I have a question/example to clarify if I understand correctly what you’re asking. I work for CVS. On December 9^th, CVS’s computer systems went down for over 9 hours (about the 5^th time this past year). Management starting calling each pharmacist at each store DEMANDING that they continue to fill prescriptions at a comparable rate before the systems went down. Problem: manual DUR on each fill, no prescription hard-copy images (at all) so all would have to be pulled from storage individually to process the 10^th refill on a prescription, no way to check the state’s drug monitoring program on controlled medications, and these are just a few of the problems associated when computer systems go down. Along with the demand to keep pushing prescriptions out the door and into the hands/bodies of patients, management said verbally to each pharmacist, “If you don’t keep filling prescriptions you will be targeted for termination.” My response, “Send me that in writing with your name clearly printed and signed with a date and phone number where you and your supervisor can be reached because I’m going to fax the document to my contact at the Board of Pharmacy and see what they have to say about this first.” Supervisor stammered a bit and then replied, “I don’t have to do that because this is company policy.” I then said quite firmly, “Never can any company or corporate policy trump federal regulations, state laws, or rules of the governing Board of Pharmacy. Unless you send me something to send to the board of pharmacy, I will not be filling prescriptions because I feel uncomfortable with the process and think filling prescriptions at this point would endanger the health, welfare, and safety of the public and patients I serve so I will not be filling prescriptions. Perhaps CVS should be spending some money to ensure this type of problem doesn’t happen again. I have pharmacist friends working at other pharmacies and they never have complete system failures with their computers such as CVS.” I have since learned that I wasn’t the only pharmacist that balked at management’s phone call and I also wasn’t the only one to contact the Board of Pharmacy. I truly believe that corporation pharmacies have a plan in place to try and isolate pharmacists so they won’t talk to each other and learn what is going on all over the company – I believe this in completely intentional.

I sent patients away to competitors the rest of the time the computers were down. I also had to put a tech on notice that I was her PIC and that corporate policy never dictates how I perform my responsibilities as a pharmacist and she worked under my direct supervision – not the other way around. I am getting all the forms completed to write up the tech.

I did call my contact at the Board of Pharmacy (immediately after the phone call with the management) and told him everything that was going on (I said to him,”Guess what CVS in trying to pull now.”). He confirmed my beliefs and indicated I should not fill any prescription if I even felt slightly uncomfortable with the process and assured me that CVS could not fire any pharmacist for exercising professional rights in refusing to fill prescriptions.

Now, I was at another CVS pharmacy yesterday and I was able to locate a faxed document that went to all stores 3 days before the computer systems went down AND it has a paragraph where it stated that pharmacists would be terminated if they refused to fill prescriptions when the systems are down. I made a copy and brought it home with me.

Is this the kind of example you’re looking for? I also have e-mails that I have sent (with read receipts) about my concerns for health, safety, and welfare of patients and how CVS wants things done (several actually). I do have an appointment with an employment lawyer for a consult in late January to discuss these same issues for my peace of mind. I’m tired of having my position as an excellent pharmacist threatened because I insist on following all compliance issues first and putting company crap (telephone calls, etc.) as dead last in my daily responsibilities.

I hope I haven’t missed the point of what you need from us. I really want to be helpful in this process of getting back on track with pharmacy

Pay attention to this.  The pharmacist above is an intelligent, confident mature person who was 50-something when he/she got his/her PharmD and became an RPh.  His/her attorney asked that he/she remain anonymous in any communications that get disseminated widely.  This pharmacist had a full career navigating the federal regulatory landscape.  He/she is perfectly positioned to really stir it up.  He/she knows the law and how to apply the law.  Also, he/she entered pharmacy with no baggage.  Where you and I ignore indignities and bad conditions, this pharmacist had clear eyes and said, “What the f…?”  To this newcomer, it was very clear that something was very wrong. JayPee

CVS, as usual, plays the “termination” card.  Is Big Evil “The boy who cried wolf”?

This letter is from a member of The Pharmacy Alliance in regards to a private initiative that TPA is developing.  It is basically a Cover-Your-Ass-While-You-Demand-Your-Rights-As-A-Pharmacist program.  I am convinced that Steve Ariens, TPA’s National Public Relations Director, is an expert on this.  So, please don’t go off half-cocked.  Do not act from anger.   Join The Pharmacy Alliance and take advantage of years of experience in navigating these waters and decades of  knowledge and communications expertise.  Visit www.thepharmacyalliance.com

From another member of The Pharmacy Alliance.  Good questions. Are member of any other organization asking pointed questions like this?

I can appreciate that the privacy issues involved with sharing information can be complicated to tackle in an equitable manner, but why have a state board of pharmacy in the first place if it can’t effectively do its job? If the state board doesn’t support the new PSE tracking system or even have any say in its implementation then I have to wonder what is the in the boards agenda? I am sorry I am in the dark here because I don’t know all the details but from over here it doesn’t add up.

If the state doesn’t want to cooperate with its own agencies or governing bodies to help enforce its own laws then I guess the answer is to quit trying because it can never be made to work? It takes a lot of work to make change and it is also very costly. Sounds a lot like what goes on Washington D.C.

What conclusion can someone come to other than drug diversion must be big business in Indiana if the state doesn’t want to cooperate with itself to slow it down? The war against drugs is won by those with the most money. So really what you are saying is that the board blames the AG and BMV for not cooperating. A political victory for those who claim they try to fight it masquerading yet another frustrating setback for those sent to fight the war without weapons.

It’s easier for the state board to blame the AG or BMV for causing setbacks and to stop functioning than to take an even handed approach at solving the problem. If the board is ineffective at doing its job maybe there is no need for a board at all?

The AG’s agenda is influenced by those who contribute to his campaign. He skirts over the main cause of prescription drug abuse while publicly patting himself on the back as he addresses the problem. In this press release he skillfully makes it look like he actually trying to do something about prescription drug abuse. However, if you read it carefully, he blames the problem on unwanted drugs left over in the medicine cabinet. He also adds that rogue healthcare providers are also to blame for diversion and boasts that “many physicians are criminally indicted for improper prescribing”. He makes no mention of how prolific poly pharmacy and doctor shopping are in his state or how profitable it is for pharmacy chains. He completely ignores this, the biggest cause of the problem or how to curtail it effectively. CVS has this guy in their pocket. Again CVS gets away with breaking laws by just paying small fines and no one spends time in jail because of it. What about all those rogue doctors that he boasted criminally indicting? Why not indict some CVS execs and put them in jail, it’s not like you don’t have plenty of opportunities because they are constantly breaking the laws. Oh yeah, I forgot they have a river of money flowing straight to the people charged with enforcing the laws it would be foolish to stop them.

We have people on our side. Copy and Paste This Into a Document and Pass this on to your doctors and patients. Baby steps.  But, if everyone took baby steps, we will have given the Vampire Squids bloody noses and black eyes ….Jay Pee

Is PBM Spread Pricing Increasing The Cost of Your Self-Funded Employee Health Plan?



PBM Settles Lawsuit, Rehired by Same Group It Was Accused of Defrauding
CVS Caremark has agreed to pay nearly $20 million to settle claims that it defrauded three state pension systems from 2003 to 2006. Two former CVS pharmacists filed a whistleblowers lawsuit alleging that the PBM had falsified records, improperly switched patients to higher priced drugs, and dispensed drugs that had been returned to its warehouse. Caremark said it settled the case to “avoid the costs of continued litigation…There were no findings of wrongdoing or any admission of liability.”

CVS Caremark will pay CalPERS, the California state employees pension fund, nearly $7 million under the terms of the settlement. Illinois will get $4 million and Florida $3 million. The rest of the money will go to the plaintiffs’ attorneys. Usually the whistleblowers also receive some of the settlement funds.

Last June, CalPERS rehired CVS Caremark after its first PBM choice, Medco Health Solutions, became embroiled in a CalPERS bribery scandal. CalPERS said it had put new safeguards in place so that there would be no repeat of the earlier problem with CVS Caremark. During the saga, complaints were expressed in California over the lack of competition in the large PBM market and NCPA is bringing the episode to the attention of the Federal Trade Commission and Congress as they review the proposed Express Scripts-Medco merger which would further consolidate the market.

The graphic on the back cover of “The Comfort Demands OCCUPY PHARMACY” is a black and white drawing of a Vampire Squid.  It reads “Stop the Vampire Squid OCCUPY PHARMACY”.  Each of you have your own Vampire Squid.  It might be Rite-Aid or WAG or Wal-Mart.   For me, the Vampire Squid is the PBMs, with CVS-Caremark the worst example.  They bend the law and even break the law at every turn.  CVS is a bad actor.  They do not run pharmacies.  They operate dispensaries.  Pay close attention to the Kelly Hoots vs. CVS in North Carolina case.  CVS blatantly violated the law and they will lie under oath.  If Kelly does not get satisfaction, I say we go for the NC board and leave some bruises and bloody noses.

I worked the late shift last night with one technician from 4:30 PM on..  I have been doing this too long and and I am much too experienced to let it affect my health.  I didn’t come close to the cortisol levels that were flowing through the vessels of my poor technician.  He is a 59 year old man who has been teching for a couple years.  I don’t think that he understands that he is not the only pharmacy worker who gets creamed like that.  He takes it personal.

I can usually go with the flow because I know that it only hurts for a little while.  But when the skinny ass 40-something pre-menopausal babe hollered, “What the fuck do you do back there?  Twiddle each other’s ass?  I brought my perscription in twenty minutes ago.”  The flight or flight hormones surged and I went storming to the counter.  I am fortunate that the pharmacy is huge and it is a good 40 feet from where I was to the counter.  By the time I got face to face with this Hitch, spelled with a B, I had a better strategy than expressing my anger.  I calmly smiled and told her that there was a problem with her prescription.  Between you and me, there was no problem that I could not figure out.

She placed her hands on her hips, stuck out her meager chest, flashed some teeth behind her ruby red lips.  ”What is wrong with my perscription.”  It was an Okay, Buddy.  I dare you to delay me any longer.

“I am sorry, but I cannot fill this prescription on your insurance.”

“What?  You have too.”

“I can fill your prescription, but I will have to bypass your insurance and fill it for cash.”

“What?  You can’t do that.”

“I have no choice.  It’s not expensive.  It will only cost you a little over $60.00″.  The Rx was for lorazepam 1.0 mg and I believe that she had gone without for a few days.  Her eyes were wide.  She was smacking her lips.  Her mouth was dry and when she said, “Fuck you, Buddy” it came out like Buck ou Boody.

“Why do you think that I would want to help you when you use bad language like that?  This is not a fast food place and I am not bagging fries.  This is a pharmacy and I am the pharmacist.  My job is to make sure that everyone here” I waved at about a five person audience “gets the right drug in the right dose with the right instructions.  Then I have to make sure that everyone understands if there are dangers or side effects.  Then, I answer any questions they may have..”

Had she apologized right then, I may have cut her some slack.  I mean, come on, a patient habituated on benzos and being off for three days or more would be one kinda Bas-Ket case.  She did not apologized.  She told me that she would call the manager.

“Call whomever you want.  You can call George W. Bush in Dallas and I would ask him if he was a pharmacist and then I would tell him to mind his own business”.  Who knows what the hell that could be.

“I have to have that drug.  I could have a fit.”  Oh, a real smart rat.  I trusted that she meant a seizure.

“The problem is that your doctor did not put instructions.  He put As Directed.”

“I know how to take it,” she howled.  I swear she was starting a seizure the way she was dancing.  ”I take two a day.”

“But your insurance company doesn’t know that.  If I put a 30 days supply for 60 tablets without the doctor signifying the instructions and bill your insurance, we would be dinged big time if we were audited.”

“$60.00″, I said and was feeling a little guilty, but my brain supplied twiddle each other’s ass in perfect detail down to the squeal of her voice and I became strong.  ”You can get less than 60 tablets,” I said.  ”It would be cheaper.”

“I have sixty dollars,” she said.  A bit of dried spittle was forming on her lower lip.  She threw three twenties on the counter.

“Okay, I’ll go get your prescription ready.”

“What?  It’s not ready?”

“You are third in line.”  I heard What the fuck do you do back there in my mind’s ear and added, “About fifteen minutes.”  I had had enough.  She started whining, but I walked away.  At the counter, the technician pointed at her filled prescription, billed to her insurance.  I updated it and made it cash.

I was absolutely right about being audited.  I am not a mean man.  I have a serious heart problem.  It is too soft, but this babe went beyond my limits so far that I had no need to make nice with her.

She was seated beside a woman who is a regular.  When she started to complain to the regular, all she got was a terse one sentence answer and then she promptly shut up.

I love my job, but I only work two or three days a week.  Rarely two days in a row.  When I have an evening like last night, I know that I will be off the next day.  I work one day shift which is always a pleasure.  I work one late shift which is always a challenge between 4:PM and 8:PM.  So. you guys are not alone.

We are gonna fix this shit.  Trust me.   We are gonna fix it if we have to leave teeth and blood on the floor.

Jay Pee

Smart People Ride The Horse In The Direction It is Going

And.. the horse’s direction is immunization and other pharmacist duties.

If you believe that they are going tio pay you $10 grand a month to stand behind the flickering computer screen and click, click, click, tap, tap, tap all day long, you are dreaming.   Sooner than later, advanced technicians will be doing all of the filling duties.

What does it take to fill a prescription?  Not a helluva lot of knowledge.  Perhaps some experience.

You should be thrilled that immunizations will be an increasing function of the pharmacist.

Just do your part to make sure that legally a pharmacist must be present if an Rx is sold.  It is the law right right now.  If you let them take that away, you are screwed.  Also, during the filling process, you must be called over when the computer signals a problem.  A pharmacist must be the person to “fix it” and with a secret password allow the process of filling to go on or have it stopped and other action like calling the doctor initiated.

There are bonuses.  You are a single woman and getting ready to give a flu short to a hunky young lawyer.  Hell, you can lean over and whisper in his ear, “Do I kiss you before I stick it in?”

Had a conference call this morning. Apparently, RAD has won a lawsuit filed against them pertaining to overtime pay. Therefor, effective at the beginning of the new fiscal year, pharmacists will no longer receive “premium pay” for hours worked over 84/pay period. Firstly, RAD decreased actual store hours a few years back which decreased pharmacist pay. No big deal, I like only working until 6pm on Sat. Secondly, they now eliminate “premium pay”. Still no big deal for most pharmacists but I think you can see where this is going. The preceptor of the call went so far as to say that “pharmacists’ salaries are no longer untouchable” and that this is the direction of the industry. How long before they cut into our actual base salary?

The industry is only as strong as its weakest link. RAD’s failures are affecting the entire reatil pharmacy industry. We work in a “me too” business. If RAD decides it’s time to cut salaries how long before CVS, WAG, etc. follow? The industry NEEDS for all players in the game to be strong.

I will not take a pay cut to do this job. I haven’t received a real “raise” in 5 years. Sure I get a rate increase but it doesn’t even qualify as a “cost of living” incease. I bust my ass at a high volume store that continually beats the “plan” in both rx dollars and rx count. There is no respect, simply orders to do more. You guys can have this job, I’m looking for a way out.
*********************

Salaries skyrocketed years ago due to low pharmacist supply and high pharmacist demand. This has completely flip flopped due to an over abundance of pharmacy schools. Unless we as a profession are able to push forward and prove our value in manners other than generating income for businesses, we face an inevitable pay stall/decrease. The job market has become very, very competitive…there is no need for the chains to increase salaries to attract workers. A consistent surplus of available workers almost guarantees those pay cuts will become a reality. It’s just the way businesses work

*******************

We are just a few years off before a “shirt” walks into a store and starts with the staff Pharmacists and tells the staff Pharmacist(s) that I have a newly minted PharmD that will work for $xx,xxx.xx less per year than you are and you have 24 hrs – or less – to decide if you want to keep your job at the new rate – or less than the “green” PharmD is willing to work the store.
Within a few years after this… the chains will hub a 24 hr store around 5-10 mile radius with stores that operate as one-man stores 10AM – 8PM M-Sat.. making the typical RPH’s work week 60 hrs.. we are professionals and -by law – automatically classified as salaried. BTW.. the increase in hrs from 40-45 to 60 will not bring with it any more pay

This picture is probably close to how this woman looked 20 or 30 years ago.  She was well dressed in a skirt and light jacket.  It was a chilly, windy afternoon in Galveston.  The salty mist from the ocean meant that my car would have a thin residue covering it when I got off.  The drug store is right across the street from Stewart Beach.  The Gulf of Mexico was churning.  The woman was wearing a babushka.

She started making a fuss and I went over to the counter.  I asked her what was the matter.  Her English was terrible which surprised me because she is the spouse on her husband;’s insurance and the insurance told me that he worked at The Galveston National Laboratory.  One of only two labs in the USA like it.  That is a triple air-lock lab that deals with ebola and shit like that.  You don’t work there if you just fell off a turnip truck.  Her husband was a big shot in the bio-world.  You would think that his wife would be well educated.

Her name is Ekaterina Volnisnikovh.  She had three prescriptions.  It was 4:30 PM and we were swamped.

“Maam, I’m sorry, but your prescriptions are not ready.   I think I heard the technician tell you a half hour.  It has only been ten minutes.  You will just have to wait.”  Boy, was that a hot button.  You’d think that I reached out and squeezed one of her very nice tits for an older woman.

“Wait?  I am not don’t wait.  I wait all life in Moscow.  Nobody wait in America.”  She glared at me. “I don’t wait.  In Russia, I wait for butter.  I wait for cheese.  I wait for sausage.  I wait for bread.  My husband, the professor, not like the party so no American store for me.  I tell him to be a communist so I can go American store.  Only party member go there.”

“I take it your husband, the professor, was not a member of the communist party.”

“My husband is a professor at University.  He is scientist.  He doesn’t care in Russia that I wait in line.  He told me you have all day to wait.”She leaned toward me and winked.  ”He worry that I have affair with neighbor again.”

“Again?”

“I didn’t want.”  She shrugged and sighed.  ”It just happen.”

Oh shit, that is so American.  If your spouse has ever cheated, I’ll bet he/she said It just happened.

“Well, Ekaterina Darling.  You are going to have to wait.  Sit down.  I will go find your prescriptions and personally shepherd them through the process.”

She gave me a look and smiled.  I often call older women Darling, but it was a mistake.  Ekaterina’s English skills could not distinguish the nuances of Darling.

She said, “Your name is…?”

“My name is Jim.”

She gave me a look.

“Jim, James, Dimitri.”

“Ah, yes, Dimitri.”  He eyes sparkled.  ”I wait for you, Dimitri.  You are good doctor.”  She extended her right hand and grasped my right hand and gave me a hot gentle squeeze, letting it linger.  ”I like Dimitri.”  Her breath came in small gasps.  This woman was talented.

At that point I determined in a split second that even if I was not a happily married man, I would not tumble for Ekaterina.  I’m not going to shit you.  She is a very sexy woman,  50 something.  Her eyes and that little squeeze caused a falling sensation up the backs of my legs.  I liked Ekaterina too.  But, alas, I may be dumb, but I am not stupid.

“Ekaterina, you will have to wait.”

“I will wait, Dimitri.  Can you give me flu shot?”  Her look was animal.  I interpreted the flu shot question as Can you give me……?”

When her prescriptions were ready, I took her into the private area behind the screen and watched as she peeled her shirt over her head.  It was totally unnecessary because I could have gotten to her deltoid easily by rolling up the sleeve.  As I approached with the needle, she gave me a little girl’s look, vulnerable and open.  When I stuck her she gave a little ‘Oh” noise that made my knees weak.

These Russian women.  They are getting prescriptions all the time.  I can flirt with the young ones without danger.  Ekaterina?  I be berry berry careful.

When this pharmacist first contacted me, he asked that I include his name, address and contact information.  His attorney suggested that he hold off on that.  This is anonymous.  You can leave comments with your contact information, if you want to talk with him.  Or send to me at jpgakis@hotmail.com and I send to him.

Our industry is like a third world country.  Perhaps like a mid-eastern country.  Cut off his tongue if he swipes a lorazepam.  Industries like high tech, law, accounting.  When a valuable employee gets into cocaine, they actually pay for the treatment.  Drug Store and Big Box companies kill the pharmacist off.

You have all been here.  7:00 PM.  The cashier leaves for the day.  Your technician is inexperienced and struggling.  There are four people at the register.  Some asshole at the drive-through has been honking.  He thinks it is an express lane.  There are ten prescriptions on the counter that haven’t been started.  You got a headache.  Right there, in front of  you on the fast shelf is the 0.5 mg lorazepam. Very seductive.

From the July, 2001 issues of Drug Topics.  Study by Dean Dabney, Ph.D.  Georgia State University, Criminal Justice Department.

95% OF PHARMACISTS HAVE DIVERTED Rx ONLY DRUGS FOR SELF USE.

45% OF PHARMACISTS HAVE DIVERTED POTENTIALLY ADDICTIVE Rx ONLY DRUGS FOR SELF USE.

61% OF PHARMACISTS HAVE STOLEN THESE DRUGS

24% STARTED IN COLLEGE

8% OF THESE PHARMACISTS FORGED PRESCRIPTIONS

I am writing this letter to inform everyone in the pharmacy community how Wal-Mart treats its pharmacists. I am particularly interested in warning those pharmacists who Wal-Mart actively recruits to move to rural locations where they have difficulty staffing the stores.

In April 2002, I voluntarily surrendered my pharmacist license due to chemical dependency issues. This voluntary surrender was simultaneous with my entering the intensive outpatient treatment at the state’s Drug Court. The Board of Pharmacy and I stipulated that I would serve a five year suspension and then five years of probation upon my return to the practice of pharmacy. At this time, I had no savings and no income. My loss of employment and lack of savings resulted in my eviction from the house that I was living in and loss of my health insurance. Fortunately, I was able to piece together social service programs that allowed me to obtain housing and health coverage.

Per my agreed order on suspension, I completed the Drug Court program successfully, and during the same time, I participated in the State’s Recovering Pharmacist Program. I completed the Recovering Pharmacist Program after a little more than five years of monitoring approximately one year after I returned to practice of pharmacy first as an intern then subsequently as a licensed pharmacist.

In the summer of 2007, I applied to the Board of Pharmacy for reinstatement of my license. The license was reinstated on probationary status as originally agreed, and I was given a pharmacy intern license to complete 300 hours of internship and prepare for re-licensing exams.

I applied to three chain drug stores, and received offers from two of them. At all of these interviews, I fully disclosed the nature of my disciplinary action. I settled on Wal-Mart because at the time I was confident that if I kept my nose clean and followed all of the rules, I would have lifetime employment. After all, there was no reason to believe that Wal-Mart would go out of business. On the day that I completed my new hire paperwork, I provided both my district manager and the pharmacist preceptor I was working under with copies of the order reinstating my license subject still to probation. I also had my Pharmacy Preceptor and subsequently Pharmacy Manager complete quarterly reports to the State’s Recovering Pharmacist Program.

In January of 2008, I took and passed the NAPLEX and Law exams, and my license as a pharmacist was reinstated on probation. After completing the State’s Recovering Pharmacist Program, I was appointed to the Recovering Pharmacists’ Advisory Board and continue to serve on the Advisory Board.

I continued to work for Wal-Mart as a staff pharmacist, and in the fall of 2009 I purchased my first house. Please understand that the purchase of this house was a struggle, but nevertheless a significant achievement for me. Because of my financial predicament in 2002 experienced because of the loss of my license, I had destroyed my credit and cleaning it up enough to qualify for an FHA loan was nothing short of a minor miracle.

So, all has been well with me since the reinstatement of license on probation in 2007. In September, I celebrated my fourth anniversary of service at Wal-Mart. Then, on October 12 at approximately 4 pm, I was called by my Market Health and Wellness Director and I was told that I needed to meet her at the district office over 20 miles away from my store on Thursday, October 13. I did so the following day, where I was told that due to the fact that I have a history of disciplinary action against my license, effective immediately I was no longer eligible to work for the company. I was being terminated with absolutely no severance pay. This is despite the fact that I fully disclosed this information in my interviews and received above average reviews for the four years I was there, and passed the original new hire background checks. Needless to say, I was stunned and asked why this was an issue four years later. I was told it is because Wal-Mart policy has changed. The sole reason was the disciplinary action. I have no criminal conviction and I am not listed on the US Department of Health and Human Services List of Excluded Individuals and Entities.

Fortunately, I found a very good attorney who has taken this case, and on the Wednesday before Thanksgiving, I completed an intake interview with the United States Equal Employment Opportunity Commission, who agreed to accept a charge of disability discrimination against Wal-Mart. I think that it is ironic that on the day before Thanksgiving last year, the Market Health and Wellness Director called me to open the store and be the only pharmacist that day because another pharmacist had called in sick and she “[had] nobody else to turn to.” A year later, I was the person filing a charge of discrimination against Wal-Mart.

I will keep Jim P. advised of how this case progresses against Wal-Mart. But please, let this be a warning to those of you who are considering going to work for Wal-Mart. Particularly those of you who Wal-Mart is begging to move to rural locations where Wal-Mart is the only pharmacy around for miles. Imagine how you will feel when Wal-Mart decides to cut you loose after moving you hundreds of miles away from your home without even a penny in severance. Don’t ask if it can happen to you, ask when it will happen.

Whadaya mean "Fifteen Minutes? You think we are idiots? The lawn chairs for $9.99? I am a highly trained medical professional. I don't do lawn chairs?"

This essay gathered a ton of comments.  Let’s see if it has legs

The Five Biggest Lies The Chains Tell About Their Pharmacists

Our Pharmacists Are Our Most Valued And Honored Employees

We Respect Our Pharmacists As Highly Trained Medical Professionals

Our Pharmacists Are Encouraged And Empowered To Always Put The Patient’s Needs First

Our Pharmacists Are Given All The Tools Needed To Practice Pharmacy In A Legal And Ethical Manner

Our Pharmacists Enjoy The Most Supportive Professional Environment In The Industry

How about those cowboys?

The five statements above are common pharmacist fodder among upper management. They spout and publish statements like that everywhere you look. The CEO, the President and the board room people who light-up-the-big-cigars and pop-the –corks would never tell the truth.

They may even be sincere, but there is a disconnect between upper management and the middle managers.

The middle managers are institutionalized, just like you and me. Their job is to produce numbers. They couldn’t care less about the single mother who can’t read. You are wasting your time when you spend twenty minutes counseling her

on her baby’s dose of Prednisolone.

Here is how the middle managers hold you as a valuable employee.

“Listen, Buster, we pay you enough . So just do your goddam job. Nobody waits more than five minutes and you take coupons and give away antibiotics with a big smile.”

“What? You want a meal break in a 14 hours day? You have a nice roof over your children’s heads. They eat good food. They go to good schools. You can afford Disneyland every year. You have friends who think you are hot shit because you drive a Lexus.Bitch, bitch, bitch. What more do you want?”

“You make me laugh, asshole. Self respect? You think I go home at night and feel proud of myself? You think my job is dignified? I gotta produce numbers and you gotta cooperate so I get those numbers or your ass is grass.”

“You run the worst pharmacy in the district. You have the longest wait time. I don’t care that that heart transplant patient wrote to The New York Times about how you saved her life. You either get acceptable wait times or I’ll find somebody else to do the job.”

“You want self-actualization? Where did you get that term? In Psych 101 at your Junior College? You are a pharmacist, Judy.We give you money and that should make you happy.”

Is that enough about the Big Lies?

There has been talk on this site about how to enhance the pharmacist’s image with the public.

I think you should start acting like the pharmacist that the upper management aims at with the five talking points. Start acting like you are what the CEO says you are.

You are an idiot if you want to enhance your image and still refuse to counsel according to legal requirements.

I counsel on 85% to 90% of all new prescriptions. This is not a big damn deal with most prescriptions, but often, when I scan the bar code that I wear around my neck, the patient will occasionally ask,

“Is this something new?”

I explain that the scan is just a legal record that I counseled on their Rx.

Trust me.. My professional image is enhanced.

The route to being seen as a “Highly Educated Medical Professional” is through counseling. The price of the Rx is not a consideration when I tell a patient something they really need to know and they recognize that I have provided a valuable professional service.