Jp Enlarged





I read with great interest the article “The Political-Medical Complex “ by Robert L. Mabee, Rph, JD, MBA, published in Drug Topics on December 10, 2013. I have had the privilege of speaking with Mr. Mabee on several occasions in the past year, and consider his opinion to have particular weight and merit.  His unique qualifications as a pharmacist, a lawyer, and MBA, as well as his personal values and common sense approach were a great help to me and a sustaining voice of reason as I tried to make sense of a profession that has been hijacked by the chains, the insurance industry, the pharmaceutical companies, and indeed, even our once trusted academia and state boards.  In our profession, as in many other professions and occupations, those of us who do the actual work at ground level have no voice. We have never been able to organize, we are afraid for our livelihood, and we do not have the funds to influence and elect politicians who will represent us. We accepted the word of university faculty that promised that pharmacy would soon be elevated to going beyond count pour lick and stick. We kept thinking that if we just held on and kept increasing our skills and working hard, that this dream would eventually materialize. All we needed was time. Meanwhile, the chains and hospitals kept cutting back our support staff  and increasing our responsibility, ensuring that we remained exhausted and separated by virtue of our long hours, lack of breaks, and outlandish schedules. Our compliant and people- pleasing nature, our extreme sense of responsibility, and our self-destructive work ethic also took a toll on our energy and self-esteem. We became our own worst enemies.    Meanwhile, the big chains infiltrated our state boards of pharmacy, donated money to our colleges and universities, and accepted kickbacks from the pharmaceutical companies. Staff and professionals at local hospitals and doctor’s offices became employees of huge corporations as their hospitals and medical complexes were bought out and swallowed up. Medical decisions were increasingly dictated by insurance companies, P and T committees, and hospital administrators, as well as the CEO’s of the medical machine.  In reading a book entitled “How to Live…A Search for Wisdom from Old People while They are Still on This Earth, I came across the story of Granny D. At the age of 89, Doris Haddock, a.k.a. Granny D, walked 3,200 miles in 14 months to support the McCain-Feingold bill and its limiting of lobby-based or “soft” campaign financing. Two months after finishing her walk, she was arrested, handcuffed, and taken to the police station for reading the Declaration of Independence aloud under the Rotunda of the Capitol in Washington DC.  When she appeared before the judge two months later, she said:  “Your honor, the old woman who stands before you was arrested for reading the Declaration of Independence in America’s Capitol building. I did not raise my voice to do so, and I blocked no hall… Your honor, we would never seek to Abolish our dear United States. But alter it? Yes. It is our constant intention that it should be a government of, by, and for the People, not the special interests…In my 90 years, this is the first time I have been arrested. I risk my good name, for I do indeed Care what my neighbors think about me. But, your honor, some of us do not have much power, except to put our bodies in the Way of justice—to picket, to walk, or to just stand in the way. It will not change the world overnight, but it is all we can do.”    The time will come when those of us who know what is going on will have to stand up. Many of us are afraid, have been disrespected, harassed, and had our lives upended. Our self-esteem is in the toilet. Those who have not been “excised” have been forced to endure brutal working conditions, threats and ill treatment. District Managers, Store Managers, and even some of our technicians spy on us, second guess our decisions, and report us if we step out of line. The public and other health care professionals treat us with disrespect, and we grovel and apologize in fear that we will lose our jobs. We work on the ragged edge of control, hoping every day that we do not hurt or kill someone because of the pressure and stress.  And now there are rumors (and substantiated evidence) that our pay will be decreased and ourhours reduced so that our employers do not have to provide us with benefits.   If you have not been shaken up or forced to change , your time is coming. Those of us who have been forced to face the truth are out here. Our numbers are escalating. We are hurt and angry at what has happened to us. Maybe it is time to unlock the golden handcuffs and make a leap of faith.   Kimberly A. Ankenbruck Rph



  1. Pharmaciststeve  •  Jan 24, 2014 @2:46 pm

    The functionality of our society seems to have moved from cooperation and respect.. to that of fear and intimidation.

    Reportedly, the NSA is “snooping” on virtually everyone in our society.

    Everyone on the drug side of the healthcare distribution system (prescriber, wholesaler, pharmacy/pharmacist).. is fearful of the DEA

    Don’t forget those wonderful people at the IRS

    I know that most RPh’s are fearful of PBM audits.. what new wrinkle will they come up with this audit to extort and claw-back what little bit of profits they give in the first place.

    IMO.. fear is a sizable thread in a corporation’s fabric.. From the CEO – who fears the stock market and the company’s stock price.. to the DM or PDM whose has a heavy hand hanging over their heads … and will come down.. if all the staff under him/her does or doesn’t meet some arbitrary production metric..

    I have been told that recently that in this same chain.. that the front-end managers have been instructed to go into the pharmacy and pay attention to the metric icons on the Rx system and if behind… NUDGE the RPh to go FASTER.

    Imagine that a person who does not have the legal right to be in the Rx dept without the permission of the RPH on duty.. NUDGING the RPH to move faster..

    IMO.. if they want you to move faster then they can work the register and window and free up whatever sparse technician help that you are already allotted.

    I have also been told that this same chain reduced the tech help in one particular store from the 1 tech hr for every 10-15 Rxs to 1 tech hr for every 20-30 Rxs.

    Right now, few businesses are not fearful of the cost mandates of Obamacare.. in reaction to that fear.. they are cutting employees hours to < 30/wk to lessen the impact on their bottom line… or trying to prevent their bottom line from becoming a negative number and have to go out of business.

    The chains and PBM's are fighting for every last penny to put on their bottom line.. The exemption that the PBM's have from Sherman Antitrust.. does not make it a fair struggle.

    As long as we have a surplus of RPH's and a high unemployment rate.. and the vast majority of RPH's are passive/ball-less/spineless pleasers.. Nothing is going to change.

    No one is going to be able to stand up for the profession unless/until the professionals within the profession.. first stands up for themselves.

    Each of us.. sees the person at fault of where we are at today.. when they look into the bathroom mirror every morning.

  2. Pharmacy gal  •  Jan 24, 2014 @5:38 pm

    Is it time to take back the profession we love, or is it too late.

  3. Whistleblower  •  Jan 24, 2014 @10:37 pm

    Coming to a CVS near you ..The Nudge. This is fact and a email to prove it!!!
    The other little tidbit of news is that a new hire RPH will work 30 hour base and must be PIC ready. Oh and evaluations are coming in the next week or so…California is doing them this week and I live in Central Pennsylvannia, RPHs beware you are most likely writing your own termination!!

  4. pharmacyslave2000  •  Jan 26, 2014 @9:43 am

    These anecdotes are great to call attention to what is occurring in our profession, but we already know about it. My question is, “What do we do about it”? Everyone says, “grow a pair”, “stand up for yourself”. Ok, who is going to be the first to martyr themselves? What difference is a few pharmacists who’ve “grown a pair” getting fired going to make? We didn’t get to this point overnight and we’re not going to get out of this situation anytime soon, if ever. There is no white knight who is going to swoop in and rescue the profession. Unless there are some viable, real world suggestions on how to make things better, there is no need to rehash sob stories.

  5. pharmaciststeve  •  Jan 26, 2014 @10:26 am

    @slave.. we have discussed what needs to be done over and over…
    You document… document.. document.. all the wrong/questionable doing of your employer.. Keep it off site.

    If you find yourself.. in the position of being “set-up” to be shown the door.. you contact an attorney and have them send a letter to COO/Legal.. that will stop them in their tracks of showing your the door.. at least in the short term.

    If your company gets called to task in the media.. if the documentation you have supports that your company in fact did what they shouldn’t have done.. share it with the media

    If one of your colleagues finds themselves in trouble and hasn’t documented well.. share yours with them .. and again the media..

    Encourage your unhappy pts to file a BOP complaint against the company. If you have documented well.. you can support that you were just following the company mandate.

    I have heard rumors how the major corporations are making changes to make it harder for employees to secure documentation.. do you ever wonder why?

    I have stated over and over.. if you have a one to one conversation where you are told to do something that you consider questionably legal, unethical or increases the risk of med errors.. send the person telling you a email confirming your understanding of the conversation..

    When Whistle blower gets thru with his former employer in court.. IMO.. you are going to see a whole bunch of attorney firms .. interesting in following down that same path.

    Actions or lack of actions will depend on how much documentation individual RPH’s have in there possession.
    sit on your hands.. do nothing.. whine .. bitch.. moan.. your results will equal your input.. NOTHING !

  6. bcmigal  •  Jan 26, 2014 @12:07 pm

    That 30 hour workweek is already here. The non-rxfilling tasks have increased. And if the metrics are not met, we are to be ” retrained”. Isn’t there a sci-fi movie in which that technique is utilized?

  7. Steve Moore  •  Jan 27, 2014 @8:17 pm

    “What do we do about it?”

    I’m an owner, and admittedly biased, but the answer is to do something different. I am paraphrasing but Einstein said the definition of insanity is doing the same thing over and over and expecting different results. For some pharmacists something different may mean changing jobs and others changing the way that they do their current job. I am not saying that these are easy things to do, but I do not see why they aren’t considered viable real world suggestions.

    If we want the benefits of the profession we’re going to have deal with with some of the ancillary, nonclinical, issues too. I personally think that we would all be better off if more pharmacists had a financial stake in the profession. Whether that be as owners I don’t know, but everytime Medicare tries to cut physician payment rates, the AMA and all of its members are up in arms. When pharmacy reimbursement rates get cut, the vast majority of pharmacists have no clue about it and are left complaining about how they have less tech hours all of a sudden.

    Pharmacists need to find a way to change the game. There are pharmacists who are doing so and more who will. I know of a pharmacist that switched his business to a cash model based on providing 6 or 12 months worth of scripts at a time instead of 1 or 3 month supplies. He focuses heavily on generics and ships all over his state. Unfortunately, I also think that there are going to be pharmacists that get left behind wondering why they aren’t making 6 figures anymore just for having a pulse and a license. I hope there are more of the former than the latter.

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