Pharmacy. Jim Plagakis. Pharmacist

“Jim, this nurse wants you to loan some Dexedrine to this patient.” The technician stood with the phone in her hand. She knew that my rule on “loaners” was a 3 days supply and never controlled substances.

I took the phone with anticipation. This could be the kind of perverted fun that I like. I’d listen to her, but there was no chance for her request to come true.. I asked her what she proposed I do.

“The doctor is out of town until Monday. I want you to spot her a few capsules to get her by until the doctor can write a prescription.”

“I can’t do that,” I said.

“I’ll write you a letter,” she complained. I’ll write down anything you want.”

“Are you authorized by the doctor to make such requests.”

“Yes,” a haughty reply. “Of course I am authorized.” She made a whooshing sound as she exhaled.

“Are you a registered nurse or, perhaps, a nurse practitioner?”

A long silence. Another whooshing sound. “No, I am not a nurse. I am the doctor’s secretary and I am absolutely authorized. I am asking you to spot her just enough until the doctor gets back on Monday. I’ll fax you the letter.”

“I can’t advance a Schedule II drug,” I said. I stifled a laugh.

She tried the old “What is your name?” trick. Like she was going to be a tattle tail
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with the doctor.

“My name is Jim,” I said.

“Your last name?”

“I’ll spell it. Pee Ell Ay Gee Ay Kay Aie Ess. Plagakis.”

“Well Mister Plagaski,…”

I interrupted her. “That is PLAGAKIS. It has a kiss at the end, not a ski.”

“Whatever!” She whooshed again. “You will be hearing from the doctor.”

About an hour later, the doctor called. I told him what had transpired and informed him
that I was not spotting anyone anything Schedule II. The law allowed me, however, to fill an emergency prescription for a weekend’s worth on the promise that he would get
the written triplicate to us within one week. That would be 3 capsules of Dextroamphetamine SR 10 mg. He had to proclaim an emergency.

“When did she get it last? I am in the car on the way to New Orleans and I don’t have her chart. Hardy har har har.

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I looked. “Her last amphetamine Rx from us was in April, 2006.” BINGO, “but she regularly had Xanax, Vicodin and Soma filled here.

“I don’t write those drugs!”

“Three other doctors did,” I said.

“Don’t give her anything.”

“I didn’t intend to.”

“Will you print out her record and mail it to my office?”

“I will do that.”

“Thank you.”

I told him that I had a question. “Why do you give authority on prescriptions to a woman who is not even a Registered Nurse.”

A short silence. “I can trust her. She knows how I do things. Why do you ask?”

I didn’t tell him that my question was rhetorical. I asked just to give him the opportunity
to examine his procedures. “Just wanted to know,” I said.

Doctor Zhivago rip I am not an economist. This is hypothetical. I will take a real figure and a real policy and
I am going to draw conclusions that people with a vested financial interest will argue against. They would rather I not say such things.

This is about automatic shipments of new pharmaceuticals. Recently, it was 3 pieces of Symbicort. $437.51 worth. Automatically shipped to the store.

There are about 55,000 pharmacies in the USA. Times $437.51 = $24,063,000.00.
This is an inhalation product, so the cost to manufacture is more than tablets. We all have a good idea of what pharmaceuticals actually cost the manufacturers to make. (We all know also who is making the big bucks in our industry, but that is another talk we’ll have some day) Let us guess that the net net value to produce this stuff is $5.00 x 3 = $15.00.

Remember, this is hypothetical, me just having some fun. I contend that there never has to be a prescription written for Symbicort and the company will make a substantial profit.
Really. No prescriptions, nada.

Say that only half of the pharmacies remember to return the product in a timely
manner. Let’s really stretch out here and say that they go outdated, that the pharmacy will lose the entire value.

That leaves about $11,600,000.00 profit split between the company and the wholesaler without us selling one prescription. Is this fuzzy thinking on JP’s part?

We have a very small slice of the profit pie these days. That’s wrong and as long as the manufacturers can count on
mullti-million dollar paydays just to bring a drug out, our slice will stay the same.

I always hated the auto shipped medicines. They were just extra work.

There has been discussion about getting paid for our knowledge and experience. OTC counseling comes to mind. Medical advice too. We are the point person of triage for the entire stack. How many people without money come to the pharmacist to see if they REALLY NEED TO SEE THE DOCTOR? I say a lot. If they don’t have money, most will come see you.
Where else can you get the kind of attention we give for nothing?

We really need to figure this out one of these days.

Yesterday, I was called out front. There were 3 people there. Two Hispanic men, 30-something and 40-something. An elderly grandmotherly type who was the interpreter.

This is way south Texas and they were probably illegals. Regardless of your stance on the immigration bullshit going on, stick with me. Listen to this.

The grandmother told me that the older man needed his blood pressure taken and recorded on an employment sheet by a doctor.

I looked at the sheet. “I’m not a doctor, but I’ll do it for him. If they won’t accept it from a pharmacist than we know that doctors have quite a racket going on.”

I sat the guy down and put the cuff on him and pushed the button. That was it. AND DOCTORS CHARGE FOR THIS SHIT?

188/118. “This is not going to help him get the job,” I said, “He really needs to see a doctor and very soon.”

“Really?’ She rattled off something in Spanish. The 40-something guy said something back.

“Really. We are talking about stroke territory here. He better get some medicine and then take the blood pressure if he expects to get hired.”

More Spanish. I shook the hands of all 3 of them and headed back to the pharmacy.
The entire deal took me less than 5 minutes.

“Excuse me. Excuse me.”

It was the younger man. He came up to me and tried to hand me a 20 dollar bill.
“Gracias,” he said.

I couldn’t NOT TAKE IT, you guys. 20 bucks is a hell of a lot of money for him.

Anyway, the way I see it is this: These people wanted to pay for services. They
would make terrific citizens. How many times have you given extended advice
to someone who obviously has money and don’t even get a thank you?

These 3 can stay here as long as they want.

Victoria said, “It has to be cultural thing, Jim.”

Hmmmm. Think about it. That guy tried to compensate me for my time, experience and knowledge at the rate of $240.00 an hour. That is lawyer’s wages.

Think about it. We gotta figure this one out. I want that guy with the Mercedes sportster and the trophy wife to lay a few bucks on me when I do something for him.