The Drugmonkey is pissed this night my friends. The kind of spit in your eye hellraising pissed that was so common in my Bush administration prime. If you've been with me that long you may remember Lloyd Duplantis of Gray, Louisiana. The "pharmacist" who had his 15 minutes of fame back in the day for refusing to fill birth control prescriptions, once telling National Public Radio they were "the most dangerous chemicals that have ever been put on the market." The Drugmonkey viciously destroyed Lloyd afterwards. To the point where if you Google "Lloyd Duplantis " right now, the first two results are posts from this very blog, above his own store's website.
Awesome.
But I also knew the work of vigilance against these pharmacy pretenders is never done. I wrote this back in 2009:
...don't think you should stop kicking the likes of Lloyd Duplantis of Gray, Louisiana and his ilk.
Because you and I both know they'll be back. Pat yourself on the ass for awhile and get ready to huddle up for the next play.
Well it's playtime again my friends. From Mother Jones, the magazine that once broke the story of Mitt Romney's "47 percent" foot in mouth episode:
When Brittany Cartrett lost her pregnancy in March, her doctor prescribed misoprostol to help her complete the miscarriage. The drug, which would allow her to avoid a more invasive surgical procedure, is the same one used to induce many abortions. Which is why, Cartrett suspects, two different pharmacies in central Georgia refused to fill her prescription.
Yup, we've been down this road. See if you can detect a difference this time though:
Cartrett slammed one of those pharmacies, the Walmart in Milledgeville, Georgia, in a Facebook post published last week. When she asked the pharmacist why she wouldn't fill her prescription, Cartrett claims, "She looks at me over her nose and says, 'Because I couldn't think of a reason why you would need that prescription.'" Cartrett says she then explained that she'd had a miscarriage, and the pharmacist replied, "I don't feel like there is a reason why you would need it, so we refused to fill it."
Did you see it? Not even pretending to have a good reason anymore. No trumped up safety concerns. No thinly veiled medical rationale. Just "I don't think you need it and you don't need to know why"
That is, until it gets to the level of the corporate spin doctor. This is where it really gets crazy folks:
Walmart, however, disputes that its pharmacist refused to fill the prescription on principal. She refused, says Brian Nick, a company spokesman, because the prescription did not follow FDA guidelines.
Everyone in the pharmacy profession just shot scotch out of their nose. Even if they were drinking water, scotch is what came out. Even if no beverage at all was around, the sheer ridiculousness of this explanation caused single malt to flow through sinuses. Because Wal-Mart, through its spokesman, just seemed to say that prescriptions that do not follow official FDA guidelines should not be filled.
Which is unadulterated bullshit. Lloyd Duplantis wasn't allowed to spew bullshit into my profession and you're not either Wal-Mart. Prepare to be called.
It's estimated 76% of all prescriptions of Seroquel are for off-label, non FDA approved uses. Which I'm sure means Wal-Mart dispenses 76% less Seroquel than its competitors. Right Wal-Mart?
Right?
I bet you never allow any amitriptyline for neuralgia to ever leave your place either, right? And no trazodone to treat insomnia. Because there are no official FDA guidelines for that either.
I could go on all night. Because the list of prescription drugs used off label is endless, and Wal-Mart knows it.
But for some reason......only the off label use of misoprostol seems to show up on your radar. What could that reason be?
Because.... that off label use of Seroquel I mentioned really has raised some serious safety concerns, unlike anything to do with misoprostol. Yet... I don't see any Wal-Mart pharmacists taking a stand on off label Seroquel.
So again, what could the reason be? That just this one drug......out of zillions that are used off label.....is the one to be concerned about?
Everyone reading this now knows the reason Mr. Wal-Mart corporate hack, so you can cut the crap. That pharmacist of yours didn't fill that prescription because she's an anti-abortion zealot who thinks she's entitled to put her beliefs above the people she is obligated to serve, and is also too stupid to know misoprostol has a myriad of uses that wouldn't raise her self-righteous, hypocritical hackles.
Tell the truth Wal-Mart. If you're going to take a stand and give cover to your employees when they attempt to force others to live by their moral code, at least don't lie.
Because while not everyone agrees on the abortion issue, there's a pretty clear consensus among all faiths that liars go to hell.
Fuckers.
15 comments:
Thank you from one who was once in the position of either explaining to a pharmacist and the curious general public why I had been prescribed a particular medication or leaving without it. Thank you.
ain't free enterprise grand? aren't we lucky pharmacists to practice our profession in a country where we get to make decisions based on our own professional judgment and not be forced to dispense drugs that we choose not to. beware the force of government. what if government force prevented you from dispensing drugs that you knew to have real therapeutic value. but because the winds of public policy change with every election you might someday not have the right to help people you want to provide medicine to. force is a double edge sword and it will cut both ways.
good thing there's a drug store on every corner and two in every shopping center. if you don't like how a certain pharmacist practices you can find another one within walking distance.
free enterprise. free commerce. capitalism is the only economic system where people can make their own choices and decide for themselves what kind of store, restaurant, movie theatre or bakery they want to spend their money in. and the people who run these businesses also get to make choices. if enough people don't like how a place runs their business, they will soon be out of business. and that's okay because it is their business. and success or failure depends on the decisions they make.
I was under the impression that the script was written in a manner that it could not be filled.....incomplete or lacking SIG. Which is why after taking it to a few different pharmacies she was still unable to get it.
I'd be curious to see how this one shakes out. I don't doubt some Pharms refused these types of scripts....but if you pull this sort of BS at walmart you are likely to get fired. Wally-world want you to fill absolutely everything.
Fundamentally I agree with the poster above to some extent....it is a slippery slope when people talk about having .gov require/force/make a pharmacist fill a script. Unless .gov is prepared to assume the liability for my fills then they shouldn't be able to tell me I HAVE to fill something.
I already have enough soccer moms insisting I HAVE to fill their childs Rx, that is likely a fatal overdose, because it was written by their DOCTOR who knows more than I do.....
@anonymous7:54 - what a compelling, cogent argument you make. did you have to use both of your brain cells to think that up?
Anon 6:19,
I haven't heard that the Rx was incomplete, and honestly, I don't think that story would be very credible, simply for the fact that the pharmacist would have said something like "I'm gonna have to call your doctor on this because there aren't any directions" and if the customer was too dense to understand than Wal Mart would have simply said "Our pharmacist had to contact the doctor to clarify the prescription," and that would have been the end of it.
That's not what happened. On either level.
And GOVERNMENT trying to force me to fill something is the least of my worries. The only entity that ever tried to force me to fill a prescription against my better judgement was Rite Aid. The GOVERNMENT of California is actually a force for sanity in these types of situations, the state board stating very clearly, in a poster that is required to be posted in every pharmacy in the state, exactly when a pharmacist can and can't refuse to fill your prescription. Suspected overdose of death? Absolutely. Your imaginary friend in the sky telling you you'll go to hell? You don't have to, but you're responsible for finding a place that will. And if your GOVERNMENT comes up with a policy in your state that's bogus, you'll be far better off lobbying the public officials there for change than you would be the CEO of a profit-maximizing corporation.
If you don't believe me, I'd be happy to have you step in my place in my current dispute with AT&T. I'd rather deal with my Congressman, who's a Republican shithead, any day of the week.
And was1 is kinda douchey. The term being subjective of course, and not really open to argument. He has his uses every once in a while though. C'est la vie to the vinegar and water one is what i say.
was1: Why did you become a pharmacist instead of a preacher? If you REALLY believe the Jesus/Christian rhetoric then have the courage to LIVE the gospel to the fullest. Don't go to the doctor when you have rectal bleeding, pray for a cure. Don't call the fire department when your house is ablaze, pray for rain. GOD gave all those patients diabetes, ebola, shingles, pinworms, etc. EVERYTHING in the pharmacy is against GOD'S will if your religion trumps logic.
And you are still a douchebag. In an enema box.
@ my anonymous friend (and
DM, too)... fyi I am a devout atheist. so this is not a religious issue for me. I am a proponent of all forms of birth control and strongly pro-choice. but I want my choices to be my own, as well. if I decide that I don't want to dispense a drug (any drug, for any reason) I don't want some functionary from the government overriding my decision. by the same token if I choose to sell Plan B or misoprostol or any other drug, for that matter, I don't want somebody who has no stake in my business telling me that I shouldn't.
there... I've told you something about myself and why I think like I do. Now, how about you tell us something about you that will let us understand why you have such a fixation on feminine hygiene procedures.
Oh was1 of the vinegar and water,
No fixation really, "douche bag" is just a general insulting term that seems to have ingrained itself into the popular culture. Maybe because douching is unnecessary and irritating, which pretty much describes you to a T. In my subjective opinion that is.....
The license WE carry as pharmacists is government issued. The public health takes top concern not individual belief systems. If you own a pharmacy and do not want to sell burner cell phones or OTC snake oil yhomeopathic "cures", so be it. A surgeon can refuse to operate on a gay man? No more condoms for you young whore-ish woman!! Get thee to a nunnery!! If you want to start refusing to fill legitimate Rxs based on pseudoscience and personal heebeejeebies regarding judgments on peoples behavior, you picked the wrong profession.
You could always begin cleaning vaginas out with a garden hose and a test tube brush.
I had to look twice at 3:49 response to make sure it wasn't one of my comments that I'd forgotten about in a fit of righteous indignation. It used all the euphemisms, similar examples. Excepting I don't think I could come up with burner batteries. Righteous indignation. Hmmphhh. Take that, and that, and that, too.
Now, for the next example of our rights (pharmacist). How much of the story of Big Pharma do we know in the environment of ACA that is allowed to flourish in the aftermath of 'no sales reps'?
Have you heard the one about insulin glargine 300 units/mL? It's an interesting and a little complicated one and surely would take too long to try to explain in a comment box.
It used to be (when I graduated pharmacy school 30 years ago) that we pharmacists 'knew' something about the games that were being played and could come up with workable alternatives for our patients. (Hmm. I guess that was 30 years ago that we could know). Tides changed shortly thereafter when the can of worms opened with the generics industry.
Not that 'generics' is bad. It's not, but Big Pharma (in hand with 'the government' which knows nothing about legal drugs, or any real drugs for that matter and the individuals with power get theirs from Canada) has made the generics (and every endeavor) a cash cow in every era since, starting with brand name companies making their own generics and selling them for a penny less than the proprietary so-named product, to 'artificial sole-produccer crises' (did you ever believe it when morphine and potassium and magnesium sulfate were unobtainable?) to the lastest cash-in on grandfathered generics going brand-name like colchicine and neostigmine. Now, the costs of generic drugs are sky-rocketing with sold-production status? But, that's on drugs everyone uses. For those drugs which only a small percent of Americans use, Big Pharma is in cash cow free-for-all for Big Pharma, no one else.
I think Was1 missed the point entirely, that he COULD NOT PRACTICE pharmacy without a license from the government. All skilled professions have some sort of government oversight because of the potential danger that having an unskilled untrained person in a skilled position represents a preventable disaster to the public. If was1 did not want to dispense controlled substances, he could simply return his DEA license to the DEA and only fill legend drugs. Filling controlled drugs under a DEA license to only those he deems "worthy" would be a violation of that license. I never hear of the self righteous pharmacists refusing to fill Erectile Dysfunction drugs with the same vigor that they refuse to fill Plan B or Birth Control.
Which is odd since it is easier to take bullets out of the gun rather than wearing a bulletproof vest.
This may offend some here, but I have always wondered why religious persons feel that their god is so weak that he/ahe/whatever needs them to be on standby all the time. Are they taking away the aspect of free will when they step into his lofty prada shoes? I would have more respect for a believer that would just believe their god will actually meet out justice as they are told will happen in their books written in the bronze age.
We get to deny or fill RX's based on documented therapeutic harm/good NOT based on some asinine MORAL beliefs.
... back in the early 80's I was a pharmacy student enrolling patients and filling prescriptions in then,investigational AIDS drug regimens (we did not yet call this HIV as we were still diagnosing based on PCP and KS presentation). Many of the Staff Pharmacists had objections to treating such patients. It was decided that as the student, dispensing and counseling would be delagated to me. I was humbled by the patients I was priveledged to care for.
... this is Health Care people, if I have beliefs that prevent me from making decisions solely based on the health my patients then I need to notify my State Board I'm mailing back my license.
News Flash to Make Your Day.
Lloyd DuPlantis is 2015 APhA Bowl of Hygeia winner.
Not every pharmacist has sufficient malpractice coverage to take responsibility for the medical consequences of an unsupervised 'completion of miscarriage'. These practices are why Ob Gyns pay the big bucks for their polices.
American men won't be liking their plunge to a similar level of medical status as women, in the coming years.
Holy crap. More to follow........
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