Tuesday, April 29, 2014

Ripped Out Of Today's Headlines, By Me, Eight Years Ago.

In light of tonight's news about the botched execution in Oklahoma, I think we can all agree here that I am some sort of prophet:

Original Blogpost Air Date: June 13, 2006

Government Can't Even Not Create A Bureaucratically Screwed-Up Policy When They Kill You.


Ok, so I'm being a living stereotype this morning, an elitist liberal leafing through his copy of The New York Times, when I come across a story about a death row inmate appealing his sentence to the Supreme Court. Nothing unusual there. Can't blame a guy for wanting to live I suppose. Buried in this story though is a piece of evidence that shows just what a fucking genius I am. Stick with me here. I've been against the death penalty for a long time now. Partly because of the whole "an eye for an eye and the whole world goes blind" thing, but mostly because, and I have 2 different ways of phrasing this depending on who I'm talking to:

1) If you're a member of the general public: Would you trust the same organization that runs the DMV to have the power of life and death?

2) If you're a member of a medical profession: Would you want the same people who run the Medicaid program in your state to decide if you live or die? (OK, their decisions may decide if some people live or die, but in a different way)

Actually I have 3 different ways of expressing my thoughts. Sometimes I'll say that capital punishment is just another big government program that doesn't work very well. That line seems to work especially well with Republicans.

It is the particulars of this man's lawsuit that proves my brilliance. It seems his argument is that the way a lethal injection is carried out in his state is cruel and unusual. According to the Times:

The focus of concern is two of the three chemicals that make up the lethal cocktail used by most states. One is sodium pentothal, an anesthetic, which Mr. Hill argues in his lawsuit is insufficient to make the procedure painless.

The second is pancuronium bromide, which causes muscle paralysis but does not block pain or interfere with consciousness. Studies indicate that while inmates who receive this drug look calm and peaceful as the third chemical, potassium chloride, is administered to stop the heart, they can actually feel intense pain without being able to express themselves.


Anyone who knows even a little bit about drugs is probably saying to themselves right now... "WTF?" Anyone ever hear of long acting barbiturates? hhheeeelllllloooooooooo.......cheap as dirt, and a little IV push sends your condemned gently drifting off to an eternal sleep. The sodium pentothal they already use is a short acting barbituate. Crank up the dose of that alone and you'll do the trick with no problem.

But no. Some bureaucrat gone wild had to come up with an unnecessarily complicated cockamamie 3-step procedure that leaves open the possibility of having someone suffer a heart attack while feeling everything and being able to express nothing. Less effective, more complicated, more expensive. Remember this the next time you're in line at the DMV. At least sooner or later you'll walk out of there alive.

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...

...do 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.....

YOU COULD STOP DISCHARGING PEOPLE ON A GODDAMN FRIDAY NIGHT WITH A HANDFUL OF PRESCRIPTIONS ANY IDIOT OUGHT TO KNOW THEY'RE NOT GOING TO BE ABLE TO GET FILLED!!!!!!!!

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.