What About This Pisses You Off So Much?

Jp Enlarged

Some very strong people who have both feet in this game do not feel that unionizing is the solution.  They do not want an adversarial relationship.  They want Win Win.  This is very generous and in an ideal professional business Win Win would work.

Those were my feelings exactly until recently.  I doubt that Win Win is possible in many situations.  When your supervisor threatens to fire you and hire a new pharmacist for 20% less wage, what about that is NOT adversarial?  This is a good old-fashioned labor – management – ownership nose to nose fight.  You are the Mexican villagers wearing white pajamas and straw hats and the company represents the bad ass gang that comes and takes the fruit of your labors every harvest season.  In pharmacy, who represents the Magnificent Seven?  Could it possibly be The Guild for Professional Pharmacists?  Or, in a pinch, the Pharmacy Division of the Food Service Workers of America.  I’d rather see the Guild since everyone involved is a pharmacist.  There is much to think about or there is nothing more to think about.  7/19/2013

“Over here, guys.  The druggist is getting beaten up and we have to help drag the company brute off.”

“Whatcho mean you aren’t worrying about the metrics.  You gotta worry about the metrics or we will find someone who will worry about the metrics.  For less money.”

 

“But, we can’t join your Guild, Meester Union Agitator, they will fire our colleagues indiscriminately.  They will rape our burros and kidnap our  sons  daughters.  I mean wives.  They will tighten up their metrics until we dream all night long about them.  Win Win, how is that possible?”

am revisiting this because of the wealth of comments when it was originally published.  I recall 119 in like three days.  What is it about this?  When I put this up, I did not expect that much interest. JayPee

I have received a number of emails at my private email address (the one published here) from pharmacists (at least they claim to be pharmacists) who want to know why I allow pharmacists to camp out in the “Comments” and whine and complain.  They tell me that the whiners and complainers should be doing something about it rather than just visiting sites where they can basically spend too much time metaphorically digitally jerking off .  

I had one woman tell me that she would commit suicide rather than humiliate herself in such a manner.  I asked and she told… She is the PIC of a pharmacy in a very small grocery chain in the middle of nowhere.  The map shows that her town is almost 200 miles from the closest town with a chain drug store.  I accused her of being insensitive.  I told her that she needed to spend just one Monday morning, from 8:00 AM to 12:Noon, with the Lead Technician out sick, in your shoes.  She wrote back that she had been a pharmacist for 12 years and, from experience, she knows that it cannot possibly be what you guys describe.  I asked her why she did not express her feelings with a response in a comment here.  She told me that she would not lower herself.  She is a dignified woman who is professional in her work.

Poor girl.  She just might have to suck the gas pipe if she had to make her living at Big Evil or Big Stupid.

My knee-jerk was to just tell her to “Eat Me”, but I behaved.  What I told her was this.

“The pharmacists who write comments here are strong and decent people who see injustice and want to change it.  They can’t help it that, right now, they are swimming in the rapids and barely know which end is up.  Working conditions are one thing, but now they are seeing their brothers and sisters being killed off.  They are being taken out back and being shot in the head.  Damn good, veteran pharmacists are being fired simply because they are veterans.  They are being fired because they are women.  They are being let go because they have earned too much vacation, because the metrics suffer while they are counseling.”

These pharmacists are good men and women who did absolutely nothing wrong.  They are being treated like galley slaves, factory-floor piece-work workers.  They are decent human beings who want to help people, but all the MBA Masters of the Universe see are “The numbers”.   

So, I ended up advising that she Eat Me.  I suggested that if she pay attention to the comments that some of you may want to explain further.

 

 

62 Comments

62 Comments

  1. anonymous  •  Jul 12, 2013 @4:35 pm

    I have contacted his attorney. I guess she is busy with the cases. I have been out of work for months. The store I left is in chaos. Rather than admit they let a good pharmacist leave, the company has staffed the store with a less than stellar staff. A call was placed to me almost a month ago assuring me that an investigation into the matter will be done. Not a word since. I wish I had a job. I have tried just about everything. I hear these excuses: I need to place the new grads, you don’t have the qualifications (hospital jobs), we are looking at other candidates. For those of you who are in the same boat, you have my sympathy. We, I know I am not, are not whiners. We are caught up in a perfect storm of metrics gone wild, foolish management and even worse HR. I have corresponded with others who have been fired or quit the chains. Their stories are virtually the same. It is scary to read the details and say to yourself, hey that was me several months ago. You build up anger at first, then the resentment sets in. I am a strong individual yet this experience has made me feel pathetic. I have my good and my bad days. I pray for a job and then I remember what it was like to have one (stress, anger and exhaustion). You just can’t win. I have read the comments and have not posted in a while. In a perfect world, if we all opened up independent pharmacies (and wouldn’t get robbed) we would be much happier and the chains would have to compete on a service level. Where I live and even 40 miles west, independents are not thriving. Two were just sold to the chains after being in business for 5 or more years. The others are doing okay but have to go the extra mile to make money.

  2. pharmacyslave2000  •  Jul 12, 2013 @5:00 pm

    Sorry to hear about your situation “anonymous”. This is a very dark period for the profession. Unfortunately, I don’t see any light at the end of the tunnel. Everyone posting here has their own opinions on how to “fix” our problems. “Open an independent”, “sue for wrongful termination”, “contact the board”, “document and send info. to HR”, etc., etc., etc. These “fixes” may work or may have worked for certain individuals in certain situations, however, they do nothing to truly “fix” our profession. I believe it is beyond repair. We are past the tipping point. The chains have everything exactly as they want. No more shortage, the ability to fire employees at will, and more profitable than ever before.
    What is left for us? I could see a salary reduction as the next slap in the face. All it takes is ONE company to get the ball rolling and the perfect scapegoat, Obamacare, is just around the corner. If I were you “anonymous”, I would search out alternatives outside of pharmacy. So it won’t be worth fretting over.

  3. AJ  •  Jul 12, 2013 @6:04 pm

    anonymous said “In a perfect world, if we all opened up independent pharmacies (and wouldn’t get robbed) we would be much happier and the chains would have to compete on a service level. Where I live and even 40 miles west, independents are not thriving. Two were just sold to the chains after being in business for 5 or more years. The others are doing okay but have to go the extra mile to make money.”
    .
    .
    Please someone explain this nostalgic love affair everyone has with independents! All I hear and read any more is oh if there were more independents there would be no problems…if there were more independents we would all love our jobs…Give me a break! You are all like a bunch of old men sitting on the front porch bitching about how much better things were 50 years ago.
    .
    anonymous – You really think we would all be happier working 60 – 70 hours a week running a business? Dealing with all the headaches and hassles that go alone with it? You know why so many independents have sold out to the big chains? Because owning and operating your own business is a pain in the ass!
    .
    If you think we are in a mess now imagine how bad it would be if there were no more big chain pharmacies. Then you would have 20 versions of Joe’s Pharmacy trying to undercut each other to make a buck. Can you imagine the nightmare it would be trying to negotiate with the insurance companies? The big insurer’s woulds play 20 Joe’s Pharmacies against each other with each one trying to go lower than the next guy in order to gain a competitive advantage. You think the reimbursement is low with the big three going against each other imagine 20 or more going against each other! Big chain or independent there will always be some idiot that accepts the unacceptable because they think they will gain a competitive advantage and make it up on volume.

  4. Pharmaciststeve  •  Jul 12, 2013 @8:23 pm

    Nothing is going to happen – until – maybe.. wages start falling… and hours are cut to P/T and benefits start falling away. As narcissistic as we are collectively… small groups go on strike and other RPH’s and techs fill in the holes like the ocean does a depression on the shore.

    As many RPh’s have found out.. once you are out the door.. for whatever reason.. you have lost any/all advantage that you may have had and/or legal options that you may have had.. as opposed to seeking legal counsel before you are shown the door.

    The period in which we could have done something has passed.. ended some 5+ yrs ago.. IMO.. it is down hill from here..

    If you notice.. the chains.. no matter what they do.. they get a fine… and go back to business as usual.. you do something wrong.. it is license revoked and maybe jailed..

    You allow the chains to push you to a volume that mistakes are a near certainty .. it is just a matter of how often and how serious.. and once again.. the chain will pay a fine… and you will be screwed… because you allowed them to put you in such a position.

    Personally…I am getting tired of all the whining and bitching and no action..

    As JP has stated… there is a lot of reading.. and can’t even take the time to express an opinion…

    IMO.. within the next 10 yrs the whole process will implode.. schools will start closing.. and RPH’s will be looking else where for employment.. until the everything swings in the other direction..

    I see 2000 Senior Rphs getting tossed to the curb over the next few months and that number will grow until it reaches 4000 by the year 2017-2018… and for how many years after that.. who knows how long it will continue..

  5. bluetowelboy  •  Jul 12, 2013 @9:20 pm

    I gotta agree with pharmacist steve here. At every management meeting I go to we are told by my management how much of a shitty job we do and how they could get a new grad to do it for $25000 less because they have student loans to pay off.

    They changed the pay scale where I worked last year so there could be more fluctuations in pay between pharmacists. It’s just a matter of time before pay starts to fall as they hire those new grads and say take it or leave it.

    I met a kid the other day who just got accepted to a private pharmacy school in my state. He was so excited and I just felt sorry for him. $120000 in loans and a $50000 retail job when he gets out. He will never pay it off. An intern worked at my store last week and he has been with the company for 8 years. He almost didn’t get a job with us and even though he has one it’s floating with a 1 to 2 hour commute.

    It’s gonna take the reduction in pay before people start to feel it on a personal level. Get your resume ready and have a back up plan because its coming. I would be especially careful if I was a BS pharmacist. They don’t even have to ask how old you are and they can figure out you are older than 40. No age discrimination there.

  6. Peon  •  Jul 12, 2013 @9:44 pm

    Maybe most of the people here are whiners and complainers…myself included. I have tried, within my chain, to get some changes made to improve our working condition. In fact, I have, on an occasion, told the head of the pharmacy division that something was a ‘nutty’ idea. I have sent numerous emails to corporate headquarters about things that needed improvement. And, as JP knows, I have worked to get the message to pharmacists, professors, and deans of pharmacy schools that pharmacists need to unite and that pharmacy students need to know what the ‘real world of pharmacy’ will be like upon graduation. AJ makes a good point about how pharmacists tend to look nostalgically back into pharmacies past and say things were better. 20 to 30 years ago I was working a lot harder than I am know and I was working for independents. Today, I work for a chain and my job is really not that bad. The one thing that has changed, and in my opinion, for the worse, is the every increasing restrictive laws on us. And, the other thing that is really different and very annoying is the metrics. I do not like the direction my company is going with their metrics and their ever increasing number of policies and procedures. But, this is not something unique to pharmacy, and I think a lot of pharmacists that come here to post don’t realize that the metrics are a corporate phenomenon that is not unique to pharmacy. We simply hate it because we believe that we are ‘professionals’ and that professionals should not have metrics applied to them. I have certainly held that attitude. But, I do recognize that the world is changing and that what is happening to us is not unique to our ‘profession’. The future of chain pharmacy does not look good, but neither does the whole of healthcare in the US. A local medical supplier just stopped billing Medicare for diabetes supplies because they were not making any money. A few days ago we filled a rx for diabetes strips and our computers showed we lost $550! My company may be buying strips at a price cheaper than they tell us. If not, they are going to ‘lose their shirt’ on diabetes supplies on Medicare patients. My guess is that they are really losing money. They believe they can make it up on the patient buying other things. I don’t think so! For some of us older pharmacists, we can remember when the same thing happened to medical equipment. Medicare dropped reimbursement so low that pharmacies stopped carrying medical equipment. How long will it be until the medical equipment businesses go out of business? I am hearing stories of some docs that cannot make money on Medicare patients. There is talk that a lot of docs may retire or stop taking Medicare patients. There is a growing shortage of physicians. The idea is to replace them with NP’s. But, what will happen to the quality of healthcare. I just read something this morning about a comparison of the quality of healthcare in the US, as compared to European countries, and the result was that the quality of healthcare, for the first time, is on the decline in the US. Some of the local hospitals here are looking at ways to cut costs because they are expecting lower reimbursement under Obamacare. Is their a ‘train wreck’ in the making for the whole of healthcare in the US?
    -
    As whiners and complainers, we are really trying to reach out to other pharmacists for help, not just for ourselves, but for the whole of pharmacy. We want our fellow pharmacists to join with us to help us arrive at ideas and ways to get change in pharmacy and to have a ‘professional’ environment in which to work. We want the corporations to ‘get off our backs’, leave us alone, and let us do our jobs. We would like to be treated like the average worker in the US, where we get breaks and a decent lunch break and where our hours are not 10 and more hours per day. Our jobs require intense concentration and a human being is not adept at concentrating like this for 10 hours or more without a break. As I think about these things, I see that these are very issues that brought unions into existence. Unions are good and bad. They can overreach…go too far. But, they can also bring workers out of the ‘dark ages’ and into the modern world. Pharmacy still exists in the ‘dark ages’. Pharmacy has not unionized, to any extent, and we are paying the price for this today. In our corporate world, the corporations will work people for wages so low that the people can hardly support themselves, much less a family. I work with techs that have children on Medicaid and techs that are receiving food stamps. I talk to workers that are only working because they need the sorry insurance that the company provides. Our government, bending to the wishes of corporations, have allowed these companies to dole out work to foreign companies, which has cut out jobs for Americans. More and more Americans are being left with Burger King jobs. Our country is run and ruled by the corporations. Our executive and legislative branches are mere pawns of the corporations. Over the past decade the corporations have been able to crush the power of the unions. As bad as I hate to say it, what we need is a strong union. To get improvements, we are going to have to have a powerful organization and an organization that will ‘fight’ to get us what we want. We cannot depend on government legislation or the BOP’s. We have no where to turn for help, other than ourselves. JP is talking about a guild. Pharmacists must become active and stop being passive. The future of pharmacy will require a ‘fight’. Nothing is going to be handed to us on a ‘silver platter’. It is the law of the jungle in the US! The strong get what they want and the weak get trampled into the ground. We have sat around for decades hoping that good things will fall into our laps. After all these decades, where is MTM? Where are all those pharmacists providing professional services and getting paid to do it? We can no longer wait on others to do things for us. We must do it ourselves. Instead of waiting around until all the metrics become too much and you lose your job, you better be ‘fighting’ for your future. If you don’t, then you will not have a future.

  7. Pharmaciststeve  •  Jul 12, 2013 @10:48 pm

    @Peon.. you are right about the neighborhood HME dealer going broke.. I just took over as COO/CFO of a multi-state HME dealer.. The only reason I took this job is because the couple that owned this business..we have been friends with for a couple of decades… he had a massive stroke/clot and will most likely spend the rest of his days in a skill nursing home bed.

    The wife had little involvement with running the business and she called me the night he had the stroke.. and asked me to come and run the company.

    This company has a very diversified business mix.. I was told this week that one section of the business where Medicare is 20%-25% of the business and because of Medicare cuts.. this section is expected to take a 10% OVERALL cut in gross revenue..

    Some of the staff there.. are people that use to have their own HME business and they sold out to this company and came to work for them.

    I expect that before the end of the year.. I will be evaluating every section of the business and any section that is not showing a profit directly or indirectly… it will be subject to the company no longer providing the product/service.

    Healthcare is now nothing more than JUST BUSINESS…

  8. unhappy pharmacist  •  Jul 14, 2013 @8:07 pm

    STEVE, you hit the nail on the head! Healthcare is just Business

  9. AJ  •  Jul 16, 2013 @1:05 am

    Holy Cow JP! Why you gotta hate on her like broncofan7 hates on everything? She has it good for now…let her have her fun. The harsh reality will come crashing in soon enough.
    .
    I had it good like this once. Union grocery store, time and a half over 8 in a day and 40 in a week with an hour lunch everyday. House in the mountains overlooking a valley full of Aspens and the continental divide off in the distance. New Harley in the garage, no kids, no worries and the best damn time of my life. Oh but I thought I could do better and f’ed it all up and moved to Texass. Reality has never hit anyone harder than it hit me!

  10. Broncofan7  •  Jul 16, 2013 @8:58 am

    AJ, I don’t “hate against everything”–just everything that your employer does and stands for. Our profession and healthcare in general would be better off if your employer never existed. Given an even playing field (and that will never happen as long as the financial interest of the middleman is given a free and unencumbered reign) Independent and community Pharmacy will THRIVE once again. Mail order should be an option for patients who want it, but it shouldn’t be incentivized by copays or mandated outright. But we BOTH know that many mail order operations couldn’t exist if they had to compete on customer service with the local Pharmacies

  11. Goose  •  Jul 17, 2013 @7:29 am

    Pharmacy’s real problem now is that even in this age of rapid communication and knowledge sharing, we are still pretty isolated.
    The chains promote this. They don’t want you knowing anything about what is going on, even in your own town. I know in the case of CVS locally, they have flipped DMs and pharmacy supervisors around here several times lately. There can’t be a big increase in talent there, and there is no inovation whatsoever. The upper management just has one formula and it is rapidly moving towards a flashpoint.
    Hospitals are adopting the same model. My friend who is president of the Indiana BOP just had her hospital job eliminated in Indianapolis. New boss came in for the cardiac unit, an RN who sounds like she doesn’t like pharmacists. They got in a pissing contest over procedure and my friend lost. Tells you what people think of the BOP, that would have been unheard of a few years ago.
    There is not one answer for all of this folks, there are many answers. You’ve got to hit the issue from all sides. Promoting independent practice is one. Joining your local pharmacy organization (or staring one if there isn’t one) is another. Investigate the union option. Write a letter to the dean of your pharmacy school expressing your displeasure with the state of things. Quit sending pharmacy schools money, that’ll get their attention.
    One thing really bothers me and I’m seeing it more and more all the time. People have just given up. Bloggers who used to write on a regular basis haven’t posted in weeks or months. Old-timers are usually poo-pooed for telling you to grow a set, especially on JP’s blog.
    I have been fired (twice), had my phone bugged, screwed out of a store buying opportunity, screwed out of 100 large profit sharing, passed over for promotion due to my age (twice) and dealt with some of the
    biggest assholes this business has ever produced and I have never been down on this business as much as some of you.
    Darwin said you don’t have to be the strongest or the smartest to survive, you have to be the one that best adapts to change. I have changed many times over the years to survive.
    That’s our problem, we can’t figure out how to change.

  12. Pharmaciststeve  •  Jul 17, 2013 @7:13 pm

    Goose… look at the average chain Rx dept.. the RPH has so many balls to handle.. that they have been force to delegate more and more tasks to the techs.. till we have gotten to or soon will be.. that the techs are basically running the dept.. except for the legality of it all. The chains have standardized the Rx dept layout and with trained techs… any old/young RPh will do.. to keep the dept legal.. It seems that the chains have settled on two basic formats for the Rx dept.. the Rx dept staff in nearly “wide open spaces” that encourages distractions or where the RPH is seldom seen.. unless someone asks a question and we are back to the techs being the face of the dept and the chain..

    we are part of the commodity chain.. if the pt gets pissed.. you give them a gift card .. to encourage them to be pissed.. because it pays off..

    Pavlov got a dog to salivate at the ringing of the bell.. many in the general public.. can be trained in a similar manner.. bitch and you get a gift card…

  13. another one  •  Jul 17, 2013 @8:13 pm

    Yes-
    calls to attorneys have gone un-answered. No one wants our problems and now I’m past the 6 month point. Not that I would have sued. All of us veterans can think of many reasons why they would fire us- we all joked about it.
    All their Metrics and R&R. There’s no way any pharmacist can measure up to the pharmacists in their training videos. It used to be called professional responsibilty or judgement
    Pharmacy really used to be a profession.

    We are who we are- been doing this for 25+ years.

  14. Pharmaciststeve  •  Jul 17, 2013 @8:30 pm

    @another one..
    try this group http://bernabeipllc.com/
    my understanding .. they will return calls

  15. Peon  •  Jul 17, 2013 @9:02 pm

    Steve, the Pavlov dog experiment is a perfect example of where I work. People believe that by bitching and complaining they can get what they want. It probably works pretty well through Wal-Mart, except the pharmacy. Bitch and complain and you will get less help from us. Bitch and complain and we will remember you and the next time you need some help…you can forget it. It often amazes me the way people will act to try and get what they want.
    -
    I do not believe that techs will be running a pharmacy without a pharmacist. There are just too many things that only a pharmacist can handle. And, with the poor salary some of these techs are making, they don’t care much about how good or accurate they are on the job. And, since the pharmacist is ultimately responsible for what they do and they do not face any repercussions, they tend to be lax at their job. If pharmacy reaches a point where techs run a pharmacy, just watch out for the errors to through the roof.
    -
    I know one thing: I am a valuable asset in the pharmacy! These chains may not appreciate us, but we are what keeps them in business.

  16. Pharmaciststeve  •  Jul 17, 2013 @9:19 pm

    @Peon.. I am not suggesting that the Rx dept runs without a RPH.. it is just that the chains have standardized the Rx dept format and the techs technically run most Rx dept.. they key in the orders.. they write the wholesaler order.. etc…etc…etc.. making it so that just about any warm body with a RPH license can walk in and the Rx dept will – for the most part – run on all cylinders.. The “customers/pts” expect to deal with techs.. when they want our opinion.. which they might not take .. they will ask.. and expect us to drop everything and come a running.. of course – for free.. and typically.. they don’t care if they have never seen the same RPH before… we are GENERIC.. we are nothing more and a “smart tech” to the general public..

  17. goose  •  Jul 17, 2013 @10:51 pm

    I had a patient today at the Coumadin Clinic complaining about CVS. Filling scripts wrong, doing auto-fill on scripts he no longer takes, etc, etc, etc.
    I gave him the phone number and address of the Indiana BOP and told him to file a complaint. I thinks he’s gonna do it too.
    What if you printed up a bunch of business cards with nothing on them but the name and address of your state’s BOP.
    Every time you get a complaint, blame it on staffing, potholes in your store’s parking lot or whatever and give the person a card.
    If one in 20 complain, it’s still a shitstorm for the BOP.
    Might be fun.

  18. goose  •  Jul 17, 2013 @10:54 pm

    Or we could just all give up. I could take a 50% reduction in pay and still make more than my daughters and sons-in law. They all have advanced degrees too. I have a daughter with a PhD making a third of what I make. Or less.
    Yeah, let’s just give up.
    Pussies.

  19. Pharmaciststeve  •  Jul 18, 2013 @6:25 am

    Most BOP’s website have a public complaint form on their website.. might want to put that on the card.. because if you call a BOP.. they are just going to tell you to file a written complaint.. Unless their is diversion of controls… I don’t think that any BOP will act on a verbal complaint..

  20. broncofan7  •  Jul 18, 2013 @11:40 am

    http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3687123/

    “The new millennium ushered in a period of hope and change for the profession of pharmacy. The doctor of pharmacy (PharmD) degree became the exclusive first professional degree as of 2000, bringing with it expectations for a dramatic expansion of direct patient care roles for pharmacists. Just 1 year later the pharmacy academy began a period of unprecedented growth, fueled by a long-standing shortage of pharmacists and an outstanding job market for new pharmacy graduates, making jobs for PharmD graduates easy to find and causing salaries to spiral upward. As a result, the PharmD degree became a hot commodity, generating a seemingly inexhaustible supply of applicants to colleges and schools of pharmacy. Inevitably, higher education came to see pharmacy as a “golden goose.”

    But no goose harbors an infinite supply of golden eggs, and the inordinate rate of academic growth that ensued has put the academy at risk, along with its students. Calls for measured academic growth, brought forth in published commentaries in 2005 and 2010, went largely unnoticed.1,2 The house of student delegates of the American Pharmacists Association-Academy of Student Pharmacists even weighed in on the subject in 2012 by approving resolution 2012:2 — Creation, Expansion, or Reductions of Schools and Colleges of Pharmacy Relative to Pharmacist Demand, which called upon current and future schools to evaluate the demand for pharmacists before taking action.3 Remarkably, most leaders of pharmacy organizations and academic institutions remained relatively silent on the matter.”

    MORE AT LINK

  21. Pharmaciststeve  •  Jul 18, 2013 @7:20 pm

    Major whistle blower lawsuit filed against CVS by former RPH/PIC
    http://www.pharmaciststeve.com/?p=4024

  22. Peon  •  Jul 18, 2013 @10:53 pm

    Goose, someone needs to do a REAL survey and examine the cost of mail order rx’s vs retail. The coumadin guy is just an example of the enormous waste involved with mail order. People get meds they no longer take. They get 3 months supply and then the doc changes their med the next day. If it is really cheap, a lot of people never notify the mail order that they no longer need the med. The idea of a 3 months supply is a bad idea. People’s meds get changed and a lot of meds go to waste. I don’t believe there is any savings over mail order as compared to retail. And, most people hate mail order because of the time it takes for them to get their meds. The mail order’s mantra of being able to save healthcare money is as ‘phoney as baloney’. It is all about making money.
    -
    Telling patients to complain to the BOP….good idea!

  23. Pharmaciststeve  •  Jul 19, 2013 @7:30 pm

    Wall Street Journal picks up on CVS whistle blower lawsuit
    http://www.pharmaciststeve.com/?p=4031

  24. AJ  •  Jul 19, 2013 @7:39 pm

    Blah, blah, blah same ‘ole same from the I wish it were 1950 again crew!
    .
    Guys give me a break! The ship sailed along time ago on all the problems you continue to bellyache about on here. Have you ever heard the saying “You can never go back home?” It has happened, it is done and we can’t go back.
    .
    You have to laugh at how fast things have changed. 10 years ago a store manager so much as poked his head in the pharmacy he got his ass chewed off by the PIC. Now a days the store manger walks back into the pharmacy without so much as a by your leave and starts chewing the PIC’s ass because the little blocks on the Key Retailing metrics chart for floor vacuuming were not checked on the correct day. No one should be surprised. During the height of the great pharmacy shortage of the early 21st century someone interfered with the pharmacy we gave them the finger and dared them to do something because we knew there was nothing they could. Now days you don’t fill in the Key Retailing chart just right you get written up and fired.

    .
    No sense complaining about it. It is what it is as they say. Be smart and get the hell out of retail before it is too late. The time to jump off a sinking ship is before everyone realizes it is sinking. If you don’t get out now you have no one to blame but yourself when you go down with the ship.
    .

  25. another one  •  Jul 19, 2013 @9:41 pm

    Fuck You AJ
    “Please someone explain this nostalgic love affair everyone has with independents! All I hear and read any more is oh if there were more independents there would be no problems…if there were more independents we would all love our jobs…Give me a break! You are all like a bunch of old men sitting on the front porch bitching about how much better things were 50 years ago.”

  26. another one  •  Jul 19, 2013 @9:58 pm

    No all of us gave up something to become pharmacists. Artist, Doctors. Veterinarians, Teachers, scientists.

    These Independents are being sold to those who are being approached by those who can pay to shut down that business.

    We are offering the most that we can? -we lose. We need to get to those older Rph that want to sell. Convince them to take a chance. We need to keep these independents alive.

  27. another one  •  Jul 19, 2013 @10:13 pm

    AJ
    wait until you marry- have 2 kids.Then That Fucking ship has sailed. You can’t find a job/fired from a job you were great at – because they can hire someone cheaper than you. You’re regreting your choice of occupations. So what do I do?
    Put your kids in the subsidized lunch program.
    Yes – we have to laugh at how fast things had changed

    Still-last year’s tax returns dictate this years tuttion.

  28. AJ  •  Jul 19, 2013 @11:20 pm

    another one, next post try and make a salient point. Do you think losing your job or getting fired is unique to pharmacy? I guess you are the only sad sack in the world that doesn’t have a job. Boo Hoo you fucking cry baby.
    .
    From the quality of your posts I can tell you lost your job because you are an idiot.

  29. Jason DeVillains  •  Jul 19, 2013 @11:59 pm

    Times have changed. It used to be that win-win situations were possible for pharmacists. http://youtu.be/WumaYp7Ubqs

  30. pharmacyslave2000  •  Jul 20, 2013 @7:05 am

    I have to agree with AJ on this subject. His words may be a bit harsh but he’s speaking the truth. Pharmacy is vastly different now than it was even 10 years ago and we aren’t returning to the “glory days” any time soon. Industries change. Steel, coal, automobiles. All great american industries that provided an above average quality of life for many people but their time has gone. Technology, economics and business models changed and these industries, and their workers, were left behind. No union or public outcry could save them. Pharmacy is on a similar path. Much like the workers in the previously mentioned industries, we supply the public with a product. When that product can be “produced” (i.e dispensed) cheaper and faster with technology or changes in the business model then we begin to see downsizing. Our corporate employers see only one thing…profits! They don’t care how many kids you have, where they go to school, how large your mortgage is, etc, etc, etc.
    ***
    My suggestion to all of you, regardless of age, is to start looking NOW for alternatives to retail pharmacy. The wheels are already in motion. You can get out of the way now or get run over later.

  31. Pharmaciststeve  •  Jul 20, 2013 @7:28 am

    @slave… I think that to add to your comments.. that corporate pharmacy – or corporations in general – could care less about the health/well being of their employees and it would appear that corporation pharmacy does not care much about the health/well being of the customers/pts that we are suppose to take care of. IMO.. this will not change until the cost of “paying off ” pts for med errors takes a serious hit on their bottom line. IMO.. the arithmetic progression in the “efficiency” of producing/filling Rxs.. will result – sooner or later – into a geometric progression of med errors and harm to pts. It will probably take another 10 years before the flood/tide of new RPH’s coming out school will take a turn around and another 10 years before we have some sort of equilibrium between supply and demand.

    Those who are 45-50+ – those BS RPH’s – should probably start looking for an alternative before corporate pharmacy forces you to find an alternative.

  32. AJ  •  Jul 20, 2013 @11:05 am

    You have two choices. Be proactive or reactive. Help yourself or keep singing the whoa is me pity song and get steam rolled.
    .
    I started planning for the collapse of the retail pharmacist profession 3 years ago. It does not take a genius to figure out what is going to happen. I am sorry if there are some of you out there who didn’t see it coming or are still in denial. The time to jump off a sinking ship is before everyone figures out it is sinking. Honestly, I think I was late in starting 3 years ago.
    .
    It took me a year and a half of searching, applying, and interviewing for non-retail pharmacist jobs before I finally found one. I applied every where from mail order, long term care, closed door, hospital, health depratment, CMS and Veterans Affairs. It was much easier to do while I was still employed. Once you get fired or replaced for someone younger and cheaper it is too late.
    .
    My wife and I also prepared finacially. We cut our expenses, refinanced the mortgage and stopped buying things on credit. We payed off our revolving credit debt and canceled all the cards except for one to be used in emergencies.
    .
    When I finally got a non-retail job I took a $37,000 a year paycut from my retail pharmacy manager salary. I have never been happier and haven’t regretted it for a second. My only regret is I didn’t do it sooner.
    .
    Be proactive. Spare me your crying and bitching when you are reactive and get steam rolled.

  33. Peon  •  Jul 20, 2013 @2:49 pm

    AJ and Steve have pretty well summed up the position of retail pharmacy today. And, as AJ says, there is no turning back. And, I agree with AJ that retail pharmacy is a sinking ship. Pharmacy is not unique in the fact that big corporations control it. You name it and a big corporation are likely to dominate that industry. Corporate pharmacy is no different from any other corporate industry. The workers for these big corporations are facing the same issues: metrics, cutting staff, and being fired for not meeting those metrics. What we are experiencing is a corporate phenomenon. AJ has made a smart move. He has gotten out of retail and cut back on his expenses so he can live with less money. Most pharmacists are ‘stuck’ at their jobs. But, like AJ, they need to be looking into the future. It sure looks like retail pharmacy is a sinking ship. Don’t be the last to abandon this sinking ship.

  34. Pharmaciststeve  •  Jul 20, 2013 @8:38 pm

    AJ is right.. there was a proposed bill in Congress because businesses where putting out want ads and state.. do not apply if you are unemployed. It is consider today, that within 6 months of being unemployed your skills deteriorate and become dated.. the last thing a company wants today – with high unemployment .. is to have to expend much in training a new employee.

    And as far as the chain pharmacy industry goes.. the staff at the bottom (Rx dept) is just the end of the line for metrics.. everyone above them.. have same/similar metrics to be met.. why to you think that they are riding your ass to meet your numbers.. their job is on the line.. just like yours.. you only have a handful of employees to keep in line.. they have dozens of stores miles apart .. that they are being held responsible for making metrics..

    Even the CEO is responsible to the BOD.. who is responsible to “The Stock Market”.. Look at CVS 1.22 billion of outstanding stock shares.. for every $1 stock price up/down there is over a billion change in value for the company and its stock holders..

  35. broncofan7  •  Jul 21, 2013 @9:50 am

    Community Pharmacy is the BACKBONE of our profession with almost 70% of us being employed at least part time in Retail positions. Go ahead jump off of the community Pharmacy boat(but being that there are now 128-29 Pharmacy schools you’re going to find that there will be too few life preservers available to keep you afloat in that big ocean of managed care job, home health and hospital jobs). Myself and other Pharmacist entrepreneurs will swiftly move in and take back our profession one independent at a time. For all of the doom and gloomers out there here is the Bureau of Labor statistics job forecast from 2010. http://www.bls.gov/ooh/Healthcare/Pharmacists.htm

    Is it the year 2000? No. But do we have a more positive outlook than many other professions. YES.

  36. AJ  •  Jul 21, 2013 @10:36 am

    Oh my brocofan7, you are so confused. You need to open your eyes or you will get steam rolled. The Bureau of Labor statistics are out of date a year before they are published. You are foolishly waving around the statistics from 2010? Give me a break! If you wait for the statistics to show a decline in the job numbers you are 5 years too late.
    .
    Think about what you said…retail pharmacy is 70% of the profession. That alone should be enough to keep you awake at night. Then you mention the explosion of pharmacy schools and the soon to be unprecedented surplus of pharmacists. It doesn’t take a smart man to see where the profession is headed. Keep dreaming about 1950 and six pharmacists behind the counter all the way to unemployment.
    .
    Again, I ask you how independent pharmacy is going to save the profession? Do you have a clue or are you just repeating the same tired old lines everyone else is? Times have changed, society has changed and the business has changed. People care about three things when it comes to prescription drugs. How much, how fast and convenience. All the customer service in the world will not save you if you can’t beat the big chains on those three. As an independent you can’t.
    .
    If you think owning a business with a 1-2% net profit margin that is volume dependent piece work I guess go for it. In the end you are still working in a retail pharmacy setting with the hassles and issues that entails. Unlike a chain you also get to deal with your supplier, pay the bills, do the books, keep track of all the records, handle the audits, and answer to the State Board among many, many other things. The other issue is, you are never off. If your pharmacist is sick, you are on. Problems? All on you.
    .
    Again tell me how independent pharmacy is going to save the profession?

  37. AJ  •  Jul 21, 2013 @11:06 am

    To dispel another one of your romantic notions of the past broncofan. Customer service alone has never saved a business or a profession. If your prices are higher, you deliver the product slower and you aren’t convenient your screwed. Even with the best customer service in the world.
    .
    The game has changed my confused friend. Change with it or get left in the dust bin of history along with six pharmacists behind the counter, independent bakers and butchers, milkmen and icemen. Clinging to the past will ensure you stay there.

  38. broncofan7  •  Jul 21, 2013 @11:26 am

    Your naivety of having never signed the bottom right hand corner of your checks shines through with every post.Go collect your check Benedict Arnold because your daily activities (and your blog posts)are doing everything except for helping our profession…….

    1) convenience means different things to different people. For some it may be getting their Rx in the mail. For others its going a pharmacy @ 10pm. For others it is seeing the same Pharmacist the majority of the time. It’s know that they can speak to the owner if there is an issue and it’s having a level of trust in that Pharmacist owner that makes it more convenient for them. Add in home delivery and Independents rise to the front of the line in a competitive market.

    2) the average wait time in independent Pharmacies is 10- minutes or less.

    http://ncpanet.wordpress.com/2013/07/15/patient-survey-finds-more-good-news-for-independent-community-pharmacies/study-drug-chains-rate-highly-in-convenience

    Here’s more data from the link above:

    Some other numbers of note from the survey include:

    Independent pharmacy consumers were among the most likely pharmacy users to say their pharmacy had improved over the past year (on top of already high satisfaction scores in the previous surveys). Mail order patients were least likely to report an improvement in service.


    Patients of independent pharmacies receive their prescriptions within 20 minutes on average—much more promptly than those who patron other pharmacies. Patients said it takes two or three time as long, on average, to receive their prescription at other brick-and-mortar pharmacies. Moreover, one-third of independents’ customers received their prescription in 10 minutes or less.


    Independent pharmacists interact with their customers far more often compared to other pharmacy types. Perhaps not surprisingly, a much larger percentage of independent pharmacy customers report the pharmacy staff as the main reason they chose their pharmacy, compared to other options.


    Independent pharmacies scored slightly higher than mail order in patient satisfaction with pricing. Yet, on a separate question, the vast majority of mail order customers (69 percent) report choosing mail because of “pricing/insurance” (emphasis added). Arguably, this reinforces the conventional wisdom that few patients willingly seek out mail order pharmacies, but many are required to use them by insurance plans, even if the costs to the plan may be higher.


    Independent pharmacies’ helpfulness with insurance issues increased markedly compared to the same 2012 survey.

  39. broncofan7  •  Jul 21, 2013 @11:28 am

    AJ,
    I still find it ironic that you were the one who wrote that I can’t see the forest from the trees….

  40. broncofan7  •  Jul 21, 2013 @11:30 am
  41. broncofan7  •  Jul 21, 2013 @11:39 am

    Here’s some analysis by a shill for the PBM’s and big Pharma…

    http://www.drugchannels.net/2013/06/drugstore-industry-profits-rise-again.html

    Although he states it’s getting LESS Profitable–it’s still remained relatively stable at 22-25% GROSS MARGIN

    “The drugstore industry’s overall average gross margin, as reported by the U.S. Census Bureau, has remained fairly stable throughout the past 19 years, averaging 25.3%. In 2011, drugstore gross margins were 23.6%, equal to the 2009 figure”

  42. broncofan7  •  Jul 21, 2013 @11:39 am

    that’s 22% on average of $3.8 million in sales–do the math

    http://www.ncpanet.org/index.php/home/independent-pharmacy-today

  43. broncofan7  •  Jul 21, 2013 @8:15 pm

    AJ, your arrogance is amusing. RE:

    “I started planning for the collapse of the retail pharmacist profession 3 years ago. It does not take a genius to figure out what is going to happen. I am sorry if there are some of you out there who didn’t see it coming or are still in denial. The time to jump off a sinking ship is before everyone figures out it is sinking. Honestly, I think I was late in starting 3 years ago.
    .
    It took me a year and a half of searching, applying, and interviewing for non-retail pharmacist jobs before I finally found one. I applied every where from mail order, long term care, closed door, hospital, health depratment, CMS and Veterans Affairs. It was much easier to do while I was still employed. Once you get fired or replaced for someone younger and cheaper it is too late.
    .
    My wife and I also prepared finacially. We cut our expenses, refinanced the mortgage and stopped buying things on credit. We payed off our revolving credit debt and canceled all the cards except for one to be used in emergencies.”

    You are ONE PBM acquisition (ala Express Scripts buying Medco) away from the unemployment line…and then you will be clamoring for a position alongside those who you so readily denounce who practice as Community Pharmacists. Your current position within a PA department of a PBM does not require any particularly special skill set that makes you more employable than other Pharmacists. You’re not a Nuclear Pharmacist with a special designation. You’re simply employee #xxxx.

    Don’t believe me?

    “Express Scripts, which reports second-quarter earnings on Aug. 7, laid off 258 employees throughout New Jersey on Thursday, including 244 in Bergen County, the company said. Shedding those jobs represents about a 12 percent reduction in Express Scripts’ workforce in Bergen County, one of the largest single layoff announcements in the county this year – See more at: http://www.northjersey.com/news/163036846_Express_Scripts_lays_off_258_in_Jersey.html#sthash.Zmfv0ayY.dpuf

  44. broncofan7  •  Jul 22, 2013 @9:17 pm

    AJ, tick tock, tick tock, tick tock tick tock…..

    http://aishealth.com/blog/pharmacy-benefit-management/2013-outlook-outtakes-what-kind-pbm-consolidation-activity-tap

    “In 2012 the PBM landscape was impacted by some major consolidations, and we believe that consolidation within the industry will continue based on continuing cost pressures on the business,” observes Jon Roberts, president of CVS Caremark Corp.’s PBM business. “While it is not possible to accurately predict what, if anything, will happen in 2013 related to consolidations, mergers and acquisitions in the PBM space, CVS Caremark will pursue meaningful acquisition opportunities in a financially prudent manner as they arise.”

    AJ, unless you are planning to not work as a Pharmacist altogether going forward, you’d better get your A$$ firmly behind independent Pharmacy, the NCPA and the TPA and may I also suggest American Pharmacies CO-op. Because when the last independent closes, you’ll more than likely already be out of a job…see above.

  45. Peon  •  Jul 22, 2013 @9:37 pm

    Broncofan7, how many retail pharmacies will go out of business if the PBM’s make more reimbursement cuts and the government makes more reimbursement cuts? Have you noticed the DME suppliers dropping, like flies, out of the diabetic supply market? Where will the next cuts be? What will be the next healthcare market to go out of business? It appears that Obamacare is simply a mechanism to cut payments to providers. Will the docs be the next segment to stop taking Medicare patients?

  46. broncofan7  •  Jul 22, 2013 @9:48 pm

    Here’s some good material for community Pharmacists; particularly those in Texas.

    http://www.aprx.org/issues-advocacy/pbm-issues

    Also see the links on this page. Very insightful as to the political workings of our profession.

  47. broncofan7  •  Jul 22, 2013 @9:49 pm

    Here you go Peon.

    http://www.forbes.com/sites/aroy/2012/10/30/in-florida-obamacare-to-cause-27-of-doctors-to-stop-accepting-medicare-patients/

    and a google search will provide many more examples of Physician push back on medicare.

  48. broncofan7  •  Jul 22, 2013 @9:55 pm

    Peon,
    The PBM’s cannot adequately serve patient’s needs through their mail order dispensaries. what is beginning to occur are the preferred provider plans (humana/walmart-etc)–but those are already under great scrutiny for limiting patient access and only could theoretically work in heavily populated urban areas.

    http://ncpanet.wordpress.com/2013/04/11/medicare-chief-queried-on-medicare-part-d-preferred-pharmacy-plans/

    You will see wage cuts at the chain stores before retail pharmacies begin to collapse and go out of business

  49. Peon  •  Jul 22, 2013 @11:08 pm

    broncofan7, those are good links, and you make some very good points about physicians pushing back on medicare. If the government slashes pharmacies too much, these chains may start pushing back too. It sure looks like a ‘bumpy road’ ahead, and I have no idea where pharmacy is headed.

  50. AJ  •  Jul 23, 2013 @7:02 am

    Broncofan7 I am going to start calling you the Links Man. Do you have an original thought or idea? Posting all the links is great and shows you don ‘t have a clue whats going on. The handvwritting is on the wall my confused friend. Ignore it at your peril.
    .
    One of the lynch pins of Obamacare and one of the main ways it will be funded is by reducing waste and improving efficiency. Reducing waste by auditing the shit of out of everyone and taking money back or not paying it in the first place. Second point, incresing efficiency is where you lose. You distribute drugs. Thats it. Your pay is directly tied to the distribution of a commodity. The way we distribute drugs in the United States is the most expensive and inefficient product distribution system the world has ever seen.
    .
    Face the facts and stop hiding behind your dated articles written by chain drug store insiders. Two 100k+ a year pharmacists standing in front of 250k of drug inventory is inefficient, expensive and under the new healthcare law soon to be a thing of the past.
    .
    Face the facts or prepare to be steam rolled by them.

  51. AJ  •  Jul 23, 2013 @7:04 am

    broncofan do you understand the difference between gross margin and net margin?
    .
    Here is a little lesson for you since all you do is post links to articles you do not understand because you can’t make a stand alone point on your own.
    .
    Many Independent Pharmacy Owners Need a Lesson in Economics.
    http://pharmacytechnologyblog.com/?p=463
    .
    Here is another one for you.
    NCPA Digest, sponsored by Cardinal Health 2012 Digest.
    .
    http://www.ncpanet.org/index.php/digest-public
    .
    See page #2
    .
    Average sales less than 2010. Gross margin decreased from 24% to 22%. NET PROFIT – IE  WHAT YOU TAKE HOME was 2.9% unchanged from 2010 and the lowest it has been in 5 years.
    .
    I love how you blast the bias of the URAC white paper yet you post links to the same kind of fox guarding the hen house research to support you incorrect theories.

  52. AJ  •  Jul 23, 2013 @7:14 am

    I love how you blast the URAC white paper yet post links to the same kind of biased fox guarding the hen house research to support incorrect theories.
    .
    Here is a link for you Links Man. http://www.ncpanet.org/index.php/digest-public
    .
    Sales down compared to year before. Gross margin decreased from 24% to 22%. NET PROFIT, IE WHAT YOU TAKE HOME was 2.9% unchanged from year before and the lowest it has been in 5 years.
    .
    You know there is a difference between gross profit and net profit right? Here is another link because you seem confused.
    .
    http://pharmacytechnologyblog.com/?p=463
    .
    Many Independant Pharmacy Owners Need a Lesson in Economics

  53. AJ  •  Jul 23, 2013 @7:20 am

    JP what is the deal man! Why do half the things I post say “Your comment is awaiting moderation”. Why you gotta keep a brother down? You let confused broncofan7 post a million worthless articles!
    .
    AJ, my brother. Akismet did not let your comments through the firewall because you apparently used either a computer with a different URL or you used a different e-mail address. After I moderate the new “addresses” the first time, you are good.
    Akismet will let anything you write through the firewall.

  54. broncofan7  •  Jul 23, 2013 @8:26 am

    AJ, you’re pure hilarity. A Pharmacist working in a
    PA department for a PBM is going to ask a Pharmacy owner (who incidentally used to do the very job you currently have)if he knows the difference between Gross Margin and NET margin. Really?

    -The average independent did $3.8 million in sales open 6 days a week 55 hours per week

    -the average independent made 22% gross margin = $836,000

    -the net margin for the owner is 2.9% of $3.8 million= $110,000 if you sit at home on your A$$ and don’t work your store

    subtract out payroll as your gross margin is your sales- COGS (cost of goods (drugs): average 55 hours per week $170K RPH
    Tech $60K/yr
    Clerk $25K/yr
    lease $36K/yr
    Electricity, phone etc etc and the Pharmacy owner on average makes $110K AFTER PAYING HIMSELF A PHARMACIST SALARY.

    Here are the facts AJ; if our profession isn’t able to maintain our role in the community, there will be no profession left to salvage.

    AJ, you continue to bash community Pharmacy telling everyone how it’s dead and dying while at the same time collecting your check from one of the reasons why our profession is dying, the PBMs. You literally offer no solutions; and worse you bemoan those who do offer potential solutions. I have posted numerous links for you to join the NCPA, the TPA and now American Pharmacies. All of these organizations are fighting for the interests of community pharmacy and therefore fighting for our profession to exist in the brave new world of the ACA. Our future as a profession rests in the hands of our power to lobby for our interests; your solution? Getting a job at a PBM while PBM’s are coming off of a record year for consolidations and they employ but a fraction of Pharmacists as compared to community Pharmacy.

  55. AJ  •  Jul 23, 2013 @9:25 pm

    Ahhhh now we are getting somewhere! Finally you asked the golden question! A question I might add you have failed to answer when I ask you.
    .
    You want to know if I have a solution? I do.
    .
    If the profession is going to survive it will have to reinvent itself. Stuck in the past pharmacists like you will drive us straight to extintion. Drug distribution is not how we will survive. Pharmacists need to divest themselves from getting paid based on the profit margin for distributing a commodity. Simply put pharmacists must become providers.
    .
    All are national organizations and pharmacy schools have failed to capitalize on the best opportunity for the profession to survive. The Affordable Care Act otherwise known as Obama Care. Right now is a golden opportunity for pharmacists to ditch the counting spatula and help ease the coming primary care physician shortage. Our national organizations should be out there pushing for a Pharmacist Practioner degree. Pharmacy schools should be screaming from the top of the ivory tower how they could change to meet the new training requirements. The data is out there. There has been pharmacist prescribing under physiciam protocols for years. Nearly every pharmacist gives immunizationsone one of the cornerstones of prevenative care. The new Accountable Care Organizations should have us all slobbering over each other.
    .
    Instead we have pharmacists like you who can’t see the forest for the trees and against all logic and reason think independant pharmacy is going to save the day. Then you have Pharmacy Schools continuing to open new schools and crank out record numbers of pharmacist for a system that is no longer viable. Then there is our worthless national organizations sitting on their thumbs like usual doing nothing.

  56. AJ  •  Jul 23, 2013 @9:34 pm

    broncofan7 instead of posting a bunch of links answer a few questions on your own. Explain how independant pharmacy is going to save the profession. Better yet explain how retail pharmacy will fit in and survive under Obama Care. Explain how you will be able to survive on a profit margin less than 2%.

  57. broncofan7  •  Jul 24, 2013 @8:24 am

    Separating our profession from the role of supervising drug dispensing BEFORE we have acquired the ability to practice medicine under a physician’s protocol(which is what you’re recommending–and wait for it, wait for it–I AGREE WITH YOU!) would be irresponsible to our profession as it would no doubt undermine the financial viability of what we do.

    The NP/PA organizations would fight tooth and nail to not allow this to occur on a large scale. In fact, in Texas I’m only aware of this happening in teaching hospitals. Diagnosing URI, looking at cholesterol panels and prescribing drug therapy, looking at a TSH and prescribing a thyroid medication dose those are but a few of the things that I feel many Pharmacists are currently capable of doing.

    As an Independent Pharmacist and owner, I am uniquely positioned to take part in this change in scope of practice because of my flexibility….but it has to make BUSINESS sense as well. So truthfully, getting to the end point of us being health care providers has 2 main components 1) getting the legal expansion of Pharmacy practice to accommodate working under physician protocols

    and 2) getting the insurance payers to pay us at a rate that allows this to be truly a sustainable business model. For example, some states allow NP’s to practice WITHOUT physician oversight, however the INSURANCE companies do not pay them at a rate that allows them to actually be independent of physician oversight….and I believe that Medicare also requires a supervising MD/DO to sign off of records for medicare reimbursement

    Here’s an example:

    http://www.kaiserhealthnews.org/Daily-Reports/2010/November/17/States.aspx

    “When nurse practitioner Mary Lou Hendrix opened her own high-risk-pregnancy practice in Evergreen and Cherry Creek last spring after more than 25 years of providing such care in physicians’ offices, she was well-prepared for the medical challenges she would face. But she was not ready for the still-unresolved nightmare of trying to get recognized and reimbursed by insurance companies. … This is happening to advanced-practice nurses in solo practices across Colorado despite a 2008 state law that specifies nurse practitioners do not need to work under the auspices of a physician to be credentialed and reimbursed by insurance companies. State law also requires that these advanced nurses be reimbursed the same as physicians for providing identical services”

  58. broncofan7  •  Jul 24, 2013 @8:27 am

    Here is a link to the few Pharmacists who have prescriptive authority in Texas….and it has grown in the past year

    http://www.tsbp.state.tx.us/files_pdf/DTM.pdf

  59. broncofan7  •  Jul 24, 2013 @1:13 pm

    And although AJ posted this as an attempt to slight me (and other independent Pharmacy owners) This blog post below is SPOT ON.

    http://pharmacytechnologyblog.com/?p=463

    Summary: If you’re an independent Pharmacy owner and you use Amerisource Bergen as your primary vendor you need to get out of that contract ASAP! Go switch to mckesson, HD Smith or Cardinal….

  60. AJ  •  Jul 24, 2013 @11:16 pm

    Well old buddy good luck…your going to need it. I guess what they say about leading a horse to water but you can’t make drink is true. I suppose I will see you on campus in a couple years when everything falls apart and you get your old job back. I promise I won’t rub it in…too much!

  61. broncofan7  •  Jul 25, 2013 @11:19 am

    LOL @ AJ…..you still don’t know what you don’t know…

  62. broncofan7  •  Jul 25, 2013 @7:38 pm

    Right on cue!

    This is how we take an active role in the direction of our profession..

    http://www.c-spanvideo.org/clip/4460316

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