Pharmacy. Jim Plagakis. Pharmacist

Ignorance is Bliss.  Or… is it just Ignorance.  The modern pharmacy schools are robo-dispenser Mills that put out the metrics-minding, speed-burner 14 hour shift factory piece-work dispensers that believe that what they do is practicing pharmacy.   Goose and Peon and Steve and Pharmacy Gal have had their feet in this mud puddle for a long time and they know what it is to be a “Druggist”.

There was a time when “Druggist” was a derisive label.  It was not as professional as pharmacist.  It painted a picture of a balding guy wearing a bow-tie who always had time for the patients.  Before Durham-Humphrey, a Druggist was an alternative to the Doctor.  After the early 1950s, people still came to the drug store expecting the druggist to help them.  We did too.  The OTC shelves were choking with really good drugs.  Merrill made an OTC antacid with 5 mg of dicyclomine per 15 ml.  Diarrhea was a significant problem back then.  We bought Lomotil by the thousands.  A patient could bypass the doctor and get paregoric in 60 ml bottles from the Druggist.  Sign the “Exempt Narcotic” register and wait the prescribed length of time before coming back.  Cough-Cheracol, ETH & Codeine and Robitussin AC.

It was a different world.  I liked it a lot.  It was fun and I perceived that I was making a difference.   At Wentlings, there was a lunch counter.  We gave prescription patients a coupon for a cup of coffee while they waited.  And, they had to wait.  I’d estimate that 30% of all prescriptions were compounded.  I’d often go over to the counter and have a cup of Joe with them before or after I completed their order.  As I said, a different world, one that was fun.

The other evening I was remembering Charles Larwood.  He was the Dean of The College of Pharmacy.  He was also a Pharmacognocist.  What the?? That is what some of you newbies just asked.  Pharmacognosy.  That probably is not offered at 95% of the schools.  I would bet that the dean of Touro University, one of what I have termed the boutique pharmacy schools, does not even know what pharmacognosy is.  No shit, I am serious.

Anyway, I was imagining having a Friday night vodka martini with Dean Larwood.  I took a sip, too much vermouth and only one olive.  My ideal martini has a drop or two of dry vermouth and three olives.  I explained the 14 hour work day to the dean.  He tapped the table with his right forefinger.  His eyes widened and he pursed his lips tightly. “You can’t go to the bathroom?”  After 5 minutes, he raised his right hand, palm toward me, the universal signal to stop.

“It shouldn’t be this way,” he says.

“The pharmacy schools are the pimps for the drug store companies,” I said.  ”They are gluttons for the donations.”

“It shouldn’t be this way,” the dean repeated.

I do not see how we can fix it.  Guys like me, Peon and Steve are done other than the shouting.  Shouting is all we can do.  Goose will be around for awhile as will be Pharmacy Gal.  Most of the new kids do not know anything.  I visited Toledo for homecoming 10 years ago.  My room-mate “The Fabes” shared this experience.  A little girl (about 5 feet tall), but a budding rock star, gave us a tour.  She took us to a lab and proudly showed us what they did.  Suppositories, creams, emulsions, suspensions, etc.  ”Official” products.  For you who did not get or will not get a real pharmacist education:  ”Official” are those found in the U.S.P. and N.F.  That’s MY school and I was proud.  50 years later and the kids are getting what I got.

Is pharmacist education producing two levels of practitioner?  Pharmacists and Robo-Dispensers?

The quintessential pharmacist’s art is compounding and these new schools do not even teach it.  No one other than the pharmacist can legally compound and they don’t teach it.  Give me a break.  Compounding is ours.  We need to covet it and charge plenty for it.  New pharmacists do not know how to do it.

They have not been taught the art of being a “Druggist”.  If they lose this, they are losing it all.  Pharmacies become dispensaries.  I have no problem with dispensaries like CVS or like the mail orders run, by the way.  Just do not call them pharmacies.

I spent lots of time with a brand new pharmacist before I left Galveston.  She knows what a Druggist is now.  She knows that Druggists are the elite pharmacists.  It is more so a ground of being.  We spent a decent amount of time compounding.  She knows that using an over-sized bottle and making a “Shake” lotion is much simpler than using a mortar and pestle.  You also get a more elegant product.

I did my part, you guys.  Just one 20 something girl who now thinks and acts like a “Druggist”.  What about you?  Fuck this preceptor shit.  Be a mentor.

Goose was fortunate to be “taught” by Varro Tyler at Purdue.  I really love and depend on “Tyler’s Honest Herbal”.  Varro cut the crap.  He gets right to the gold.  Most monographs are less than two pages.  The “Summary Chart”  at the end of the book is priceless.  Each Herb (In alphabetical order) has six points.  Common name, Source name, Part Used, Principal Uses, Apparent Efficacy, Probable Safety.  “Honest Herbal” is a terrific resource for any Druggist.

The comments on the original “Bad Ass” theme are terrific.  If you have the time, go back a couple three years in the archives and read some of the comments.  The general impression was that pharmacists were like the chubby, effeminate sopranos in the men’s choir.  No vision, no guts, no future, no balls.  The pathetic evidence is in their comments.  I trust that you girls can get this.  A feminine characterization would be a woman with her face covered, walking four feet behind her husband and looking at the ground.

There was one important comment that came to me at jpgakis@hotmail.com.  The writer asked me to remain anonymous and to not copy and paste the letter.  But I gotta pass on the message.  The writer feels really good.  Self-assured and confident.  The use of tradecraft is life.  This woman (Yes, a female crusader) is on a mission to make a big dent in the drug store company that she works for.  They have mistreated her, she believes.  The have arbitrarily moved her away from the store she had been in for almost two decades.  Her commute was ten minutes.  Now, it is an hour.  She got mightily pissed.  She said, “Information is my weapon.”  She prints and saves every email and memo.  Some of them, she claims, are damning to the District Manager.  She recently bought a clandestine voice recorder from an Internet security provider.  She downloads all recordings to two files on her computer.  One labeled:  ”Gotcha” and another “.  She asked my advice.  ”What do I do with all of this?”  I honestly don’t know, but, I’d bet that some of you do.  Good for her.  I wish I was 40 years old again and know what I know now.  This woman is a major Bad Ass in my book.

Here are just a few others:  We know who is at the top.  He took on Big Stupid and won.  Goose is loaded for bear and just wants a posse to go with him.  Pharmacy Gal, she will step up when it is time.  Steve, as always, like a predator waiting for Big Evil to make another mistake.  Peon.  This guy has been playing hard for years.

THESE ARE ALPHA MALES PLAYING ON THE “A” TEAM.  There are others out there.   Maybe you just don’t know that you are one of them.

5/14/13….You know, you guys, that we live our lives on automatic, not really conscious of what we are doing.  We are asleep.  The worst thing for Big Drug Store is if a bunch of us woke up at the same time.

 You get out of bed, scratch the itchy areas.  Shave or put on a little makeup.  You dress in the “uniform”.  Casual pants or slacks.  A shirt or blouse.  You actually have your work clothes  in a designated area of the closet.   If a tie is mandatory,  you put on one of the five that are work ties.  You know the ones that have ketchup stains and are choking, absolutely choking, with bacteria from patients coughing or just breathing on you.  

I quit wearing a tie (actually threw away 90% of my ties) when I read about the toxic ties in The New York Times a couple years ago.  Google it.  If you read the reports and continue wearing a tie, you are an idiot on drive.  I was asked about “Why no tie?”.  I gave the questioner a copy of the Times piece and let it be known that I would never again wear a tie to work.  There was a “Hmmmph” and a stare, but I was never asked about it again.  I worked the last year of my drug store career wearing “golf” shirts, short sleeve and very comfortable and good looking.  No white jacket.

Anyway, after brushing your teeth to make sure the purple wine stains are removed,  you grab a Quaker Breakfast bar and hit the road.

 The following 8 or 12  or 14 hours are conducted totally asleep, on automatic.  You never question the insane multi-tasking around 12 noon.  You know what I am talking about.  This is no way to conduct the business of an important medical professional.  There is No You there, just a frikkin’ dispenso-robot.  No wonder you have so little self-respect.  And the problem is NOT the profession.  It is YOU that is the problem in your work life.  Have you noticed the one consistent fact when you are having problems at work?  YOU are always there.

So, wake the fuck up.  Rather than just walk shackled to the next task, look at what you are doing.  Notice how you feel about it.  Document everything.  Like this:  Today, I knew that I should have intervened in that temazepam prescription for the 90 year old woman.  I did nothing because I have never done anything about anything in the last ten years.  This shit has got to stop.  

After you have 20 pages, read them.  Share them with a colleague you trust.  Suggest that perhaps asking guidance from The Guild might be a good idea.  If the fucker stabs you in the back, get him (or her if you are a woman) in the parking lot at 10:10 PM some night and knock him around.  When you have his ass sitting on the ground, threaten the fucker.  Threats are nothing, by the way.  Police laugh at you if you think they will investigate a threat.

Does that sound too severe?  Hey, these are desperate times and desperate times call for desperate actions.

Take the time to view this video.  I was an adult man, a practicing pharmacist in 1968.  ”Where have all the flowers gone” is a protest song, an anti-war classic.  In 1968, it affected me profoundly.  In the 21st Century, it caused an icy shudder to vibrate done my spine.

I think of the young men and women who have been killed and maimed in Iraq,  Afghanistan and who knows where else.  But the prevalent image, for me,  is a pharmacist without the spark of possibilities in her eyes.   I can see her and smell her because I have worked right beside her for decades.  She does not groom herself as she did in the beginning.   That was when practicing pharmacy for her was brand and shiny new.  She still believed that she was going to make a difference.  She was going to make a difference.  Her hair was always fashionably done and shampooed regularly.  Her fragrance was an expensive Elizabeth Arden offer called “Green Tea”.

Her eyes were, indeed, bright and sparkling.   I loved working with her (all of them).  They were playful, fun and confident.  When it came time to make a judgment, they were all-business.

New pharmacists, as their careers geared up, knew, with equivocation, that they were the captains of the pharmacy ship.   I hated watching it happen, but I couldn’t miss it.

There came a point when they gave up.  They were like children who were beaten and abused for something a small as spilling the milk.  Women and men!  Their grooming.. well…something was different.   A degrading from the cutting edge to the dull edge.   Everything, almost, had changed from medical professional to a piece work factory worker.   Why buy new slacks?  The khakis I have been wearing for 6 months are fine.  Who cares anyway?  I just want to put in my hours and get the hell out of here alive.

It is the little things that make you cringe.  So many pharmacists have had the spirit beaten right out of them.  I mean beaten out of them.  Some of you can feel it in your shoulders.  Most of you can feel it in your psyche because you know that you are denying everything that you believed in.

I do not have to outline everything because that would be the epitome of redundancy.  You live it every day.  Nobody has to remind you.

So, what do you do now?  I have never advocated unionizing.   I was a member of the Retail Clerks International Association in the 1960s.  I benefited greatly.  Now, in May of 2013, I have changed my mind.

It is time to unionize.  I’m not talking about a sliver of the Restaurant Workers Union or a division of the Teamsters.  I am talking a real pharmacists union.  There already is one.  The Guild of Professional Pharmacists.   I can’t do this for you.  It is up to you.  One or more of you will have to contact the Guild and find out how you do this.  I do not believe that the process is difficult.  A bonus is that once you start the deal with the Department of Labor (I believe) they can’t retaliate.  Your ass is basically protected.

Now, let’s see if there are any Bad Asses willing to come out of hiding and get this shit done.

Let’s see if you are a pharmacist I can trust.   That is all I want to know.  Can I trust you and do you have a set of balls?

Jay Pee

I know that the script size has changed and I will try to find out why.

“The Drug Dealer is the woman.  Blonde, short.  She wears a white coat.  The name tag says “Doctor”.

“Doctor?  Of what?”

“Just get her down and cuffed.  Same goes for her assistant.”

A few weeks ago, before I gave up the ghost, I worked for a major chain.  We were told that our Schedule II orders would be monitored and the quantities may be changed.   Apparently, the DEA is getting scary, after us.   The huge majority of pain prescriptions are legitimate.  There is something very wrong here.

The DEA is behind ALL of this.  Because of what happened in Florida last year, everybody is in fear of losing their license … Wholesalers, Physicians, Pharmacies and Pharmacists.  It is a shame that the DEA has SO MUCH power and SO LITTLE medical and therapeutic knowledge.

I was told in February I had a “threshold”, but no one knew WHAT it was.  In March my CII order of Oxy 30 was HELD (I had to partial fill my clients to get through until my “reset date”) and I started to complain.  I went through a 3 hour audit on April 4th and on April 15th got a call from MXXXXXX SXXXXXX IXXXXXXXX Headquarters asking me to “take the MXXXXXXX SXXXXXXX sign down”.  I was informed that I should be very afraid of the DEA because I “had a target on my back”.

Whatever the gentleman who conducted the audit reported almost cost me my life’s passion and put 12 people out of work.  I have been told the contents of the audit are “confidential”.  My Attorney was not allowed to be present during the audit and wants to pursue this.

We have always had strict policies when it comes to filling CII’s, we only accept commercial insurance (NO CASH, NO DISCOUNT CARDS), we run everyone through the Rx Monitoring Program, we ask the prescribing Physician for a Diagnosis (not just an ICD-9 code, but DETAILED information), Treatment plan and a recent Drug Screen.  Yes, this is a lot of work, but it DOES WORK to eliminate the “frivolous” prescriptions. Not to mention the fact that my Interns and Techs are learning MTM.

I AM DOING MY JOB TO THE BEST OF MY ABILITY AND I STILL GET PUNISHED.  How do I explain that to the Students I precept?

I have stopped accepting any new chronic pain clients … this goes against everything I learned in school.  The Primary Care Physicians won’t prescribe pain medications (I even had an Oncologist tell me he won’t prescribe pain medication for his Stage IV Cancer patient), I’m guessing that goes against everything they learned in school as well.

We ALL need to get together and tell the DEA enough is enough.  There is a VERY EASY solution to this problem if someone would just listen …

Morning JP …

I received a phone call yesterday from Cxxxxxx Hxxxxx informing me that they would no longer be sending me any OXY 15 or 30mg … because I was four times over the National average on prescriptions for these drugs.  He refused to send me any information on those statistics, or even any confirmation that I had been shut off.

Last month I filled 22 OXY 30mg and ZERO OXY 15mg prescriptions.  Less than 4,500 tablets total, and NONE filled for cash … all insurance.

Please compare that with what you filled and tell me whether I’m filling FOUR TIMES more than you … better yet, if you don’t mind, pose the question on your website and let’s find out what the TRUE National average is.

This is WRONG and it’s going to cost me $300 per hour for an Attorney to prove I am in full compliance with the law.  I have never seen anything like this in my 30+ years in Pharmacy …

Thanks for listening,

Some of you will know immediately who this pharmacist is.  She did not indicate either way if I could include her name, so I chose to keep her anonymous.  I have not met a pharmacist with higher standards.   That is in 47 years in the drug store business, since my first job as a high school kid.   Our pharmacist most likely has the goods on this hospital.  Before pharmacy, her job was with OSHA.  She can navigate this territory, but we cannot leave her all alone.  At the very least, give her support.  I’d bet that she could use some high quality legal assistance.  Jay Pee

I find myself starting over yet again.  The hospital gig was going okay – well, until I pointed out to the pharmacy director their practice of receiving unwanted medications from the community was illegal in our state and the meds could not be sent to a reverse distributor (as they have been doing) because they would be considered waste.  I should have just reported it to the board of pharmacy and not said anything to the director, but I was trying to make sure we were compliant.  It was the right thing to do, but has cost me my job.  I was terminated on Friday.  I did report it to the board a couple of weeks ago when yet another person came to the pharmacy to drop off unwanted medications.  I even have an e-mail the director sent me indicating she sent the meds to a reverse distributor for destruction.

I was put in an impossible situation – no tech, working noon until midnight Friday/Saturday/Sunday – with only a couple months of actual training.  I was driving 2 hours daily roundtrip.  I was just a glorified data entry clerk/pharmacy tech – much less than I was promised.  None of the staff were ever really friendly and I didn’t get to really spend much time with other pharmacy staff.  So once I mentioned the unlawful practice, the director began a smear campaign of sorts — tracked every little error, questioned every decision I made, and encouraged nurses to complain about me.  So the reason given for my dismissal was poor performance.  She was not aware, however, that I had entered electronic interventions on errors I corrected that were input by other pharmacists – I was forbidden to keep paper documentation even though it was at the computer terminal inside the pharmacy.  I made no more errors than the veteran pharmacists – I can tell you, I have never been a poor performer.

She called me into HR yesterday.  I had never even met the HR guy and he didn’t want an introduction.  He asked me to sit down and proceeded to tell me my performance was poor and I was being terminated.  I was not allowed to go over anything and I was not asked to sign anything.  I was given a form to apply for unemployment benefits, walked to clean out my locker, and not allowed to speak to anyone.  I did have the satisfaction of telling them for the first time that the illegal practices in the pharmacy had been reported to the board of pharmacy.  Talked with inspector yesterday and she’ll be headed there in a week or so.

I really wanted this to work for me, but today I’m quite relieved in a way – humiliated, but relieved.  I’ve saved enough money in an emergency fund to last a year, but I don’t want to go without employment.  I’m taking a week off and then applying for everything and pounding the pavement and knocking on doors.  Because I had a regular schedule for the last 4 months, I’ve been able to lose 23 pounds and feel much better – still losing as a matter of fact.  Well, I haven’t been very hungry the last couple of days but that will pass.

Whistleblower, yep – but that’s not much help.  I’ve used an audio recorder for all these conversations.  I’m not hopeful any of this will help me.  I know I sleep okay.  I may not have a job, but I still have my pharmacy license.

It IS your party!  If it is turning out to be a stinker, it is your own damn fault.

No one, absolutely no one gets out if their dreams and expectations alive.  But, this is ridiculous.

You expected, at the very least, to be able to respect yourself.  If you are older, like me, there was a template to follow.  You noticed that the drug store owner had a following.  Customers liked him and came to him for advice.

Nowadays, it could not be worse… or could it?  They don’t care who you are, for the most part.  The national organization with the magical name (includes American) has done nothing to enhance pharmacy’s/pharmacist’s public image.  Pharma (before it became just too big) used to advertise how wonderful pharmacists were.  Remember when you were the most trusted professional?  More trusted than the clergy?   Pharma helped to promote that image-builder.  The APhA did absolutely nothing.  I believe that some of the state organizations ran local promotions. Not any more.

Most of us are decades away from pharmacy.  Most of us work in dispensaries.  The difference?  If you do not know, we are doomed.  Actually, you are doomed.  It really does make a difference to me, but if you aren’t willing to man the barricades to defend our profession it will not affect my life.  I am a Florida retired guy.  Remember that?  It has not changed.  However, I am a pharmacist.  I cannot run away.  I want to be proud of what we do, but it isn’t easy.  So many of you are so damaged that you would not behave in a professional manner if you had all the time in the world.  It is like we are all actors and the other players in this drama are all dead.  Big Evil went and burned down the theater.  Can you call what you do practicing pharmacy.  

Victoria and I left Galveston on the 8th of April.  The moving truck arrived at our place in Sarasota on the 10th.  We have been doing all of the moving stuff since, with plenty more to do.  There is a break, however.  Life is reasonably uncluttered.   I don’t feel guilty sitting down and writing this.  Comcast lit us up only 6 days ago.  I have been effectively absent from www.jimplagakis.com since the first week in April.  About three weeks.  There have been numerous messages to jpgakis@hotmail.com.  Many of the usual complainers.  A few sending me stories about Big Evil and Big Stupid.  It seems as if both of these companies are slipping the noose around their necks.  If the writers are actually keeping good records (including official company emails on policies and procedures) Evil and Stupid will take a big hit, probably sooner than later.

In three weeks, I was sent 3 stories of firings.  Each was a female pharmacist 40 years old or older.  They all worked for a chain.  Each of them had earned the maximum number of vacation days allowed.  Two were PICs.  The reasons for their firings were ridiculous.  If these companies fired every single RPh who made these chicken-shit errors,  most of the pharmacies these companies run would be closed most of the time.  All of these pharmacists report that they were replaced by twenty-something RPhs whose starting wage is less than what the fired women were making.  An important question is:  If three pharmacists reported their firing to Jay Pee, how many were fired who did not write to me?  Scary?  What are we going to do about it?

A young pharmacist who is an immigrant from the UK, on a limited VISA, was worried about his Big Stupid job.  His Pharmacy District Manager reprimanded him for refusing to refill an Rx because the patient was using the medicine in a manner not commensurate with dosage.   This pharmacist sought advice from Jay Pee and Pharmacist Steve.  He followed our advice.  Too lengthy a story to write specifics here, but suffice it to say the bottom line.  Big Stupid, at last report, offered him $7,000.00 to settle and promise to not sue them.  He is not sure what he is going to do, but indicated that he is leaning to refusing the offer and suing their ass from here to next January.

Pay attention to this:  He is offering to donate some of the money he will get to The Pharmacy Alliance as seed money for a fund to help out other pharmacists who find themselves in a battle with the Bigs.  TPA was pivotal in his search for a way to defend himself.  A second pharmacist sent an email to jpgakis@hotmail.com offering money for a fund to help defend pharmacists.

My question is:  Is it time for action like this?  Why do I want to spell U N I O N?

It is time for my break, Linda. Be back in an hour..

Victims give me a pain in the ass.  I don’t like people who dramatize their “victimness”.  I don’t like me when I act like a victim.  I have to tell myself, “Snap out of it.  This won’t get you shit.”

If your husband is an asshole and you married down, and you know it, face up to it and do something about it.  I believe that it would be best if you don’t have kids with this guy.  Just save your dignity and do not act like a victim.

That goes for you men, also.  I have been preaching for years, “You date the stripper.  You don’t marry the stripper.”  When your friends ask what work your wife did when you met her you, tell the truth.  It will help you to get out faster.  Claiming that your wife was a dance major is so much haw hee.  Save your dignity, man.

If you are used to getting pushed around at work, stop putting up with it.  The law is your trump card, play it.  We will be discontinuing Internet service on Thursday afternoon.  I’ll come back when we get lit up in Sarasota.  If it is taking too long, I can visit the local library.

Jay Pee In The Day. 1970s. This was on a trip to South Shore, Lake Tahoe. My days off were Sunday and Monday. A bad divorce and bad bills to pay so I was a reprobate, cigarette smoking, Stinger drinking blackjack player. I never gambled. I played the game right and NEVER went home on Monday night without at least $500 more in my pocket than when I drove up after work on Saturday.

Tomorrow, Tuesday 4/2/13, will be my last shift working in a pharmacy. I don’t know what to think of that. Getting off my feet is necessary. I was diagnosed with progressive post-polio muscular atrophy in 1987. I attended a few clinics, but felt like a fraud. Here were people my age in wheelchairs and using canes and crutches. Some of them wore braces. I felt as if everyone was staring at me because I was walking around with seemingly no ill effects. Subsequently, in 2007, I was told by a neurologist who did an electromyogram that I could not hurt myself by working. We were back in a corner laboratory. Him, me and an impressive array of computers. The doctor brewed coffee and we had a cup of laboratory Joe while he inserted 4 inch 18 gauge needles deep into my leg muscles. He had me flex the muscle, and then made notations into the computer. He answered two questions. Victoria had to know if I would ever need a wheelchair. A profound “No”. I had to know if I would hurt myself by working on my feet. “No. You can’t hurt yourself, but you will know when you better hang it up.” That moment came about 18 months ago, during a 1:30 PM to 10:00 PM shift. I came home and announced to my ever lovin’, “I can’t do this much longer”.

That much longer comes at 4:00 PM tomorrow afternoon. Why did I continue to work for 18 more months? We had a place in Sarasota, Florida in mind to be where we ended up. We pulled the trigger on a condo in our dream gated community on the day after Thanksgiving in 2011. It was the bottom of the real estate bubble. It was one half the asking price in 2005. V put some money into it, but it is our forever place. Well worth the investment.

I also continued to work because I enjoyed it. The company that I work for is huge. I get the impression that the separate districts are somewhat autonomous. I doubt if it is this was in every company pharmacy, but I always took a half hour meal break. A real one. I liked to go to Pho 18, a Vietnamese Noodle restaurant around the corner. An absolutely brilliant cup of coffee and a few spring rolls took the place of that ubiquitous Snickers bar and 20 ounce Diet Coke that costs the same as one share of stock of Big Stupid. I ran my personal lunch program. If I had errands or needed to get out a little early, I didn’t take a lunch that day. It is amazing how good a Big Grab of Fritos, a few handfuls of fun-size Kit-Kats taste when you do not have to have that kind of meal.

I was scheduled only to work two days (16 hours) a week. I did plenty of favors and put in extra shifts, but I was part time. I qualified for profit-sharing retirement and a company stock fund. I bailed out of both two weeks ago. I was in both of these for barely 4 years. V is having tile floors put into our condo as I write this. Our forever place remember. This company treated me very well.

It competes with Big Evil and Big Stupid so the Masters of the Universe get all hot and bothered by the usual money-losers. Following the $4.00 prescription jackass is the model. Gift cards for transfers. On and on. There are metrics, but
anyone with sense can handle the metrics.

We can handle all of the bullshit that is killing our industry, because we have to right now. Do not bitch and complain. Say you are going to do it with a smile. Then, do it if you can. There are opposing forces in the industry. There are people with power on our side. You, be a force for change. Did you ever give your kid that candy bar because he whined for it?

The best part of my job has been customer service. Rx counseling and OTC counseling. When I get an OTC question, I never leave it at, “Left side of aisle 9”.
I always go right out front and triage. They tell me their symptoms and, after a few questions, I recommend an OTC product, suggest that they better see a doctor or tell them, “Get your ass to the trauma center right now.” I would rather OTC counsel than Rx counsel. It is what I was trained to do in the 1960s. It was called Counter Prescribing. It was what druggists did. I am proud to be a druggist, man. Pharmacists who are willing to play the role of druggist save our nation billions of dollars a year. Because these people would go to emergency without your triage skills.

So, I am done. Man, I am so relieved. We will be in Sarasota by next Sunday. I will then spend an extended period of time being a retired Florida guy. I will wear short pants and tee shirts. I have a straw Panama hat that looks silly, but it shades my head. I will read a helluva lot, get a small tan and swim. We will eat good food. Drinking superior coffee and reading the papers in the morning cannot be beaten. A glass of wine or a finger of scotch whiskey with V, on our lanai, at sunset is a good way to wind the day down. I will do this until I do not want to do it anymore.

When I want to, I will be coming back and going full-frontal on the culture that has been ruining our business. There is a whole list of them. We can start with the MBA Bean-Counting Masters of the Universe. Continue with Big Evil and what they have done to denigrate an honorable profession. I will intend on being a player in the crusade to get the message that working conditions are killing people to the people with power. Think television investigative reporter.
I will expect you and every one you can get together to join me.

Pelican Cove

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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 commit suicide 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.

Guild anyone?

“Whistleblower” continues to offer his help with employment law.  Why aren’t you contacting him if you have been terminated unfairly?  Is it because you do not know how to contact him?

I found this message in the comments.  Paul Garbarini is a Boston Lawyer on the faculty at Northeastern College of Pharmacy.  (I believe that is current) He has been Legal Counsel for The Pharmacy Alliance since the beginning.

The Truth-

Contact me at 413-727-8191 regarding your desire to file a complaint with a BOP.

Paul Garbarini, R.Ph, Esq.

It is all out there, you guys.  What was the quote from revolutionary times?  We either all hang together or we will certainly hang separately.  Jay Pee

There are so many places to hide in the darkness.  Only a short while ago, the bad players in our industry could do evil things and get away with it because nobody could see what was happening.   They could break and bend pharmacy laws and regulations with no consequences.  They could mistreat pharmacists and technicians and it wasn’t noticed.   Then, a young man from the UK who works for Big Stupid in Oregon joined The Pharmacy Alliance and asked PharmacistSteve and Jay Pee for advice.  His DM RPh was working him over.  He took our advice.  He followed our recommendations to the letter and now, after a Starbucks evening meeting with someone from Human Relations, it looks as if the DM RPh has her ass in a sling.   If she is lucky, she will find herself in a store behind the counter, making the metrics right beside you.  Most likely, though,  she will be out looking for a job.  The power of documentation, clear and concise communication, knowing the laws and regulations, complying with those laws and calling the DM out when she insisted that he cut corners.  The Oregon Board sent her a letter for correction and reprimand.  Our friend from the UK, I believe, is untouchable.   My advice, first Join TPA. then, as a member, take advantage of the TPA network, ask the advice of experts.  TPA has legal counsel who is a pharmacist/attorney on the faculty of Northeastern College of Pharmacy.   When  you have issues with Big Evil, follow the simple steps. You know, we have been beating our brains out about this and I don’t think I feel like giving too many freebees.  Really, pharmacists have proven to be cheap and a shade of yellow that is not appealing.  Take my advice.

Last evening, Pharmacist Steve and Jay Pee spent close to a half hour on the telephone.  The question we discussed was: What is wrong with these people?  They hold all of the Aces of Trump and they rarely used them.  Our TPA colleague in Oregon  used his trump cards and he is clearly the winner.  Unless he does something really stupid, they will leave him alone.  The Federal Government will destroy Big Stupid with the first scent of retaliation.

Steve and I discussed dumfoundedness (Is that a real word?) at the thousands of colleagues who are complaining all by themselves.  You can get together here or at Steve’s blog.  There are attorneys involved.  The Federal Government is involved.  The Wall Street Journal wants to be involved.  The WSJ has to have verifiable stories with names, dates and the laws that are being broken or the harm that has been done to patients due to the working conditions.  The Metrics = errors.  Death, man.  I am talking over-worked, over-tired, ill-fed, ill-hydrated, scattered, trying-to-make-metrics-and-the-patient-be-damned Killing People.

How many times do you think that the niece and nephew of Aunt Maggie go to her house when the phone is not answered.  Of course, she is dead.  Flopped into an unnatural posture on the floor.  One arm underneath her, one leg still on the sofa.  Her eyes open in a scream.  Her mouth gaping.  Her hands tightened into fists.  She had wet herself.

“I sure wasn’t expecting this, Marie.  She was doing so well.  Laughing and joking at the holiday dinner table just last Sunday.”

“Well, she was old, Tommy.  She was frail.”

“Eighty years is not old, especially with modern medicine and drugs.”

They don’t even think about the prescription bottle in the medicine cabinet in the bathroom.  It had been filled at Big Evil at 8:50 PM two days ago, by a young, hypoglycemic female pharmacist.  No technician after 8:30 PM.  No cashier help.  The out-front supervisor did not care shit one that the young pharmacist was on the verge of crying.  The waiting time was 45 minutes.  The metric battle had been lost hours ago.  Still, she rushed, made an error and the patient died within 30 minutes of the first dose.

Nobody will know.  The pharmacist will not know.  Marie and Tommy won’t know.  The pill bottle will be discarded with every other bottle ihn the medicine cabinet.

We  need a concerted and coordinated effort.  We are in a war.  A frontal charge would be stupid.  We need to fight as guerrilas, in the night.  The Internet is our flood light into the darkness.

Let’s use thepharmacyalliance@hotmail.com as a central place to collect information.  Steve and I will monitor it regularly.  Please DOCUMENT.  Give us everything.  The details.  Time, place, names and what has happened.  Please be courageous and give us your real name and contact information.  You will remain anonymous until you choose to stand up.

There’s are our girls.  Well-fed, well-rested, dignified and  focused on what is right.  You fat guys at Big Evil, watch out, “your ass is grass”.

Pharmacists put out a helluva lot of money to the organization that owns this building.  When was the last time you left the store for a real, uninterrupted meal break?  How many of you still write a check every year?  

The following was written for the website of The Pharmacy Alliance

There have been a number of pharmacists lately criticizing, belittling and demeaning The Pharmacy Alliance.

They attack, claiming that the website is ill-maintained.  That is true.  I offer any of you who want it, the title of Website Manager for The Pharmacy Alliance.   Of course, I doubt that any of you will volunteer.  Very few of our members are willing to do anything other than pay the dues… one time.   At least the members aren’t rubbing their hands together after they have written an email to me telling that the organization is just a piece of shit because we are not leading the way in anything.

Really?  What have you done to bring the pathetic and dangerous working conditions to the light of day?  What have you done to make known to the public just how dangerous it is to have an exhausted pharmacist handle prescriptions at hour 13 of a 14 hour day?

It is no secret that TPA is not the A.Ph.A.  The A.Ph.A. is huge and it is said nothing that has helped you to get a meal break.  The organization with the magic name sort of smiles when called out.  David Stanley nailed the A.Ph.A. in one of his first Drug Topics columns.  A new pharmacist had written to him, complaining about the lack of help, long hours and errors.

A.Ph.A. CEO Thomas E. Menighan blew all of us in a letter to David.

“I certainly feel for the situation,” he said, “If someone is feeling beaten by the ‘system’, no one can say they are wrong.  He then quickly changed the subject to M.T.M. and flu shots.  He actually wrote the high sounding stuff about, ‘Improving medication use and advancing patient care’.  ( and they have the nerve to put the words American and Pharmacists in their title) He went on, “We have members on all sides of this equation.  Our challenge as a membership is to unify”.

What is the equation?   Org + RPh = ZERO?

What makes the A.Ph.A. different from The Pharmacy Alliance?  TPA does not blow smoke, take in millions of dollars and still does nothing.

We are a tiny, little group of pharmacists who want to make a difference.  Our only mission is to return Dignity, Self-Respect and Integrity to the job of working in a pharmacy.   What is so wrong with that?  How does that make us a piece of shit?  Tell me why I have been stupid since November, 2007?   That is going on six years of abiding faith that you guys will eventually decide to get on board and get this done.  Perhaps I am just a dreamer.  I am getting tired with so little help.

Here is what we do with the members money.

We pay expenses and that is not very much.

Every other dollar, as long as it lasts, is to pay for these per diem expenses to any member who will personally attend a meeting (best one on one) with a state legislator, state board member, a journalist or (best of all) an investigative reporter who is likely to blow the top off the charade that is what some companies present as a patient-centric business.

TPA will reimburse.

One night hotel room at a reasonable rate.

Two meals

Gas money

That is the best we can do right now.  For you who have to try to take down any and all honest efforts, the conditions you work under are on you.   Don’t whine to me, or Peon, or Goose and you know the rest of the names.

 Jim Plagakis, Founding Member of The Pharmacy Alliance.

I had a long telephone talk with a pharmacist who was summarily terminated by a chain on very flimsy evidence under really difficult circumstances.  Divorcing your technician and continuing to work with her is not a good idea.  We all make mistakes.  This, however, begs the questions:  Who was she fucking?  The written story below is, indeed, an abbreviated version.  A higher management person with this chain was an ex-member (I believe he said president) of the State Board of Pharmacy.  0.029%?  How many of you have had a beer at noon with the cold pizza from the night before when you were due at work at 2:00 PM?  This is not a predominant Islamic culture.  A drink is allowed.  Many years ago, I had a 12 ounce glass of beer at a restaurant with my lunch during my one hour lunch period.  I did not go back to the pharmacy for two hours.  I knew better.  Never again.  Since we had only one pharmacist for the day, I lied.  Told the store manager to consider himself lucky.  I was sick to my stomach and was tempted to just take the rest of the day off.  

I did not even ask our colleague if he had a toddy a couple hours before his shift.  As he said, an airline pilot is not dinged until 0.04%.  He is getting a royal hosing here.  The chain probably had been planning on getting rid of him.  Apparently, the technician is the one who “turned him in”.  Wife, divorce, custody battle!  Soap opera.  How did she get so close to management?  Was it a set up?  I keep circling back to a quick grope and rustling of clothing and quickened breathing in the manager’s office going way back, while the pharmacist (husband) was holding down the fort in the pharmacy.  Just like many of us:  A hard working, loyal dumb rat.

This pharmacist is in West Virginia now, living there and looking for more dependable work.  Those of you in West Virginia (or who have contacts there) let’s give him a hand.  You may not have a job, but you may have a lead for him.  It would be generous to share your network with him, give him an introduction into the West Virginia pharmacy culture.

I have his contact information.  Get in touch with me at jpgakis@hotmail.com and I will hook you up.

Jay Pee

This is a brief synopsis of my story.

My pharmacy license was suspended due to accusations of alcohol abuse. Alleged event occurred in 12/2011. I was told that my PBT (preliminary breath test) registered .029 %. This occurred as I was summoned to take a random drug test on my way in to work that day. At the time, my now ex-wife, with whom I was going through a divorce and child custody case worked at the same location (as a pharmacy technician). I asked for, but was not allowed to prove my innocence through a much more definitive BLOOD ALCOHOL TEST.

I was terminated and have since been referred to the state board of pharmacy which has subsequently suspended my license. I have been in pharmacy practice since 1997, and have never had a problem prior to this.

I have retained an attorney and also have a brother who has been a trooper with the state police for 20 + years. Both have acknowledged that PBT’s have a margin of error, for many potential reasons, and therefore must be followed up with a more definitive test. Also, please understand, even airline pilots do not face disciplinary action with a blood alcohol content of less than .04. Higher than what I have been accused of. Furthermore, no accusation of any misuse of drugs (prescription or illicit) has ever been placed against me, as I have never had a positive drug screen at any point in my career. Has anyone ever been through a similar situation or have any advice for me?

In addition, I have complied with every stipulation that the board of pharmacy has asked me to do. I have seen many health care/mental health/substance abuse professionals and all agree that there is no problem and that I am more than fit to practice pharmacy.

Should I just say the hell with it and get out of this rat bastard profession, after all the years and sacrifice ???

March 5, 2013, 12:42 pm

Ask Well: Can Weather Affect Mail Order Drugs?

Many of you have figured out where I work two days a week.  I am not going to publish that information yet.  When the sale of one of our two houses closes, we will be gone.  For weeks, I will be a Florida retired guy.  I will wear shorts and get my hair cut when I want to.  Good coffee in the morning with the papers.  A scotch whiskey in the evening with Victoria.  My Kindle, a table in the shade at the pool I like the most in the afternoon.  I’ll take a bucket of ice and a jumbo Diet Coke.  That is all I am going to do for weeks.  My ambitions and a project will wait.

The company I have worked for treats their people very well, I believe.  I am only in one spot, but I watched as a marginal, very slow older pharmacist was coached multiple times.  I believed that he was a lost cause, but, the last I heard, he was still working.  A pharmacy manager in his early 30s, was a lost cause.  Really incompetent as a manager and not that good as a robo-dispenser.  After 4 years of coaching and correcting, he was asked to step down.  As far as I know, he is still working.

Then we have Big Evil, Big Stupid and here comes Wal-Mart.

Hello,
I was a female Pharmacy manager, just turned 52, who was just recently
fired from Wal-Mart for a “Policy violation”. I worked in Flint MI. at
a Sam’s club for 7 years as the PIC. I Built the business on strong
trusting customer relationships. I was always there for my patients,
and my business grew.

I took pride in the customer service I gave. I was happy, loved my
job. Loved my co-workers. I would have done anything for Sam’s. I
literally would bend over backwards to help out my company.

Then, Feb 20th 2013, at 7pm right after my shift… My Pharmacy DM
showed up, with someone I had never seen before, he said, after you
close the pharmacy, you need to come and talk about a previous issue
in the pharmacy.. I said OK….then at 7pm I closed and I was taken
into the Office by my Pharmacy Supervisor, and the stranger from loss
prevention… and told I was terminated. Stone faced, inhuman,
uncaring, no explanation except for a “you left the Pharmacy from
5:38pm to 6:30 pm on 1/23/2013″. I said that doesn’t sound like me. I
would never just leave and go out in the store and waste time….
Where did I go? I am aware I am on 27 billion cameras within the club.
They would not answer me. I tried think back. Why would I do this?
Well, while I was sitting there stunned and blind sided .. I said to
them, I must have been doing CBL’s, in this very office.. It was
coming back to me. …It was a very cold sub zero week in Michigan
during January. I used the time of quiet to go do a learning module
that was late. I left my Tech in the pharmacy while I kept running
next door to click through the modules. I remember I kept coming out
and checking on her, She kept saying she was fine, no customers. Don’t
worry, all is fine. so I finished my modules. Little did I know, I was
putting the Death Nail in my Career with Sam’s. I thought I was using
my time wisely, getting things done, being efficient, as I NEVER have
time to get these Learning modules done. The modules don’t run on the
Pharmacy PC’s. So I have to do them on a different computer.
(by the way, these modules talk so much on discrimination, for age,
race, gender, etc.) How Ironic! I’m Female, and 52! The Male Rphs do
the same thing with no repercussions! The “Policy” has never been
enforced in my entire career with Wal-Mart as far as I know.. My male
co-worker were shocked. one told me he is shaking…physically shaking
right now ….because he leaves the pharmacy too!. and he hoped they
were not watching the cameras on him!

I had no Idea I was doing anything wrong..

So, I was in oblivion about the over supply of Rphs and how
frustrating the RPh job search can be… I am now trying to find
employment. I just have a BS in Pharmacy, no Pharm D…

I stumbled across your web-site because I was looking for Pharmacist’s
fired from Wal-mart, and looking to see if I had a discrimination
case. I have been learning so much about Pharmacist’s my age being
killed off.
The thing is in my district area, Wal-Mart doesn’t fire the older men.
I was the oldest female they had.. as far as I know…..It is quite
fishy, as Wal-Mart called me and told me I am rehire able, but must
wait a year. they also admitted to me in a phone conversation, they
know my “Intent” was not bad..and they did not want to let me go. ???
They also admitted they took this up as far at the Wal-mart Vice
president of operations, and the Sam’s Vice president of operations…
both divisions…so strange….