Wednesday, April 16, 2014

An Ethical Dilemma.

So, let's say one day you're on the road and your baby starts to come down with a cold. And you, the master of all things pharmaceutical, know exactly what product to get to relieve her suffering. Unfortunately, the only place that seems to carry the product to help the woman you love is an outlet of a certain chain drugstore. A chain you're very familiar with. A chain you used to work for. A chain with whom your association did not end well. This leads to quite the dilemma indeed. Namely... you stuff the product in your right or left coat pocket before you walk out the door?  I went with left, but something tells me right is the proper protocol in these situations.  

Monday, April 14, 2014

From The "Someone Couldn't Afford Their Abilify" File

An actual comment just zapped to the email box. Completely unedited.

All pharmacists r murderers plain as that the antidepressants the barium drinks for upper and lower gi they know what's in that stuff they r like the nazis just following orders i call them murderers to thier faces traitors to humanity the nerve of killers acting like birth control is the issue also old dictionary says its witchcraft

I want a copy of that old dictionary. I have a feeling the way to get it involves eating mushrooms or something though.

Sunday, April 13, 2014

I Come To The Aid Of Every Hospital Administrator In The Country

Dear Bean Counter,

So, it's the dawn of a new healthcare era. Changes.....big changes coming down the pike. Paradigms to be reworked, strategic innovations to be thought of, or is that innovative disruptions you're so excited about? You MBA types are hard to keep track of with your business speak sometimes, but for this hillbilly pharmacist with a simple Bachelor's Degree, a lot of the new health care world seems to boil down to this:

The people that pay the bills are finally starting to give a shit about quality of care, and not just quantity.

Take Medicare for instance. The part of our health care system that actually is government run has decided it's tired of paying you extra when people you discharge as healthy end right back up in the hospital in less than a month. Stupid bureaucrats. They should understand that as long as a person's patched up when you roll them out the door that's all they really can expect of you, right? Yet here they are gonna start taking money away from you when these inconsiderate sick people get themselves readmitted.

What's a Master of The Universe business school grad to do? After all, real money is on the line here. During the first year of this government intrusion into how you spend its money, over 2,200 hospitals paid over $280 million in penalties.

I know the challenge seems insurmountable, but you know what? I'm here to help. Let me put on my consultant's hat and see what I can come up with.

You really can't think of anything to lower the rate of readmission? Seriously?  Well.....


Every pharmacy in the country has a story about the Friday night customer who comes in with their Dad who's just had a heart attack sitting in the car and a prescription for some obscure med that no pharmacy in a hundred miles is gonna have on the shelf.

So, Einstein, you know how the pharmacy at your hospital doesn't get deliveries on weekends? Works the same way in the world outside your place. Which means you just fucked 'ol grandpa sitting out there in his Buick. Because Dr. Dumbass, IF you can figure out who he is based on the scrawl at the bottom of the prescription, makes himself unavailable after his shift, and the doctor there now, IF you can even get through, has no idea what's up with grandpa's case. The most likely scenario here is that grandpa's gonna wait until Monday to get his meds. Because you're a stupid fuck whose drug knowledge comes from ads in journals and sales reps expert in the art of flirting.

Bystolic? Seriously? You know what the word "Bystolic" means in English? It means "I hope you like applying for prior authorizations dipshit, because every insurance company seems to know what you don't. This drug is overpriced bullshit"

Livalo, translated from the Latin, can loosely be interpreted as "I hate my patient and am hoping to drown him in red tape"

Again, that's when the numbnut who wrote for this garbage is even around to inform him he gave birth to a paperwork baby.

So, beancounter, you wanna lower your readmission rate? Put in a night cabinet. Remember those? You did away with them when the insurance companies cracked down on your practice of using them as obscene profit centers. But now, even though you wouldn't be able to charge $10 for a Tylenol tablet anymore, making sure every discharged patient had enough meds to get them through a weekend would go a long way towards making sure you're not contributing to that $280 million I mentioned earlier.

Not to mention it would train those brain dead docs you have staffing your ER. 'Cause ain't no night cabinet gonna be stocked with Dexilant. We both know that, don't we?

Look at me, just saved you smarty pants people a lot of money I did. even without knowledge of your strategic initiatives to promote people's passion in the workplace. Just used a little common sense, which in your world is far from common. No need to thank me or even pay your e-consultant here. This one's on me.

Just be aware, the next time someone brings me a Dynacirc prescription on a Saturday morning, it gets shoved up your ass.

And then Medicare will come take your money.

Now go try to do something useful.

Saturday, March 22, 2014

I Entertain The Thought Of Renewing My Past Fruitful Business Relationship With Rite Aid.

An actual postcard that showed up in my mailbox awhile back:

It wasn't enough that I sent that back to them along with my wish that they have intercourse with themselves. A couple weeks later they followed up with this gem.

I guess I just wasn't clear enough with my first letter. I'll try again.

Dear Asshole:

Nice job leading off with the Obamacare stuff. Totally original idea trying to instill fear in people by spreading bullshit about the Affordable Care Act  But it's not bullshit you say? Then let me ask you this...

What's your company's plan for dealing with this apparently apocalyptic scenario? (Revenues down by as much as 0.4%!!!!) After all, while I have 1 store, you have over 5,000  nearly 4,600 of them. So whatever catastrophic impact is coming down the pike is gonna be 4,600 times worse for you. So I bet you have a plan. Right?


Because in your annual report, you don't seem to talk about it much. Just a quick little mention in the section where you're legally required to warn investors about every little thing that could possibly go wrong with your business. You seem far more worried about something called the Coutu family. Man those people seem to scare the shit out of you. I think I like the Coutu family.

Anyway, let's move on and see what else you have to say here.

"Due to our highly-regarded reputation in the retail pharmacy business...." 

BWWWWWAAAAAAAHHHHAAAHAHHAAAHHHAAAHHAAAAAAAA!!!! Seriously? Highly regarded by whom exactly? Crackheads who know you stock the yellow Norco and pressure your pharmacists to fill inappropriate controlled prescriptions? I didn't realize many of those guys had jobs as Wall Street analysts. Or even jobs.

"As you can imagine, it has been a 'Win-Win" situation for everyone involved" 

No, I can't imagine that.

"If you are interested in exploring this opportunity to utilize your professional training, skills, and expertise, please contact me...."

Did you know I once told 35 people where the bathroom was in one of your stores in a single hour? I don't blame them, as (shoplifters take note of what I'm about to say) you really can't find anyone else working in one of your places. I do blame you though for the respect you showed our professional training, skills, and expertise by implementing that 3 prescriptions in 15 minutes guarantee. Seriously, if you can't come up with any good ideas of your own, stealing from a failed Domino's publicity stunt (that got them sued) isn't the best alternative.

And I didn't even mention the coupon book giveaway with every flu shot. The dog food in there was a nice professional touch.

So, sorry to break your heart, but the answer's no. I'll take my chances in the post Obamacare pharmacy calamity picture you paint, and if it all goes to shit next year, that'll be at least one year where I get to maintain my dignity, self-respect, and professional judgment. Which is more than I ever had when I was associated with your organization. The fact I couldn't wear a colored dress shirt because it showed right through your paper thin company issued "lab coats" says it all really.

And if by some chance I do manage to survive the coming disaster, when the time comes for me to retire to that great pill room in the sky and pass on my legacy, I will find a deserving kid just out of college and GIVE my life's work to them before I will ever allow you to put a hand on it. The people of this town have been too good to me for me to subject them to your standard of "service"

There isn't enough money in the world.
Never write back.
Fuck off.



Wednesday, March 12, 2014

It's My Artificial Self's Birthday, And You Get The Present.

One year ago today I formed my corporation and took the first step away from corporate servitude.

What better way to celebrate my independence than to spread the word of what my last life was like. Because I gotta tell you my friends, since I got away from the chains it feels like I've been born again.

Anyway, to celebrate, the Kindle version of my awesome first book is half price through 11:00 P.M. Pacific Time, March 14th.

Go here to get your bargain book, and immerse yourself in the world I've left behind.

Saturday, March 01, 2014

I Explain The Country's Continuing Race Problem In A Way Even A Numbnut Should Be Able To Understand.

Oh man I can hear it now. I just admitted the existence of a race problem in this country, which means legions of angry middle aged white men just went ballistic. Quickest way to get a middle aged white guy riled up is to say even a trace of racism still lingers in this nation. They will huff and puff and yell and scream about Obama (we'll get to him in a second), about African-American NFL coaches and bosses at their work. The smarter ones might even realize there is a sitting African-American Supreme Court Justice, along with two of the last four Secretaries of State. That's it. Case closed.

Not so fast. You could write more than a few books on what's still not right about race relations in this country, but I'll throw two things out at you that oughta make it crystal clear. First, from the world of the criminal justice system:

Rap lyrics and videos are turning up as evidence in courtrooms across the country with alarming regularity. Last year, the American Civil Liberties Union of New Jersey found that in 18 cases in which various courts considered the admissibility of rap as evidence, the lyrics were allowed nearly 80 percent of the time.

And I turned twenty-one in prison doing life without parole/No one could steer me right but mama tried, mama tried.....

Ladies and Gentleman of the jury, as you can hear with your own ears, Merle Haggard clearly planned from the beginning a life of homicidal mayhem. Under the law you have no choice but to find him guilty.

And do I dare bring up the authority's negligence in allowing Johnny Cash to die of old age a free man after his confessions of not only shooting a man for no other reason than to watch him die, but to the brutal stabbing death of a beautiful young woman.

I plunged a knife into her breast/And told her she was going to rest/She cried "Oh Willy, don't murder me/I'm not prepared for eternity."

I took her by her golden curls/I drug her down to the river-side/An I there threw her in to drown/And I watched her as she floated down

Not to mention the drug use:

Early one mornin' while makin' the rounds/I took a shot of cocaine and I shot my woman down...

Merle and Johnny could write whatever they wanted knowing that to use their lyrics against them in a court of law would be ridiculous. Yet entering a rapper's words into evidence works about 8 in 10 times.

Do you see now how more than an African-American on the Supreme Court might be needed to ensure all people are treated fairly by the judicial system?

Let's stay in the world of music for a second. Remember when Paul Ryan told the world Rage Against The Machine was his favorite band? Most people who had a reaction at all just kinda chuckled, "ha ha...that silly guy listens to hard rock"

But......let's take a look at a few of the lyrics the man who was nominated to be Vice-President of the United States says he enjoys:

Bam! Here's the plan/Mother-FUCK Uncle Sam... 

The present curriculum, I put my FIST in 'em!/Eurocentric, every last one of 'em/See right through the red, white and blue disguise/With lecture I puncture the STRUCTURE of lies! 

What? The land of the free?/Whoever told you that is your enemy

And that's just the start. There's plenty more where those came from.

Now Paul Ryan is free to listen to whatever he wants, I love Rage myself. But I want you to think about something....

What if it had been Barack Obama that said this was one of his favorite bands? You think that would have flown under the radar of the nation? Or do you think maybe Sean Hannity, his friend O'Reilly and the rest of the Fox News goons would have shouted fear into the heart of every white heart over 50 until they were red in the face and foaming at the mouth?

Fox News host Bill O’Reilly told White House adviser Valerie Jarrett that the Obama administration has to enlist the help of “gangsta rappers” if it really wants to help young men of color. 
“You are going to have to get people like Jay-Z, all right, Kanye West, all of these gangsta rappers to knock it off. That’s number one,” said O’Reilly, who attended the launch of President Barack Obama’s “My Brother’s Keeper” initiative Thursday.

That actually came from yesterday's news. Guess we have our answer.

So my friends, the day Barack Obama is as free to talk about the music he listens to as Paul Ryan, the day young rappers have the same artistic freedom as old cowboys, we may....may be able to start thinking about a post-racial society. But he's not, and they're not. So there is still a race problem in this country, and I for one will not rest until every bloodthirsty redneck is in a cage where he belongs. Here is all the evidence you need:

Saturday, February 22, 2014

It's Not The Way The Pharmacist Defended A Mistake By Saying "Well, You Know, They Both Begin With H." That Bothers Me The Most About This Story.

...even though that's bad enough. I'm ahead of myself here though, so let me back up a little.

The pharmacist really did say that. Through the magic of the internets, let's go to the entirely appropriately named town of Surprise, Arizona to get the whole story:

Sparling received a call from Walgreens to inform her that she was given the wrong medicine for one of her prescriptions. She was given blood pressure medication instead of the pills to treat her hives. "She goes, 'Well, we probably couldn't read the doctor's handwriting.' Then I said, 'Well, I know that that's not possible because the prescription was printed out,” Sparling recounted. “She kind of paused and said, 'Well, you know, they both begin with H.’"

Did you know that pharmacies used to file old prescriptions in big steel boxes? Seriously. I just bought a boatload of pharmacy antiques to decorate my store and the prescription file boxes that came probably could withstand a nuclear explosion. That's how seriously we used to take the responsibility of being trusted with the chemicals people needed to live. Now we just wrap a slightly thicker piece of paper around a bundle of a hundred prescriptions and throw them in a drawer. Some stores I've seen didn't even do that. And evidently still others feel getting the first letter of a drug name right counts as a good enough effort.

But that's not what bothers me most about this. Don't get me wrong, that was a dumbass thing to say and it bothers me, but not as much as this:

Phil Caruso, Walgreens spokesperson, issued a statement to KPHO that reads, "We're sorry this occurred and we apologized to the patient. We have a multistep prescription filling process with numerous safety checks in each step to reduce the chance of human error.

And I'm supposed to feel better about this now? Let me explain something to you Mr. Walgrrens hack, if you do indeed have a "multistep prescription filling process with numerous safety checks" you now look even STUPIDER. Because, and follow me here, a GOOD process with FUNCTIONAL safety checks would PREVENT someone only concerned about the first letter of a drug's name from getting prescriptions out the door.

Got me? I'll go over that again. The object of a safety check is to make a mistake less likely to happen. So, you see,  when a boneheaded move like this manages to get through your "multistep process"  that's maybe a sign your process sucks. Trying to impress us with the fact you have a process will not work, because the whole thing the process is designed to prevent  JUST HAPPENED.

Or you know what? Maybe it will work. Because people used to expect more from their drug store back in the age of the indestructible prescription file. I'm starting to get a feeling this night...that they probably expected more from corporate spokespeople as well.

Sunday, February 16, 2014

Tonight, The 3rd In Our Series Of Pharmacy Debates. Customers Or Patients? The APhA Takes On Rite Aid.

Good evening ladies and gentlemen, and welcome to the latest in our series of debates covering all things pharmaceutical. I think we can all agree that the only constant in our profession is change, and that in the last generation the changes in pharmacy have been tremendous. It is hard to believe that in today's world of pharmacy residencies, MTM, provider status in California, and our role on the front lines of vaccination, that there was a time, and not that long ago, when pharmacies weren't even required to keep a permanent patient profile.

Or is that a customer profile? That is our question tonight as one of the largest pharmacy operators in the country takes on The American Pharmacists Association over the question, "The people we serve, patients or customers?"

First off, let me say Rite Aid, it takes a certain amount of courage for you to even show up here. I mean, even when I was back in college, it was pretty universal to refer to those on the other side of our counter as "patients." I can remember the quickest way to get some APhA nerd's boxers in a bunch would be to either use the word "customer." or "retail pharmacy," yet here you are, right here on stage with the most powerful professional pharmacy organization in the country.after contending in a court of law in Landay v Rite Aid that the people you fill prescriptions for are most certainly customers.

"Power is relative Drugmonkey. That will be the lesson in this little exercise"

I see, well, I'm sure the people at APhA are champing at the bit to get their point of view in here, so without further delay....Hm, I see there are two people at the APhA table, I was only expecting a PR representative, who are you sir?

"Saul Goldenstein, chief counsel for the organization"

"But...this isn't any kind of legal proceeding, it's just an informal.... "


"Very well.....would you like to make an opening statement?"

Mr. Goldenstein whispers intently into the APhA official's ear for 15 seconds, which is followed by another minute of silence"

"We cannot comment on an ongoing court case."*

Really? A company goes against the very essence of what you've been preaching for over 20 years and you just plan to sit there like a bump on a log?

"Well we think that while it's important..."

The man from Rite Aid now clears his throat loudly and glares


"Sigh, well I'm not totally surprised. Why don't I just go ahead and go over the basic facts of the case to bring our audience up to speed. Rite Aid had a policy of charging $50 a page for a person's prescription records, and was subsequently sued by someone who claimed that this was in violation of Pennsylvania state law, which sets the amount a patient can be charged for their own medical records. Rite Aid then countered that people who seek the services of a pharmacist are not patients, but customers"

"So let me just ask, really Rite Aid man? Did you seriously say that?"

Silence.....punctuated with a steely glare is the only response.  

Well, no need to answer, as the court documents I have in my hand are crystal clear. You know what else I have in my hand? A press release from September 2010 where you used the word "patient" to describe the people you serve twelve times. Twelve. So, which is it? Maybe we should have scheduled this debate with your PR people, as they seem do be doing a better job of opposing you than APhA."

A loud chorus of laughter engulfs the auditorium


" already blew that wad man. You can't do that twice. Whatever power you have over APhA, you got none over me anymore."


"And for that you have my eternal gratitude. APhA, are you sure there's nothing you'd like to say here?"

"Know your medicine, know your pharmacist!!"

"OK....well I think the conclusion of tonight's debate could not be more obvious. Thank you again Rite Aid, for coming here tonight and proving what most of us could never have believed. APhA continues to find ways to become more and more useless. I can only wonder at what they will do next. Any response to this at all APhA?"

"Is it time for a handshake picture now?"


*that's what they actually said on their Twitter feed, days after saying this issue would be "huge" 

Thursday, February 06, 2014

CVS Makes A Paradigm-Shifting, Disruptively Innovative, Strategically Focused Business Decision. Then Wows The World With Its Modesty.

WOONSOCKET, RI- In a major announcement seemingly sent simultaneously to every media outlet in the world, leading pharmacy operator CVS unveiled a bold decision unlike anything it or any other drugstore operator has tried in living memory.

Actually doing the right thing for once.

The operator of over 7,000 pharmacies and possible spawn of Satan announced it would phase out the sale of tobacco products in its stores over the next eight months, leading almost no one to ask "Why the hell was a company that claims to be a health care leader selling tobacco in the first place?"

Instead, the company that has, among other things,  fought multiple accusations of Medicare/Medicaid fraud, violates the intent of the North Carolina Board of Pharmacy's labor standards with impunity, once dispensed multiple prescriptions written for children's flouride with an anti-cancer drug, and was caught employing a fake pharmacist when someone finally bothered to do a routine license check has been treated like it won the Nobel Peace Prize or something.

"You don't get a cookie for doing what you're supposed to do!!" comedian Chris Rock once said in his act. But evidently he was very wrong, as everyone from the AMA to anti-cancer groups to the president of the United States has lined up to present cookies of all flavors to the drug chain that recently finished tied for last place in Consumer Reports ranking of pharmacies.

Hopefully they were low fat cookies. Not the kind that CVS sells.

"This is a wonderful way to distract attention from the ways in which our company falls short......" said CVS President and CEO Larry Merlo before a lawyer started whispering in his ear. "I mean, I'm proud that we're able to finally set an example for ethical business practices and make those fuckers at Walgreen's look like, and do the right thing."

"I'd like the word 'finally' struck from the record" the lawyer then added.

Asked if the company might now look for other ways in which it could actually do the right thing, Merlo was noncommittal, but did say, "This one is gonna cost us two billion dollars, so you can probably guess. Right now we'll just savor the fact we actually  one time took into consideration the possibility that we might want to live up to the image we like to project."

"After all,"  he concluded, "that's a claim no other drug chain can make."