you know

    IT IS LOOKING REALLY GOOD.

After you read Guerrilla, maybe you will be willing to step up and play the amazing TRUMP cards you have in your hand.

Cheap right now if you want to subscribe. $3.00 an issue $30.00 a year.

Send your subscription money by PayPal to: tpafund@hotmail.com (Drop an e-mail to jpgakis@hotmail.com so I know what the $$ are for)

By check to be deposited to a TPA checking account in Galveston.

Guerrilla
C/o Plagakis
1609 Bayhouse Pt. Dr. BA229
Sarasota, FL 34231

IT IS TIME, YOU GUYS. IF WE HAVE TO LEAVE TEETH AND BLOOD ON THE FLOOR TO GET OUR PROFESSION BACK,
WE WILL. The non-pharmacist bean-counting MBA Masters of the Universe will have their assholes puckered and it will be a complete surprise because everybody knows that pharmacists are spineless lemmings. I am not buying it. There is a WARRIOR in every one of you.
JP

8 Comments

From Pharmacist Steve. Comments from Blog Reader Addressing Foreign Pharmacist – H1b Visas.

Jp Enlarged

H-1B VISAS allow RAD & CVS to treat RPhs as indentured servants

Re: Drug Topics Magazine “2015-salary-survey-pharmacist-incomes-hold-steady”

THIS SHOULD OPEN YOUR EYES. Rite-Aid and CVS. WAG is not even in the picture. Current statistics from MyVisaJobs.com

#1 Sponsor Rite-Aid 387 H-1B
#2 CVS 308
#3 Wal-Mart 82
#4 WAG 58
#5 Winn-Dixie 20

#10 & 11 K-Mart & Kroger ties with 5 H-1B pharmacists each

From: SRA (steve@steveariens.com) Passing on comments recorded on his blog

When I looked at that survey.. the numbers in the sample were very small.. All you have to look at is the number of graduates back to the early 70’s – those that would be retiring today – abt 5000 –6000 and the number of graduates coming out today.. one more pharmacy school announced today http://drugtopics.modernmedicine.com/drug-topics/news/new-pharmacy-school-planned-miami.. Look at the total number of net new stores … I would suspect that you will find about twice as many graduating today… than retiring… and that the net store count is fairly flat.. There are rumors that both WAGS & CVS are reviewing all of their 24 hr stores and many may pull back 8 hr over night shift of the Rx dept only and leave store open.. or pull back the entire store 8 hr over night for closure… each overnight shift eliminated will be abt 1.5 FTE RPH’s per store.

I think that if you investigate … that the number of “third RPh’s” in non-24 hr stores are in the process of being eliminated or nearly eliminated.

I have talked to RPH’s mainly from CVS that RPH’s are being reduced to 28-30 hours and many are put into “floating pools”

I have seen estimates that by 2017-2018 that 20% of the graduates will not be able to readily find a job upon graduation. Shortage/Surplus and pay seems to be in indirect proportion to population and population density.. big cities – high surplus – low pay… “out in the sticks”… more opportunities and more normal pay.

I am also hearing/seeing more harsh penalties from the BOP… on RPH’s when things go wrong as there was 10 –15 years ago when there was a dramatic shortage. The majority of the BOP’s are stacked with non-practicing corporate pharmacists and there is no longer a need to protect the labor pool.. because there are pharmacists standing in line for any job that opens up.

5 Comments

Retail Preceptors Should Be Ashamed. New Pharmacists Are Robo-Dispensers Because They Do Not Know Better and You Have Looked the Other Way.

Jp Enlarged

My First Drug Store Job. 1957. A Stock Boy. This Guy, Mr. Hale, taught me more than my first official preceptor.
JP’s first drug store job. 1956. Stock boy. The druggist, Mr. Hale, taught me more valuable lessons than any preceptor.

I have acted as a preceptor during my career and I am guilty of letting the students down. I worked at a pharmacy that was within walking distance of The University of Texas Medical Branch. UTMB is a major medical school. I talked with students and residents every day at work. It was apparent that they were being taught how a doctor should act. Even first year students display a certain superior panache. They stood tall, made eye contact and questioned my choices when I helped them make OTC decisions. These kids knew absolutely nothing and they would still run their doctor act at me. I liked it. They will be flying the medical system airplane even if they will have to share the cockpit in the 21st Century and I want everyone up front to be confident and competent.
Young pharmacists (old pharmacists too) often behave like little children who have not been taught how to act around adults. I blame the pharmacy school faculties for this first. There are exceptions, but most professors don’t seem to think that how a pharmacist behaves is important. There is a professor at the University of Georgia who is the exception, but I personally know of no other.
What would be wrong with a P-1 class that expressed these messages:
1. You are beginning a career as a well-educated, highly trained medical professional. Act like one.
2. You will be the last word on drug therapy. Accept that role.
3. You will be the foremost expert on all drugs, that includes Rx-Only and OTC. Act like it.
Why not tell these kids that they need to ACT like they are important professionals and not simply prescription fillers. The retail system is not designed to allow them to easily be important. The schools and the preceptors must give them permission to ACT like they are medical professionals. When they get their first job with a big box store, there will be strong forces playing against them. The companies will want to keep them in their place.
I was a preceptor three times in my career. My students were all trained by me to do well in retail. However, as I see it now, I was a dismal failure. I believe that a preceptor should assist the student in aspiring to the highest standards. I didn’t do that. I taught them to do what I did. At the time, I was a Prescription Mill caretaker. Most preceptors are equally disappointing.
Students see how their preceptors act and model their own behavior after what we do. They are effectively taught how to ACT as a second class medical professional. We show them that it is normal to have to work a twelve hour shift with no meal or rest periods. We tolerate bad language from abusive customers and the student sees, over and over, that this is the way it is.
How many preceptors have seen the student watching as they allow themselves to be intimidated by a doctor, even when the preceptor is right.
“I’m.. Uh.. I’m sorry to bother you doctor, but I believe that the dose is..”
The preceptor’s face reddens when the doctor shouts at her and hangs up the phone. She looks at the student and shrugs.
The student says, “You’re not going to fill it that way, are you?”
“I have to. The doctor won’t change the directions.”
The patient is put in danger. The student feels helpless and the dangerous slide down to second class medical professional is only iced up and slicker than ever.
Preceptors have a responsibility to strongly express these messages: Do not do it like I do it. Do it like I say to do it. Do not believe that a twelve hour shift with no breaks is normal. This is an aberration that has been perpetuated for more than three decades. The non-pharmacist store manager runs the store, not the pharmacy. I know that I dress frumpy, but you don’t have to. You are a doctor. Dress like one. And on and on.
It is immoral to allow new pharmacists to hang there, twisting in the wind, with no instruction on how to ACT like a professional. All of us veterans have a responsibility to a profession that is in transition. Pharmacy will only be as strong as its practitioners. We need to support them in ACTING proud and competent in any and all circumstances.
By tradition and according to the law in the United States of America, the pharmacist must be involved with the delivery of every single drug. Think about this: 90% of all routine doctor office visits end up with one of more prescriptions being written. The pharmacist is at the bottom of the funnel. You are where the rubber meets the road. Without you, everything stops. What about that kind of power is so hard to understand?

5 Comments

A Health Update for JP

Jp Enlarged

My WALKER Can't wait to be able to use it on trips longer than to the car

    MY WALKER. I JUST WANT TO BE CLEARED TO USE IT OUTSIDE FOR TRIPS LONGER THAN TO THE CAR

Some of you have asked me how I am doing. Mid-February and the ordeal will extend to six months. When amiodarone was Dced the encephalopathy went with it. The coma broke. I looked up and saw Victoria sitting in a chair. I said, “Hello Mrs. Plagakis”.
V teared up and that was that. I was discharged to Palmer Ranch Rehab Center and after 8 days went home.

THE BIGGEST ISSUE WAS A FOOT WOUND. ON THE EDGE BELOW THE LITTLE TOE. A PODIATRIST DID SOME SNIPPING ON 8/18/14. I WAS TAKEN TO THE ER ON 8/19/14. THE PODIATRIST MUST HAVE CUT A BIT TOO DEEP. I DID NOT KNOW ABOUT THE FESTERING WOUND BECAUSE I WAS OUT OF IT.
ANYWAY, THE WOUND CARE HOME HEALTH NURSE SAID, “I CAN’T HELP YOU, JIM. YOU HAVE TO GO TO A WOUND CARE CENTER.”

October 16TH, FIRST APPOINTMENT WAS DEBRIDING. HE SENT TISSUE FOR CULTURING. NEXT WEEK, 2ND DEBRIDING AND THE REPORT. 4 AEROBIC AND 3 ANAEROBIC BACTERIA, INCLUDING GANGRENE. EXTENDED COURSES OF AUGMENTIN AND CIPRO. he said, “If you want this to heal, you will stay off it.’ I got a knee scooter and have been a very good, if not perfect, patient.

EARLY DECEMBER, I HAD VASCULAR SURGERY. SINCE MY VEIN WAS USED FOR THE TRIPLE CABG, HE PUT IN A SYNTHETIC VEIN FROM MY GROIN TO MY CALF WITH ONLY TWO SMALL INCISIONS.

WITH A NIAGARA OF FRESH, OXYGENATED BLOOD GETTING TO MY FOOT, THE HEALING HAS BEEN DRAMATIC. I EXPECT THE WOUND TO BE HEALED IN TWO OR THREE WEEKS. I WILL BE WALKING WITH MY WALKER. THEN, A CANE.

BECAUSE OF INACTIVITY AND TIGHT DRESSING IN THE BEGINNING, I HAVE A SERIOUS CASE OF POST-POLIO SYNDROME. I ROLL WITH THE TERM “THE LATE EFFECTS OF POLIO”. I REMEMBER THE SYMPTOMS FROM 60 YEARS AGO. DROP FOOT. CALF MUSCLE TIGHTER THAN TIGHT. TOES WANTING TO PIGEON IN. I HAVE BEEN DOING YOGA AND PT EXERCISES AND AM WAITING FOR MEDICARE TO APPROVE AN EXTENDED SERIS OF VISITS FROM A
PHYSICAL THERAPIST.

I AM OKAY, MY FRIENDS. I WAS SITTING ON MY SHOWER CHAIR TAKING A LONG HOT THIS AFTERNOON AND I THOUGHT. LIFE IS GOOD. THIS HAS JUST BEEN A SIX MONTH SPEED BUMP.

6 Comments

WANTED… REAL Pharmacists to Step Up Legally & Ethically. LIVE UP to your Own Personal Standards.

Jp Enlarged

After lunch at Pelican Cove around 2003

After lunch at Ferrante Winery in Grand River, Ohio around 2003

This is the 21st Century. 15 years out from Y2K, when everything run by computers would shut down at 12:59 PM. VICTORIA and I were newlyweds. We lived in Bellingham, Washington. V worked as a Level A Pharmacy Tech for Rite-Aid and I worked for Longs. We were married at noon on January 14, 1999. Lunch time. Our witnesses were the two young women who ran the business office of our apartment complex. The rent-a-minister was on the list given to us at the Whatcom County Court House Licensing office. She has a Greek name and her husband was a reporter at the Bellingham paper. That is how I made the choice.

The wedding was brief and glorious. V and I were dressed for a casual ceremony. Jacket. shirt & tie. V in a stylish dress. I bought corsages for the minister and the girls. A white carnation on my lapel. V’s Bouquet was very nice. I had a local deli deliver the food. The 5 of us ate good food. We had talked about a ceremony in the spring of 2000, but the ability to file an IRS 1040 as a married couple was too tempting.

Anyway we got a little spooked about Y2K. The media was relentless. ATM machines would jam up. Banks would not open. Credit cards
would not work. It could be dangerous with bad people looking to exploit Y2K. V and I had $1000.00 with no bills larger than a twenty. Lots of fives and ones. Y2K proved to be nothing.

Today, in 2015, my definition of a REAL pharmacist is very different than my definition in.. say… 1990 was very different. in 1990
I was most interested in keeping my good job. I loved the 10 minute commute. The job was just a PIC job. Much just floated by me. I ignored the store manager. He tried to micro-manage.

TODAY, I am looking for a few REAL pharmacists. Are there any out there? Do any of you stand up and do your job legally?

“Brenda, you are the store manager, but you are not a pharmacist. You have a bad habit of entering the pharmacy without my permission.”

“What? I do not need your permission. I’m the manager of this store.”

“But you do need my okay, Brenda. It is the law.” An icy stare. “You cannot come in the pharmacy and wander the bays, looking at the drugs. Why do you do this? Why are you so interested in handling the drugs?”

“Ah, the inventory looks too high.”

“Bullshit. You do not have a clue about the cost of the drugs.”

Don’t you trust me?”

“I do not trust anyone back there with bottles labeled Vicodin, Valium, Dilaudid (CIIs were spread out) so do not enter the pharmacy without my permission and stay at the counter when you visit. One more time, Brenda and I will write you up.”

“You can’t write me up!”

“Try me.”

Phyllis Wene is a pharmacist who is an investigator (not inspector) for the Washington State Board with police powers. She can arrest offenders. Phyllis told me this story. A store Manager at a Haggen’s Grocery Store called the board and accused the PIC of breaking the law. Phyllis agreed to meet him after the store closed. Very late, like midnight. When she got there, the store manager was in the pharmacy nosing around. Phyllis went in and listened. The guy’s accusations were nothing. The PIC was doing his job legally and ethically. She wrote her report, brief and concise. Then she asked the manager, “How did you get in the pharmacy?” He told her the key
in the safe.

Phyllis did not hesitate, she busted him. She cited the number of the law, told him that he and his boss would get a notice of the day and time to appear in Olympia. The manager was ordered to NEVER enter the pharmacy. Haggen’s had to pay a stiff fine. The board was lenient. He was told that Phyllis could have arrested him right then and there.

All of you are REAL pharmacists. Just show it once in awhile. Tell me if this piece is a dud. It is amazing what you like. I put up a letter from a Walgreens PIC during the WAG/Express dust up. She was very critical of the WAG CEO. That week, for 7 days, the number of visitors to this blog was 700+ every day. I did not expect that. The piece on the RPh must be present when an Rx is sold law has not had no comments. That is a surprise. Your life is on the line. I know that plenty of Rxs are sold with no pharmacist present. Lunch time. Before the pharmacy opens or after it closes. Sundays, holidays. I had a manager open the pharmacy because he said he heard the water running. He also used Hycodan for a persistent smoker’s cough. Yeah, water running. This guy is the grandson of the founder of the company. 400 stores. I WAS NOT a Real Pharmacist that week, that month, that year.

Are You? Just give me one shot. Write a comment. Make all of us proud.

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