Pharmacy. Jim Plagakis. Pharmacist

I know, some of us get irritated when we call for a transfer and the pharmacist’s accent is so “bad” that everything has to be spelled out and I takes 3 times as long as it should. We get really cranked when that pharmacist has no clue about “transfer protocol”. We have to tell the patient who is leaving us that it is the “receiving” pharmacists job to do the calling and waiting on hold.

“Maam, I don’t care what the pharmacist at Walgreens told you. I understand that she
said that I would call her with the information. That is not the way it works. There is a code of behavior that we follow and this is not it.”

I still talk to pharmacists who are downright bigoted. They talk about America for Americans. They have derisive nick names for different ethnic groups. They make fun of “foreign” pharmacists. And….THEY HIRE THEM.

The business of pharmacy (not the profession) depends on foreign pharmacists with H1-B professional visas to fill in the cracks. If you haven’t noticed, there just aren’t enough rosy cheeked, apple pie, baseball-loving boys and girls with pharmacist licenses to go around. So, we are friendly and welcoming to darker skinned, falafel eating, cricket-playing boys and girls with H1-B visas in their pockets.

I’d throw a bet out that CVS would fall all over themselves if every job they had could be filled with pharmacists with a from-birth natural comprehension of the English language, spoken idiom and all. That’s my bet.

That is not the way it is. Period! We need H1-B visa holders who have jumped through the necessary hoops to get a pharmacist license in one of the 50 states. That can’t be easy. Navigating American culture can’t be easy. I’ll handle it to them. They show a type of courage that Americans don’t have to exhibit.

I never imagined that the immigration flap could affect the business of pharmacy. Well,
if you are one of the pharmacist recruiters who thought that H1-B visa holders were
your aces in the hole, you may be unpleasantly surprised. We are not talking about
crops not getting picked. We are talking about drug stores having to reduce the pharmacy hours. We are talking about closing on Sunday.

Of course, the chains will think they can fix the problem by throwing money at you. It is always the answer, isn’t it!

Proposed legislation (nothing in stone yet) will increase the number of 1 to 6 year H1-B professional visas from 65,000 to 115,000 a year. That sounds good, huh? Maybe not.
America’s cutting-edge technology companies depend on software engineers from off shore. Engineers from, say, Ireland, India and China, are eager to work and have a taste of life in the “promised land”. They also bring exceptional talent to the job.

Mark Krikorian (Center for Immigration Studies) recently said that (NOT PHARMACY)
the new H1-B visa program is “A version of importing cheap tomato pickers.” In the real
high tech world, apparently these H1-B visa holders will work for less, work more hours and even sleep on the floor just for a shot at America. I know, that’s crazy. This is from the Washington Post. I didn’t make it up. These H1-B folks will settle for about $12,000.00 less than their American counterparts. They don’t even have to outsource anymore. They bring highly trained professionals here. This is especially noticeable in the huge insurance industry in Connecticut. Many natives who once held skilled jobs have been laid off and replaced by low-cost foreigners. That, my friends, is a new twist on cheap labor. That is not why I am writing this, however.

My point is based on my observation, my instincts and what I know about the management of big compaies. I have a good eyes. Pharmacy is in deep shit. We don’t pay the Filipino guy less than the American next to him. He may say, “Balium por da nerps”, but he’ll get that $100,000.00 just like you. The young woman pharmacist from Pakistan who willingly works extra shifts so you can go to your daughter’s college
graduation makes premium pay just like the girl who played with Barbi dolls around 1990.

There are only going to be 115,000 H1B visas granted a year. Are the drug store
chains ready to fight it out with Microsoft, Google, Virtual Atlantic and a thousand
other tech companies for the spaces? I don’t think they have even thought about it.

Regardless, they are going to start throwing more money at you pretty soon. Book it!
Be ready. Take everything you can get and ask for more. If you are squeamish about
negotiation, drop a line to Krag. He is an expert.

Update 6/10/2007 From reading the immigration reform news, it looks like
contractors, farmers and slaughthouses will be fighting for the open spaces. They don’t
necessarily need cheap help. They need dependable help. Immigrants from Latin America
ARE dependable. If they eliminate the illegals who come over for the harvest seasons in
California & Arizona, for example, farmers, agri-business, will be duking it out with Tech
companies and PHARMACY COMPANIES for the available visas. And you can expect to
pay a lot more for a head of lettuce or a peck of pears. Yesterday, a woman who runs
landscaping crews told me that she pays $10.00 to $14.00 an hour depending on the
job. Not bad money. CASH. No questions asked. Young, white Americans would take these jobs if it
WASN’T FOR THE SOUTH TEXAS SUN. Hispanics can work all day and thrive. An
American high school graduate wilts in 2 hours. HOUSTON, WE GOTTA PROBLEM.

Be careful out there! It doesn’t matter if you do everything right. It doesn’t matter that you are a responsible pharmacist. Providence doesn’t care if you have your eyes on the
practice. You have to make tough choices on occasion. You get uncomfortable, but as the assholes in the office often say with a grin, “That’s why you make the big bucks”.

I had an incident that scared the hell out of me happen on January 20, 1984. My daughter was 4 days old. I was the pharmacy manager at the Pay ‘n Save store in Pittsburg, California. I was home on the 22nd, I think it was a rainy Sunday, a day that the pharmacy was closed. I’m telling you the truth. Closed on Sunday!

My partner and I were used to having a relief guy for Saturdays. It was very nice having 3 hours of pharmacist overlap Monday through Friday. The weekends off! So, when this
50 something guy from Richmond stopped in, looking for work, I hired him.

• King Kong on dvd

We had our first pharmacy computer. 6 months. 3PM, a company out of Michigan.
Very easy. It was a very profit-friendly program if you played it right. Individual drug
schedules allowed me to get 600% profit on some drugs and 3% on others. It was a game in January 1984, just as it is now. 3PM was very user friendly.

The Lodge divx

This Saturday guy was in way over his head. He had not clue one on how to run a computer. It was the reason why he had to drive all the way to the Sacramento River delta from Richmond. After a month or so, the store manager called me. “Geezuz, Jim. It is
already noon. The pharmacist has managed to fill a whooping 4 prescriptions.”

“How did he manage the other Saturdays?”

“He didn’t manage,” the manager said, “You gotta let him go.”

So, I came in and watched him work while I pretended to do some book work. He stood in front of the computer screen, frozen, a dear in the headlights. I let him go, as gently as I could. As usual, I picked up the slack and finished the day.

January 20, 1984 was about 6 months later. I was reading the Sunday San Francisco Chronicle. My wife was nursing the baby and my 10 year old step daughterwas drawing at the table. The television was on. Pete Rose had just signed a contract with the Montreal Expos. The door bell rang.

It was computer guy, standing there with a growl on his face. His head was wet from the rain. He was wearing a long trench coat. His hands were buried in the pockets. He smelled of gin.

I couldn’t even remember his name. My 4 day old daughter was colicky and started to cry. My step daughter came to the door to see who it was. My wife asked, “Who is it?”

I tried to keep my face relaxed. This just did not feel good. I mean, it felt very bad, very scary. My legs were weak. My heart was pounding. My hands were like ice as my
flight or fight response clamped down my peripheral vascular system so I wouldn’t bleed to death. I was not much better than a snake or a lizard. This guy was scaring me. My children and wife were behind me. My dorsal lateral prefrontal cortex still had some life.

“How are you, man?” I smiled.

“Is that a baby I hear? What is this pretty girl’s name?” His voice was husky and
had a distinct slur. The gin! Did he drink it to get courage? For what?

I answered his questions. I just wanted him to leave. He asked if he could come in the house. He actually started to move by me.

“We are very busy,” I said, moving to guard the door. “Christy, go to your room,
“Denise, take the baby into the kitchen.

He gave me a menacing look and fooled with something in his right hand pocket.
What does this fucker have in that pocket?

I asked him if he was working. It was the wrong question. He face grew darker. I could almost see an ominous shadow cross over him.

“I haven’t worked since you fired, me, motherfucker.” He started to frantically try to get something out of his pocket.

I don’t know if it was the flight or fight or if my angels were watching over me.
“I didn’t fire you,” I said.

He stopped searching in his pocket. “Who the fuck did then?”

“The manager made me fire you.”

Alright, I can hear you now. “Chicken shit Plagakis blamed the store manager.” Hey! What do you want me to do? Go, “Yada yada, I fired you and you haven’t worked in 6 months” to him and take a slug from a .38 Jack Ruby style right into the gut. Wait until you are face to face with an alcoholic who has a huge nut against you. What if he has a gun in his pocket?

I’ll tell you what you do. You lie. You slam the door and hide. You jump the sunuvabitch before he can get the gun out. Anything to get him the hell out of there. I don’t think that this guy really wanted to hurt me, but I think he wanted some kind of perverted justice for all of the times he had been fired. For his wife of many years leaving him. For his estranged children. He wanted anything so he
would not have to shoot me.

He turned and walked out into the rain, to his AMC Pacer and drove away. No more than 3 minutes later, the cops arrived. Denise had called 911. She felt the danger too.

As I said, BE CAREFUL OUT THERE!

Advanstar (the publisher of Drug Topics) is bringing out a book of all 167 of my
JP at Large columns. Number one was published in January, 1989. I offered
to separate them into chapters and to write a short introduction for each chapter.

Chapter Number ONE is entitled Working Conditions. Other chapters were entitled, for example, Jazzman and Bleeding Heart. Poetic sort of titles. I could not find anything lyrical for Chapter One.

The subject of working conditions has gathered more response, more passion, more anger than any other subject I have written about. I believe that some pharmacists would be happy if that is all I ever wrote about. I have gotten a huge helping of bitching and complaining about pharmacists’ working conditions for almost 20 years.

Alvin and the Chipmunks movies

I know all of it. You don’t have to remind me that you don’t get even 20 minutes for an uninterrupted chance to eat. I know that you damn near pee in your underpants before you just have to dance to the bathroom, the anticipation killing you. You have to work
12 hour shifts even if you don’t want to. You earn a 2 weeks vacation and the bastards tell you that you have to take it one week at a time…. in November and April. A summer vacation has to be earned.

Not enough help. What else is new? Employers have been nickel and diming the pharmacy departments about payroll hours for decades. You and I know that it is penny-wise and pound-foolish, but they don’t notice that customer service goes right into the hole. They get to show their bosses all of the money they have saved. What a joke. I hurt myself laughing.

I know that there are other issues. I’ll leave it to you guys to list them in your comments.
What I want to say is this: Bitching and complaining has gotten us shit. It is going to take a paradigm shift to get a new reality in working conditions. Just stick with me a little bit. Be willing to go along with Plagakis’ airy fairy old hippie ideas. You see, I strongly have faith in the power of affirmative thinking.

It goes like this: As long as you EXPECT to be treated like galley slaves (Thanks Paul T), that is exactly what you are going to get. Most of us are INSTITUTIONALIZED. Like an abused child who gets spanked every day, we EXPECT the treatment we get. Hey, these employers have it made. We do not EXPECT anything better.

Neverwas download

So, what is the fist step. Modify your EXPECTATIONS. This is not easy. You guys actually BELIEVE that it can’t get better. Do some creative visualization, like a world class athlete, and do it until your mind gets it.

When 20 out of a 100 pharmacists EXPECT just 20 minutes to eat….. all of us will get it.
Drug store companies will begin to RECRUIT based on better working conditions. Mark it!

It is up to you. I’ll keep this subject going only if you show interest and the willingness to engage in a dialogue as a group.

Oh, by the way, some of you blame the profession in angry, virulent messages.
IT IS NOT THE PROFESSION, STUPID. THE PROFESSION IS FINE.
IT IS THE JOB.