Thursday, November 24, 2011

Nation Prepares For The Annual Running Of The Tools.

BETONVILLE, AR-  From the small town Sears to major shopping destinations in cities around the country, excitement filled the air today as millions readied themselves for the start of the annual shopping season that begins tonight with the Running of The Tools. This years Tool Run is expected to begin as early as midnight at retailers in all 50 states, as dullards of every stripe gather to test their mettle in competition with what passes for human beings these days in an effort to score a discounted price on electronics, clothing, toys, and other miscellaneous crap that will most likely end up in a landfill within a year. 

"We used to call it the running of the sheeple" said Wal-Mart Vice President Johnnie C. Dobbs. "but then we realized that sheep, unlike the crowds of barbarians that gather in front of our stores every year, very rarely get violent when crammed together in large herds." 

Dobbs then climbed to the top of corporate headquarters and tossed 10 vouchers good for $100 off any laptop computer to the crowd below "just to give them a little taste of blood" One person's eyes were gouged out in the resulting melee. 

While the precise origin of The Running of The Tools is unclear, archaeological research indicates it may have begun as part of a ritual of giving thanks for the sweatshop laborers whose work producing plastic disposable trinkets makes it possible for Americans to maintain a standard of living unmatched in the history of humanity. 

Actually, "living" is probably the wrong word to use there. 

In that spirit of thanks, Tool Run participants across the country this year will pause for a moment of silence to honor Jdimytai Damour, the Wal-Mart employee trampled to death under a frenzied crowd of Tools desperate to get rid of their money in 2008.

Not really. There will be absolutely no recognition of what happened to Mr. Damour tonight. Except possibly among the people who loved him. 

"Unless you come from the dark place inhabited by these people's souls, the significance of the Tool Running can be hard to understand" said Dr. Glen Nealon, author of GET YOUR HANDS OFF THAT DVD PLAYER!! Tools And The Ascension Of Consumption As The Basis Of The Modern Economy "In the absence of meaningful relationships based on caring and consideration, worthy cultural outlets, or any other type of intellectual stimulation, the life of a Tool soon devolves into a search for meaning through competition for material symbols of status, and they are willing to risk almost anything to fill the vast void of nothingness that is their existence."

"HOOOOOOOOAAAAAAAAAA!!!!!!!!!! I'M GONNA GET ME A PLAY STATION FOR SEVENTY-FIVE BUCKS!!!!!" said local Tool Jacob Hatfield, who said he had been waiting in front of a Target store for 36 hours. He also added that if we even thought about barging in line in front of him, we could expect to be cut. 

Reached in the eternal glory that is heaven, the almighty Jesus sobbed softly when asked for comment. 

My Thanksgiving Gift To You. A Passive-Aggressive Way To Strike Back A Bit At One Of The Forces Destroying The Profession.

Some of you followed my live blog of this as it happened the other day via my Twitter feed. For those of you that didn't, here's a fun game to play the next time you have to call a Medco mail-order facility for a prescription transfer:

The process will be excruciating, as you are probably well aware. It will start more times than not with a customer giving you a scrap of paper with an 800 number on it that will get you nowhere near a pharmacist. You will wade through voicemail hell to get to a human, who will begin the process of transferring you to a person who can actually help you. The ordeal will be like my penis, long and hard, but so worth the effort to get to. Because, when you finally reach that pharmacist practicing the profession from a cubicle 2,000 miles away, and you beat the information you need out of them, they will ask you a question:

"Can you repeat that back to me?"

It is their policy that you repeat the information they just gave you back to them. Their policy I said, not the law. Which means at this point you should hang up on them. Then the fun will begin. Because they will try like hell to get that repeated information. They will call you back almost immediately, and now my friends, all the power in this transaction shifts into your hands.

I've figured out they'll hold for about 10 minutes of silence before they give up. So what I'll do is around minute 7 or 8, pick up the phone and apologize for being so busy, but tell them if they can just hold on a little longer, I'll get to them as soon as I can.

Then I assure them their call is very important to me.

A couple of other tricks you may want to use: If you have a bilingual staff, you can help out the Medco cubicle rat by offering to help them in multiple languages. They'll appreciate your commitment to customer service as you let them know they can request Spanish by pressing numero seiete. In my case, I can also offer them Hindi. I bet they'll give me an extra dispensing fee for that.

Or, you may want to remind the cubicle rat that Medco's CEO seems to think that talking to retail pharmacists is vastly overrated, and that robots may be the way to go. Then maybe suggest that the cubicle rat go try to call a robot and hang up again.

The possibilities are endless really, and it makes your workday....I dare say...slightly pleasant. I now treasure an opportunity to transfer a prescription from Medco almost more than anything else I do.

Until the robot comes that is.

Wednesday, November 23, 2011

Highlights From A Half-Day Of Pill Counting Action.

OK, so, I have a question for you. Let's say you're out there in the world, just kinda living your life, going about your day to day business, everything going just fine, and all the sudden you get a call from a robot who says you have a prescription  ready. What would you do? Would you 1) Ignore the call because you know you're doing OK with your meds, or 2) At most, go to the medicine cabinet and check your bottles to see what you could be running low on so you could decide whether you wanted to buy another refill? Because if you would do either one of those two things, I have another question for you:

Do you really exist? Seriously. Are there people out there who would make the slightest effort to find out what the machine has told them to buy? Because I'm not seeing it. What I do see is a constant parade of people coming to the counter because they have been ordered to. They have no idea what they could be about to purchase. Not a clue as to how many prescriptions could even possibly be waiting for them. I'm not kidding you, when they get that call from the robot it's like getting some sort of surprise package for them. My already low opinion of humanity managed to sink a few more feet when I saw the other day how many more prescriptions we've been selling since the corporate mothership started their auto-fill program. The only good thing is the bonus money I'll be getting from all that extra revenue coming in.

BWWWWAAAAAHHHHAAAHHHAAHHHAAAAAA!!!!!! There's no bonus.

That does remind me of our district manager though, who I've mentioned before kinda sounds like a pirate when she talks. I know it's hard for a woman to sound like a pirate, but trust me on this, she pulls it off. An imitation of my District Manager is usually sure-fire comedy gold but my attempt this day fell flat on its face as I entered the happy pill room. I thought maybe it had something to do with the lady I saw brushing her teeth in our parking lot on the way in. How someone spitting their used toothpaste into the public sphere might put people in a bad mood. I was wrong.

The District Manager had been in earlier in the day evidently. With her boss. And her bosses boss. This was the equivalent of a visit from the Pope, or at least a high ranking Cardinal or two, thankfully without the pedophilia. Reports indicate the first thing they did was inspect the trash. There are now at our company, let me pause and make sure I'm getting them all... five different categories of trash. Each of which has it's own container. For example, a used alcohol swab, which, thanks to the characteristics of alcohol, is within a minute or two is a dry piece of cotton, is "hazardous waste," while a cotton ball used to stop someone's bleeding after an injection, which I will point out has and always will contain human blood, is just regular trash, and can be thrown out with my empty coffee cup and read newspaper. Call me a rebel, but I've always put the blood stained things in the sharps container. Fortunately no one noticed this during the trash inspection conducted by the man with a Masters in Business Administration.

The MBA man did leave word that I was unacceptably behind in my computer training modules though. So once I settled into work I stopped filling prescriptions and taking phone calls and learned that if there was a fire in the store, I should make my way to the nearest exit, and not walk up to the fire and try to make sweet love to it as I had previously thought.

Here's another question for you. Do you know if you're right handed or left handed? Because the first flu shot of the day didn't seem to. I always ask, you see, because my goal is to put it in the arm you use the least, as that arm is gonna be sore for a couple days. After a good minute of the man explaining that he did some things with his right arm but considered himself left handed, but he had an identical twin and he thought his twin was right handed, but threw a baseball with his left hand, I took a page out of the robot's playbook and just ordered him to roll up his left sleeve. While this was going on a man was insisting to my Supertech that his zero co-pay be put on his medical benefits card.

"I'm going to the bathroom" she said when the transaction was over.

"It's really gross back there." I reminded her.

"I know, but at least I'll get some peace and quiet for a few minutes."

About 10 minutes after I explained to a man that I could only print out an expense report for the year that covered his prescription drugs, and not what he paid for his extended hospital stay in another state, two fatty carts got in a wreck. Seriously. One of them just broadsided another right at an aisle intersection and neither of the fatties wanted to get up and help untangle the damage. I bet there would had been some road rage if either of the fatties had been able to muster up the effort.

The man who didn't know if he was right handed also missed his own age by 10 years when he filled out the flu shot questionnaire.

It could have been worse though. My Daddy could have toiled nights in the plastics factory, picking up overtime whenever he could in order to give me a chance to make something of myself, and I could have toiled away in one of the nation's finest universities, forgoing parties and football tailgating, in order to put into my head the knowledge both theoretical and practical that would allow me to make it in the world of commerce, and then... I could have been given the trash project, and spent my days making sure the HIPAA paper was always kept separate from the HIPAA plastic. Which is nothing like what a janitor does.

I also could have been ordered by a robot to buy the cheap scotch. Which makes me glad I didn't give them my real phone number. Cheers.

A Thanksgiving Rerun: After Roughly 400 Years, I Think The Lesson Of The Holiday Is Crystal Clear.

If strange white people come wandering into your neighborhood, kill them. That is the lesson of Thanksgiving. I seriously don't think you can make a case that the Indians wouldn't have been better off if they had just killed the Pilgrims. Or let them starve.

Same way with Louis and Clark. Indians totally should have just killed those honkies.

Friday, November 18, 2011

California's Medicaid Problem Solved.

The Drugmonkey settled into the soft glow of the nightlight as it filled the room and felt the warmth of scotch slide down his throat. It had been a rough week in the happy pill room, and he was letting it go. Decompressing. Forgetting. Beginning the process of regaining his strength for the workweek to come when the glow... became brighter. Steadily and surely, against the room's far wall a figure appeared. An overweight man it looked like. With wings. And a halo, a five 'o clock shadow, and a glowing white wife beater T-shirt. He had a lot of body hair. The Drugmonkey knew it wasn't good to mix alcohol with Wellbutrin, and as he sat his scotch glass down on the table he swore this would be the last time.

"Fear not, oh pill jockey" said the disturbing yet somehow comforting figure. "I am the Medicaid Fairy. And I bring good tidings!!"

"Oh happy joy!" said the Drugmonkey, "California Medicaid is in the most awful of ways. The state budget is a shambles, with revenue down and those in charge reducing Medicaid payments to providers, already among the lowest in the country, by another 10 percent!! Egads Medicaid Fairy, my friends who run independent pharmacies have told me they will actually lose money on any brand name prescription over $50! Imagine that, losing money by filling a prescription! Please make it better!"

"Make it better I shall, my friend, the Medicaid Fairy has a solution..."

"Yay! I can only assume this plan involves asking those that have benefited the most from living in our society to once again pay their fair share in order to make that society better for us all, as opposed to breaking the backs of small independent businesses. Perhaps we could restore the top income tax rate for millionaires to what it was under the Clinton administration, or better yet, the rate that prevailed during the reign of that stalwart of the GOP, Dwight Eisenhower."

Thirty seconds of silence enveloped the room. Punctured by the sound of a  deep belly laugh.

"Oh silly Drugmonkey, we cannot possibly risk returning the American economy to the state it was in during the 1950's or 90's. Plus, most of the drugstore owners who are about to get shafted with a barbed wire penis would not hesitate to tell you raising taxes on the affluent is not a solution to any problem."

"But.....isn't Medicaid funded by tax dollars? So if we collect more of them, then we won't have to subject doctors, hospitals, and pharmacies to these drastic cuts. Right? I mean, more money coming in means more money to spare providers these painful cuts, and maybe a pharmacy could even get paid more than a prescription costs them."

"SILENCE!!" said the Medicaid Fairy. "I have the solution to your problem, and it as follows!! No one will pay any taxes from now on!!"

"Really?"

"Yes! And as a matter of fact, everyone will get a $500 rebate from the state. And pay no more taxes. Ever!!"

"And will they get a puppy too?"

"Yes. And a blowjob from the supermodel of their choice."

"Wow. So the Medicaid Fairy just shows up, waves a magic wand, and enough money appears to keep the providers who serve the poor from getting fucked. I'm pretty sure that's what everyone was counting on happening all along. Can I ask one question though?"

"Yes."

"How does it work, this magical system where we continuously reduce the tax burden of the rich while taking a chunk out of the hide of those upper middle class people who think they belong to the elite of society?"

"It's the magic of the free market Drugmonkey. No one outside of the tea party is capable of understanding."

"Really?"

"In the world of fantasy and magic, of course. In the realm of reality though, you're doomed. I was just fucking with you."

And with those words, the Medicaid Fairy disappeared, and a retroactive invoice for 10 percent of all medicaid payments made since June was left in his place.

Wake up independent drugstore owners. Like it or not, you are most certainly part of the 99 percent.

Thursday, November 17, 2011

Another Reason Your Prescription Costs So Damn Much. Medco Wants A Chunk Of Your Lipitor.

The whole idea of a Pharmacy Benefit Manager is that it will save an insurance plan's sponsor money. I mean, why the hell else would you hire a company to do something for you if it ends up costing you more than it would take to do it yourself? "Let us take care of the pharmacy end of your insurance plan" the PBM's say. "We know the ins and outs of the pharmacy business and can drive a hard bargain with drugstores." It's the whole reason they exist. To create savings and pass them along to the plan sponsor. Keep that in mind as we talk about this article from Friday's New York Times:

The biggest introduction of a generic drug in pharmaceutical history is being met with tough business strategies by Pfizer and pharmacy benefit companies, according to recent letters to pharmacists. Many drugstores are being asked to block prescriptions for a generic version of Pfizer’s Lipitor starting Dec. 1, when the company loses its patent for the blockbuster cholesterol drug and generic competition begins. Medco Health Solutions, among the nation’s largest pharmacy benefit managers, is one of the companies issuing instructions, seeking to have pharmacists keep filling prescriptions with the more expensive Lipitor for six months.

What? Has Medco lost its mind? Requiring pharmacies to use a more expensive drug? "Medco must be stupid" Some of you are probably thinking.

Pfizer has agreed to large discounts for benefit managers that block the use of generic versions of Lipitor, according to a letter from Catalyst Rx, a benefit manager for 18 million people in the United States. The letters have not previously been made public. 

"Oh my gosh! Medco isn't stupid, Medco is smart!" You're now saying. "After anal raping drugstores to the point where they have nothing left to give, Medco is going after the drugmakers and negotiating discounts! They really will be giving value to plan sponsors when they pass all those savings from Pfizer along!"

To which I will say..........BBBBBWWWAAAAAAHAHHHAAAHHHAAAHHAAAAAAA!!!!! You obviously don't know PBM's very well:

A pharmacy group and an independent expert say the tactic will benefit Pfizer and benefit managers at the expense of employers and taxpayers, who may end up paying more than they should for the drug. “I’m stunned,” said Geoffrey F. Joyce, an associate professor of pharmaceutical economics and a health policy expert at the University of Southern California, after reviewing the letters. “This is just an egregious case. Clearly there’s been some negotiation between Pfizer and the large P.B.M.’s saying we’re going to make this cost-beneficial to them, but the plan sponsors are going to eat it.” 

"Eat it" in this case, is a polite way of saying "take it up the ass"

Objections to the deal were raised publicly on Thursday in a news release from a group called Pharmacists United for Truth and Transparency, which opposes some tactics of pharmacy benefit managers. The statement called the move “a blatant attempt” by benefit managers to keep Pfizer’s discount while employers still have to pay the full price of the brand-name drug. 

Got that? Medco negotiated a discount from Pfizer alright, and evidently is planning on keeping it all to itself. Now I only had a few business electives in college, so maybe an MBA out there somewhere can explain to me how that's not a kickback.

But is Medco really planning on something so brazen? Why don't we just ask them directly:

Melissa Mackey, manager of public affairs for Medco, said its letter described “a custom plan design, which is not a new concept,” in which clients could “tailor their formulary to maximize value.”

That, my friends, is a textbook case of corporate bullshit. You ever need an example of how to talk without saying anything, you just go back to that quote. Why don't we try just asking them a simple question that requires a simple answer:

Asked in an e-mail specifically whether Medco would pocket the Pfizer discounts while employers and taxpayers paid more than the generic price for brand-name Lipitor, Ms. Mackey declined further comment.

Yup. Think we have our answer. And I'm thinking we can expect more of the same when Medco merges with Express Scripts and controls a third of the market.

Tell me again why I'm supposed to be afraid of socialized medicine?

Wednesday, November 16, 2011

So...Um....Yeah...Not Sure Where That Last Post Came From. Moving On....

What's the deal with water towers? Seriously. Every podonk town in the Midwest had one and I don't understand. I mean, I understand why the podonk town wants to have water, but why put it up in a tower like that? You have to expend energy to get it up there, right? So I don't see the advantage here. Other than being able to paint shit on them. That can be kinda cool.

By the way, I said get it up.......huh huh.....huh huh. Beavis and Butthead are back in case you didn't know, and that makes me very happy.

So anyway, the fact I don't see water towers all over California the way I saw them all over Ohio also leads me to believe the idea of storing your water 500 feet off the ground isn't the best one. Feel free to enlighten me.

I'm glad I'm thinking about stuff like this again. I think the Wellbutrin has finally kicked in.


Tuesday, November 15, 2011

Side Effects May Include The Ability To Get Through One More Mediocre Day.

It's nighttime, and soon I'll swallow the Ambien that will serve as a cut off switch to end this day. Hopefully I won't drink too much and I'll remember to lie down before it sinks into my brain, so I won't do things like have entire Facebook chats I don't remember, so I won't have to piece together what I did this night from clues that are available tomorrow morning. Hopefully, but don't count on it. There are new episodes of Beavis and Butthead on MTV.com, and those little guys remind me of the 90's, which were my decade of hope. I'll probably watch them and not remember.

Soon it will be daytime, and a jolt of Wellbutrin will make it possible for me to get out of bed and face you. I'll open the bedroom curtains and look for something. It's better with the Wellbutrin, honest it is. Before the Wellbutrin I didn't know if it was gonna be you or me, but someone was gonna get hurt. Probably me now that I think about it. I'm a lot easier to hurt. Anyway, we don't have to worry about that these days. The Wellbutrin has lifted some of the fog from my brain and let me be productive again and keep a smile on my face as you ask me about shampoo and demand to know what happened to BC headache powders. The only reason I'm able to type this now is because of the Wellbutrin. Otherwise I'd be outside on the deck staring into the night looking for something.

It's probably making some of you uncomfortable to read this. People don't like to hear about other people who take antidepressants. I'll put you at ease by instead writing about how I burned my hand on the stove tonight. The skin on my fingers is turning white and thick and it hurts like hell. I'll take a couple more pills for that.

I wonder if you know I have to wring every last bit of norepinephrine from my brain the way a man stranded in the desert would desperately squeeze out every last drop of water from a sponge just to be able to get through a workday. My mind probably stopped producing the norepinephrine on its own because it saw what it was getting me. Making me say it three times won't change the fact you should see a doctor for that wart on your genitals. No, there isn't an over the counter cream that will help. Even if you make me say it four times.

The little red light just went off so I ran to the phone. Maybe somebody left me a message on Facebook. The little flickers of light are the only moments of hope left in the day now. Like dying embers in the fire of the 90's. The other day Michael Moore sent me a direct message on Twitter. Seriously.

The giant martini I just poured will help me forget about this. It'll wipe the memory clean and let me jolt myself awake with the Wellbutrin tomorrow with a blank slate and the ability to pretend maybe something will be written on it. Or at least that the little red light will go off and it will be someone I'll want to text back.

There has to be more than this. I know there can be a lot less.

Republican Presidential Candidates. The Gift That Keeps On Giving.

I understand a lot of you aren't following the politics that much. It's a whole friggin year before the election after all, and you have other things to do. I get it.

It's just that....the people who *are* following the politics...they're about ready to give the presidential nomination of one of the two major political parties in this country to this man. I really think you should know this.

So, um, maybe you could tune in, just a little? Because they haven't yet, which means there's still time to change things. Plus the entertainment value can be very high at times.

I promise.


 

Thursday, November 10, 2011

Speaking Of Debates....

A lot of you have no doubt seen this already, but for those of you who haven't, this is real, actual footage of last night's Republican presidential debate. The featured speaker here is Texas Governor Rick Perry:




I'm thinking my fellow uber-liberals and I could use this to our advantage:

 "It was Defense"

 "Wha?"

"The third agency of government you said you would eliminate Governor, it was the Defense Department"

"I said that?"

"Yes, of course, it was genius"

"Was I drunk?"

"Probably, but it doesn't matter, this is quite frankly the boldest, most decisive game changing move in the history of presidential politics. Now eliminating the entire Pentagon might be a tad extreme, but immediately ending the bailout of Iraq and Afghanistan would put you in stark contrast to President Obama, showing you have the cajones to actually do what he only dreams about."

"You mean, I'd be doing the opposite of what Obama has done?"

"Absolutely, you could be the second American president in a row to win the Nobel Peace Prize, and the first to deserve it."

"Well sign me up pardner......YEEEEEEEEEHAAAWWWWWW!!!!!"

Yup, a tough talking Governor of Texas, short on smarts, not much for details, leads with his gut and reliant on others for big picture guidance.

What could possibly go wrong?


Oh. Yeah. Um, never mind.


Wednesday, November 09, 2011

What Better Way To Cut Through Bullshit Than With A Good Old Fashioned Debate.

The Drugmonkey settles in behind a very statesmanlike looking podium as the buzz among the crowd settles into a low whisper. A bald, clownish-looking man enters stage left while four tired and rumpled people slowly stager in from the other side. The four are offered a seat and they immediately burst out in tears of gratitude. They sheepishly ask if there are snacks or perhaps bottled water that will be provided during this event. Not one asks about restroom facilities, as if they have no expectation of nature calling. The low whisper in the auditorium drifts into silence as the Drugmonkey takes the microphone.

"Good evening, and thank you all for coming to tonight's event. As you all know, pharmacy faces tremendous challenges as we move forward into the 21st century, and views differ as to how the profession will best meet the obstacles before us. One thing is for sure, no matter what direction pharmacy ultimately takes, CVS/Caremark will play an integral part. With over 7000 stores and control of one of the nation's major Pharmacy Benefit Managers, some will already say that as CVS goes, so will go the profession. With that in mind, we present tonight's debate, "CVS, a progressive force for the future or an embarrassment to pharmacy?"

"First let me introduce Tom Menigan, CEO of The American Pharmacists Association."

"Thank you for the opportunity to be here Drugmonkey. I gotta say our new headquarters in Washington, D.C. is much nicer than this dump though."

"And now, four pharmacists currently employed by CVS"

"May we speak now?"

Let me jump in here and let you know that while this debate took place only in my imagination, every word attributed to APhA's CEO comes from this post on his blog, while the words from the CVS pharmacists come from actual messages I have received in my e-mail box. 

"Mr. Menigan, would you like to make an opening statement?"

"Recently, Megan Sheahan, Michelle Fritts, Erika Trevino, Olivia Putman, and I visited a CVS Caremark pharmacy in the Dupont Circle neighborhood of Washington, DC, where I received my annual influenza vaccination. We had a chance to see their advances in patient care, including numerous systems upgrades to assist pharmacists in identifying, monitoring, assisting, and documenting patient care activities and outcomes."

"Interesting. I think what I'll do now, as opposed to the traditional role of debate moderator, is step back and just let the two sides engage in a little back and forth. CVS pharmacists, you're up next."

"This pharmacy keeps enacting brand new programs (more things to do). I refer to myself no longer as a pharmacist. I am now a prescription salesman. I do not counsel, I do not care about outcomes, All I am supposed to care about is getting another script filled."

"By improving patient engagement through enhanced interactions, pharmacists have created new ways to improve clinical care and provide counsel that can improve adherence. By using increased technology and maximizing the use of pharmacy technicians in the pharmacy, CVS pharmacists are improving the health of patients while lowering the overall cost of health care."

"I managed to stick out 4 years at CVS before the fateful night of January 2nd, the Monday after New Years and the busiest day of the year when I worked a 14 hour shift with one 10hr technician, filled 300 prescriptions, fell asleep driving home and ended up crashing my car into a median. As soon as I woke up, I gave my notice and went to a grocery store pharmacy, making the same money with much better hours and 10 times less stress."

"The CVS team of Papatya Tankut, Cherise Wilson, Scott Staso, and Rosaline (Rosy) El-Khoury showcased recent patient care initiatives the company has implemented to allow pharmacists greater opportunities to interact with patients and prescribers."

"This is not why I got into pharmacy, I am not a telemarketer, I am no salesman, but I am that person that will tell you, 'don't take tylenol while on that'. I would give anything just to be a pharmacist again."

"It’s clear to me that the organization is taking enhanced pharmacists’ services seriously."

"There are the traditional complaints about retail and then there are the extreme cases and CVS is one of those.... CVS takes the cake with pharmacist abuse."

"Let me just jump in here now, since the subject of pharmacist abuse has come up. Mr. Menigan, what do you have to say about published reports that CVS systemically ignores the will of the North Carolina Board of Pharmacy, which has mandated a 12 hour workday for pharmacists, by having pharmacists in North Carolina routinely work 14 hour days?"

Since APhA has never said a word about this flouting of a law it helped defend, you can insert 30 seconds of the sound of crickets chirping in the background here. 

"Very well then. Well it seems that one thing is crystal clear tonight. The views of The American Pharmacists Association differ sharply from those of actual pharmacists. Mr. Menigan, you managed to get your message out even when outnumbered 4 to 1 by people in the profession you claim to represent. That's quite a feat, but to be honest, not at all unexpected. I see the corporate special interests that actually control pharmacy have come with their pocket now, which means it must be time for you to crawl back in. Thank you for being here, and thank you you to the CVS pharmacists who have to be back at work for a 14 hour day bright and early in the morning. Try not to drive into any highway medians on the way home!

And a special thanks to our audience here at the Medco auditorium and around the world on C-SPAN and online. Be sure and tune in next time when Walgreen's Chairman and CEO Greg Wasson will discuss the topic, "How tobacco sales can drive top line pharmacy revenues" Until then, goodnight, and be sure to meet that flu shot quota!!


Tuesday, November 01, 2011

Walgreen's POWER Outages Continue: The Emergence Of "Deep Pill 2"

Get it? Walgreen's calls its initiative to redefine the future of retail pharmacy its POWER program. POWER outage....you with me? 'Cause people are outing it....bwwwaaahhhaahhaa...

I'm so damn funny it's a wonder I can be around myself all day without my head exploding.

At any rate, here's my original post featuring a source I've dubbed "Deep Pill" exposing what life is like in the real world of a Walgreens central-fill POWER pharmacy. Tonight we'll let "Deep Pill 2" give us the scoop on conditions at a POWER retail store. I am tired of body and weak of brain this night, so I'm pretty much just gonna run Deep Pill's story unedited. I'm sure you'll agree that story speaks for itself. And that we're all, pharmacists and customers alike, very fucked if Walgreen's gets its way:

 I worked for the WAG in AZ for just about 10 years.  I have seen many changes... but not as destructive as POWER.  Your article about POWER was spot-on.  I wanted to share with you some of the problems I experienced with POWER during my tenure at the WAG.

WAG, for those of you not in the know, is Walgreen's stock symbol. 

I was the pharmacist at the store-level.  Not sure if you were aware of this... but anyone who wanted to remain a staff pharmacist at the store-level when POWER was rolled out, had to re-apply for the job.  I kid you not.  After working for a solid 8 years, I had to re-apply for my job.  For those pharmacists who wanted to transfer to the CPO, they did not have to re-apply-- they were automatically accepted.  Then WAG spent a TON of money to hire an independent hiring company to make the determination whether or not we could remain a staff pharmacist at the store level.  This whole process was absolutely stressful on all of us.  Pharmacy managers who wanted to stay at store level were exempt from re-applying. 
I made the cut.  Great, right?  Not so much.  I had to deal with understaffing, angry customers who were misrouted by our "colleagues" at the call center, managing two lanes in the drive-thru, customers at the counter, and customers at the consultation window.  I forgot to mention flu shots.  Now POWER looks great on paper. All this "free time" to provide MTM services (which all our friends at APhA are probably orgasming to...).  This simply wasn't the case. (emphasis mine)  Because of the lack of staffing, we had zero time to perform MTM services.  Our District Supervisors told us time and time again to call upon the store manager if we needed extra help in the pharmacy.  Well, a lot of the store managers were not willing to come back to help us out.  They had their own crap to do.  I don't blame them... but I digress. 
One of the biggest problems I had to deal with was the amount of errors that I caught from our wonderful "colleagues" at the call center (CPO).  These errors were careless and made my job a lot harder.  Let me give you an example.  I was counseling a patient on her Prometh w/ Codeine.  The sig: Take one or two TABLETS every 6 hours as needed for cough.  Now I know this may not sound like a huge deal... but I have a huge problem letting a prescription leave my pharmacy that has a blatant error.  In order to fix this, I had to delete the prescription, find the hard copy, re-scan it so that our wonderful CPO can retype it.  Mind you, this patient is in the drive-thru wanting to get home because she's feeling lousy.  So the whole verification process at the CPO starts all over again... 
The District Supervisors encouraged us to fill out an error form online so they can take proper corrective measures with the people at the CPO. (Drugmonkey to malpractice lawyers; those error forms are no doubt stored somewhere, and subpoenable I bet) I have no idea if that was done or not.  I'd still get error after error.  Let me say this: I totally understand that technicians make mistakes while performing data entry.  What makes me frustrated is when pharmacists at the CPO are under pressure to "make their numbers" and when quantity takes precedence over quality.  This isn't totally the pharmacists' fault.  I'm sure the corporate 'tards stress the importance of quantity quantity quantity.  These verification pharmacists at the CPO did not have to worry about the drive-thru, phones, customers, etc.  Their ONLY job is to verify prescriptions without any distractions.  One error (which I caught) was Augmentin 500mg Take 4 tablets an hour prior to dental appointment.  Of course the prescription image said Amoxicillin.  And of course, we at the store-level looked like retards when the patient came in to pick up their medication.  We had to take the blame from the patients for the errors that were made at CPO.  What makes this so ironic is that the pharmacists at the store-level actually prevented harm to the patient.  We were not allowed to talk bad or against the people at the CPO. 
Arizona is a mandatory counseling state.  I have seen pharmacists who do not counsel.  Combine that with the errors at the CPO can lead to a disaster.

I'd be willing to bet a Benjamin that it already has.

And that we're all fucked.

Thank you APhA.

Thank you Boards of Pharmacy.

But the biggest thanks of all..... goes to the Pharmacy America Trusts.

At least they're still a decent place to buy cigarettes.