Gary Schnabel, RPh  Executive Director of the Oregon State Board of Pharmacy

“A Pharmacy is a professional environment.  It is not the deli counter”.

What about this is there NOT to celebrate.  This is what you have been bitching and whining about for decades.  Oregon is just the beginning.  Still, I get e-mails from you idiots who can’t stand it when you win.  You write, “Yeah, okay, we’ll see.  The big boys will find a way around this.”  Or one guy wrote, “When they suspend a CVS pharmacy for a week, then I know they mean it.  Until then, more of the same.”  There are no CVS stores in Oregon.  All of you who can’t stand it when good things happen, if you don’t have the courage to spout your negativity in the comments here for everyone to read, don’t bother.  I do not want your private e-mails.

Thousands of pharmacists giving thousands of hours in many separate organizations have contributed to this.  Small groups, individuals.  Take some credit.  A compromised pharmacist due to bad working conditions makes mistakes.  The Pharmacy Alliance has stated “A tired pharmacist is a dangerous pharmacist” for the last three years.  Members of The Pharmacy Alliance can pat themselves on the back.  You helped get this done.  The rest of you, visit www.thepharmacyalliance.com

The game is on.  We just made a first down.  The next step is to publicize the result in Oregon everywhere.   Ask this question of the media, “If this is necessary in Oregon, to protect the public, don’t you think it is necessary everywhere?”

Ask this question of your board, “Isn’t it time to do your job, protect the public?  You know that pharmacists are compromised by long hours, no adequate meal or rest periods and a work place that is frenetic and very dangerous.  You must act before the media jumps on this and embarrasses the board and the profession.”

Ask this of your colleagues, “Are you ready now, to do something other than complain”?

We cannot miss this opportunity.  We have to keep what happened in Oregon last week right where everyone can see it.

This is huge.  If you like this, go to the Oregonian on-line, May 27, find this article, print it, make copies and pass the copies out to your pharmacist colleagues.   Urge them to contact your state board and their local state representative.  Send a copy with a letter to your state board.  Tell your BOP that it is time to cut the crap and do their job.  The job of every BOP is to protect the public by regulating the profession of pharmacy in a manner that actually protects the public.  TIRED PHARMACISTS KILL.  Period.  Now is the time to put pressure on everyone.  The business of pharmacy will do fine.  As long as the playing field is level, no one will have a competitive disadvantage.  Next, we go after the VAMPIRE SQUID, the PBMs.  Jay Pee

Oregon pharmacists say: We’re not burger flippers

Published: Sunday, May 27, 2012, 6:51 AM Updated: Sunday, May 27, 2012, 8:51 AM

By Susan Nielsen, The Oregonian The Oregonian

Patrick Bowman opened Tualatin Pharmacy last year. Before opening his store in Tualatin, Bowman worked as a temporary floater to large chain stores. The experience, he says, was not good. In a recent survey and in testimony to the Oregon State Board of Pharmacy, many Oregon pharmacists who work in chain stores express concern about patient safety and workload.

Oregon pharmacists are fed up.

They say they’re overwhelmed with the crush of prescriptions totaling hundreds per day. They’re tired of long days with rare bathroom or meal breaks. Mostly, they’re worn down by the stress that comes with dispensing life-or-death medicines in a burger-flipping environment.

So they’re fighting back through the board that licenses their employers. Last week, the Oregon State Board of Pharmacy approved new rules governing working conditions in pharmacies. These rules may compel some of the big chain stores, which are coming to dominate the pharmacy world, to adopt more patient-centered business practices.

This is good news for people in Oregon who regularly get prescriptions for themselves, their children or elderly parents: The status quo simply isn’t safe enough.

“Patients aren’t being treated well,” says Oregon pharmacist Blake Rice, a former pharmacy board member. “The board is finally bringing into immediate relief the staffing issue at outlets.”

In 2011, the board invited the state’s 5,000-plus licensed pharmacists to answer an online survey about working conditions. The 1,400 respondents highlighted a troubling gap between chain outlets and independent pharmacies in Oregon. Only one quarter of chain store pharmacists said their working conditions promoted safe and effective patient care, compared with more than three quarters of pharmacists at independent stores.

Chain pharmacists also warned about their workload and patient safety. They further railed against the endless incentives that chains often use to encourage people to transfer and fill prescriptions: the gift cards, the bonus coupons, the fuel points. The incentives may be good for luring people to buy groceries, but they also create billing headaches and dangerous prescription mix-ups as patients swap pharmacies to save $10 or rack up fuel points.

“I feel like I’m sort of a glorified gas station attendant now,” says Portland chain pharmacist Belinda Misterek, who works for one of the major grocery-store chains and who testified last week to the state board. “People who don’t need prescriptions, they’re just filling them to get their fuel points. … These working conditions are awful.”

The survey and testimony spurred the board into action. Under the new rules, the state board can fine pharmacies — and even suspend or revoke their licenses — for creating a work environment that puts patient safety at risk. The rules require employers to provide rest periods and meal breaks and to allow pharmacists enough time to do their jobs, including patient counseling and prescription verification.

The board wisely backed down from a few heavy-handed proposals that would have restricted what businesses can say when they advertise. However, the board bucked the chain-store lobby and prohibited pharmacies from “incenting or inducing the transfer of a prescription absent professional rationale,” which is intended to curtail some of the frenetic pharmacy-swapping.

“I think soon you will start to see changes,” says Lis Houchen, a regional lobbyist for the National Association of Chain Drug Stores. “Each company will have to look at the rules and see what they need to do. There’s probably going to be a trial period.”

Gary Schnabel, the executive director of the pharmacy board, agrees. He says the board’s intent isn’t to dictate business operations, but rather to discourage any activity that becomes detrimental to patients, from inadequate staffing to crazy-making promotions.

“It’s about the environment,” he says. “A pharmacy is a professional environment. It’s not the deli counter. I think some of the stores had forgotten that.”

It’s impossible to know for certain if pharmacy error rates are going up, or if chain stores in Oregon have more problems than independent ones. The system relies largely on self-reporting and the data aren’t reliable enough to confirm suspected trends. But the feedback from pharmacists is telling, and it mirrors what customers see from their side of the counter.

I’ve seen it many times, waiting in line for medicine at the local Safeway and watching the staff scurry around like fast-food workers. In fairness, I’ll confess to adding to their stress by being irritated when my prescription is not ready instantly, as if it were a pound of turkey or a Tillamook cheeseburger rather than actual medicine.

So these new rules represent progress. Ideally, they will push chains to step up their staffing and allow pharmacies to treat customers more humanely, as patients.

But there’s more to the story here. Real change may require pharmacy customers — with their prescriptions in hand and internal clocks ticking wildly — to be a little bit more patient, too.

– Associate editor Susan Nielsen, The Oregonian

Jamie Francis/The Oregonian

Pharmacists who feel their workloads are a threat to public safety may soon get a helping hand from the state.

Responding to a scathing workplace survey, the Oregon Board of Pharmacy on Thursday will consider rules letting the board fine, suspend or revoke the license of pharmacies with working conditions that don’t protect patients’ health and safety.

Hundreds of Oregon pharmacists, especially in chain stores, expressed concern over poor working conditions in a survey last fall. Many pharmacists expressed alarm over pressure-cooker conditions, saying they process hundreds of prescriptions during 10- and 12-hour shifts with no breaks but with plenty of distractions – increasing the risk of errors.

To address complaints, the board started considering new rules that don’t set specific targets for workloads, but allow the board to gather information and set standards over time.

In April the National Association of Chain Drug Stores sent a letter of opposition, calling the rules “subjective and counterproductive.”

Dozens of pharmacists, however applauded the board’s attention in comments to the board.

“I am very proud of my profession, but have seen it deteriorate dramatically in the past five years,” wrote Paula Stark, a Kmart pharmacy manager in The Dalles, in a letter. She called pharmacy workplace changes around the state “very dangerous… to public health and safety.”

Independent pharmacies, which once dominated Oregon, now constitute roughly 200 of about 750 retail pharmacies statewide

There is no data to definitively show more pharmacy errors are occurring, or that they happen more in chains. Pharmacies do not have to report errors to any public agency. The board considers roughly 80 cases a year involving errors.

State and court records show medication errors including a Paisley man who suffered sudden Parkinson’s disease symptoms, and a Hillsboro man who was pulled over for driving erratically after taking the wrong drug.

Although pharmacists are required by law to report unsafe working conditions, none ever have, according to the state. In the survey, several pharmacists said they fear being fired for speaking out.

There is a sea-change going on, you guys.  This was not even above the radar five years ago.  Put pressure where you can.  They are like children.  You just keep on repeating the message.  Jay Pee

The video is a good laugh, but the subject today is deadly serious and I mean “deadly”.

How many people die every day due to pharmacist errors?  Come on, think about it.

According to the Journal of the American Pharmaceutical Association, “dispensing errors are a problem on a national level, at a rate of four errors per day in a pharmacy filling 250 prescriptions daily.” The 2003 article also stated that “an estimated 51.5 million errors occur during the filling of 3 billion prescriptions each year. This figure includes 3.3 million errors of potential clinical importance.”

Think about it.  3.3 million per year means 9041 errors of potential clinical importance every single day.  You give me a figure, but I’ll use 0.1% cause death whether the patient’s family or doctor or coroner realize it or not.  That would mean that about ten people die every single day due to pharmacist error.

Let’s pretend that a pharmacist at Three Pee Ex was in the 13th hour of a 14 hour shift.  It was her second of back to back 14 hour days.  She was compromised.  Her blood sugar was low.  She ate a whole bag of Hershey’s Minatures, but it only made it worse.  She didn’t realize that she was hypoglycemic.  She needed protein.  She needed a good meal, but the work load was more than 400 prescriptions with two technicians who overlapped only between 2:30 PM and 3:30 PM.  She had to squeeze it in order not to pee her pants on the way to the Ladies room.  When she got there, three teenagers had locked the door and refused to come out.  Probably shoplifting.  Finally, she used the Men’s, but too late.

To make matters worse, she lived and worked in North Carolina and she had violated the law.

The North Carolina Board of Pharmacy established a 150 prescriptions per pharmacist per day threshold for citing both the pharmacist and the permit holder in a disciplinary proceeding. The Board adopted this threshold level using information presented at the National Association of Boards of Pharmacy (NABP) Health Law Officers Conference in 1996. Experts on this program gave the range of not more than 10 to 20 prescriptions per hour as established levels of safe dispensing. (From the World Wide Web, Jay Pee)

At hour 13 of her second 14 hour day in a row, she made an error.  She dispensed Actos instead of Actonel.  Of course, the doctor’s handwriting was horrible.  The pharmacist was exhausted.  Three Pee Ex always says that a 14 hour shift is the pharmacist’s choice.

The patient was an elderly woman who lived alone.  She did not question her prescription, but she did not feel well.  Two days later, she died.  (I honestly do not know if this scenario is likely, but you get the point)

Grandma was old, the family said.  She had lived a good life. Her daughter-in-law believed that something was wrong, but no one questioned her medications.  The leftovers were flushed before anyone had a chance to examine “the evidence”.  That is the way it usually happens.  Ten times a day, a pharmacist kills someone with an error and it is so far under the radar that no one ever knows.

What if someone did know?  What if someone (take your pick.. family member..doctor..caregiver..another pharmacist..a technician) made an issue out of it?  What if someone went to the media and showed that a pharmacist, working like a indentured servant, was so compromised near the end of her 14 hour shift that she made an error that killed a patient?

There was a time when I would have thought that this kind of negative publicity was unacceptable.  We could not allow the public to know our “dirty little secrets”.  It would demean our profession.  That attitude today, with the realities of the 21st Century, is a load of shit.

Something has to happen.  There has to be change.  Companies such as Three Pee Ex do not give a shit if a compromised pharmacist makes a serious error.  Errors are built into the algorithm.  Actuaries hand out spread sheets.  Taking a chance on serious errors is profitable.  Eliminating dangerous situations would cost too much money.  The bottom line would be affected negatively.

State boards are not going to do anything.  We saw that in North Carolina just ten days ago.  Legislatures are bought by the corporations.  There are certainly some courageous legislators who would carry our banner, but it would be like farting in a hurricane.

What’s left?  Don’t mention the APhA.  They are too busy.  The media is all the chance we will get.  I hate this, but I am not mentally ill.  I know that doing the same thing, like begging the state boards, will never get a result other than lip service.  The K**** H***** vs. 3 P X case is the poster child of ineffective regulation.  Rightfully, 3 P X should have been nailed for multiple violations of the law.  The usurping of a pharmacist’s authority being the one that pisses me off the most.  The non-pharmacist store manager should have been cited and fined, at the very least.

Sorry, back to the point.  How about headlines like this in the Equirer, at every check out across the nation.

3 P X Pharmacist Kills Senior Citizen by switching drugs.

The story reads:  Pharmacists at 3 P X are expected to work 14 hours straight with no rest periods and no meal breaks.  How many errors do 3 P X pharmacists make when they are exhausted? It goes on to question our industry.  Is pharmacy broken?  Can this industry safely provide millions of prescriptions every day without errors?

You and I know the answer to that one.  Hell no.

Are we getting to the point where the only way OUR profession can be saved is by wrecking it first with that kind of publicity?  It is OUR profession even though most of you wouldn’t defend it if it was burning down.

How would you feel if you were standing in line at Kroger to buy a six pack or a half gallon of milk and you saw that headline on the Enquirer?

Pharmacists United for Truth & Transparency.

You do not have to be a store owner to help.  There are rumors that the big boys are anonymously in this game.  A smart move.

I work 16 hours a week, you guys.  I donated $100.00 on Monday.  That means if you work 5 days/ 40 hours a week, your “tithe” is $250.00.  At least match my One hundred.  Even half it at $50.00.  Steve is right on as we used to say in the 1970s.  By the way, PUTT is based in New York.  I may not remember exact, but I believe they stopped mandatory mail order.  Also, “Mail Order PHARMACY” is a misnomer.  They are “Mail Order DISPENSARIES”. Jay Pee.  Oh, do not tell anyone, but I believe that the Big Guys are somehow laundering money and getting it to PUTT.  They have to be careful, but if they are not somehow supporting this outfit, they are mind addled.

A Year In Review

Well, it’s been a busy Spring season, and so first I must apologize for not getting an update out in almost 2 months.

Obviously the most distressing news was that the FTC approved the Medco/ESI merger. While profoundly disappointing, I cannot say it was unexpected. Until we have a new UNBIASED FTC study that exposes the PBM industry for what it is, any Federal relief is not anticipated, so go on we must!

As we approach the end of PUTT’s first year in existence, I think a brief summary of how far we have come and a showing of where we have been successful is in order.

The first posting of the need for a PR approach the PBMs was in June of 2011. Within 3 months, we had reached our first goal of raising $75,000 from 200 store owners. To date, we have raised just short of $200,000 and have 1060 members.  The overwhelming majority being pharmacy owners  but there are also other pharmacists and a handful of industry insiders.

While our membership numbers continue to grow, the bank account continues to shrink. While the administrative work of PUTT is accomplished by a Board consisting of 8 volunteer pharmacy owners, the public relations work is done through our PR firm “Fenton” http://www.fenton.com/. The monthly retainer for Fenton’s work is $13,000/month. Trust me when I say, this is money well spent. Their media contacts and copywriting skill are excellent.  I do not have enough space to list all the media outlets, some of which include the (NY Times, Bloomberg, USA Today, Forbes, LA Times) we have been in as a result of their effort.

The link below is a PUTT Google search that brings up many of our media successes.

http://www.google.com/search?sugexp=chrome,mod=5&sourceid=chrome&ie=UTF-8&q=dave+marley+and+PUTT

Fenton has also created a PUTT Twitter account http://twitter.com/#!/truthrx   and will be actively utilizing that medium for further media outreach development.

For those who became members in 2012, it was PUTT who broke the Lipitor rebate story and for the first time put the PBMs on the defensive. We opened a crack into the shady world of PBM rebates.

http://www.nytimes.com/2011/11/12/health/plan-would-delay-sales-of-generic-for-lipitor.html?_r=2&ref=business

We continue (often with your help) to look for examples where we can shed the light on PBM abuse. Spread pricing, rebate retention, and the effects of mandatory mail have been our primary focus. Just today I spoke with another Bloomberg reporter about Plavix going generic, and I shared with him an actual ESI document that describes how the PBM is made whole (at the employer’s expense) when drugs go generic and the PBM looses rebate money.

And of course, we all anxiously await the airing of a comprehensive PBM expose on a major TV network. Some of you may have seen that we are fairly confident that this episode will air in June. I must also remind you that we are dealing with network television where decisions can be made outside the reach of the producers we are working with. Schedules change, current events happen, and God forbid shows get cancelled. Right now everything still appears to be a go. As the date gets closer, and we are given ”the green light” from the network to publicly promote, I assure a newsletter to all of you will go that day!

Into The Future

Going forward the PUTT Board has decided to make addressing the PBM’s aggressive intrusion into Medicaid and their attempts to replace traditional TRANSPARENT fee for service Medicaid programs with NON-TRANSPARENT PBM models our top priority. Some states have gone this route and reversed course, some states have recently convert to managed care, and many more are considering it.

At this very moment we are working closely with Florida to address a restricted managed pharmacy network that has locked independent pharmacy out.  Texas is also facing a series of store closures as a result of reduced reimbursements. Kentucky  recently went managed care, and the implementation there has been a nightmare. NY is in trouble too.

If you know people in those states specifically who are not yet PUTT supporters, forward them this email with instructions to join here.

http://www.truthrx.org/join/

The Future is Now and It Is Up to YOU!

I share all this with you because it will be YOUR response to THIS newsletter that determines whether or not PUTT continues or fold up our tent.
As a reminder, we only take money from pharmacists, and individual pharmacy owners. No corporate financial support has ever been solicited or accepted. Two local pharmacy owner associations have donated, but their individual members are encouraged to contribute as well.

Many of our early supporters have already contributed $2000 each, many more $1000 and $500. If you have been blessed with a successful pharmacy, we ask only that you give in terms of what you perceive the value PUTT’s past and future accomplishments to be.

So there it is folks, what say you?

Keep PUTT going or fold up shop? Right now the bank account will run dry in August. If that happens, well then the message is loud and clear. It is the hope of the PUTT Board that YOU will not let that happen.

If you want us to continue, than I am asking those that have given in the past 12 months to at least re-up in the amount you gave last year, and if possible increase it. If you have joined, but not yet given, now is the time to open the wallet and get out the credit card…..and I mean right now.

Just click on the link below and you will be directed to our PayPal site (you do not need to have a Pay Pal account).

http://www.truthrx.org/contribute/

Without trying to sound like an infomercial, I have over 1000 brochures, complete with a 15 minute DVD that explains everything YOU and your community need to know about PBM games. These brochures were initially developed as the marketing package for a transparent PBM (RxDisclosure) that never got off the ground, and was later converted into PUTT!  You can see a 1 minute teaser clip of the DVD here.

http://www.truthrx.org/2012/04/16/spread-pricing-in-plain-language/

For a $500 contribution, an original 3 color “RxDisclosure” brochure and DVD will be shipped to your store at no cost.

On behalf of the PUTT Board of Directors, I want to thank all of you for your past support and look forward to fighting on your behalf through 2012 into 2013.

Onward and Upward!

Respectfully,
Dave Marley, PharmD
President
PUTT

Letters of Warning for me (K**** H*****), (Three Pee Ex), and my former district pharmacy supervisor.
These letters are not disciplinary, and do not impact pharmacy licenses in any way. Effectively, a slap on the wrist.
I am relieved that this is the extent of the Board’s punishment for me – and now that it is over, I am exhausted.

There is a reason why I chose a feminine puppet.  The majority of new pharmacists are women.  Women have a horse in this race, but I don’t get the feeling that many of the pharmacist who comment here are women.  I have been a feminist since the Equal Rights Amendment days of the early 1970s.  This amendment was first introduced by Alice Paul in 1921.  It did not pass Congress until 1972.  IT HAS NEVER BEEN RATIFIED BY THE NECESSARY 38 states.  Equal Rights is NOT the law of the land.  Except in Washington State.  They did it themselves.

What am I missing?  Are women satisfied with the way it is?  If so, the men might as well give up.

Since the mid-1970s, the puppeteers have been the guys who have taken our profession to the brink.  The non-pharmacist MBA bean-counting Masters of the Universe.  They have NO standing in pharmacy.  They have never acted as a cashier.  They have never accepted a new prescription.  They have no clue how to enter a new patient, new insurance and then type the prescription.   The idea that they would have any sense of what the pharmacist does is laughable.  I’d love to see one of these Masters of the Universe at the drive-through.  How would he handle a guy smoking cigarettes and demanding his Norcos now.  His 20 year old Cadillac is spewing fumes through the drive-through drawer and he refuses to turn his engine off.  His obese girlfriend with a tattoo of a Big Mac on her neck is eating “healthy” food.  A deep-fried chicken sandwich.

“Sir, your prescription is not ready yet,” says the Master of the Universe.

“Get it now or I’ll see you in the parking lot when you get off work.”

Just a little fun.  You get the point.  Non-pharmacists with power and authority have taken our retail pharmacy industry to the point of failure.  What we do is not sustainable.  I won’t discuss the professional failure today.

About 40 years ago, some non-pharmacist Bozo said to the Executive Committee, “We do not need 40% profit.  (We were a 40% profit industry until the 1970s)  Let’s lower our prices on the top 50 prescription drugs.  Let’s go to 25%.  We will still make a ton of money and get a competitive advantage.

You know what happened.  In order to not be in a position of competitive disadvantage, every chain company lowered their prices.  It finally got to the point of ridiculousness.  Nobody had a competitive advantage.  The industry threw money at every problem with no return.  If our industry manages to squeeze out 18% gross profit in 2012, I would be surprised.

Non-Pharmacists MBA bean-counting Masters of the Universe need to be assigned to the variety store where they belong.  Feet-on-the-floor pharmacists (good drug store merchants) need to be brought into the decision-making loop.

Our industry is on the brink of failure.  We have been trying to maintain a 50 year old model without the profit.  The model is not sustainable.

When our industry is unable to deliver the prescriptions that our culture demands, turn out the lights.  They are watching us.  Who are “They”?  The interests that want dispensaries and not pharmacies.  A lot more mail order.  Central filling.  This is a horror to think about.

10,000 Americans turn 65 every single day.  Our population is 330,000,000+.  Our culture expects prescriptions when they go to the doctor.  What can you give me, Doctor? is the question.  Big Pharma will answer that question.

The Masters of the Universe have an answer for diminishing returns.  Well, Larry and the rest of you executives enjoying this catered lunch of Rhode Island clams, I know what we can do.  I am an MBA and I know that the answer is to cut overhead.  Turning off half the lights is so 1970s.  How about we cut the budget for ancillary help.  They don’t need a cashier after 7:00PM.  (One again, the fucker has never come within a football field of the working side of a drive-through).  They don’t need to have technician overlap on Tuesday, Wednesday and Thursday.  This would save us about $400.00 a week.  That is pure profit.  (I like calling the Masters of the Universe FUCKERS because they have been sticking it to us for four decades) Larry hands out big cigars and the MBA Master of the Universe thinks What a good boy am I.

By the way, you are not going to find MBAs who were “A” students at The Wharton School working for CVS.  You will probably find “C” students from a public school at best.  Night school at worst.  The brightest MBAs from Stanford are on Wall Street getting huge bonuses from moves that lost billions.  Go figure.

Having non-pharmacists design the pharmacy business plan is like having an MBA running a medical office.  Doctors are not stupid.  The people who have been running drug store companies make you wonder.

Okay, Plagakis, get to the point.  If our industry was still a 40% business, we would have no problem delivering the crush of prescriptions to come.  We could have extra cashiers, extra technicians.  The technicians beyond the RPh:Tech ratio could be doing maintenance work.  We could run streamlined operations and still make a terrific profit.  We could counsel.

The non-pharmacist bean-counting MBA Masters of the Universe have simply fucked us up.  This is PHARMACY, not a variety store.

One more word.  We get chicken-shit reimbursements from the PBMs because we lowered our prices to rock bottom.  The PBMs say, “We are not paying you more than the industry standard.”  How much better would it be if the starting point was 40%?

Received an e-mail from K*****. It read: “The hearing is at 4pm on Monday the 14th. I do not believe it is open to the public”‘

MONDAY, MAY 14, 2012.  North Carolina Board of Pharmacy offices.

6015 Farrington Road, Suite 201, Chapel Hill, North Carolina.

A preliminary hearing will be conducted.  K***** H**** will be charged with violating the Pharmacy Practice Act.  He was the pharmacy manager at the Three Pee Ex store.  He was working with a marginal technician.  His best tech was out sick.  At hour seven of a 14 hour shift, he had been reviewing, verifying and completing prescriptions at the rate of one every 80 seconds.  He had neglected important counseling and was behind.  For the health, safety and welfare of his patients, he chose to close the drive-through.  He did this so he could focus on running Three Pee Ex’s Prescription Mill and to funnel the sale of all prescriptions to the front register.  A terrific idea.  He had the legal right and the professional responsibility to do this.

The non-pharmacist store manager went ape-shit.  He marched into the pharmacy, usurped the pharmacist’s authority, and opened the drive-through.  K***** H**** closed the pharmacy and went home.  Three Pee Ex, with an army of attorneys (3 P X is huge), apparently filed a complaint with the board and charged K***** H**** with violating the pharmacy practice act.

K**** H**** filed his complaint with the board.  He charged that 3 P X violated the pharmacy practice act.  He alleged that the non-pharmacist store manager has no authority in the pharmacy whatsoever.  (alleged?).  This is backed up by the law.  The store manager barging into the pharmacy is no different than the Vicodin-seeker storming into the pharmacy.  No shit.  That is not hyperbole.  Non-pharmacists have NO authority. Pharmacists who are not licensed in North Carolina have no authority in a North Carolina pharmacy.  That is the law.  The NC BOP either recognizes the law and cites 3  P X or they are a joke.

There is a North Carolina law that restricts a pharmacist’s shift to a maximum of 12 hours.  Every single 3 P X pharmacist in North Carolina works 14 hours shifts.  3 P X will claim that that is the pharmacist’s choice.  Tough shit, 3 P X.  The law is the law.  There is no fudge factor.

There is a law restricting the number of prescriptions a pharmacist can “fill” in a shift.  I know.  You get a hiatal hernia from trying to stifle your laughter as you fill 400 Rx at the local 3 P X.   It is so bad that you pee your pants.  K**** H**** was filling one every 80 seconds.  That is 315 prescriptions in the first 7 hours.

The North Carolina board is interesting.  Google it and take a look.  There are no chain drug store executives on the board.  The board is elected.  I believe elected by North Carolina pharmacists.  There is a good chance that 3 P X will be cited.  Of course, the 3 P X army of attorneys will be brutal.  They will try to paint K***** H**** as a rogue pharmacist who endangered the public.

K**** H***** has an attorney.  One attorney.  That is all I know.

My only reason for writing this is to urge you to attend this meeting.  If Monday is a day off and you live fairly close to Chapel Hill, please invest the hours in pharmacy’s and your personal future.  3 P X may have a cadre of high priced attorneys in $3,000.00 suits with an arrogance that makes you want to slap them silly, but you are pharmacists.  The presence of just 20 or 30 pharmacists would make a huge impact on the board.  You do not have to do a thing, but sign in: Jill Jones, North Carolina Pharmacist # 654321.

This case is HUGE!  Think about it.  If 3 P X is cited, it would be precedent-setting.  If 3 P X is ordered to cease and desist on the 14 hour shifts, it would have nationwide reverberations.  If the NC BOP says, Yes, we mean it.  The law of the state is XXX prescriptions in a XX hour shift. That would cause a tsunami in California.

This is no little preliminary hearing.  This is no insignificant meeting.  The members of the NC BOP just want it to go away, but it won’t.  K**** H***** has them boxed in and they have to do something.  The board knows that pharmacists all over the USA are watching.  K***** did not do this out of meanness.  He had no choice.  He was fired.

3 P X would have been very smart to say, “K*****, this was an unfortunate incident.  How about we give you a year’s wage with 12 month of benefits and you just withdraw your complaint.”  But, 3 P X is a bully.  This thing could have gone away.   They could have quietly painted K***** as a loose cannon to their other pharmacists and could have gotten away with it.  But, hell no.  No pharmacist can be allowed to close the drive through and then close the pharmacy.  3 P X wants to make an example of K*****, but they are in a very dangerous position.  3 P X’s big ass is squarely balanced on the line.  You can help push them off.

My call is that K*****’s hand will eventually be slapped.  If the NC BOP actually punishes him and suspends him, they absolutely MUST suspend the pharmacy license of that particular 3 P X for the same number of days.

This is your frikkin’ Super Bowl whether you can see it or not.  Bigger than the Super Bowl.  Your very life may not depend on it, but your professional life is at stake.  Not just if you work in North Carolina.  This case will affect you in Salt Lake City, Seattle, Birmingham, Tucson or Honolulu.

Attend the meeting.

Be respectful.  Dress in business casual.  If they give you a chance to comment, be careful.  K***** has an attorney.  However, you are a pharmacist with standing.  What you have to say could make a huge difference.  Remember, the BOP is mandated to protect the public from excesses like the 3 P X 14 hours shifts.

Then whine and complain and cost your CVS pharmacist in a store in the deep south $5.00 from his/her pocket.

This has been passed from RPh cell phone to RPh cell phone all over the deep south.  It finally made it to Jay Pee a couple days ago.  It originates from the Tupelo, Mississippi “District” of CVS.

IF, We do not address you by name

If, We are not courteous and professional

If, Your script was not ready when promised

If, You are waiting and it took longer than 15 minutes

We consider this unacceptable service and we will give you $5.00

Jimmy Eddleman, Pharmacy Supervisor CVS

I have been told that the $5.00 comes out of the employee’s pocket.  Big Evil at it’s best.  They will never let us down.

Here are some thoughts I have.  GREED.  Bullying, Nasty, Brutish in a hidden corner of the black ages of pharmacy.  All of a sudden, Jimmy boy, we are all watching you.  The damage done by ignorance is glaring.  Fight the brute with self-control, empathy, morality and reason.  I would never suggest that you undermine and sabotage.   You could, but well that is not who you are, is it?  Sadism, revenge, dominance.  Fear = Obedience.  There are animals in the jungle you need to watch.  There are animals that you can walk right by.  I have learned to carefully watch the animals that can kill me (metaphorically).  Watch the animals that can kill you and kill them first (metaphorically).

Self-control.  Don’t be stupid and righteous.  Protect your good thing.  Be the HUNTER, not the HUNTED. Underneath all of Jimmy’s bull shit, he is afraid of you.  All it would take is for five of you to turn on him in a dark alley (metaphorically) and Jimmy is done for. Where is his head?   Certainly not in the game.  Has he forgotten that you are pharmacists?  Most of you are well-experienced.  Most of you MAKE MONEY FOR CVS.

Centralization of authority & ineffective bullies as” leaders” has caused a mess.  What is this?  The 6th grade?

Death by a thousand cuts.  This is just one cut.  Every pharmacist has multiple scars.  How long are we, as a group of professionals, going to put up with this kind of humiliation?  The disrespect of the last 25 years has been crushing.

Is Jay Pee an anarchist as the CEO of Price Less Corporation charged?  (Drug Topics is banned from Price Less because the pharmacists were reading “JP at Large” and getting uppity)  I am far from an anarchist.  You can call me the Dean of “The College of Change”.

That is what Jay Pee thinks and I have this advice:  Find the Power and Identify the Weakness.  That is all I will advise.  If and when you take Jimmy Boy down, I did not tell you what to do.  I simply advised that you examine your situation carefully.

Take baby steps.  Anger can be your friend.  For crissake, do not go off half-cocked.  Righteous, knee-jerk anger can kill you.  You have a family to take care of.  Let your anger work for you and not against you.  (Read “The Prisoners of Comfort”).  Smile a lot.  Nod and say “Okay” even if you are thinking “No fucking way, asshole”.

Take it easy.  You are a bad ass if you play it right.

My last word is, “Good bye, Jimmy, it was nice knowing you.”

Please take the time to comment.  Get some righteous screaming in the comments.  Adult language is encouraged.  I am not adding my offerings at my usual pace.   Your comments will help keep my unique visits between 350 & 400 a day.  My ego, you see.  I will take the MPJE on May 14th and the NAPLEX on June 14th.  I am am reading a lot.  Thanks, JP