WHO BENEFITS?

Jp Enlarged

The Phantom Pharmacy Refrigerator
I believe that it was Karl Marx who asked, “Who Benefits?” In the Prescription-selling industry, the answer is clear. Not you!
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Cui bono

From Wikipedia, the free encyclopedia
(Redirected from Cui Bono)

Cui bono /kwiːˈboʊnoʊ/ “to whose benefit?”, literally “with benefit to whom?” is a Latin phrase that persists.[1]

The phrase is a double dative construction. It is also rendered as cui prodest.

It is a Latin adage that is used either to suggest a hidden motive or to indicate that the party responsible for something may not be who it appears at first to be.[2]

Commonly the phrase is used to suggest that the person or people guilty of committing a crime may be found among those who have something to gain, chiefly with an eye toward financial gain. The party that benefits may not always be obvious or may have successfully diverted attention to a scapegoat, for example.
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WHO BENEFITS WHEN YOU ARE INTERRUPTED WITH THE QUESTION: “HEY YOU! WHERE ARE DA BUY ONE, GET ONE FREE CHICKEN POT PIES?” The questioner is a large man wearing a soiled Tee Shirt hanging over his belt line. The shirt reads “Fuck Obamacare”. Close to the collar were red stains. Ketchup? Blood? His cargo shorts were camouflage. Attached to his belt was a K-Bar knife. The tattoo on his neck, a black cobra.

YOU DO NOT ANSWER. DOCTOR JONES JUST PRESCRIBED NEXIUM FOR A POST-STROKE PATIENT TAKING PLAVIX. YOUR SOFTWARE WENT APE SHIT AND REMINDED YOU OF THE PROBLEM AND NOW YOU ARE GOING A LITTLE APE-SHIT YOURSELF. WHOEVER ANSWERED THE PHONE AT DOCTOR JONES SAID, WITH AN EXASPERATED EXHALE, “DOCTOR BOB IS EXPERIENCED. HE KNOWS MORE ABOUT DRUGS THAN A PHARMACIST. IF HE PRESCRIBED IT, THERE IS NO PROBLEM.”

“WHAT IS YOUR NAME?” YOU DEMAND. “WELL, BRENDA LEE, YOU ARE WRONG. DOCTOR JONES ..BOB. IS NOT A DRUG EXPERT. THIS MISTAKE…..

“DOCTOR BOB DOES NOT MAKE MISTAKES. JUST FILL THE PRESCRIPTION.”

“THE MARIE CALLENDER ONES. YOU BETTER NOT BE OUT OF DEM.”

“GET THE DOCTOR ON THE LINE. IF WE DO NOT GET THIS MATTER SETTLED, I WILL HAVE NO CHOICE BUT TO ADVISE THIS PATIENT TO TALK TO HER ATTORNEY.” This was blowing smoke, of course. An attorney is important if there has been harm. BRENDA SLAMMED THE PHONE DOWN.

YOU ADVISE THE PATIENT OF WHAT WAS GOING ON. YOU SUGGEST THAT SHE INSIST ON A NEW Rx FOR RANITIDINE. YOU WENT BACK TO WORK, VERY AWARE OF THE AMMONIA ODOR THAT GAGS EVERONE WORKING IN THE PHARMACY WHEN YOU GO NEAR THE REFRIGERATOR. What the hell….? You called the company maintenance guy three days ago.

LATER, LIKE THREE HOURS LATER, THE STORE MANAGER SHOWS UP. HE HAS HIS CLIPBOARD, PAPERS AND A PEN. HE HAS THAT PLAYGROUND BULLY LOOK. “SIGN THESE,”HE ORDERS. “WE’LL GO OVER THEM LATER.”

YOU KEEP WORKING. THE PHONE IS A NURSE. SHE TAKES TIME. THEN A PATIENT NEW TO ORAL CONTRACEPTIVE USE WITH BREAKTHROUGH BLEEDING. YOU WALK OUT FRONT TO ASSIST AN ELDERLY MAN WHO NEEDS YOUR HELP CHOOSING A LAXATIVE. THE MANAGER SHAKES THE CLIPBOARD AT YOU. “TWO SIGNATURES. THAT IS ALL I NEED.”

YOU TAKE A DEEP BREATH, INHALE AMMONIA AND COUGH.

“WHAT’S THAT SMELL?”

“IT IS THE STINK OF FIFTEEN HUNDRED DOLLARS YOU HAVE TO SPEND FOR A NEW REFRIGERATOR.”

HE BRISTLES. “I’M NOT BUYING A NEW REFR……”

“THEN YOU CAN EXPLAIN WHY CLOSE TO FIFTEEN THOUSAND DOLLARS WORTH OF PHARMACEUTICALS WENT BAD AND HAVE TO BE REPLACED.”

He does not like that. He hisses, “Fuck you, Plagakis.” THAT’S OKAY. YOU’VE HEARD THAT BEFORE. YOU ARE A PHARMACIST, FOR CRISSAKE. DIGNITY? THAT IS A JOKE IN MOST JOBS. “JUST SIGN THESE.”

“THEY ARE ‘Write Ups, correct?”

“Yes, they are. Why couldn’t you just tell that biker guy where the pot pies are?”

“BECAUSE I WAS ON THE PHONE WITH A DOCTOR’S OFFICE DISCUSSING A SERIOUS ERROR.”

“That’s the second one. Geezuz, man, don’t I have enough trouble with Ayella? Where do they find these pharmacists?”

“WHAT ABOUT THE SECOND ONE, DON?” YOU HAVE A PRETTY DAMNED GOOD IDEA ON THAT ONE.

“Why did you insult the doctor?”

YOU HAVE THIS ONE HANDLED, “I MADE IT CLEAR THAT DOCTOR JONES IS NOT AN EXPERT ON DRUGS. I AM THE EXPERT ON DRUGS AND EVENTUALLY PEOPLE WILL DIE IF WE
LEAVE IT TO JONES.” YOU GIVE DON A LOOK. “I’m NOT SIGNING ANYTHING.”

“YOU HAVE TO.”

“THE ONLY THING I AM SIGNING IS THE LETTER I AM SENDING TO JENNY JASKELA”. (THE COMPANY’S CHIEF COMPLIANCE OFFICER)

“You can’t……”

“Yes, I can and, Don, I will if you can’t retreat your sorry ass out of the pharmacy and not come back until you are invited.”

    WHO BENEFITS?
    That burning sensation in your stomach indicates certainly NOT YOU.

    It is called PHARMACY. The answer to the question would be different if PHARMACISTs were the ones navigating the ship.

    The End

4 Comments

4 Comments

  1. Vagabond Rx  •  Apr 2, 2014 @2:30 pm

    I believe the current translation of cui bono is “follow the money!”

  2. Jeremy  •  Apr 8, 2014 @5:28 pm

    While I do agree with the scenerio, your choice of interacting medications is outdated, though maybe it took place many years ago since you now are retired. The interaction between Plavix and PPI’s is now considered to be of low severity if at all. But I do whole heartedly agreee that being written up for not giving a person attention when he can clearly see you are on the phone or being considered insulting when trying to verify/clarify a prescription is asinine.

    Spencer, thanks for your editorial comment. My stroke was 1/11/14. It was characterized as a “Small” stroke. I went to http://www.FDA/medwatch to confirm the Plavix/omeprazole and there it was front and center. Since it as me, I will trust the FDA. Here it is:

    OMEPRAZOLEWARNINGS AND PRECAUTIONS
    Interaction with Clopidogrel (PLAVIX)
    • Avoid concomitant use of esomeprazole/omeprazole with clopidogrel. Clopidogrel is a prodrug. Inhibition of platelet aggregation by clopidogrel is entirely due to an active metabolite. The metabolism of clopidogrel to its active metabolite can be impaired by use with concomitant medications, such as esomeprazole, that inhibit CYP2C19 activity. Concomitant use of clopidogrel with esomeprazole/ omeprazole reduces the pharmacological activity of clopidogrel.

  3. Jeremy  •  Apr 22, 2014 @5:24 pm

    Yes, Interaction is possible but severe enough to advise patient to seek an attorney? Severe enough to yell? No, your rant is more about the nurse saying the doctor is a drug expert, not the drug interaction. The two (plavix and nexium or prilosec) are often given together for those with increased risk of gastric bleeding. It is enough of an interaction to advise patient to discuss it more with their doctor though. Not for ranting about the severity. The pharmacological effect of plavix is decreased but the consensus on the clinical outcome is up for debate. I just don’t want any newbe reading your blog and thinking, the two can NEVER be taken together (so much so that I have to argue with a doctor over it). Anyway, I love your blog, keep it up. I love to rant to about stupid customers and managers.

    Retail RPhs get one shot. The FDA says, “Don’t do it” and they explain why. Good enough for me. I AM THE PATIENT. Looking objectively
    is an exercise I choose to avoid. I will tell patients, “Don’t do it.” How’s that for a rant. JP

  4. Jeremy  •  Apr 23, 2014 @10:43 pm

    So, if a physician prescribes a medication for an off label indication, you would absolutely refuse to fill it?

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