Wednesday, October 28, 2009

I Was Going To Write Today About How UPS Went Out Of Business.

.......but the people at the blog review site iwillfuckingtearyouapart seem to think I'm turning into a one-trick health care reform pony of late, and they might have a point. So if you used the Post Office today to send or receive mail I'll leave it to you to figure out the gist of what I was going to say about the public health insurance option. I'll also point out that far from going out of business, UPS, which competes with the Post Office, made a $3 billion profit last year.

This post isn't about the public health insurance option though. This post is about me giving you something. I'd like to give you my right to marry. Seriously. I doubt I'm gonna need it again. I already exercised it once a long time ago on what seems like another planet with a woman I knew I didn't love and ripped it and her to shreds. Screwed it up so much that short of wiping my ass with the marriage license I'm not sure what else I could have done to disrespect the institution more. We don't need to get into the details here, yet me, Elizabeth Taylor, and Britney Spears are all free to make another legally binding "lifetime" commitment any time we'd like. On a total whim if we want. And I'll bet you two of the three of us will take advantage of that again before we're dead. Not me though. I don't deserve the right, and cannot get rid of it, and if you're gay or lesbian, no matter how hard you've fought or how deeply you have loved to this point, you most likely do not have the right.

I'm not the only one who sees something wrong with this picture I hope.

So if you're some big shot, smarty-pants lawyer and you can figure out a way to transfer my abused and unwanted right to someone who will treasure it, and their partner, the way rights and partners should be treasured, let me know. I'll sign the consent forms. Short of that, you could lend some support to protectmaineequality.org, and light a candle against the darkness of those that would take away the right of marriage in one of the few places where loving gay and lesbian couples currently have it.

They deserve it more than I do, and the fact I put "lifetime" in quotes up there and it didn't surprise a single one of you shows they deserve it more than most of the rest of society as well.

I'll be rooting for every gay and lesbian person in the state of Maine, and love, on Election Day.

Monday, October 26, 2009

Once Again, It Takes Until Monday Night Before I Can Bear To Recall Friday's Pill Counting Highlights.

We have a floater tech that makes her way to the happy pill room every once in awhile, and by "every once in awhile," I mean twice in almost 4 years. My employer's usual reaction to one of our technicians going on vacation or being out sick would be translated from corporatespeak as roughly, "tough shit." We are expected to muddle through the day short staffed and magically fill the same amount of prescriptions in the same amount of time. And the corporates wonder why I long ago stopped listening to any critiques they may have of my performance. This day though, we had Marissa, which isn't her real name of course, and I was beginning to worry that Marissa might never come back.

Marissa is Latina you see, and talks with a bit of an accent, which the people in the lilly-white environment in which I work these days equate with being stupid. Marrissa spent the first few hours of her shift being talked to as if she were a first grader. Not outright hostility mind you, just the soft bigotry of low expectations.

"So, Marrissa," I said when we got to a quiet moment. "Who exactly did you piss off that they sent you down to this place today?" We instantly bonded. I really am a blast to work with. One of the great things about being me is that I get to work with me all the time.

Except that I'll eat your food. That's the one bad part about working with me. You leave something in the pharmacy and it's in my stomach within 5 minutes of your departure. It's a bad habit, an addiction almost, but to my credit, I am the only person I know of who does this that will admit to it.

There was no time to steal my coworkers food however, as there was a crazy thyroid lady to deal with. An exasperated Marissa kicked her up to me after a good 5 minutes of trying to deal. I started from the beginning. That's usually the bast way to deal with crazy people, as it calms them down sometimes.

"I have a prescription for some Armour Thyroid, and that woman I just spoke with...."

It was clear by the emphasis she put on the word "woman" that what she meant was "stupid Latina woman who talks with an accent"

".....said you don't have any"

"That's right ma'am, there's a manufacturing problem, and our wholesaler isn't always able to supply it, it's been hit-or-miss for awhile now."

"WELL YOU NEED TO FIND SOME!!!! DO YOU MEAN TO TELL ME YOU DON'T HAVE A SYSTEM WHERE YOU CAN CHECK OTHER STORES????"

"I called the other (insert name of large corpro-pharmacy here) last night and they don't have any either, and no, I don't have a way to check stock of my competitors."

"WELL WHY NOT?????"

She went on hold. "Marrissa, you have to promise me something, OK? Don't ever do this. Ever."

Marissa nodded, and I then hung up on crazy thyroid lady. I am a total blast to work with.

"Why is the blood pressure machine out of order? Is it because of the flu?" Stupid customer. Everyone knows when the blood pressure machine gets shut down it's because it's HIV positive.

Immediately after this the assistant manager comes in and wants to borrow some tape. I point her to the tape dispenser, and she walks up to the tape dispenser, which I will remind you, is a machine that dispenses tape. Which is what she wants to borrow take. The tape is clearly visible. She then asks:

"This one?"

I went to school 5 years for this.

As I raided the refrigerator in a futile search for leftovers from Marissa's lunch, I noticed an oven thermometer. The last time the state board inspector was in she wrote in her report that we needed to have thermometers in the fridge. I think technically we might be in compliance now. I'll have to check.

I looked up a short time later and saw a man running down the aisle in order to get his place in the prescription pickup line. He accomplished his goal. He totally beat the hunchback little old lady in her walker. "I was here first!!!!!" he announced to Marissa's replacement, and there was no arguing he was right. Chivalry is dead and it's corpse is cold my friends. Maybe it was overrated anyway.

It was at that moment that I realized I was in love with the iPLEDGE lady. For those of you not in the profession I'll let you know the iPLEDGE program is a redundant, pain in the ass set of hoops everyone has to go through to make sure the acne medicine isotretinoin doesn't end up in the hands of a pregnant woman and giver her a baby with a football shaped head. Part of the process involves me calling a phone number to make sure a patient has met the requirements of the program, and the womanly robotic voice that answers is sometimes the most competent interaction I will have in a workday.

The iPLEDGE womanbot is never stupid or rude. In fact, she's amazingly patient when i accidentally hit the wrong button trying to answer her questions. The iPLEDGE womanbot is always cool and collected. I bet she's really smart. And has long hair down to the small of her back that is black as the night of a new moon. She even has an accent. The way she says "pre-SCREAPT-tion" melts my heart. After the machines take over civilization, I want to marry the iPLEDGE womanbot and have her babies. I know none of them would have football heads.

I closed the gate on this workday with a head full of dreams of the iPLEDGE womanbot, and hopes that Marissa would come back the next time we were short a tech. And maybe bring some food.

Monday, October 19, 2009

Let's Try Something A Little Different In The Health Care Debate.

Radical even. Call me crazy, but why don't we see what the people who actually deal with the healthcare system on a daily basis think about the situation. After all, wouldn't doctors know a bit more about what needs to be done than bonehead politicians interested in nothing other than getting re-elected?

Besides, we all know the federal government messes up everything it tries to do. Except blowing shit up and killing people. The federal government does that very well. It actually built a pretty good interstate highway system too. And runs a decent system of National Parks. It also makes sure almost 50 million people get their social security checks every month and is behind the delivery of almost 700 million pieces of mail every day. Other than that though, it's obvious the government can't accomplish anything.

Let's see what the doctors think.

...we conducted a national survey of physicians to inform federal policymakers about physicians’ views of proposed expansions of health care coverage.

...Survey respondents were asked to indicate which of three options for expanding health insurance coverage they would most strongly support: public and private options, providing people younger than 65 years of age the choice of enrolling in a new public health insurance plan (like Medicare) or in private plans; private options only, providing people with tax credits or subsidies, if they have low income, to buy private insurance coverage, without creating a new public plan; or a public option only, eliminating private insurance and covering everyone through a single public plan like Medicare. We also assessed the level of physician support for a proposal that would enable adults between the ages of 55 and 64 years to buy into the current Medicare program.

Overall, a majority of physicians (62.9%) supported public and private options. Only 27.3% supported offering private options only. Respondents — across all demographic subgroups, specialties, practice locations, and practice types — showed majority support (>57.4%) for the inclusion of a public option. Primary care providers were the most likely to support a public option (65.2%); among the other specialty groups, the “other” physicians — those in fields that generally have less regular direct contact with patients, such as radiology, anesthesiology, and nuclear medicine — were the least likely to support a public option, though 57.4% did so. Physicians in every census region showed majority support for a public option, with percentages in favor ranging from 58.9% in the South to 69.7% in the Northeast. Practice owners were less likely than nonowners to support a public option (59.7% vs. 67.1%, P<0.001),>


Huh. How about that. The people who know the most about our healthcare system, the ones who are immersed in it every single working day, unambiguously feel the federal government needs to step in and be a part of the cleanup of the rotten mess we call healthcare in this country. What does that tell you my friends?

IT TELLS ME YOU'RE SOME SORT OF COMMY DRUGMONKEY!!!!! I can hear some of you saying. WHY DO YOU HATE AMERICA!!!???? JESUS IT PISSES ME OFF THE WAY YOU PASS ALONG SOME LEFT-WING PROPAGANDA PIECE YOU FIND ON THE INTERNET AS IF IT WERE SCIENTIFICALLY SOUND RESEARCH!!!

And you would be right. If you consider The New England Journal of Medicine to be a mouthpiece of left-wing propaganda that is. Most people however, would consider it the epitome of scientifically sound research.

Only 27.3% supported offering private options only.

Only 27.3% supported offering private options only.

Only 27.3% supported offering private options only.

Don't you think that maybe....just maybe....we should give some credence to the opinion of the people who know the most about healthcare?

NO! GLEN BECK KNOWS MORE!!!! HE HAS MANY YEARS EXPERIENCE AS A RADIO DISC JOCKEY!!!!!! HITLER HITLER HITLER!!!!! SOCIALISM!!!!! DEATH PANELS!!!! BWWWWAAAAAAAAAAAA!!!!!! BE AFRAID!!!!! Say my friends on the right.

By the way, I will never forgive the conservatives for coming up with that death panel story. Because I was totally looking forward to serving on one until I found out they just made the whole thing up. Dammit.

Anyway, my point here is that the more you know about medicine, the more likely you are to think......like me.

Of course I work in healthcare too.

Why don't you ponder that the next time you're driving down the interstate.

Wednesday, October 14, 2009

APhA Starts To Engage Me In Dialogue. Then Abruptly Stops.

I gotta admit I was a little shocked when this showed up in my mailbox out of the blue:

Hi Mr. Drugmonkey,

I wanted to see if you'd be interested in an interview opportunity with Kristen Binaso, Senior Director of the American Pharmacists Association,

Um, yes. Yes I would. I haven't been shy about my opinion of APhA, the professional association so ineffective it can't even get all the letters in its name capitalized, and there are few things I would enjoy more than the chance to tear into one of their egghead, self important, ivory tower useless suit types busy "shaping the future of the profession" while the profession dies.

I thought to myself that maybe if you wish hard enough for something you really will get it. The e-mail then continued:

According to the FDA, over 1.2 million people each year suffer from injuriescaused by medication errors. Choosing your pharmacist carefully is crucialto your overall health; but it's an aspect of the health care process that'soften overlooked.

In this interview opportunity Kristen will discuss:
- Why choosing a pharmacist is just as important as a choosing a doctor

- Why it is important to see the same pharmacists and keep accurate, updated medication records

- Important questions every patient should ask their pharmacists


I see. A lamefest. How unexpected from APhA. I bet this was tied in with some sort of campaign to let people know not to keep their medicine in the bathroom medicine cabinet as well. We all know heart attack rates could be cut in half if only people could be convinced not to keep their medicine in the bathroom. APhA doesn't back away from the important issues.

At least, they wouldn't if I got a hold of them.

I emailed the PR hack back and told him I would be delighted to interview the good Ms. Binaso. I was very polite and grown up about it. I really wanted this interview. PR hack writes me back:

Does 7:30am ET work for you?

Here's what we can do: you can interview Kristen over the phone, but we'll tape her live from our studio as you're conducting the interview. Then we'll edit the audio with the footage and produce a Web video of the interview that you can embed on your blog -- or you can use the content to write a post.


My God I was living in some sort of wet dream. Not only would I get a chance to corner APhA about how they are fiddling as the profession burns, but it would be on tape! I was salivating.....literally salivating.

Not for me so much....but for you. Because everything I do is for you guys.

A few hours later I get this from the PR hack:

I'm really sorry, but we're going to have to cancel the interview. I thought we had a free time slot, but there was another commitment I wasn't aware of. Would you still be interested in emailing some questions that we can have Ms. Binaso answer and using the content for a post? Feel free to send me some questions.

Again, really sorry about this.

"I'm really sorry" of course, means in this case: "someone in the office finally got around to actually reading your blog"

Still, I figured I might as well play out the string here. I sent the good Ms. Binaso the following questions:


1) Ms. Binaso, you seem to be in a unique position in our profession, with both your experience at APhA and "in the trenches" of retail pharmacy. As APhA points out, the FDA says over 1.2 million people each year suffer from injuries caused by medication errors. We both agree that the best way to reduce medication errors is to have patient/pharmacist interaction, yet you surely see every time you call another pharmacy during your workday just how much of a challenge simply talking to a pharmacist can be at times. In an era of corporate pharmacy cutbacks, staff cuts, ever increasing workloads, and the constant promise of new technology that claims to increase time available for counselling but never actually seems to deliver more counselling time, what changes would APhA like to see that would move the profession in the direction of more personal interaction?

2) Do you think staffing levels in most retail pharmacies are adequate to provide mandated OBRA counselling on each new prescription? If so what do you see as the major barrier to OBRA compliance and how do we change it?

3) The name of your organization is The American PHARMACISTS Association. What in your opinion are the major concerns of the average retail pharmacist and how is APhA working to address these concerns and advocate for the rank-and-file members of our profession?


Here's a hint as to what kind of an answer I got back:




"Hello darkness my old friend" What an appropriate song, as APhA is the darkness masquerading as the professions friend. What an appropriate picture. Simon and Garfunkel running away in silence from the mighty Drugmonkey. Remember, I didn't start this, it all began with an unsolicited e-mail from them.

Pussies.

Monday, October 12, 2009

Bush Finishes Third In Nobel War Prize Voting.

OSLO, Norway- (Drugmonkey News Service) In the second extraordinary Nobel development involving an American president in less than a week, The Nobel War Prize was awarded not to former president George W. Bush, but will be shared jointly by his nemesis, Osama Bin Ladin and Afganistan's Taliban.

Bush, who started two wars during his first three years in office, was widely expected to win the prize for his efforts to tie the conflict in Iraq with the events of 9/11. Iraq is almost a thousand miles from the base of operations of the terrorists who attacked the United States on that day, and none of the attackers were from that country. Nevertheless, Bush was able to convince a public with unfettered access to these facts that the war was an appropriate response due to a fictional Iraqi "weapons of mass destruction" program.

"While the use of propaganda to scare a gullible population into acquiescing to a senseless, pointless, conflict at the cost of over half a million lives is to be admired" Nobel War Prize committee chairman Charles Taylor said in a statement issued from the United Nations prison in The Hauge, where is is currently standing trial for crimes against humanity, "the fact remains that relatively speaking, Bush's opponents in his 'forgotten war' were far more successful at the art of warfare, given the huge gap in training and resources available to them. In the end, I think I can speak for the whole Nobel committee when I say regarding Mr. Bush, 'an "A" for effort, but close only counts in nuclear war"

Neither Mr. Bin Laden nor Mr. Bush, whose father won the Nobel War Prize in 1991, responded to repeated requests for comment. A spokesman for the Taliban cut off the hand of a reporter who reached him in an undisclosed cave in Pakistan's Frontier Province.

Coming in second in this years voting was Vladimir Putin of Russia, whose conflict with the former Soviet Republic of Georgia in 2008 "showed that in this age of war waged ostensibly for grandiose, vague causes, a good old fashioned land dispute could still start the bullets flying"

Thursday, October 08, 2009

Nancy Pelosi Singlehandedly Destroys Any Chance Of Healthcare Reform In Our Lifetime.

From this morning's LA Times:

Surrounded by supporters, Hilda Sarkisyan marched into House Speaker Nancy Pelosi's San Francisco office on a chilly fall day. As an almost year-long debate over remaking the nation's health care system heads towards the finish line, Hilda wanted to speak with someone in her Congressional Representative's office about the issue.

"I am completely opposed to any more involvement of government in our healthcare, and I want to make sure Nancy Pelosi knows this." said Ms. Sarkisyan. "For me the issue is more than an academic debate. My daughter is very sick, and may need a liver transplant soon, and I can't imagine fighting with an uncaring government run bureaucracy while my daughter fights for her life. I just want to speak with someone to tell them, please stay out of our healthcare."

What she got was something quite different.

Staff members of Pelosi, looking down into the atrium lobby from a balcony above, began heckling her, she said, with one of them giving her "the finger."

Sarkisyan walked out, stunned and hurt.

"They showed me their true colors," she said. "Shame on them."

About a month after the incident, the Sarkisyans received a letter of apology from Pelosi.

"I was very disappointed to learn of the behavior of one of our staff members when you were at my District Office," wrote Ms. Pelosi. "I sincerely regret this individual's offensive and inappropriate action," she continued. "Please know that he did not represent my views or the views of other members of Congress."

Great. That's just fucking great. Can you imagine what the right-wing fucktards like Glenn Beck are gonna do with this? Crap, maybe they're right. If this is how they're gonna treat a mother worried about the health of her critically ill child, maybe these cold hearted government bureaucrats have no business being involved in health care.

Actually, they're definitely right. If you're going to heckle and flip off mothers of seriously ill children, you have no business in the healthcare system. I think most of us can agree on that. Right?

Right?

I just tricked you. Kind of. Substitute "Cigna" for "Nancy Pelosi" and you'll have the real story about what happened.

Oh. And I changed one detail as well. The mother wasn't worried about her seriously ill daughter. She was grieving for her daughter. Who died after Cigna denied coverage for a liver transplant, then changed their minds after intense public pressure a few hours before she passed away.

Just in case you're not quite following me here I'll repeat myself.

Employees of Cigna heckled and flipped off the mother of a dead child who came to talk to them about why she was jacked around when she supposedly had insurance.

If you're going to heckle and flip off mothers of dead children, you have no business in the healthcare system. I think most of us can agree on that. Right?

Right?

The olive in the martini was the last line in the "apology" letter Sarkisyan received from Cigna after the incident:

We deeply empathize with you and wish you peace and comfort in your loss.

"Because empathy and wishes of peace and comfort don't cost us anything" the letter didn't add, but easily could have.


Monday, October 05, 2009

This Was Going To Be A Post About Michael Moore's New Movie. It Is Not.

The film is called Capitalism: A Love Story. It's awesome and you should go see it. That statement will surprise no one who knows me. If he were 100 pounds lighter and I were gay I would marry Michael Moore.

I saw a late showing of the film in the middle of a soul-sucking work weekend, and ended up socializing afterwards, running up a sleep debt I knew would make Sunday morning no fun. Fuck it. The release of a new Michael Moore film is like a holiday for me, and I could handle a sleep debt. Sunday's customers just better not give me any crap.

So naturally there was someone waiting for me to unlock the pharmacy as I drug my seriously sleep-deprived ass towards the happy pill room Sunday morning. I sighed to myself. Then I saw she was crying.

She told me she had been raped the night before, and asked if I sold the Plan B "so I can go home and just make this go away"

Jesus holy shit. Here's the thing. There are people who are trained to deal with these types of situations. I am not one of them. I went to school for 5 years to learn about drugs. This was taking your local community college quarterback and putting him in a game against the Pittsburgh Steelers.

I pulled her over to the counselling area as I heard the phone start to ring. "Of course I can get you the Plan B, but that will only protect you against pregnancy. There are other things to worry about, I can't do anything for you here to help with STD's. You'd need someone with prescribing authority. It would probably be best to go to the emergency room."

She almost visibly winced at the mention of "emergency room" I decided not to play the "preservation of evidence" card. I don't know why. I'M NOT TRAINED IN THESE THINGS!!!!

Was I supposed to call the police? Am I some sort of required reporter? Fuck fuck fuck.....I DON'T KNOW!!!!! I scrambled around in the pocket as Mean Joe Greene bore down to take my head off.

I got the Plan B. I picked the single-pill version. For those of you not in the profession I'll tell you Plan B originally came in a 2 pill pack, with instructions to take one tablet now and one in 12 hours. It was always an open secret, however, that you could just take both tablets at once and not lose any efficacy. So when Plan B lost its patent it came out with a single pill version and got a new patent on that. I knew it would cost her more, but in her mental state I didn't want her to hear one set of instructions from me and see another set printed on the box. I also didn't want her to take one tablet and then flip out for whatever reason and not take the second dose, so the single pill version is what I sold her. I think I completed a forward pass for a few yards with that one, but I'm not really sure.

"I hope you'll still get some medical attention" I said as three phone lines rang and someone was beating on the gate of the drop off window I had yet to open.

"Well, do you think maybe an urgent care?" She asked softly.

"It would definitely better than nothing" I said, and told her how to get to the good one. "It's a little further away, but the staff there is really good" Which was my way of saying I hoped to hell she would avoid the house of quackery that was nearby. "Let me get you their phone number"

Later, I realized that while I was in the phone book, I easily could have found the number for the rape crisis center as well. Goddamn it. Thrown back for a 20 yard sack.

I rang out the Plan B, gave her the paper with the directions and phone number for the urgent care, looked her in the eye and told her it would be OK. I don't know if I'm supposed to say something like that. She said thanks and walked out the door. I have no idea if she went to the urgent care or jumped off a bridge. I'll probably never see her again. The day before I would have told you I've been at this long enough I could handle anything a customer would ever throw at me. Now I was rattled. Totally rattled. My hands were shaking as I finally opened the gate to face the crowd of foaming at the mouth barbarians that had gathered and was now ready to subject me to all the regular retarded shit that goes on in a retail pharmacy. The barbarians would be in a mood fouler than usual because I was not opening on time.

Later that afternoon my District Manager called demanding to know if the monthly controlled substance inventory was going to be finished by the end of the day.

I drank a half a bottle of scotch that night before I fell asleep. That's not an exaggeration.