Siesta Beach on Siesta Key. At this time of the year, no crowds at the # 1 rated beach in the U.S.A. It is a ten minute drive from our place. We will pass a CVS, a Walgreens and an independent. I’ll close my eyes.
We will be in Sarasota until mid-July. I will do my best to not think about the downwards spiral that the non-pharmacist bean-counting Masters of the Universe have us spinning on. I will still read and answer e-mails from pharmacists and technicians. I will still add essays here, if I feel like it. I will still wonder how the K**** H******, 3 P X and the North Carolina Board of Pharmacy comes out. K***** hasn’t told me when the final deal will come down.
We really do need to step up and get a seat at the table. Pharmacy is near a wreckage because the power has been handed to smart aleck MBA Masters of the universe. Pharmacists have very little say about what happens in the business of pharmacy. Don’t tell me that a pharmacist came up with the $4.00 prescription. It was not a pharmacist who said, “Let’s give away $25.00 gift cards to get them to transfer prescriptions”.
More of the same. Everywhere you look, a shiny initiative is announced by a company. The Masters of the Universe have to do something to justify their salaries. What looks shiny and bright is just the old and dull polished. Dan’t you see a toothy grin when one of the Masters of the Universe says, “Let’s give away gift cards.” What the …..? How is this new? It is simply throwing money away. It is what they have been doing for over 30 years. They have shown me that they are not capable of creating the quantum shift that is the only way we can save pharmacy.
Here is what they do:
More…. Better…. Different .
They take the old, tired, broken ideas and they try to do it MORE. If that doesn’t work (And it never works) they try to do it BETTER. (More failure). The last hope is to try to do it DIFFERENT. (It is still the same smelly shit)
No matter what they try to get a competitive advantage, IT IS THE SAME AS THEY HAVE TRIED HUNDREDS OF TIMES. Customers are not impressed. They do not even hear the television commercials. It is expensive white noise.
You can start by snickering when you are informed of a new, shiny program thought up by the Masters of the Universe. It is not new. It is simply ridiculous. The MBA non-pharmacists bean-counters have NO STANDING in the pharmacy. They do not even hear the music. You, on the other hand, are Travolta. You dance the dance without even thinking about it.
The MBAs have never stood at the drive through. They have never been in the grinder that is retail chain pharmacy on a Friday evening around 5:30 PM. They have NO STANDING. Why should anyone listen to them? Why show the people who are ruining us any respect? They need to get out in the variety store where they belong. Think about it. If could not be worse if they hired a grocery store manager to run the show. Oh, they did. The CEO of Rite-Aid is a grocer from Pathmark Grocery.
I worked for Pay ‘n Save ( a Seattle Company ). In the 1990s, they had a committee of feet-on-the-floor pharmacists review and talk about the programs that came from the executive suite. The committee gave thumbs up or thumbs down. There were few, if any, bullshit promotions, policies or programs.
The biggest question, I think, is: How are pharmacists going to get seats at the table? I believe that pharmacists could make the difference if they were given the opportunity.
I see no value in a $25 gift card. They transfer their Rx, get the card, then transfer it the another place to get a gift card there. MORE, BETTER, DIFFERENT. The same old bull shit.
Professional services. We have to do better. There is a reward. When you counsel appropriately, you will find that some people will ask, “Is this something new?” Most appreciate the information. We need to shine a spotlight on the “duty to warn” station.
Pharmacists with a seat at the table! Pharmacists are smart people. Most of them know the business. Some of them are ready and able to go head to head with the Masters of the Universe if needed.
If you have NOT noticed, both the profession of Pharmacy and the business of Pharmacy are at a crisis point. I distinguish between the PROFESSION and the BUSINESS. The only thing that ties them together is that they happen in the same room.
You wear two hats. A huge business sombrero and a tiny professional beany. It is a screwed up deal and the road to what it is today is close to 40 years long. I have written extensively in my books about the history we have endured. I have practiced during three eras of pharmacy. The Classic Era that began with the Durham-Humphrey Amendment. The Modern Era that began with the Pharmacy Computer and software. The Dark Era that began when it was discovered that they could use software to spy on pharmacists.
The Modern Era was a terrific time to practice pharmacy. The Classic Era was when pharmacy was sent to the back of the bus. Durham-Humphrey was not well thought out. We became the doctors’ lackey and Pharma’s pimp. You know what is happening in the dark era.
Can the PROFESSION and the BUSINESS be saved? I believe so. We need pharmacists making decisions and choices. The big companies that have pharmacies need to stop throwing money at all of their problems. It does not work.
Our time may come.. in 2014 or 2015.. there was a piece on Fox News this week
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http://video.foxnews.com/v/1691664570001/survey-doctors-dissatisfied-with-obamacare
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89% of doctors in a survey indicated that they will consider quitting practicing medicine if Obamacare survives the Supreme Court and declared legal/constitutional ..
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and here comes 30-50 million pts with untold/unmet health issues. Depending on how high/low deductibles/copay are will help determine how long the wait to see a GP/FP appt will be.
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With the ACO’s.. which are coming either way.. any healthcare professional that can’t save the system more than are paid to help cut costs without causing harm to the patient’s quality of life.. will be the keepers..
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Concierge/boutique practices may mushroom.. giving us a place to “do our thing”
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IMO … anyone who believes that we are going to get collaborative agreements with prescribers with them being in their office and the RPH in their store… delusional… this MIGHT work in very small towns/areas… between the local indy and local a few local prescribers.
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Those who wish to get into a practice today.. and work under a collaborative agreement may have to do it on a revenue sharing basis with the practice.. you don’t see patients and produce billing and results.. you don’t get paid much..
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Those of us who are damn good at what we do.. will have the practices coming after us.. we will get to “cherry pick” where we practice patient management.
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If we are given prescriptive authority – like ARNP’s/PA.. we could become the “RPH in a box” where the chains now have “nurse in a box”.. the numbers could explode.. to easily absorb the increasing number of RPH’s coming out of school…
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The potential paths that could develop are numerous… it reminds me of the interchange on the south end of the Kennedy Bridge on I-65 in Louisville… you make a wrong turn.. you can end up in a different state, different (undesirable)part of town, or where you wanted to go.. locally it is known as spaghetti junction.
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if you don’t keep your head up and your eyes on the horizon.. you may miss a number of opportunities..
“The potential paths that could develop are numerous… it reminds me of the interchange on the south end of the Kennedy Bridge on I-65 in Louisville… you make a wrong turn.. you can end up in a different state, different (undesirable)part of town, or where you wanted to go.. locally it is known as spaghetti junction.”
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Exactly right! There are so many paths that pharmacy can take in the future. After being quite pessimistic for over a decade, I am optimistic today. I think lawsuits and government regulations will force these renegade chains to act responsibly and to treat pharmacists a lot better. There is going to be a huge demand for healthcare services in the future. Some of us like working for chains and getting paid a salary. Some pharmacists like the hospital atmosphere. There are other pharmacists that want to be their own boss and own a business. These pharmacists must adopt the ‘business’ mindset! Where are opportunities to make money? There is a whole generation of baby boomers that are going to be looking for healthcare services. A lot of these baby boomers have money. The key is the ‘market’. Can you think of a product/service you can provide where you can make money?
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As Steve says, the “potential paths that could develop are numerous”. The key is to look for opportunities.
@Peon..
My only concern over a huge growth of Concierge/boutique practices could force the Feds hand..
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There is growing evidence if Obamacare gets “two thumbs up” from the Supreme Court.. we are headed down a path of long waits to get an appt…
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what could affect how long these waits become could be highly variable…
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55 + y/o Physicians retiring
Physicians becoming employees of ACO and drop from 60 + hr week to 40 hr weeks
Concierge/boutique practices where a prescriber charges 500 pts a grand or two a year to provide them with “personal care”… guarantee same day appts… answer emails… and has cell phone. Prescriber dumps a lot of their staff.. maybe 1-3 ancillary people per prescriber.
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Imagine Congress stepping in and telling these docs that a certain per-cent of your patients must be Obamacare patients.. you take what the allowable is from Obamacare.
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This could be where we come into the program .. we could be brought in to take care of these Obamacare pts under the normal rules of a normal practice. Basically treating the pt’s as “second class pts”.. instead of the same way that the pts that have signed up AND PAID for the concierge services….
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But the number of pts that you would see could depend on what is time practical and financially practical. If to get an appt with you is 3-4 wks out… it is what it is.
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or we will not renew your DEA license… or some other draconian measure against the freedom of choice of the prescriber… to practice medicine as they see fit..
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The origins/basis of our profession was to be self-employed. For the most part… Insurance/PBM’s have changed that.
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Many RPHs are now comfortable getting that check every 1-2 wks.. and have never known the professional satisfaction of doing things – for the most part – your way…
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the times… they are a changing… some of us will rise to seize the opportunities… others will remain passive.. collecting that -for sure – paycheck.
Steve, you seem to be persuaded easily by faux news. You seem anti-government. I wonder if you and the Faux news crew also have the same feelings about Medicare.
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I will stand up for Steve. He was just observing and reporting. 88% of doctors would quit if the Affordable Health Care Bill (Romney Care) is upheld. Give me a fuckin’ break. For primary care, V and I see a Nurse Practitioner. She actually spends time with us and pays attention to what we have to say. Physicians have been aching for a breaking for decades. They are just mechanics. Without drugs, most of them become witch doctors. Pharmacists hold the keys to the kingdom. So wake up.
I was just chatting with my nurse friend over a brewski..Her latest is adjusting warfarin doses..they get an INR in about 10 minutes. The off scale ones are attributed to heavy boozing. Plavix and this new one whose name escapes me aren’t generally under consideration apparently.Don’t get excited..you will not be doing this…break…..Middle management is defined by one thing…justify your job by constantly changing the same old thing….Those at the bottom are supposed to react to these changes….I suggest smiling and nodding vigorously..repeat as needed..then forget about it……The drug store trade is not going to change for the better…note that…supposedly Buffet bought a chunk of CVS stock…good luck to him….
The two new warfarin competitors are
Xeloda – the most recent
Pradaxa
The really bad news is that the first has NO ANTIDOTE for overdose – excessive bleeding
The second.. the only antidote is DIALYSIS
From what I have been reading … the bleeding deaths from these drugs is growing dramatically
Pharmaciststeve… look-a-like sound-a-like strikes again!
xarelto = rivaroxaban (what you meant)
xeloda = capacitabine – chemo drug
FYI I have not yet seen a indication for Xeloda for the treatment of hypercoaguable conditions.
XELODA (capecitabine) is a nucleoside metabolic inhibitor with
antineoplastic activity indicated for:
• Adjuvant Colon Cancer (1.1)
– Patients with Dukes’ C colon cancer
• Metastatic Colorectal Cancer (1.1)
– First-line as monotherapy when treatment with fluoropyrimidine
therapy alone is preferred
• Metastatic Breast Cancer (1.2)
– In combination with docetaxel after failure of prior anthracyclinecontaining
therapy
– As monotherapy in patients resistant to both paclitaxel and an
anthracycline-containing regimen
I think you meant to say Xarelto (rivaroxaban), often used post op knee or hip replacement. Let’s not forget Effient post stent. They keep on comin’!
@Notsteve… I am very much in favor of a more free enterprise system. That is what allowed me to build a successful pharmacy and HME company for 20 years. The government’s interference in that free market place is the reason I sold it.. not because I was not making money.. I was just tired of spending more time fighting changes in the bureaucracy and how I could run my business.. than taking care of patients.
There is no such thing as faux news.. all news is just facts slanted by someone’s own personal opinion.. every one has one.. just like assholes.. but.. there seems to be more socialized/liberal “opinions” on the media ledger.
My wife has been on Medicare disability since 1995 and I went on it this month… and the six prescriber practice that we have been going to for the past 15 yrs.. don’t accept any NEW MEDICARE pts… they will continue to treat me.. because I am an existing patient.
Our system is awash with fraud/abuse.. we have too many middlemen that are extracting “healthcare dollars” and diverting them to their bottom line.. while providing little/no healthcare to patients.
We have too many people who feel entitled to too much — too easily accessible health care .. while taking little self-reponsibility for their own health.. particularly disease prevention and/or disease management.
If our healthcare system was a airplane.. it would be in a “death spiral” and unless those at the controls takes some positive actions.. those things never have good outcomes.
Steve, you expressed my sentiments exactly! What we need is a more free enterprise system! So much of the problems that we face today are due to government intervention into healthcare. Just look at the tons and tons of bureaucracy involved in our healthcare system today! Tons of money are spent on bureaucratic red tape and we get nothing in return. Can you imagine operating a pharmacy where every patient simply paid cash? Can you imagine the increased productivity? Can you imagine the decrease in payroll? Yes, there are far too many middlemen! They are reaping profits and giving nothing in return. The only solution is to return healthcare to a free enterprise operation and get government out of it.
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News is always slanted news. I fully agree with this statement. Everyone has an opinion. And, it is correct that the media is slanted to the socialized/liberal point of view. They do not understand the consequences of socialized medicine. They only see the one side, where government acts like some benevolent king helping his subjects. Government cannot ‘give’ money to the poor. Government can only ‘rob’ one segment of the population and transfer that stolen money to another segment of the population. Government cannot create wealth; it can only redistribute it. How do you feel about the government forcing you to send them money or go to prison? How do you feel about the government taking your money and giving it to the sorry, fat, lazy bum just down the street?
A quote from Margaret Thatcher..”The problem with socialism is that eventually you run out of other people’s money [to spend].”
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with ~ 50% of US households paying NO FEDERAL INCOME TAXES.. we are reaching a financial tipping point where there are more “receivers” of government services than “contributors” to pay for those services.
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It is common knowledge how inefficient the government is when they oversee a program.. the per-cent of monies that come in and never go out.. due to overhead.. is pathetic a charity that operated like this.. would get a POOR RATING… at best..
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Fortunately/unfortunately I can remember when all pharmacy services were CASH or store charge… no PBM’s..no “plastic money”.. NO PA’s…but there were no calculators, computers, IVR’s.. just -if you were lucky – a electric typewriter and your trusty Bates numbering machine and the wholesaler “want book”… NDC’s were what?
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a store doing 100 Rxs a day was a “three man store”
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I can remember one Xmas break.. bad flu/cold season.. I was working over Xmas school break.. the store ended up doing 200 Rxs.. it was ALL HANDS ON DECK and I had to drag my ass out that night.. for a average of 16/Rxs/hr…
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today ..imagine being EXHAUSTED doing 200 in 12 hrs with two RPH’s and pharmacy student working? You would be laughed at ….
“with ~ 50% of US households paying NO FEDERAL INCOME TAXES.. we are reaching a financial tipping point where there are more “receivers” of government services than “contributors” to pay for those services. ”
You are wrong there, couldn’t be more wrong. Just because someone pays no federal income tax does not mean they do not pay taxes. If payroll taxes are counted, the number of non-payer households drops precipitously — to an estimated 18% in 2011. Many of those people who are the 18% are the elderly or people who make less than $20k.
“It is common knowledge how inefficient the government is when they oversee a program.. the per-cent of monies that come in and never go out.. due to overhead.. is pathetic a charity that operated like this.. would get a POOR RATING… at best.”
Germany spends about half of the health care dollars per capita that we do and they are probably healthier than us, I bet Medicare gets better ratings that insurance companies with regards to care too. We get all uptight when people want to help other American’s with better healthcare but we spend billions and trillions on dumb wars killing each other and not a peep. I’m sure you think the military is a failure too?
“We have too many people who feel entitled to too much”
Yes, the CEO’s of this world. Look at Medco’s CEO. A few years ago he made of $100 million dollars in a single year, how is this fare to anyone? People are dying without healthcare and this douchebag is making over 1000 times what an average american makes. Fair, not so much.
@Notsteve.. the more you write.. the more it suggests that you are NOT IN THE MEDICAL FIELD.. at least not a higher level healthcare professional.
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I think that it would be hard for you to find a single Pharmacist that has a favorable opinion of the existence of any PBM – especially ESI, Medco & Caremark.. who control 60%-70% of the marketplace.
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Spending or not spending money on healthcare has nothing to do with the overall health of a society… it is the mind set of the society as a whole that dictates overall health. You state that Germany spends LESS per capita than we do and your justification is that they are PROBABLY HEALTHIER THAN US.. much of Germany is also bilingual… doesn’t mean that they are smarter than us either.
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In this country, a common thread for people is to not worry much about their own individual health until it is perceived as seriously going south… and then it is expected/demanded that all stops are pulled out to save their sorry sick ass.
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There was a recent study.. where people with chronic diseases were provided their medication at NO CHARGE -NO- COPAY.. the goal was to increase compliance — thus better disease management.. the end result… compliance moved from 33% to 50%… FREE MEDS to help manage their disease state and HALF still failed to take their medications as prescribed.
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You bet ya… Medicare is such a success .. that in many areas of the country and the numbers are growing, people on Medicare can’t find a prescriber to take them into their practice and treat them.. and Medicaid is as bad or worse.
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I will never defend the likes of George Paz.. but when you take into account his recent pay 51 million and the 35,000 peoples that he is directly/indirectly responsible for.. he gets paid $4/day/employee… I bet your down the line supervisor gets a lot more per employee per day for the people they are responsible for.
Ran out of Faux news talking points? In a perfect world we wouldn’t need PBM’s. I’m not old enough to remember a life in the Pharmacy without them but I am old enough to remember them without Part D coverage for the elderly. Me and Jim work for the same chain and I watched us take $100′s of dollars a month from the elderly for medications that cost us a few bucks. I don’t really see how this is any better than what a PBM does. Most of the industrialized world spends less on healthcare than we do with better measurable outcomes than us. Hopefully someday we can have universal coverage. It wouldn’t be as bad as you think, after all we essentially have it for our police, military, and national highway system where they are provided to us by the government and I have yet to see Faux complain about them.
Private industry is WHY our healthcare system is where its at. No regulation is WHY the healthcare industry defines our country. I see no way out. Economic collapse will be the only way. And I don’t mean minor collapse like 2008. You just can’t fix it without destroying millions of jobs. I just don’t see why people need to be black or white in this whole political BS system. What in the hell is wrong with something in-between. My thoughts: Healthcare should be nationalized or at least regionalized. NO PROFIT BASED systems other than at the patient level. Just eliminating insurance would fix most of what ails us. Imagine if people could choose an insurance plan (if it had to exist at all) I wonder if people would have dumped ESI over the WAG scandal. As it was the battle was completely one sided. Those ESI customers didn’t have an out. They were tied to their jobs. If only one small thing could be done I would like to see insurance uncoupled from your job. Think of it this way. The pharmacist shortage of years past: Why do these pharmacy chain corpo’s get away with what they have been doing for the past few years? Because the RPh’s can’t leave. That was the only thing keeping them in line.
@Nosteve.. if you worked with JP.. then you are probably a “left coaster” and explains a lot.
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By Faux news talking points.. you are talking about the John Stewart “news show” on comedy central?
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without our bureaucracy.. comedians would have few jokes for their monologs every night.
From my perspective.. the pharmacy world without PBM’s was MORE PERFECT… they have so F-upped our system. I would suspect that if someone was able to distill all the monies that are cannibalized by the various for profit middlemen and fraud and abuse than nearly 50% of all healthcare dollars go for things other than providing healthcare.
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In 2010 dollars that total healthcare expenditures was 2.6 TRILLION per Kaiser Perm. that is what .. potentially $8000 per capita in fraud/abuse and administrative costs.
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I am all in favor a UNIVERSAL CATASTROPHIC HEALTH INSURANCE PLAN.. implement a 2%-3% federal sales tax.. everyone will have some skin in that game.. Have a deductible of $1000 -$2500 per person – two per family… the insurance insurance industry can sell a supplement for the deductible and copays after deductible met.. Employers could self insure the deductible or portion of the deductible. Make the sales tax adjust like Medicare Part B premiums do.. if the total costs go up the per-cent sales tax goes up.. if they go down.. it goes down.
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Of course, there is going to be some provision for those who are currently on Medicaid or Medicare income supplement assistance
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Typically the more money you make.. the more you spend.. and the more you would pay toward this catastrophic coverage… can’t get much more tax progressive? and the program would be totally self-funding. The DMERC could handle the paper shuffle.. which they do for a typical 5% overhead of expenditures…better than the typical 20% – 30% insurance overhead.
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Everything is “charged/tracked” via a FSA type account.. don’t have to do any adjudication of claims until the person/family hits their deductible.. Where allowables would then apply.. if they have been a poor buyer of services… their deductible is potentially raised. We have a free market place… on the other hand if a person patronized a no-frills 50 hr/wk pharmacy.. where prices are less.. they may never reach their deductible and/or not exceed allowables.
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Once the deductible is reached.. they are provided Medicare A/B/D…for the balance of the year… with a 20% copay – no further deductibles and if they have purchased a supplement..that would kick in toward the 20% copays.
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If the free market place does not make people a prudent purchaser of healthcare services.. then the per-cent federal sales tax would just continue a upward spiral…but at least 90%+ of healthcare dollars would go toward providing healthcare to people.
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will it ever happen.. NOPE… a bureaucracy is not designed to be self-limiting.. its very nature is to grow in size and scope of what it oversees… and increasingly tries to micro-manage everything under its charge… because it takes more people/staff to micro-manage and thus helps grows the bureaucracy.
There is an error in all the thinking on this blog with regard to national health insurance, Medicare, and Medicaid. Everyone recognises the problems and everyone has solutions to offer. Instead of offering a solution, I will tell you how the healthcare system can solve its own problems. It can do this with the government getting out of the ‘business’ of healthcare. A free enterprise healthcare system will ‘run’ its self. There does not have to be central planning or central control. Those things are myths created by our government. People must stop looking to government for solutions, because government is the problem.
I’m always amused by those that think “Obamacare” or socialized medicine is the cure-all to all the problems of our healthcare system. Why is it that people think MORE government intervention is the key? I’m with Peon and Pharmaciststeve on this one. Healthcare dollars should be transferred between patient and provider in a free market system, period. The removal of any and all third party players is vital to the integrity of the system. These third parties provide nothing. They exist to make money and nothing more. Peon is absolutely correct by stating, “a free enterprise healthcare system will ‘run’ itself”.
@Peon… the only problem is … I don’t think that a free market system is possible.. that means getting rid of bureaucracy (Insurance commissioners) in 50 states. That means repealing the insurance industry’s exemption to Sherman.
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All to many people have no incentive/disincentive to use or not use the system.
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Personal example.. I just went on Medicare… left a $2500 deductible and drug card and $1100/month premium.. for a total of $250 premiums.. $350 Part D deductible and $140 Part B deductible and then I pay NOTHING .. to incur medical care – except ..if I get into the donut hole and whatever copays on the medication I take… which are similar to what copays I had been paying previously. If I incur enough costs to pay all the annual deductible in the first month.. I am still $300+ dollar ahead over previous costs. and then my only out of pocket costs is for medications for the balance of the year.
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I wish to thank all you “youngins” for footing the bill for my unlimited healthcare
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Basically, I now have very little “skin” in this game.. if I was on Medicaid or got Part D supplemental help.. I would have little or no skin in this game.
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IMO..until we change this…nothing is going change… too many bureaucrats (public & federal) that are only interested in job security and self-preservation.
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The first point of change is providing a universal catastrophic insurance coverage.. since over 50% of bankruptcy are caused by medical expenses… this is a cost to society that we can otherwise eliminate.. but.. then you will get the bankruptcy attorneys up in arms because of the potential of losing potential revenue..
Just follow the money trail
Everything I read here is so black and white when the world lives in shades of gray.
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To those who think that Government is the problem, to a large extent we have government to thank for out heavy salaries in the form of increased patient access to Rx Services at high prices. Also, in the absence of a very charitable society government intervention to at least some degree is a must to keep society from falling apart. Has it gotten ridiculously out of control? Of course, but to some degree it is necessary. Those who claim that we need to go back solely to a free-market or free enterprise system are delusional. It has never existed and never will exist. Please tell me what role business should play in the delivery of healthcare services? As I see it, it is the business model of pharmacy gone horribly wrong that ails us currently, the interaction should be strictly between pharmacist owners and patients alone minus all the meddling middlemen who rape us of our dignity and hard earned profits.
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To those who claim government should completely control healthcare are delusional too. Do you enjoy filling out ABNs and dealing with the miles and miles of red tape than NON-PHARMACISTS have deemed essential to our job for Medicare B reimbursement. Also the scale of fraud in Medicare is so ridiculous that the only response I can muster is to laugh at it all. Do you know that organized crime has increasingly turned to Medicare fraud as an incredibly lucrative way to line their pockets with minimal risk.
Don’t even get me started on the clusterfuck of waste that is the current Social Security Disability system. I dont have exact figures But I recently read that the number of people on Disability has doubled since 2006, since now being fat, being a drug addict, and having hurt feelings can qualify you for disability. Which reminds me, which one of the aforementioned trifecta qualified you for Disability Steve? Just Kidding
Seriously though, I look at Disability like I look at Worker’s Comp. There might be one or two legitimate cases in the country but the rest are just going about their life in the American way! GETTING SOMETHING FOR NOTHING ON THE BACKS ON HONEST HARDWORKING AMERICANS. Speaking of that, how un-American is a good honest days hard work? You might as well shit on an apple pie or lose some weight as nothing else could make you look more like a terrorist! I tell you what, the future of the country is about as bright as the look on these glazed-eye 30 something year old idiots as they complain to their MOM on the phone that their INSURANCE (welfare) doesn’t cover Band aids and Neosporin by Rx. But hey, they did get an art history degree at state college! That 60k per year managerial job will come soon enough if I just send out enough resumes.
We are all fucked, not just pharmacy, but America in general. Wave goodbye to all those middle-class jobs as they go overseas on the same boats that bring cheap Wal-Mart and Target Crap here to us. Thats globalization and the free-market economy for ya! Too late to stop it, too bad nobody noticed while we were fighting over distractions like abortion and sex-education. You see the powers that be divide us like that so we fight one another while all our wealth and prosperity vanish before our eyes!
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This is really good stuff, man. “YoungGun”? How young are you? I thought it was illegal for young Americans to think so clearly.
Jay Pee.
Please come back, man. Often. We need people like you around. We need light in dark places rather than just meaningless complaining and bitching because the universe does not care about our discomfort. Pharmacy? It is our own damn fault that the industry has become what it is.
I fear YoungGun is right. His rant reflects my own disgusts with healthcare and other things in general. I do hope he’s wrong though. I don’t see how a corporate controlled country with the mandate of siphoning as much money as possible from every living thing can exist. With leaders bought and paid for, Democrat or Republican, doesn’t matter. How do you fix that? You don’t.
There was a city. On one of the streets, lined with houses, no one knew each other. The city came along and put a sidewalk on that the edge of the street. The street had some nice shade trees and the traffic was not heacy. A mom got out a stroller, put her baby in it, and they went strolling down the sidewalk on a bright, sunny morning. A next door, elderly lady, was out trimming her hedges. She saw the woman and the stroller, so she spoke to the mom and asked if she could see the baby. They struck up a conversation. Along came a kid on his tricycle. He stopped to see what was happening. A young couple went out for a walk and they stopped to see what was happening. In a few weeks, this was no longer a street of nameless people. It was a small community.
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There are lots of things like this. Some simple change can have huge unseen consequences. I got out of pharmacy school and began working. One of the places I worked, was a small town in rural Mississippi. I saw old black folks coming into the pharmacy. There would be a man and wife. Then, there came the younger black women, in their late teens, early 20′s and early 30′s and they came alone or with their children. They got their meds paid by Medicaid and they were drawing a welfare check. I heard all the stories about these women having more and more children because they got a bigger welfare check. Welfare pretty much destroyed the black nuclear family(as we knew it) in the state.
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The states, in an effort to decrease problems with newborns, began welfare programs to ‘help’ the mother and baby. The unintended consequences in my state is that nearly 50% of the births are to unwed mothers. Welfare has insidiously destroyed the nuclear family resulting in a lot of bad children that grew up without a father figure. They now populate our prisons,- a burden to society.
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The US government, in an effort to help the elderly, is bankrupting the entire country. The best of intentions can pave the way to hell. That is exactly what is happening in the US.
I am 31 years old Jay-Pee, and thank you for your kind words. I have been an avid reader of all your work both here and on Drug Topics (the only good pharmacy publication). If I was a non-pharmacist and was bored enough to read all of our profession’s magazines I would guess that most of what pharmacists do involves posing for pictures with executives while smiling and shaking hands. I admire you Jay-Pee because you speak the truth. You tell it HOW IT IS, not how it should be or how it most definitely isn’t. If any of you here have yet to read the Pharmacy Warrior’s blog it is also excellent! I am sick of reading articles by students and academia who enjoy telling retail how it should be, when you can tell by paragraph two that they haven’t ever stepped foot in a retail pharmacy.
While I hold your work in high regard, but also I’m really glad I didn’t read any of it before I graduated pharmacy school. Had I known about the inhumane working conditions of retail pharmacy before I committed myself to Pharm. School I most definitely would not have entered “the profession”. I think of good retail pharmacists like I do the marines and I think the analogy is a good one. Most people look at the marines and think to themselves, “Who the hell would sign up for that?” but if you do your job and do it well, it is incredibly rewarding and there is virtually no limit to the amount of good you can do for your fellow man/woman. The job certainly isn’t full of glory, we are on the front lines, blood, guts, Prior Auths, cold lunches, and a big grab of fritos and a Mtn. Dew for dinner! A Jay-Pee favorite I hear
You would be surprised how many of us young people are waking up to the truth now-a-days. The problem is the increasing polarity seen in our society. I would argue that never before in our nation’s history (or our world’s history for that matter) has brother been turned against brother, divided by ideology and the illusion of righteousness. The problem that I see today is that everybody seems to be in sole possession of the truth. People point fingers against their fellow man and Americans with hatred in their heart, and poison in their minds. Youve likely heard it all:
Democrats and the lazy, worthless, unemployed losers are ruining America.
Republicans and greedy corporations are ruining America.
Young people are ignorant and lazy
Old people are useless and sucking on the teats of the taxpayers
A lack of morals has America on a slippery slope
Religion has no place in America and creates a zealous, extremist mentality
The liberal media bias has destroyed American values and culture
And on, and on, and on……….,
IF YOU TRULY BELIEVE ANY OF THESE THINGS, YOU ARE PART OF THE PROBLEM, NOT PART OF THE SOLUTION!
You mind is closed and all you can do is recite Faux News or MSNBC talking points and likely haven’t had a unique thought in a long time. This is one of the main problems in our society! People are taught what to think, BUT THEY NEED TO BE TAUGHT HOW TO THINK!
Unfortunately this isn’t likely to change unless a paradigm shift is in the cards. The powers that be (TPTB) want us dumb and docile. Just smart enough to function in society but not smart enough to question what you see, or make an action plan to enact change.
SO DO YOURSELF A FAVOR, QUIT BLINDLY FOLLOWING THOSE WHO CLAIM TO “KNOW” AND SEEK THE TRUTH FOR YOURSELF!
You might just be amazed at what you find, it’s the age of the Internet and never has there ever been so much information and misinformation available. Choose what you believe wisely! Here is a hint, you aren’t likely to find any truth on the TV.
Be a patriot, think for yourself! More to follow soon,
Young Gun
YoungGun, et. a;;
We must talk. I am two years your junior (29) and just graduated pharmacy school and everything you say about our “profession’s” publications, to the zombies, unable to think, hatched from our pharmacy schools, to the abject disregard of pharmacist dignity and knowledge by management is true. I have always respected the Peon/PharmacistSteve comments, but I just have to disagree with everything I’m hearing about government intervention in health care and all that. The survivors (some might call them vets) of our profession are unfortunately making too many inferences about the big picture of politics as it relates to our profession to clearly understand their arguments. It is my particular view it is futile to worry about these things in a profession of mostly spineless and meek individuals who will *never, EVER* stand up to authority. Our ilk in pharmacy will, by default, support their corporate masters in this corporate dictatorship we call “America”. Forget blaming “government” and getting on its back for our problems. You freakin’ kidding me? IM 29 goddamn years old and I know better than that, and so do you. CVS breaks the law, they pay fines (if a plaintiff attorney gets so lucky). Big Pharma puts out a drug that too easily kills patients its supposed to treat: FINE. Here, in a nutshell, is what’s wrong: since a corporation is not a person, you can’t incarcerate it and send it to jail, or burn it at the stake. There are no laws against being slimy and underhanded. CEOs get put on the stand and defense attorneys for pharma argue apex deposition: “Hey man, the CEO wasn’t directly involved in the making of this drug, he can’t be deposed”. Liability is spread out over individuals, but not on any particular individual. Nobody held accountable. CORPORATE DICTATORSHIP BABY. Free for all to do whatever they want to do. And all the judges: conservative. Will never rule against the defense unless they settle. Like JP said, settling is just another way of saying “we know what the true cost of our infraction is; Here. Here’s <1% of that value to you peasants. Thanks for letting us off the hook again, Lady Justice".
You say the system doesn't work. But actually, it works exactly the way it was meant to. You can't do anything about it but complain.
And YoungGun, you nailed it about how we're all divided politically, ostensibly in this battle royale over whose most righetous, most justified. Look guys: we all work the same shitty jobs where we get paid to be lemmings who don't use our brains. You might as well start smoking the green now; hey, take a load off. When you challenge other posters on here to put their dukes up, you're missing the point that we all earn our living at the mercy of the corporate dictatorship. And here you're trying to point your finger at government. Shit dude, government is the last parent figure, THE LAST HALL MONITOR, THE LAST RECESS ATTENDENT, we have that can keep greedy, huge businesses that employ us at bay from killing, robbing and demoralizing not only its employees, but CLIENTS (though not all of them are that way, but hard not to be when your official business mission statement has dollar signs and inferences to bottom line everywhere).
Now let's all sing koombaya and be glad they haven't started sending our very jobs to India and Taiwan. Government mandates law that requires a pharmacist on duty for any drug leaving the building. Without this law, our collective last straw is snapped in half and we have NO JOBS. Be bloody thankful and always take your own side in an issue.
CaliPharmia, things are-a-changing! Have you heard about Zoe Zoreck??? He has a whistleblower lawsuit against CVS. This is not just a lawsuit. It is a WHISTLEBLOWER lawsuit. Check out this link for more info: http://bernabeipllc.com/2012/06/ex-cvs-pharmacist-alleges-risks-to-patients/
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Now, if you went to the link that I posted above and looked, you will see that the link is to a law firm. The lawyers are getting ready to hit CVS..just watch and see. It will likely be folks like Joe that bring all these suits. These are folks that are near retirement and they have been treated badly by a chain. There is a growing awareness by the boards that the chains must be held accountable for what happens in the pharmacy. The boards of pharmacy are operating under ‘archaic’ laws! There is a growing awareness that problems in the pharmacy or not the total responsibility of the pharmacist. CVS has not learned, but will learn that they cannot break the law and that they must provide adequate help in their pharmacies. Things are-a-changing and CVS had better wake up!
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I hear a lot of complaining by pharmacists here on this blog. Take a look at the ones that mention the chains for which they work. You will see CVS named in the majority of these complaints. How many Wal-Mart pharmacists do you see here complaining? I work for Wal-Mart and I do not encounter the problems that I hear about on this blog. In fact, I like my job. I like working for Wal-Mart. They never push me to fill more prescriptions, and they certainly never push me to violate any laws. On the contrary, they are very sensitive to laws and they try their best to comply and they certainly want us to do the same.
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The big picture will definitely effect pharmacy. The US debt will have to be addressed. When it is, there will be cuts in all entitlement programs. There is simply no way around it. How that will affect us, I have no idea.
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“Look guys: we all work the same shitty jobs where we get paid to be lemmings who don’t use our brains.” My job is very important! I catch errors made by the techs. I catch errors made by docs. I catch lots of errors on e-scripts. At the same time, I go out of my way, a lot of the time, to help the customer. I do a days work for a days pay. No, I am not in a clinical setting, sitting at a desk and doing MTM. But, I never wanted that in the first place. There are a lot of us that like to go to work, do a job, and go home. The chains suit us just fine. In your situation, I am sure the pharmacy school has indoctrinated you in the idea that you are some glorified professional doctor. And, working in the ‘real world’ will probably never suit you. The ‘real world’ is messy. There are stinking people, and I do mean ‘smelly, stinking people’ that come to the pharmacy. But, they are people, and I try to take care of their needs. At times, the pharmacy can be a hectic place; but, I can keep my cool and take care of the customer. I am not a lemming! I have challenged the head of the pharmacy division over certain things. I have sent numerous emails over some things in the pharmacy that I thought needed to be changed or I thought might lead to us making errors. Had a friend fired and I got up before a congregation of pharmacists and before a regional manager and told him that he was trying to railroad one of my friends. I am not a lemming! I do good work at my job and I enjoy my job. Everything in retail pharmacy is not all bad. If anyone is dissatisfied with their job, then they need to be looking for another job. You may have to move from job to job until you find the one that suits you.
@CaliPharmia… I don’t think that the chains really understand who they are dealing with… I am 18 months off “the point” of the baby boomers generation.. The first one just turned 65 .. Jan 1, 2011.. Most of us are financially secure and once we rid ourselves of the shackles of private health insurance and preexisting conditions and high premiums if you are not working an a corporate health plan… we are THE REBEL GENERATION and 10,000 are turning 65 EVERY DAY.. We are the ones who came up with the “don’t trust anyone over 35″ and we are the ones that have moved bureaucrats and forced industries in how they market to us and what products we want and will not accept or tolerate.
This generation is going to make the “Gray Panthers” look like the “Gray WIMPS”
We are not going to accept a healthcare system that puts our health at risk.. when they are suppose to helping us maintain our health and quality of life.
The raw numbers … suggests that a few RPH at hitting that 65 y/o milestone very month.. we have friends/family/customers who will listen to us about how their health is potentially be short-changed in the pursuit of profits.
The “ripples” from that one “RPH drop” in a larger pool of seniors and we are back into the sixties.. except this time.. WE HAVE THE INTERNET for communications… and a bunch of us who are very technically savvy .. and enough that are in tuned enough to be encompassed into the “message loop”
IMO.. Corporate America needs to have concerns about the “senior boomers”… we may belong to AARP .. but AARP doesn’t lead us by the nose to the corporate water trough…
Our problems are too many to name. We elect men and women of politics, not principle. Our country is forgetting the values and beliefs that propelled us to greatness in the first place. I am more fearful now of the future than I have ever been before in my life. And I am not simply speaking about the profession of pharmacy. What becomes of a nation that loses it’s way will be for us to find out soon enough. But having said that, I don’t believe just yet that all is lost. There is still hope. There is still the possibility for change. That is what keeps me going when I just want to quit and give up.
That is quite optimistic Pharmaciststeve. Here is the pessimistic reality to consider. For every person of your intelligence and technical ability, there will be 100 who are too stupid to have been able to survive to 65. Yet there they are, living and breathing, voting against their own best interests because the TV says so.
@wrongaid… you are correct and unfortunately there are many that are barely of voting age that are so enamored with the messenger that they can see thru the BS of the message.
But we have a society that has grown up on “charge it” for whatever we want and just the pay the minimum monthly payments.. it will work out .. somehow.. but I am not going to worry about it today.
I don’t remember you ever stating your age bracket.. but.. I can assure you that once you are no longer required to be in that corporate harness .. doesn’t mean that you don’t chose to be a work environment.. your attitude will change..
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I only temp.. I bounce from LTC to community.. I could give a rats ass about metrics… if a patient/nurse needs 10 minutes… they get 10 minutes..
On rare occasions when a nurse insists on telling me how to practice pharmacy or some other BS about a order..
that I don’t want to fill or needs clarification.. I have been know to tell them.. I can look at this order with my “left liberal eye” or my “right conservative eye” .. if you force me to look at it with BOTH EYES.. I will find a solid reason why NOTHING IS GOING TO HAPPEN… trust me!
I have had nurses to threatened to call corporate on me… over me not bending to their irrational demands… I end the conversation with “my last name is spelled ARIENS .. please spell it correctly when you call them…
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I don’t let them to expect me to be able to run the Rx computer or the register.. if they don’t have ancillary staff to run it.. I decline the shift.
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I expect/demand respect from the patients.. and I reciprocate .. they give me grieve.. I give them a stiffened backbone…
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and I get all the hours that I want and then some.. because I am DAMN GOOD at what I do.. and that is being a “old school Pharmacist” that takes care of patients.
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Personally, I have never been more optimistic about the potential for pharmacists… of course pharmacists are going to have to step up to the plate and some will and they will have to take some financial risks in doing so… and they will -I think – be both professionally and financially rewarded.
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Being National Public Relations Director for the pharmacy alliance.. I wish I could share what I know that is going on behind a lot of scenes… and this is just what I KNOW OF.. I am sure that there are many other positive things that are going on that has just not been brought to my attention or the TPA has not been made aware of…it is not going to happen this week or this month… but over the next 1-2 years.. things are now just in the formative stages..and to be truthful.. it usually takes a lot to get me to see things in a positive light.. I am normally a “half-empty” type…
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It could all implode.. but.. at least there are people/entities out there putting forth ideas and implementing plans to help right this leaky ship (pharmacy) that we all love.
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just take the time to educate one pt a day and by this time next year.. this country could be a brighter place.
Wrong Aid, you are so right. On a daily basis, I see so many unfortunate people with very limited education. I think we all suffer from an illusion about ‘normal’. A long time ago I read some of the books by Eric Hoffer. If you have never heard of him, which is probably not the case, he was a migrant worker travelling throughout California in the 60′s. He was an astute observer of human behaviour and became something of a philosopher. He was siting around one day at one of the migrant workers camps and he began looking at all the people there. What he observed is that most of them had something ‘wrong’ with them. One man might be missing a finger, another walked with a limp, and one man could not see too well. What he observed was that most of the people there had some affliction and did not fit into the category that we call ‘normal’. ‘Normal’ or ‘average’ is some ideal that we all have in our minds. Most of our customers have something ‘abnormal’ about them. Some are diabetics…some have severe arthritis…some are schizophrenic..some are bipolar…some are psychotic…some have cancer…some can barely walk. Our customer are far from ‘normal’ customers and more so than most other businesses. There is no ‘normal’ or ‘average’ person. I am 63 years old and I am still learning about people. One of the things, which I have learned in the past few years, is that each person is unique. I have this tendency to quickly judge a person when they walk up to the pharmacy window. If I treat them with respect and try to take care of their needs, I discover they can be nice. I may learn that this person with tattoos and rough clothes is nice and appreciative of what I do. Sometimes, a lot of us just want to stand there at a computer and never interact with the customers. But, I can tell you that you are missing something important when you don’t. The more I have thought about it the more I have come to the conclusion that pharmacists should interact with patients. There are lots of times, when I did, that I discovered some medication error by a physician or the patient was taking some OTC poduct that they should not be taking. The more I think about it, the more I have come to the conclusion that part of being a pharmacist is ‘taking care of the patient’. It is not standing behind that chain computer and cranking out one rx after another.
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One of the reasons that I am optimistic about chain pharmacy is because of the place where I work. I don’t see the problems that these CVS and RiteAid pharmacists are seeing. Another reason is the laws and regulations, which I think will eventually force these outlaw chains to either change or go out of business. And, of course, the pharmacists that are bringing lawsuits against these outlaw chains. As Steve says, there are a lot of baby boom pharmacists about to retire. There is a good chance that they will not go quietly into the night. Joe Zorek is a prime example! Now, we are talking about the generation that were hippies and fought the ‘establishment’ back in the “60′s”. We are talking about the generation that had massive anti-war protests during the Vietnam war. We are talking about a generation that took over some of the college campuses and some of them were slaughtered by the police at Kent State. So, for those here that think pharmacists are all wimps and will do nothing…lets not be too quick to reach our conclusions.
As a CVS pharmacist with a wonderful boss (who is a pharmacist, whos boss is a pharmacist), I would just like to point out one thing.
This coupon you posted expired in 2005. CVS no longer offers this kind of incentive (does anyone?).