Sunday, December 21, 2014

'Tis The Season For Sticking It To Your Employer. Two Guys In The Trenches Simultaneously Inspire And Infuriate Me.

Tonight I feel I should turn in my MENSA card. I no longer deserve it.

We'll get back to that in a bit, but first a report on some chain drugstores who have been more naughty than nice when it comes to their dealings with taxpayer dollars. First we go to the smog-choked depths of Fresno. Home of the worst air quality you've never heard of, probably because to report it would mean admitting to having visited Fresno. While passing out the stacks of albuterol to the people of the San Joaquin valley though, it seems like Walgreen's was up to a bit of no good:

A federal judge in Fresno has reinstated a jury award of more than $1 million in punitive damages against Walgreens for firing a pharmacist who blew the whistle on alleged billing fraud...In August 2011, a jury awarded Fresno pharmacist Sami Mitri $88,000 in general damages and $1,155,000 in punitive damages. 
According to court documents, Mitri began working as a pharmacist for the company in 1996. He later was promoted to pharmacy manager in Walgreens’ Fresno district. The court documents say he first brought the billing fraud to the attention of Walgreens officials in the spring of 2009; Jones said Mitri learned of the illegal practice because he frequently filled in for Walgreens pharmacists throughout the Valley. 
After he was fired in January 2010, Mitri sued for wrongful termination under the whistle-blower statute that protects workers who report employer misconduct.
In a nine-day trial in August 2011, evidence revealed that more than 20 Walgreens stores from Atwater to Tulare and Coalinga to Porterville were found to have fraudulently billed the government involving Medicare and Medi-Cal patients, Jones said. 
For example, if a patient needed 30 pills, Walgreens would give them 10 and give them an IOU for the rest of the pills, Jones said. Walgreens would then bill the government for 30 pills, he said. 
This illegal practice also involved expensive and time-sensitive medication done by injections, he said.


This one baffles me. I did some time back in the day working for the pharmacy America trusts when they're too lazy to get out of their car, and it was very...very...clear how partial fills were to be handled. The company had just been busted for this exact thing not long before and had re-tooled its software to handle these "partial fills,"  billing only for the amount given to the customer at the time, and for the balance owed only when it was actually dispensed.

Furthermore, they were adamant to the point of crazyness that any new hires complete their computer-based training on this partial fill procedure RIGHT NOW!!!, and the documentation that they had done so was put in their permanent personnel records. So for them to get busted for the exact same thing, while firing the guy who brought it to their attention, seems incredible. I suspect the problem was an ignorant District Manager or two. Ignorant District Managers are about as rare as that smog over Fresnoville.

Anyway, whenever I hear a story like this my reaction is always the same. "Goddammit why couldn't that have been me." Cashing in while striking a blow against the corporate bastards that have ruined our profession, what a true win-win that would be. I had a set of standing orders for my keystone tech to periodically rake her memory for things the corporation could have done in the past, as well as keep her eyes out for anything in the present we might be able to cash in on. And until today, I figured we just weren't lucky enough to be in a location where any shenanigans were happening. If you're thinking the same way, prepare to read this one and weep:

Rite Aid Corp. recently agreed to pay $2.99 million to settle federal charges it used gift cards to entice Medicare and Medicaid beneficiaries to transfer their prescriptions to its pharmacies. 
According to the U.S. Department of Justice, from 2008 to 2010, Rite Aid “knowingly and improperly” influenced the decisions of Medicare and Medicaid beneficiaries to transfer their prescriptions by offering them gift cards.

Everyone who works in a chain pharmacy just gasped right now. I heard it. Every single one of you has gone through the gift card bullshit, and many of you noticed the fine print that says these cards were not to be given to Medicaid or Medicare beneficiaries. Those silly few who actually tried to enforce that restriction were universally....universally he said, meaning every time, by everyone, told to give them the cards anyway.

At least, I used to think those few attempted enforcers were silly wasters of time:

The case stemmed from allegations made by pharmacist Jack Chin. The Justice Department said that as a whistleblower, Chin is entitled to $508,300 of the funds recovered from Rite Aid.

GODDAMMIT!!!!!! GODMUTHERFUCKINGOFCHRISTDAMMITT!!!!! IT WAS IN FRONT OF MY FACE THE WHOLE TIME!!!!!! THE WHOLE GODDAMN TIME I WAS TOILING AWAY FOR THOSE ASSHOLES THE ABILITY TO KICK THEM IN THE NUTS WAS DANGLING RIGHT IN FRONT OF ME!!!!! EVERYONE KNEW ABOUT THE GIFT CARD SCAM!!!! EVERYONE!!!!!!!

Except......only one person was smart enough to do something about it. Sigh.

I'd like to blame my old keystone tech for the fact that 500 large isn't headed our way, I did issue those standing orders after all. but....no....the buck stops here. So instead of being able to hire a pharmacist to run my store so I can go into the mountains and hang out with the bears, I will be going in to my store tomorrow as usual.

Which still beats the shit out of working for them.

So the best I can do now my friends is to pass on a little advice.  The gift card thing will come around again, and when it does, there will be irate customers who don't understand why they can't have one. When that happens, it might not be a bad idea to ask your District Manager for guidance as to what to do. Ask him in writing. And keep his reply for future reference.

Because evidently getting busted for something, and putting procedures in place to keep from getting busted again, isn't always enough to overcome the power of ignorance when it rests with a District Manager type.

I know a good pharmacy lawyer. When the time comes drop me a line and I'll put you in touch.

Wednesday, December 10, 2014

Do You Know Why I Have Now Inherited The Title Of Best Pharmacy Columnist In The World Now That Jim Plagakis Is Gone? Because Neither One Of Us Ever Wrote A Paragraph Like This.

Look at it:

Clinical community pharmacist (CCP) has begun to appear recently in various venues. It was in the title of a continuing education (CE) session presented at the recent National Community Pharmacists Association convention. The CE session was presented by a panel of innovative community pharmacy practitioners who have been leaders in new direct patient care services.

I just want to point out a few things here:

1) That is the entire opening paragraph, complete and unchanged, of a column in the current issue of Pharmacy Times about, well...who the hell knows? Some character called Clinical Community Pharmacist evidently. Maybe some sort of superhero that can appear in multiple venues at once? If I want to learn about him I guess I'll have to take one of those CE lessons, because there sure isn't much who,what, when, where, or why in this sorry example of news reporting.

2) This was written by a college graduate. He claims to have a masters degree.

3) This illiterate still has a regular gig writing for a national pharmacy trade magazine and Jim Plagakis does not. Chew on that awhile.

4) This also presumably got past an editor at some point. If I ever sent her a turd like this my editor would probably fly out to California and make me eat a dictionary.

I have to go put some water in my eyeballs now, because that piece of work made them hurt and I'm afraid they are about to catch fire.

Thursday, December 04, 2014

JP At Large Cut Loose. My Reflections On The First Great Pharmacy Writer.

There was a time when I hated Drug Topics, the pharmacy trade magazine pretty much everyone in the profession is familiar with. I mean seriously hated it. Every time it was delivered to my store it invariably ended up being leaved through, cussed at, and hurled towards the garbage. What burned my ass about the mag most during of the era of George Bush The Lesser was the incredible platform they had earned over the years, a magazine delivered to and read by almost every pharmacy employee in the country,  and how they were in the process of just blowing it. The magazine got smaller every year. It was printed less frequently. The writing....was bad. Really bad. Here's an actual example pulled from my little blog garden's archives. Keep in mind this was the lead paragraph of a news story:

Can metered-dose inhalers containing flunisolide, triamcinolone, metaproterenol, pirbuterol, albuterol and ipratropium in combination, cromolyn, and nedocromil be phased out because they harbor ozone-depleting substances? If there are alternate products that provide the same benefits as these drugs, they are nonessential and can be removed from the market by, say, Dec. 31, 2009, after a transition period. So proposed the FDA in the June 11 Federal Register. The agency said it would hold a public meeting to discuss this matter. For now, please send your comments to the FDA by Aug. 10.

Reading that hurts my eyes to this very day.

It wasn't only witnessing the self-destruction of what was once the main communication channel for pharmacy that stuck in my craw. It was knowing that I could improve it. If I could only get a shot at writing for those guys, I knew.... KNEW... I could be a part of its renaissance. But I also knew the chances of breaking into the world of actual paid print writing were long and hard. I had even sent Drug Topics a Viewpoint piece once and had heard nothing in reply. So I continued to seethe. Another dip into the archives:

Apparently Pharmacy Has A Code Of Ethics. Who Knew? 
Not me. But there it was in black and white in the latest issue of the trade magazine Drug Topics. The code of ethics by the way, was by far the most interesting thing in that rag, Jim Plagakis being the exception that proves the rule. Why Jim continues to do the clowns that think we'd be interested to read about drugstores in the suburbs on Atlanta putting in generators and publishes statements like "Tylenol was one of the top acetaminophen products suggested" the favor of writing for them baffles me.

Name another acetaminophen product.

Quick. C'mon. No Googling.

See my point? Drug Topics hurts my eyes, and if it weren't for Jim Plagakis and the curiosity aroused by seeing an alleged code of ethics that governs my profession, I might have had to try to gouge them out this Christmas Eve to stop the pain.

Jim had been writing a column for the magazine since I was a zit-faced frat boy who didn't know which end of a spatula to count with. He was the last echo of what they used to be. Kind of like Christiane Amanpour at CNN. And unbeknownst to me he had noticed this angry little monkey man and his blog. Drug Topics was looking for someone to write an op-ed for them, and Jim brought me to their attention. When they balked at the, how do we put it, periodic immaturity of what I was posting to the web, Jim assured them that I could write like a grownup when the situation called for it.

So one day I got an email from Jim Plagakis asking if I was interested in writing an article for the magazine. For those of you not in the profession I'll tell you this was the equivalent of Paul McCartney taking an interest in your garage band and asking if you'd be interested in signing to his record label. And so it began:

The idea came to me while I was waiting for my weekly Andy Rooney fix. I had long ago decided that I can't just tune into the last segment of 60 Minutes to catch the ruminations of the cranky old grandfather I never had. That would be cheating, like reading Drug Topics solely for "JP at Large."

That was the first paragraph of the first article I ever wrote for Drug Topics. I was so proud of myself for getting in that JP reference.

The rest my friends, is pharmacy wordsmithing history. I have proven both myself and Jim right. I got my shot, and I HAVE had a part in moving that magazine towards where it should be. Drug Topics is a  better read today than back when it was breaking the news that Tylenol is a popular brand of acetaminophen. And you know what? My awesome columns are part of the reason why.

This isn't a happy post though, because there is a sad ending to this for Jim. He has been let go from Drug Topics, and in a way that has left him hurt and feeling insulted. That breaks my heart, as he doesn't deserve to be made to feel that way. He carried that publication through the time it was...there is no other word, awful. And to not be given the chance to say goodbye to his many fans reminds me of how they cut off Frank Sinatra's speech when he was accepting a lifetime achievement Grammy.

Paul McCartney, Christiane Amanpour, Frank Sinatra. Have I made the way I feel about Jim clear?

It won't be the same next month when I'm struggling to find something to say before deadline the way I always do, and I can't imagine it ever will be. There'll be a tinge of sadness with every article zapped to the magazine from now on. A little emptiness you can't fill with words.

I wish it had ended better than this.

Sometimes, My Friends, The Jokes Just Write Themselves. That Won't Stop Me From Taking A Crack At It Though.

During the tour of CVS corporate headquarters, it was indeed obvious Foulkes takes her butts seriously.

"No one, and I mean no one, has assembled a bigger collection of assholes than we have right here in this building"  She gushed. "And not just in the drugstore industry. I'll go on the record right now in saying that I don't think there's a company in the history of commerce that has had more butt openings than you see in front of you right now"




UPDATE 1- So here's a real quote from the butt-stopping issue. (God why am I actually reading this magazine?)

After 22 years at CVS, and a multitude of different experiences throughout the organization, Foulkes has “gotten comfortable living in ambiguity,” she told DSN. “I’ve been thrust into situations where I just don’t know, and I have gotten comfortable not knowing."

I think what we just learned here is that the CVS President in charge of stores freely admits to, as many of her employees might put it, having her head up her ass.

Wow, I need to be breaking stories like this, These executives never seem to want to talk to me for some reason though.

Wednesday, December 03, 2014

Hey, Are You A Chain Pharmacist In/Around Boston? Wanna Talk To Someone About Your Working Conditions?

.....someone who can maybe do a little something about it? If so, drop me a line and I can put you in touch with someone.