The Politically Incorrect Pharmacist

"Are you sorry?"

2011-07-02T18:54:00.002-04:00

I am not good at ass-kissing, never have been. The facts and just the facts ought to be enough. Recently a particular customer seems to desire that I grovel to her on my knees, even for things that are not my fault. Ingratiating myself to overly demanding, whining, or plain rude customers is a talent I've never mastered, nor wish to. These are the sorts of customers I am always happy to transfer to a competitor.

Now don't get me wrong, I go out of my way, as do all my staff, to communicate any and all delays in the refilling of their prescriptions. It is not acceptable to fail to call a patient and tell them their requested refill cannot be completed in full, because there is not enough medication in stock. I always give them the option of waiting for the full amount or making 2 trips if necessary. I always apologize for the inconvenience over the phone ahead of time.

Rude lady got the usual treatment from me as described above. She then went on to tell me how disappointed she was, since she would have to make 2 trips, because she only had 1 pill left! I then apologized again and offered to put her on automatic refills. She agreed. She grilled me about whether or not this would happen again, "not if you're on automatic refills," I said.

Then she decides, as an afterthought, that she wants to know why her label doesn't say how many refills she has left. I tell her it should! At the bottom of the label. She says the print is "missing" from her label, like it just "came off". I tell her, I'm not sure what could have happened, but I can look at it.

She shows up the next day at the drop off window with her bottle with the "missing" refills. I notice right away that some sort of liquid or oil has gotten on the label making the black print disappear in some places. I point that out to her.

She says, "When I got it home it was this way! Its as if the print was never on the label in the first place."

I say, "Obviously, something got onto the label took the print off. I can see the print very lightly. You can see where the liquid left a mark on the label. Right here it says I dispensed this prescription and I can assure you I would never dispense a label that looked that way. Its unacceptable."

She says, "Well I guess its your word against mine! I keep all my bottles in one place, nothing got onto this label! I guess I'll go pick up my pills"

She starts to walk away, then turns and says, "Are you sorry?"

"Excuse me?" I say.

"Are. You. Sorry? Sorry, that I had to make 2 trips for my pills?"

"Yes, I believe I told you that on the phone yesterday", I say.

The best part? She decides later to call the store manager, like he really cares, and tell him how rude I was. Strangely, during the course of the 25 minute bitch session, she tells the manager that she did get petroleum jelly on her label. Tells him I was rude, but realized it and did apologize in the end. He cared so much about what she said that he never even told me... I had to hear it from the assistant manager, who laughed.

People are nuts!

New Study: Infant Mortality Rates Higher For Most Vaccinated

2011-05-10T19:44:00.000-04:00

Very interesting. Americans are the most highly vaccinated population in the world, yet we are far from the healthiest nation of people in the world. This new study looks at the disparity between Infant Mortality Rates and the number and type of vaccinations given in the first year.

Infant mortality rates regressed against number of vaccine doses routinely given: Is there a biochemical or synergistic toxicity?

The US childhood immunization schedule specifies 26 vaccine doses for
infants aged less than 1 year—the most in the world—yet 33 nations have lower IMRs.

Prior to contemporary vaccination programs, ‘Crib
death’ was so infrequent that it was not mentioned
in infant mortality statistics. In the United States,
national immunization campaigns were initiated in
the 1960s when several new vaccines were introduced
and actively recommended. For the first time in history,
most US infants were required to receive several
doses of DPT, polio, measles, mumps, and rubella
vaccines.14 Shortly thereafter, in 1969, medical certifiers
presented a new medical term—sudden infant
death syndrome.15,16

Although there are no specific symptoms associated
with SIDS, an autopsy often reveals congestion and
edema of the lungs and inflammatory changes in the
respiratory system.17 By 1980, SIDS had become the
leading cause of postneonatal mortality (deaths of
infants from 28 days to one year old) in the United
States.18

He (Torch) concluded that DPT ‘‘may
be a generally unrecognized major cause of sudden
infant and early childhood death, and that the risks
of immunization may outweigh its potential benefits. A need for re-evaluation and possible modification of current vaccination procedures is indicated by this
study.’’

My letter to the APhA

2011-04-11T22:45:00.004-04:00

I was reading on Eric, Pharmacist about the APhA House of Delegates 2011. I was inspired to share some of my reactions with APhA, so I wrote them a letter.

Just read about your House of Delegates meeting for 2011 over at This blog http://eric-rph.blogspot.com/2011/04/apha-house-of-delegates-actions-yawn.html

You wonder why I am not a member of APhA? You're supposed to be an association for pharmacists, but your slogan is "advancing patient care", instead of "advancing the profession of pharmacy". You do nothing for our profession! Getting us recognized as providers is truly a noble and great thing, so why the heck did it take 46 freaking years for you folks to get around to it?!

What the heck is focusing on making flu vaccination mandatory for all pharmacy personnel supposed to do? It makes me think that you're making some vaccine maker, who's back pocket you're in, a little bit of profit. Most employers now pay for the flu shot for their pharmacy personnel already, if they want it, so forcing everyone to stick that needle in their arm is for what purpose?!?!? Unless you plan to force every grocery clerk, bus driver, and bank teller to get the flu shot too, why bother? What a waste of time and effort better spent on something useful.

I don't even know what collaborating with the American Public Health Association is all about. I've never even heard of it before.

You know what I'd like to see an association for pharmacists do?

Allow me to practice pharmacy with some dignity and respect, rather than making me appear as a trained monkey in a fast food restaurant. The only indignity I have yet to suffer is a paper hat! Drive thrus, 15 minute guarantees, gift cards and no lunch breaks make me a slave to a profession that doesn't look anything like health care! I'm sick of it.

What I am sick of most of all is you pencil necked geeks who kiss the drug companies', the government's, and chain pharmacies' asses and have about as much idea about what really happens in a community pharmacy as my dog.

You want to improve medication use? Make it possible for me to do my professional job without feeling like some one's whipping boy.

Now go forth and make yourself useful!

Never ask a subordinate to do something you would not do

2011-04-06T10:35:00.002-04:00

When I hear this statement, I think of ethical concerns. Of not violating my own moral code.

Apparently, when technicians hear this statement they think of cleaning the restroom, emptying the garbage, and data entry.

Our chain's mantra is "teamwork teamwork teamwork". I like teamwork! It does have its shortcomings, though.

My technicians and even their leader, the tech trainer, preaches at me that I make the big bucks, so therefore I should be able to do their jobs and my jobs, because "its all about teamwork".

Which I counter with, "but I don't ask any of you to check prescriptions or counsel patients, or make determinations on drug interactions. I am the pharmacist, and you do the technical work, because you are technicians."

Its like talking to a plant... they refuse delivery on the facts presented.

I'm getting really tired of this argument. Mostly, because in the current state of declining payroll dollars, I am somehow expected to do all my jobs, their jobs, ensure accuracy & safety, all in under 15 minutes!

Getting really tired of defending my position here. I'm not trying to insult any subordinate, I'm trying to tell you that I have a professional duty to uphold and that trumps taking out the garbage.

If you disagree, that's fine... how about you come in tomorrow and do my job, I'm taking the day off. You're in charge!

Thimerosol-Autism Debate is a Red Herring

2011-04-02T10:33:00.005-04:00

Many people will equate me with Holocaust Deniers for having been suspicious of vaccines for a very long time now. In a free market, an industry would not have to get the Federal Government to protect them from lawsuits that could potentially put them out of the vaccine business. That is exactly what happened in 1986 with The National Childhood Vaccine Injury Act (NCVIA) of 1986 (42 U.S.C. §§ 300aa-1 to 300aa-34), which was enacted in the United States to reduce the potential financial liability of vaccine makers due to vaccine injury.

If you produce a quality product, with value, the market will decide if it can afford to be produced. If it were not for government protection, most drug makers would have abandoned vaccines altogether. I am not a big fan of Altruism, especially forced upon individuals by a government. Who is John Galt?

Helen Ratajczak, a retired senior scientist at a pharmaceutical firm "did what nobody else apparently has bothered to do: she reviewed the body of published science since autism was first described in 1943. Not just one theory suggested by research such as the role of MMR shots, or the mercury preservative thimerosal; but all of them." Ratajczak's article states, in part, that "Documented causes of autism include genetic mutations and/or deletions, viral infections, and encephalitis [brain damage] following vaccination [emphasis added]. Therefore, autism is the result of genetic defects and/or inflammation of the brain." The article goes on to discuss many potential vaccine-related culprits, including the increasing number of vaccines given in a short period of time. "What I have published is highly concentrated on hypersensitivity, Ratajczak told us in an interview, "the body's immune system being thrown out of balance." University of Pennsylvania's Dr. Brian Strom, who has served on Institute of Medicine panels advising the government on vaccine safety says the prevailing medical opinion is that vaccines are scientifically linked to encephalopathy (brain damage), but not scientifically linked to autism. As for Ratajczak's review, he told us he doesn't find it remarkable. "This is a review of theories. Science is based on facts. To draw conclusions on effects of an exposure on people, you need data on people. The data on people do not support that there is a relationship. As such, any speculation about an explanation for a (non-existing) relationship is irrelevant." Helen Ratajczak, author "Theoretical aspects of autism: Causes--A review." Ratajczak also looks at a factor that hasn't been widely discussed: human DNA contained in vaccines. That's right, human DNA. Ratajczak reports that about the same time vaccine makers took most thimerosal out of most vaccines (with the exception of flu shots which still widely contain thimerosal), they began making some vaccines using human tissue. Ratajczak says human tissue is currently used in 23 vaccines. She discusses the increase in autism incidences corresponding with the introduction of human DNA to MMR vaccine, and suggests the two could be linked. Ratajczak also says an additional increased spike in autism occurred in 1995 when chicken pox vaccine was grown in human fetal tissue.

Why could human DNA potentially cause brain damage? The way Ratajczak explained it to me: "Because it's human DNA and recipients are humans, there's homologous recombinaltion tiniker. That DNA is incorporated into the host DNA. Now it's changed, altered self and body kills it. Where is this most expressed? The neurons of the brain. Now you have body killing the brain cells and it's an ongoing inflammation. It doesn't stop, it continues through the life of that individual." Dr. Strom said he was unaware that human DNA was contained in vaccines but told us, "It does not matter...Even if human DNA were then found in vaccines, it does not mean that they cause autism." Ratajczak agrees that nobody has proven DNA causes autism; but argues nobody has shown the opposite, and scientifically, the case is still open. A number of independent scientists have said they've been subjected to orchestrated campaigns to discredit them when their research exposed vaccine safety issues, especially if it veered into the topic of autism. We asked Ratajczak how she came to research the controversial topic. She told us that for years while working in the pharmaceutical industry, she was restricted as to what she was allowed to publish. "I'm retired now," she told CBS News. "I can write what I want." We wanted to see if the CDC wished to challenge Ratajczak's review, since many government officials and scientists have implied that theories linking vaccines to autism have been disproven, and Ratajczak states that research shows otherwise. CDC officials told us that "comprehensive review by CDC...would take quite a bit of time." In the meantime, CDC provided these links: Interagency Autism Coordination Committee: http://iacc.hhs.gov Overview of all CDC surveillance and epi work: http://www.cdc.gov/ncbddd/autism/research.html CDC study on risk factors and causes: http://www.cdc.gov/ncbddd/autism/seed.html

Vaccines and autism: a new scientific review

Ever wonder what a non-pharmacy job is like?

2011-02-22T21:45:00.003-05:00

Or even non-retail? Retail is all I've ever worked at. I see these union workers in Wisconsin protesting and I think, "Wow, if anyone needs a union its drug store workers!" I just don't get how they can complain.

So I don't mean to pick on this blogger, but her post about how to deal with burnout completely befuddles me. Is that how regular people's work lives are? I don't have to tell you guys that me playing Angry Birds on my cell phone for 15 minutes would make for some apoplectic customers and coworkers. 12 hours a day and I don't feel like a single minute really belongs to me... I even feel guilty about using the restroom. Somebody might need me!

Is there any pharmacist who doesn't suffer from all the symptoms of "burnout" everyday? I don't think regular people really get it. I know union workers couldn't even imagine it.

Democratic Party can't survive without government subsidy

2011-02-18T13:09:00.006-05:00

Rachel Maddow, a liberal MSNBC news personality, intends this video as an argument for the protesting teachers unions in Wisconsin. I'm finding it really hard to work up any empathy for teachers who receive $38,406 in benefits annually, whereas the average US worker receives $10,589 in benefits. Their current pension contribution is 0.2% and proposed it be raised to 5.8%. Their health care contribution of 4-6% could be raised to 12.6%. All this for no nights, no weekends, and 3 months off a year.

I haven't seen the numbers to prove or disprove if there is a state budget surplus, but what happens in 20 or 30 years when these pensions are paid out? Look what happened to the auto industry. These pampered pets with their Cadillac plans won't be cheap.

The best part is later in the clip when Rachel talks about how its the unions, such as the SEIU, who are responsible for contributing to elections in order to get democrats and Obama elected. If unions are killed, OMG! democrats may not get any support, especially since the private sector out numbers these special groups and the majority are republican leaning with their votes. These elitist union members cannot survive and live their special lifestyle without your tax dollars! Oh boohoo! Obviously, those special groups who live off the taxes of those not in their special groups want that special treatment and goddamnit, they're entitled to it!

So what do the democrat state senators do? They run away and hide, so they won't have to vote, because they know they're going to lose the vote.

Since Monday, Wisconsin teachers have "sicked out" and some have taken students with them to the protests.

Now there is evidence that the DNC has shipped in 25 bus loads of "rent a mobs" to protest. Obama is taking sides and coming out on the side of the unions, to appeal for their votes, of course.

I say, fire all those politicians and teachers who walked out and charge the ones who took students with them for kidnapping.

Dentists...

2011-01-26T14:03:00.003-05:00

I'm beginning to honestly believe, before a dentist can write a prescription, he should have to consult a pharmacist. OK, who am I kidding... I've thought this for a long time.

How bout this one.

This dentist calls on the doctor's line. I give him a lot of credit, at first, for asking to consult with me. He says something like "I want to prescribe Amoxicillian 250mg per tsp to this child. He weighs 65lbs, but I don't know how much to give him."

me: OK how old his he? (I pull up the clinical software program) What exactly are you treating?

dentist: Does that matter? He's 6.

me: (thinking uh yea dumbass) Is it an abscess?

dentist: I just need to plug this value into my software to get the correct dose.

me: well it says here to treat yadda yadda max dose is 300mg per kg per day.

dentist: well yes, but I need to plug in the kg. The child weighs 65lbs. How do I do that?

me: Oh! (pretending like this isn't as easy as it is) Uh you divide 65lbs by 2.2 and you get 29.5kg. I didn't understand what you were asking at first.

dentist: Yea, that's all I needed. Thanks! *click*

Wha? Really? This guy needed to ask me how to convert lbs to kg? Maybe he didn't have access to the Internet and our pharmacy number was close? Sort of scary he couldn't articulate the question more clearly and saved us both some time, and some pride on his part.

I thought there was going to be a fist fight

2011-01-26T13:18:00.005-05:00

The other day a polite, friendly man in his 40s came to the drop off with a script for an antibiotic. He had a kind face and a nice smile. He didn't look like he felt well, so when he asked if we had a public restroom I said we didn't, but I did offer to let him use the employee restroom. He declined and said the grocery next door's restroom would be fine. He would return to pick up the RX.

In a couple moments a cranky, old, regular customer came to the pick up. We had an RX ready for him, but he needed another that he thought would be ready, too. I told him we'd have to get it ready, it would be a few minutes. The technician took over that refill and I worked on checking the polite guy's RXs.

The nice man returned and came over to my work station and asked some questions. We were talking about them when the old guy, still standing at the pick-up, interrupts and says:

Old guy: Hey! Are you working on my prescription?!

Me: No. I'm working on this man's prescription.

Old guy: If you're going to stand there and talk to that guy you better find another pharmacist to get my medicine ready! I was here first!

Me: Actually, he was here first. (I gesture at the polite man)

Technician: John, I'm working on your prescription, right now.

Old guy: He wasn't here first! He just walked up.

Me: No (I say as slowly and calmly as I can) he dropped off his prescription at the drop off window before you even got here. Then he went next door to the grocery store.

Nice guy: (He looks over at John) I had to go to use the restroom at the grocery store and I just got back. Do you have a problem with that?

Old guy: Yes! I do!

Nice guy: Really? (pause) Why is this a problem for you?

Old guy: I don't want to wait.

Nice guy: Are you late for work?

Old guy: *snort* I'm retired!

Nice guy: *walks over toward the waiting area, passes John, and sits in a chair* So, you enjoying your time off?

Old guy: No! I'm too damn old to enjoy anything!

They continue talking. I hear the nice man trying to distract John and keep him from ranting.

The nice guy's RXs were ready, but he says, "No, you get this guy's RX first. I can wait".

I check John's refill and he goes on his way.

The nice guy says, as we're checking him out, "I don't normally say stuff like that to people, but I really feel like crap today and I just wasn't going to take that."

What a nice guy. I felt like a knight in shining armour came in to rescue me from the grumpy old guy. Some of my customers really have an attitude problem, but some of them are really great! Actually, most of my customers are really nice. I'm pretty lucky to have found such a good store.

Your pharmacist partner

2010-11-22T13:36:00.003-05:00

Funny thing, when I got out of pharmacy school I wasn't familiar with the term. I thought "partner" was a reference to significant others in a same-sex relationship. I still sort of chuckle at my confusion back in the day.

Partner: one associated with another especially in an action : associate, colleague

It sort of implies a cooperative effort doesn't it?

Why is it, then, that cooperation isn't what we often get? My non-pharmacist friends are often horrified with the stories I share with them. One of them is convinced over half of the pharmacists out there are nut-jobs or complete losers. Maybe its just me.

Let's see, here's some crazies I've worked with:

1. This one fella I worked with blew up his house cooking meth, lost his license and then went on to get in trouble for working at a grocery store pharmacy without a license. Don't they check this stuff??

2. This imposing woman was over 6 feet tall. When she talked to you it all sounded very good and was spoken with such authority, but when the conversation ended you would think, "am I dumb? I have no idea what she was talking about". This lady apparently worked for an indie for years, but resigned after the owner asked her to when he caught her sneaking into the store after hours to steal ketchup and toilet paper. She then went on to get busted shoplifting at a department store. Eventually, when I became her unlucky partner, I discovered she was writing her own prescriptions for metoprolol and Ambien. I reported it, of course. She, also, made many dispensing errors, a record of 6 in one month at a particular point, all discovered by me. It took corporate over a year to fire her... they were busy I guess. She went on to work for another chain who acted much more quickly in firing her, after discovering she was filing RXs on her $0 copay employee plan, purchasing the RXs at the register, and then backing out the claims the next day. Viola! Never ending refills!

3. The Princess. She wasn't a bad pharmacist at all, just an annoying person to have to work with. She somehow managed to get the technicians to totally worship her. They would shower her with gifts for any and all occasions. I was once asked, er rather commanded, to chip in $5 on a Boss's Day gift. "Umm she's not my boss", I argued.
The Princess, also, worked the schedule like a pro. She had it set up so of us 3 pharmacists, we each worked every 3rd weekend. We, also, got extra days off during the week if we worked the weekend; Wednesday and Thursday. Princess' regular day off was Friday (mine was Tuesday, no 3 day weekends for me, ever). Every 3rd week, Princess got a 5 day weekend! Yea.. I didn't stay long.

4. The Slacker Manager-Manipulator. This one probably happens more often than any other. The manager who does nothing, but takes all the credit and tells her boss she does everything and that you are a worthless partner. These folks are often of the compulsive lying type, with grandiose visions of themselves. You do nothing, they do everything. This particular partner I had, actually would take naps on the stool.

I could probably go on and on. I want to hear about your experiences. Maybe I just attract these people. Maybe its just me. Maybe everyone else's partners are totally normal, rational, people. Hmmm yea probably not. Comment or take the poll over to the upper right.

Free diabetes meds, $4 RXs & the wrong medications! Go Giant Eagle!

2010-09-03T11:58:00.006-04:00

A Pittsburgh woman says the Giant Eagle in Shadyside gave her Clomipramine, instead of Clomiphene

What is worse, the woman had an anaphylactic reaction. Every pharmacist's nightmare!

YOU pharmacists at Giant Eagle, it may be time for you to stress that what you do is NOT free, it is worth more than $4! If you're too over worked and working too fast to not notice how different the prescriber type and directions for these two medications are, its time to SLOW down!

Counsumers, you need to realize, you get what you pay for... choose wisely.

I remember being a young pharmacist, not familar with dispensing all the drugs, yet. I might have made a mistake like this, but today I cannot imagine I could. Clomiphene has very specific directions, distinct packaging, very different than Clomipramine.

Pharmacy whores were historically the first Health Care Slaves

2010-08-03T16:54:00.002-04:00

Now, instead of being slaves of the corporations and insurance companies, we will be slaves of the Federal Government.

Hide your kids, hide your wife!

2010-08-02T11:53:00.000-04:00

I'm going to be singing this for weeks.

A horrifying expirience for a woman in the projects results in a tune that is giving everyone an earworm. A woman wakes up to find an intruder in her bed and her brother, Antoine Dodson, frightens the man off, saving her from this "idiot homeboy". No worries, he doesn't have to confess, cuz they're looking for him, and he is dumb, so dumb, for real.

The original news story

And now, the punched up version. Absolutely infectious!

Chords:

Chords:

chorus-
gm cm dm 4x

bridge-

Eb dm cm gm
Eb dm cm F dm F

Lyrics:

he's climbin in your windows
he's snatchin your people up
tryna rape em so y'all need to
hide your kids, hide your wife
hide your kids, hide your wife
hide your kids, hide your wife
and hide your husband
cuz they're rapin errbody out here
you don't have to come and confess
we're lookin for you
we gon find you
we gon find you
so you can run and tell that,
run and tell that
run and tell that, homeboy
home, home, homeboy

we got your t-shirt
you done left fingerprints and all
you are so dumb
you are really dumb--for real
the man got away leaving behind evidence
i was attacked by some idiot in the projects
so dumb, so dumb, so dumb, so

chorus

Let's get right down to it! Funny Man, Hank Johnson is at it again.

2010-06-25T11:22:00.004-04:00

Oh that zany Congressman, Hank Johnson! He's confused, yet again! I think he may have hit his head when Guam capsized and missed hearing that Barry's biggest campaign donors were BP and Goldman Sachs! I LOVE this guy. He's like comic relief for those boring Congressional sessions.

What do Lenin & Earth Day have in common?

2010-04-22T12:05:00.000-04:00

Not only is April 22nd Earth Day, but it is Vladimir Ilyich Lenin's Birthday, too. Coincidence? Not according to Brian Sussman, who writes this article, Earth Day: An Assault on Man, for the American Thinker.

I cannot recall ever hearing April 22nd was Lenin's birthday, but choosing his birthday for Earth Day makes sense.

In 1970, Senator Gaylord Nelson (D-WS) was Congress's leading environmentalist activist. Nelson was the mastermind behind those ridiculous teach-ins, which were in vogue in the late sixties and early seventies. During the teach-ins, mutinous school instructors would scrap the day's assigned curriculum, pressure their students to sit cross-legged on the floor, "rap" about how America is an imperialist nation, and discuss why communism really isn't such a bad form of government -- it just needs to be implemented properly.

...

In 1969, following a much-hyped oil spill off the Santa Barbara coast, an overblown patch of fire on Cleveland's Cuyahoga River, and the pharmaceutically induced vibes cast across the nation via the Woodstock Music and Art Fair, Senator Nelson met with Ehrlich and reportedly said, "My God -- why not a national teach-in on the environment?" Hayes was brought in to play a pivotal role with organization and implementation. After careful consideration, a name and date for the event were chosen: The inaugural Earth Day would be celebrated April 22, 1970.

Celebrating our planet seems like an innocent & good cause, but that is not its intended purpose. It is a vehicle to control people. Control their behavior and replace their Higher Power. As Robin Berkley says in Why I Am Enlarging My Carbon Footprint,

The Left's underlying goal: to convince all of us that we don't matter. Our happiness, our cleanliness, our ease of living, our money, and our time...it's the government's business, not ours. While Marxist theory celebrates the proletarian, in actuality, people become interchangeable cogs in the collective wheel.

With the promotion of environmental hysteria, the government keeps the masses frightened and in survival mode. When you traumatize and terrify people, they're malleable. As stated succinctly by Adolph Hitler himself, "Terror is the best political weapon."

Another potent way to dominate people? Blame and shame them; make them feel defective if they trash a bottle or enjoy a hot bath. Self-hate and shame are unbearable states of mind. People will do almost anything to get out of them.

So enjoy your Earth Day. I'm off to mow the lawn, do 10 loads of laundry, burn some stuff, and throw some meat on the grill for dinner.

Obama, the African Colonial

2010-04-20T22:35:00.005-04:00

This article, Obama, the African Colonial, from American Thinker explains so much. Like many people, I often just cannot understand where this Obama guy is coming from. I don't understand his motivations. His wife says his home country is Kenya, but he swears he is a US Citizen and won't reveal his birth certificate. He seems to hate The Constitution, America, and Western Civilization. So what would motivate someone like that to become President of the United States? This First Generation born West African-American woman, L. E. Ikenga, provides excellent perspective.

Is Georgia Rep Hank Johnson smarter than a fifth grader?

2010-04-02T09:36:00.004-04:00

Probably not...

Europe and China can see it

2010-03-24T11:30:00.002-04:00

Will America wake up and stop it?

This chapter is ending soon

2010-03-05T16:15:00.002-05:00

My personal beliefs are no longer congruent with pharmacy practice.

Remember when we pharmacists used to be the most trusted professionals? This was before DTC Advertising. Before the conglomeration of Merck-Medco, and their eventual separation, due to conflict of interests. Yea, didn't see that one coming.. This was before the public saw Big Pharma, as well.. Big Pharma.

People trusted their pharmacists, because their pharmacists were part of their communities first. Pharmacists were less bullied and governed by the big corporations who run the drug chains, the drug manufacturers, and lobby the government for their own gain. Pharmacists had a degree of professional autonomy, which is fast becoming extinct.

The profession of pharmacy has been hijacked and stolen from us, the practitioners.

So, after much deliberation and weighing of values and beliefs, I find that pharmacy no longer serves my professional interests and personal convictions. I am exploring some other interests, keeping my eyes open for opportunities, and having faith that I will be shown the way to professional fulfillment and serve my community.

Someone once said there's nothing wrong with the profession of pharmacy, the problem is the job. Well, I think its a little more than that. Its more than I want or care to do battle with.

Big Corp Push for All RPhs to Be Immunizers

2010-02-26T23:35:00.003-05:00

Recently, some big chains are threatening their pharmacists, "You will immunize!" Big chains want an immunizing pharmacist available at all times. This means big bucks for the stock holders!

..but, what does it mean for pharmacists? More work, more pressure, more liability, and ZERO additional compensation.

When you bring this up to them, they'll feed you that old line about how "immunizing is a normal part of the community pharmacist's responsibilities. It will elevate your position and make you more valuable!" Well, golly! That sounds good and all, BUT SHOW ME THE MONEY! Why should I make your business more profitable, increase my value to you for nothing?

"Oh, but we're paying for your certification! An $800 value! You just need to do this on your own time, what with all those days off you have. Your family won't miss you."

I enjoyed reading Your Pharmacist May Hate You's take on this issue. The responses were even better. My favorite response, was this, from Jan:

Just wait until they decide that your new job responsibility is to start an IV
or replace a cracked filling.I mean, you can do those things, right? By the
way,
change my oil, will you?

What about the RPhs who never envisioned immunizing anyone? What happens to them? The conscientious objectors with religious, moral, and philosophical objections to administering vaccines? What about those with needle phobia? I went into pharmacy, because becoming a doctor was out of the question! I am very squeamish about blood and tissue and all that. What happens when I pass out while vaccinating?

I hear horror stories about these RPhs being forced out of their stores and into a miserable existence. This doesn't seem right, does it? This whole issue has my blood boiling. What do you guys think?

One Second After

2010-01-31T18:02:00.005-05:00

I want to tell you about a book I just finished. Now I love Post Apocalyptic Sci Fi, but this book is more. It is a warning. One Second After, by William Forstchen. This book is about what happens in Black Mountain, NC after an EMP attack. Maybe you've never heard of EMP, Electro Magnetic Pulse. EMP is what occurs when a nuclear bomb is detonated far above the earth's surface, in the upper edges of the atmosphere.

From William Forstchen's website:

As the bomb explodes it emits a powerful wave of gamma rays. As this energy release hits the upper atmosphere it creates a electrical disturbance know as the Compton Effect. The intensity is magnified. View it as a small pebble rolling down a slope, hitting a larger one, setting that in motion, until finally you have an avalanche.
At the speed of light this disturbance races to the earth surface. It is not something you can see or hear, in the same way you don’t feel the electrical disturbance in the atmosphere during20a large solar storm.
For all electrical systems though, it is deadly.

Now some folks have decided this book is just fear mongering. A crazy right-wing agenda put forth by wacko Conservatives. I don't really see that, though. I can see why some liberals are threatened by this book, but I don't understand it. To admit this sort of thing is possible and likely to occur in our life time totally shatters their little liberal Utopian bubble.

This is one of the most frightening books I have ever read. It has made me think and put some consideration into my own priorities. What do I value? What is the purpose of my existence? What are my goals? What do I hold dear? Am I prepared to react to an emergency like this?

In the book, the day after the catastrophe occurs, John, the main character, goes down to the local CVS to obtain insulin for his 12 year old, type I diabetic, daughter. The pharmacy is a mad house. There is an out of towner there threatening the pharmacist to give him Oxycontin. This is where the book really hit home for me. Can you imagine trying to care for your patients with no computer? No electricity? No refrigeration? No replenishment of stock and no knowing of when any more would arrive? We all know a pharmacy keeps only a day to a week of stock on hand. This would be like a nationwide Katrina and there would be no help coming for weeks or months.

So what about the US Government? Are they aware of this threat? In a word, yes. There is a Commission to Assess the Threat to the United States from an EMP Attack. Things are moving forward slowly. The threat looms closer and closer, though, as we face the very real possibility of a nuclear North Korea and Iran.

How anyone can possibly think Global Warming is a larger threat is beyond me.

Maybe they can get Al Gore to star in the movie, which is currently in development with Warner Brothers, and then it may get the attention it deserves.

He is the Tax Man

2010-01-28T19:15:00.001-05:00

You'll be getting your census form soon...

2010-01-28T00:49:00.001-05:00

You'll want to take some ques on how to answer from this SNL skit starring Christopher Walken.

Christopher Walken - SNL Census Bureau Skit

Narcissistic Much?

2010-01-28T00:29:00.002-05:00

Oh, this isn't about you? Really? Are you sure?

Gas Up The Truck!

2010-01-20T22:11:00.001-05:00

Massachusetts's Miracle!

..nuff said *happy dance*

Where have I been?

2010-01-18T12:01:00.005-05:00

Yes, it was as if I fell off the planet. I assure you, I have been keeping up with most issues political. Perhaps there is so much going on I am overwhelmed and not wanting to blog about any one thing in particular. Who would have ever thought our constitution, way of life, and principles would be under such blatant attack? OTOH who would have ever thought so many Americans would be so ignorant of what is going on? Political Correctness infiltrates every part of our lives. Most people do not even recognize it for what it is any longer, it has become so ingrained in their personalities. It would be amusing, if it weren't so upsetting to those of us who know it for what it is.

I do not want to go into too much detail, but the other day I was chatting with some coworkers. I said something negative about the religion of Islam. Neither of these people were Muslims, Catholics in fact. They were completely scandalized by what I had said, accusing me of being judgemental. Yes, I do tend to be judgemental when people want to kill infidels, and I happen to be one, but hey, that's just me! Crazy I know.

This story is getting longer than I would like, but in the end one of the women said she does not "see any Muslims attacking our country". To which I looked at her shocked and inquired about the "Underwear Bomber" on Christmas, 4 days ago! She stared at me blankly, no clue that had even occurred.

It also became clear to me that these women could not distinguish between Hinduism & Buddhism and Islam, as one woman asked me if "the Muslim had a red dot on his forehead". Ignorance is Death.

Ironic how these morally enlightened individuals are totally ignorant of many things and condemn me for my well informed opinions. This in a nutshell is how Political Correctness works. The biggest purveyors of it do not even know what it is they are practicing. Astounding.

Obama, you say "This isn't about me"

2009-07-24T16:22:00.003-04:00

Really?

Didn’t you tell Congressional Democrats that they were ruining your presidency if they did not pass your health care bill?

Let me be very clear, Mr Obama,

Methinks thou doth protest too much

My 5 year old can be quite dramatic. As with most 5 year olds, she is quite self-centered, as well. She also, has this way of deflecting blame. Her 4 year old sister is very good at this, too. It must be a developmental stage kids go through. At times, she would become very excited over an idea of doing something or having things exactly as she envisioned in her head. She is a perfectionist, to say the least. When things could not or would not be as she envisioned, she would say, "You're ruining my dream!"

Does this sound like anybody else you can think of?

C.A.V.E. People vs The Publicly Educated

2009-06-30T22:41:00.003-04:00

Perhaps there are more than one person on Facebook using the acronym CAVE, but for the uninitiated, it apparently means people who are Critical About Virtually Everything.

Now one of the most important aspects of education is to cultivate the ability to think critically... or at least it used to be. Once upon a time, there were these individuals who fancied themselves independent thinkers. This was before all the politically correct group think and altruism that infiltrates almost every aspect of our society now.

So, I found this gem of a comment on the White House Fan page on Facebook, regarding Healthcare reform. You'd swear some Republican had planted it to make Democrats look bad. Maybe so, but I tend to think it is the genuine opinion of the poor, dear, uneducated child who posted it:

I feel most nay-sayers (of government health care) are C.A.V.E people (critical about vitualy everything). How do these people think we became America? The Gov would be able to pay for a lot of this by repealing the BUSH TAX-CUTS...that is over a TRILLION $$ a year right there.
Why are we so scared of these SUPER WEALTHY people.
Havnt they done enough damage to our country?
We must STAND UP and NOT BE AFRAID....WE CAN DO THIS!

I won't argue her definition of super wealthy or even guess at who these wealthy elite are.. well maybe one guess, maybe she means the politicians? The political elite? Cuz' let me tell you, those guys got it made!

The part I find humorous is this, that somehow, she believes that our founding fathers would have supported our government providing health care to the people. I feel as though I do not even need to explain why this is absurd... but apparently there are some individuals who couldn't find a clue if they tripped over it, such as this young lady. Perhaps she has never been taught a thing about liberty and freedom from tyranny or how the authors of the Constitution engineered the framework of this great country to keep the federal government from wielding tyrannical power over the people. If the federal government does in fact wield power over our health care, then that is essentially having power over life and death. Our forefathers were quite critical about many things and planned appropriately. I know for a fact, they did not venture into this American Revolution willy nilly.

I do not trust these "angels" of government to look out for my best interest and I certainly do not trust them to make decisions about my health care.

I do find it a bit chuckle worthy that one should not be "critical" about the government being in charge of their health, LET ALONE ASKING "WHO'S GOING TO PAY FOR THIS?!?!" We already have a ponzi scheme called "MEDICARE" that we do not have the money to pay for, how exactly will we pay for Medicare for all???? Of that's right, the "government can pay for it"! Hey, where exactly does the government get that money? Tax payers? China? Hmm might need to think about that one... I bet they have a money tree in the White House Garden!

One more thing, if the richest people profited the most from the "Bush Tax Cuts", then who is to say that these "super-wealthy" people will bother to generate anymore wealth when these tax cuts go away? If they are so wealthy, what does it matter if they ever employ another person or generate any further income to tax? If it were me, I'd probably relocate to some other country or move my operations and assetts off shore... I'm just sayin...

They don't teach economics or history in public school anymore, do they?

Itchy crotch?

2009-05-31T21:02:00.003-04:00

The pharmacy was sort of quiet that day. I was just starting to walk out and forage for something to eat, when the creepy old lady walked up to the drop off area. She asked one technician, who gave her a blank look, "What?", she said. The other technician in the corner walks over and says, "What are you looking for?". They both look down to me, with pleading faces, "can you figure out what she is looking for?"

I walk down and she says, "I need some Vaginaless! My vagina is all burny and itchy."

"Oh, Vagasil? That's in the far aisle by cosmetics."

It sounds like a good product, though. Vagina-less! Works so well, you'll forget you even have one!

What a creepy old lady. Wrinkly, corpse like... remember that bathroom scene in The Shining?
Being the friendly, helpful, and alas still hungry, pharmacist I am, I rang her up. She was telling me, "I think this happens because I only drink coffee and strong tea"
"Maybe you should try and drink a bit more water?", I say.
"Oh I hate water! Never drink the stuff. Might be because of my bathtub, too. I soak in that rusty old tub and I bet that might have something to do with it!".
"Umm maybe." I say

Somehow, I am no longer very hungry... damn creepy, old, itchy crotch lady!

Don't blame me, I voted for Ron Paul

2009-05-18T11:05:00.002-04:00

At least during the Primary Election, when he was still on the ticket. This country is being run by a bunch of criminals.

Barney now wants to investigate and punish those responsible for the financial crisis

2009-04-08T06:36:00.005-04:00

Gee, masochistic much?

Love this kid. Just answer the question, Barney!

OK in 2007 you became Chairman, but you were warned in 2004 when you were the ranking Democrat on the Financial Services Committee. I guess you totally bought Raines line that "these assets are so risk-less, that their capital for holding them should be under 2 percent." That remark right there ought to disqualify this guy to be Obama's Economic Advisor. Clearly, his advice sucks!

Either you're with us or against us: Schools of Pharmacy

2009-04-05T13:21:00.002-04:00

The other day I was having some discussions with some young pharmacists, some pharmacy students. It seems there is a prevailing theme in the message to young pharmacy students: You specialize and get a residency or you're a loser who will end up in retail!

Wow, that's pretty harsh. The majority of my class, the last class of the 5 year program, went on to retail. For many, it was their family business. Truth is, the demand for pharmacists is in the retail sector. "So how many students are being set up to fail?", was pointed out by a wise pharmacist.

Surprising how many universities are willing to throw the historical origin of their livelihood under the bus, for what? More money spent on tuition for useless 6 year programs at graduate level prices? Residencies? Multiple rotations in everything, but retail?

Pharmacy schools could surely be doing more to improve the retail setting paradigm. Their influence could be much greater if only they spent less time sticking their scholarly noses in the air, acting as though only the degenerate, bottom of the class, red headed step child goes into retail.

Is it any wonder these pharmacists feel like failures and will take any human indignity thrust upon them? You're professionals god damn it! Stop wearing that sweatshirt with "WIMP" emblazoned upon it.

Here are some ideas for useful pharmacy courses:

Professionalism: how to stand up for yourself and get the respect you deserve as a health care professional in any setting

Bonuses & Compensation: Your humanity is not for sale, don't be a galley slave

I am sure you can come up with a million more, would love to hear them.

The Chattering Class and all those porky amendments

2009-02-20T09:30:00.004-05:00

This really puts the stimulus bill into prospective.

How does a guy like Chuck Schumer continue to be a senator? Maybe he is right, the majority of American people don't care, because they are completely indifferent and ignorant of what goes on beyond their reality TV and "E!" network. The American public schools have done their jobs. Several generations of oatmeal filled skulls now are registered to vote. The illiteracy rate in Detroit is now 49%.

I took an informal poll at work, and not one associate could tell me who Barney Frank is. I tried to explain but was asked "who the hell are Freddie Mac and Frannie Mae??"

I wish I could feel more optimistic about the future...

OK, who let all the crazies out today?

2009-02-14T19:13:00.006-05:00

Today I encountered some of the rudest, annoying, plain nutso customers ever. Perhaps they're a little down, because of their pathetic love lives with no one to spend Valentine's day with. It's probably the full moon, more realistically.

Issue #1 a customer had an RX transferred to WAG, but denied they did and screamed at my tech when she told her we would have to transfer it back. No clue what the big deal was??? Called, WAG, and indeed, the patient had transferred it and had it put on hold.

Issue #2 patient's daughter went nuts when we told her she had picked up the balance of an owe. She then got crazier, insisting the doctor had written for twice as much as the doctor actually did write for. Try to refill it and get a big ol "refill too soon". The daughter would not allow us to investigate and let us call her back, "want it fixed right now! while I am on the phone with you!" Great, tech was on the phone for 20 minutes, workflow backs waaaay up. You would think 10 grams of Silvadene per day would be plenty... go figure.

Issue #3 patient comes in with generic percocet vial, wonders why there is a red circle around the quantity. "I've never seen this before." Well, whether or not you are blind or have a bad memory, it doesn't change the fact that I am NOT giving you 5 pills you swear you were shorted. Sure, you can have corporate's phone number and address, knock yourself out lady.

Issue #4 probably the most frustrating exchange of the day:

me: Thank you for calling 'UnPCRPh's pharmacy', this is 'UnPCRPh'.

caller: I want to know how much this prescription for my son will be on my insurance.

me: Is this a refill of something you have gotten before?

caller: No, its a new prescription.

me: Well, you should call your insurance company or you could bring it in and we can try and fill it.

caller: Why, can't you do this over the phone?

me: Can you even read the prescription?

caller: Its printed out.

me: against my better judgement, but trying to be courteous OK if you can read to me what it says. What is the drug?

caller: *says something unintelligible*

me: Could you spell that?

caller: *spelling very quickly* A-L-T-A-V-A-X Could I just speak to the pharmacist?

me: I am the pharmacist. Would you please spell that again?

caller: A-L-T-A-B-A-X Are you sure you're the pharmacist?

me: Quite sure. Who is the patient?

caller: gives name

me: directions?

caller: Apply 10mg twice daily for 5 days

me: 10mg?

caller: that's what it says!

me: OK who is the prescriber?

caller: What does that mean?

me: Who wrote the prescription? The physician who wrote it?

caller: You know what? You are really annoying to me! I am just going to call some other pharmacy!

me: OK please do Don't do me any favors, lady. Gee I was just going out of my way to do something I normally don't do, and now I remember why.

CLICK!

Like I said, bunch o'crazies out there today. I haven't decided if I am going back tomorrow, yet...

If we had some Global Warming... I wouldn't have 2 Subarus stuck in my driveway

2009-02-07T10:26:00.006-05:00

Well, there's been snow on the ground for over a month now. The earth has been cooling since 1998. It has cooled so much, it negates the increased temperatures of the prior 100 years.

Funny how now the key phrase is Climate Change, not Global Warming. Hey if your theories are flawed then just re-engineer the language, works for me! So, when exactly did the climate not change? We live in a dynamic world. Ice ages, Super Volcanoes, asteroid impacts, dinosaurs... and you think driving a hybrid or a few plastic bottles are going to make a difference?

You know, Greenland used to be green! So, that right there tells you things change and human activity has nothing to do with it. 31,000 scientists agree. Not that science is based on consensus or anything *cough*... like some people say. I'm just sayin' *shrugs*

The Minnesotans for Global Warming recently had a parody of Van Morrison's "Tupelo Honey", called "Two Below Honey", removed from You Tube for copyright violation. I heard it on the Jim Quinn Show AKA America's Morning Show on Wednesday. Good stuff. These guys have a couple other parodies on You Tube that are worth hearing.

This one has a Bare Naked Ladies sound to it, very nice.

This one is a parody of Imagine. I especially like the photo of Al Gore breathing fire.

Cold climates are much more energy intensive than hot climates. Just something to think about. So get yourself an SUV and start using aerosol deodorant...

The Glamourous World of Pharmacy or the Ghetto Pharmacy Contest

2009-02-03T13:27:00.005-05:00

To get the politically incorrect reference out of the way first, Wikipedia describes a ghetto as a "portion of a city in which members of a minority group live especially because of social, legal, or economic pressure." As well as,

-"When the majority uses compulsion (typically violence, hostility, or legal barriers) to force minorities into particular areas. (sounds like pharmacists)
-When economic conditions make it difficult for minority members to live in non-minority areas."

Being the institutionalized health professionals we are, we tolerate a lot in our work places. In fact, many of us work in completely undignified, non-ergonomic, and down right filthy, dilapidated facilities.

The other day someone was mentioning Ben Franklin's 13 Virtues. Rule 10 was elaborated on as referring to home or business:

"10. Cleanliness: Tolerate no uncleanness in body, clothes or habitation."

Recently, I went to work for a new chain. I was asked to fill in at a nearby store. Now this particular location has been rented by multiple pharmacies over the last 40 years. I have never seen a more ghetto pharmacy! I went in to retrieve the key from the store manager. I found him sitting on a stool in a "broom closet" with no door, his feet resting on the safe, a phone propped on his shoulder. Actually, I have not one closet in my house as small as this so called "office", although the bathroom linen closet comes close.

The back room walls looked as though someone had tried to drive a truck through the skinny hall, or perhaps an orc battle had taken place in this dungeon; 4 different colors of paint peeking out of deep gouges in the walls, who's primary color now was a shade deeper than hospital green *barf*.

I unlocked the pharmacy, went in and saw the filthiest linoleum floors ever. Luckily, this was very hidden from the public, because of the clever design of putting the pharmacy area way back behind the cash registers, in a separate room with a large pass through window. This made it easy to get adequate exercise when coming out to speak to patients regularly. It also provided good shelter and protection if someone decided to try and jump the pharmacist. They would most certainly have to jump a counter, a wall and take out a cashier, too. That was a plus.

I could go on, but I am more inspired and anxious to see the working conditions you tolerate.

Send me photos at UnPCRPh at gmail dot com

Please try not to photograph the company logo or any other identifying features of the company you work for. Many chains have a no photographing policy, probably for the reason that they may be humiliated and embarrassed. Truthfully, I think they ought to be. I'll post the best here. There is no prize, other than the honor of your work place appearing here.

Something to cheer you up

2009-02-03T11:40:00.002-05:00

So, you say the state of the economy has you down? You say, "UnPC-RPh, why are you always so serious?"

Sometimes you just have to laugh or you would cry. Enjoy.

Spread Your Wealth Around

2008-11-08T12:32:00.000-05:00

What do we need jobs for?

2008-11-08T12:07:00.001-05:00

After seeing this, I am definitely homeschooling now

2008-11-08T00:26:00.003-05:00

You know, I do remember my teachers in elementary, middle, and high school leading us to believe Progressivism was superior. That was what they called it back then, they never said "liberal", it was always the term Progressive. In fact, I do not recall any explanation of the virtues of Conservatism. It was much more subtle than this teacher in the following video. We didn't get out right bashed for our (or our parent's) political opinions or support of one or another candidate.

I've learned far more history after graduating from college, than I ever learned in public school. For whatever reason, I do not think any history class I ever had in public school ever went over any recent history. Columbus discovered America and that was all we got. No Civil War. Certainly not any history of the 20Th century. No WW I or WWII. Vietnam? Are you kidding? Never even once studied the Constitution or The Bill of Rights in public school! I went to the same school district all 12 years, plus kindergarten!

Is it any wonder the young people of our country haven't a clue about what The United States stands for? If I am 35, and they have been progressively indoctrinated our young people and erasing our history for at least the last 30 years, is it any wonder the citizens of the United States can no longer recognize a Marxist, Communist, or Socialist when they speak in the same old phrases they've been speaking for nearly 100 years?

Those who forget history are doomed to repeat it.

Are you ready for Redistributive Change?

2008-11-03T19:58:00.005-05:00

Do you think the constitution should tell you what the government MUST do on your behalf? Obama does.

If this is what Obama believes the constitution should have been, then he does not really understand the original ideals this country was founded upon. The constitution protects our freedoms and liberties from a tyrannical, oppressive government. Nothing more. He doesn't get it at all.

Give us the freedom to create our own wealth, rather than redistributing it.

Huh? What is Obama telling these people at his rallies anyways?

2008-10-31T21:09:00.003-04:00

Apparently, Obama is going to make our mortgage payments and personally fill up our vehicle's gas tanks... or something like that. This woman couldn't just be delusional or anything...

HUH??? When I first heard of this video I thought it was a parody, but she seems genuinely moved. I'm looking forward to not paying my mortgage next month and all that free gas! Utopia at last.

Truth is Funnier than Fiction

2008-10-19T14:15:00.001-04:00

Original portion of skit cut out. Mr. Sandler thanks "Congressman Frank and many republicans for blocking congressional oversight about corrupt activities." Apparently, did not meet SNL's standards... whatever that means.

Demoralization, Destabilization, Insurgency, Normalization; Useful Idiots

2008-10-19T11:17:00.003-04:00

It appears we, in the United States, are in the tail end of Destabilization. Crisis is on the way. We're running out of time to force an end to this.

Yuri Bezmenov
Uploaded by onmyway02

Failed Bush policies? I think not. What really caused the current economic collapse.

2008-10-19T10:31:00.004-04:00

What really caused the current economic collapse in the United States? Watch this video.

White Collar Slavery; Think twice before you accept that sign on bonus

2008-09-28T09:15:00.002-04:00

http://www.rense.com/general63/newam.htm

This was written in 2005... looks like the economy is crashing as we speak. I've been aware of what this author tell us for some time now. If we do not free ourselves from our debt, we will be slaves to the system .

Gloomy, yes? But quite true in many respects. Especially, this. Thank you, to the Woodrow Wilson administration, for giving us the Federal Reserve. The dawning age of American Fascism.

Politicians and international bankers can manipulate national economies at will, much in the way the media manipulates your mind, and a decision has been made to impoverish Americans, because global government requires that everyone in the world have an equally low standard of living. Simply put, we're being robbed of all we've worked for, because our government wants us to be poor, hungry, and docile, dependant upon them for our existence, and in fear of them for our lives. The government of the United States is intentionally destroying the economy of the United States, because the politicians and the international bankers they work for have decided that the American way of life, and catering to the demands of the American constitution, is simply too expensive.

Regardless of how wealthy you think you are, you actually have no real money at all. The "federal reserve notes" that are in your wallet, and your bank account, aren't really money, but are actually only paper on a debt that can never be paid, not even by combining all the assets and labor of every American alive today. Any loan-shark with a third grade education will tell you "the paper's no good," and naturally, the foreign investors who allow us to float this debt, have come to the same conclusion.

What is commonly known as the "U.S. dollar," represents a debt that is owed by the U.S. federal government, to the federal reserve bank. The federal reserve bank happens to be the privately owned entity that lent the money that's represented by the paper in your wallet. The federal reserve act signed away everything you own, and the fruit of your labor as collateral on this debt, and as foreign investors are becoming increasingly unwilling to invest the $2 billion per day needed to cover the interest, our creditors will want to collect it.

Enviornmentalists still wrong after all these years...

2008-05-20T18:41:00.004-04:00

Funny thing about those Al-Gore-rithms you may have noticed in "An Inconvenient Truth" that supposedly take input data and spit out results showing the earth is going to burn up in a ball of man-made global warming... the thing is putting historical figures from the past do not even show an accurate account of the present day climate. So how exactly is this supposed to mean anything about the future? Oh that's right, facts don't matter, as long as the outcome is positive for the intended goal. Makes me think of Woodrow Wilson... but that is another historical lesson on progressivism in the 20th century.

It also makes me think of the crazy predictions environmentalists and other progressive political figures have been making in the last century.

For example, we should have run out of gold by 1981 and England should not even exist today! By 1984 the US would be out of natural gas! Hey?! Why is the gas company still billing me then?? Don't they know we ran out of gas 25 years ago???

For more fun facts about Environmentalists' wacky predictions check out Walter E. Williams article entitled Environmentalists' Wild Predictions.

Does your mother know you talk like that?

2008-04-12T12:37:00.004-04:00

I really want to say this to people who feel it is appropriate to drop the F-bomb on me as I am attempting to provide health care services to them. Instead I told the woman who kept saying it over and over at the top of her voice insisting that CVS doesn't ask her the date of birth or address, "If you are going to talk like that please do go to CVS next time. Please do not speak like that." To which she replied "I will Fing go to CVS next time."

Oh good glad we straightened that out...

Another man insisted the other pharmacy would have had his prior authorization renewed before he even requested the medication, 30 minutes ago. He did not plan ahead and allow time for his refill and was out completely. Lyrica is a 'life sustaining medication', don't I know, and if I were on a life sustaining medication I would somehow understand this and know this is not his fault, it is mine, of course. Wow how dumb am I? "F-you *click*" end of conversation.

Both of these F-bombers used the argument that the competitor does not require what I am asking of them or that the competitor provides superior, almost intuitive and telepathic services. Is there a Parapsycholgical School of Pharmacy out there? Perhaps I could do a correspondence course and improve my skills.

No, the truth is, these 'customers' have bought into the idea that they are always right and that this will somehow influence the way I am doing business with them. Hmm no I do not think so. Check out this blog post here called Top 5 reasons The Customer is Always Wrong or why 'the customer is always right' results in bad customer service. I will not be bullied into serving anyone who drops the f-bomb on me, so quit trying already.

The Elephant and the Dragon

2008-04-12T12:32:00.003-04:00

The Elephant and the Dragon --Robyn Meredith

This book is an amazing look at the economics and global affairs that are changing our lives. I am listening to it on audio book and it explains so much about what is changing and why. The good, the bad and what it will mean to us as China and India emerge onto the world market and make our products and do our back office work for us, respectively. It examines some of the poor strategy and policies the US has enacted and how it is eroding our status in the world.

The US seems to have miscalculated and assumed capitalism is synonymous with freedom, human rights, and democracy and China is redefining this after decades of anti business anti capitalism rule. Chinese people like their authoritarian government and capitalism now, this is a fierce combination. The USA is still debating an issue while the Chinese are already half way to the goal.

Life is probably better in many ways for the individual in China and India these days, but there are many problems, too. At least Chinese do not have to eat their neighbors children anymore... yes the book talks about the history under Mao, also.

It just covers so much in a mostly objective way. I recommend this book to anyone who wants to understand more about world economics and what is going on in the world.

Pharmacists get no respect... anymore

2008-04-02T19:27:00.006-04:00

2 events have caused me to ponder authority and respect, recently.

The other day I worked in an old pharmacy.. they say its been there since the 1970s. It was one of those small pharmacies stuck in next to the service desk. The kind that is totally enclosed on all sides, with windows on the front and a window that opens up at just one section and serves as register/dropoff/pickup/counseling. The door to the pharmacy is a heavy glass door that remains closed and locked at all times. When you open the door and walk in you have to go up 3 steps. I love this pharmacy!

Ok it was not at all aesthetically pleasing in anyway. However, when patients asked me to come to the window for counseling, they looked up into my face with respect and I might have even detected admiration and, could it be? gratitude? I felt like a judge bestowing justice upon the sick masses. No one cussed me out or spoke to me in a nasty, snotty tone. I had a wonderful day!

The other thing that happened the other day.. I got pulled over for expired tags on my vehicle. I had no idea they were expired. I bought the car last summer and had not even thought about having to renew registration so soon. The officer was very kind and just and gave me a warning, perhaps he knew I was totally clueless about this small detail I had overlooked... or perhaps I was polite and had few violations on my driving record... I cannot be sure why. The thing is, I was intimidated by this guy and I treated him with total respect, because I knew there were consequences involved if I got mouthy or arrogant. Plus this guy has a gun. He is the law.

Now I would never suggest that I like being the "drug police", but we are the gate keepers. Why don't people have a little more respect for us? Why do they fear no consequences when dealing with us?

I have no idea who decided pharmacies should no longer be raised above the sales floor, but I suspect it was some smarmy non-pharmacist manager type who was annoyed with our elevated professional status and wanted to bring us down to his level, literally. So he probably sold the idea to upper management, saying it was warmer and fuzzier and more customer oriented.

I suppose this does not fit in with the new customer centered paradigm in community pharmacy. However, where along the way did becoming "caregivers" mean we gave up authority? Why does it have to be that way? Can we not do a little more "tough-love" type care giving?

In my perfect pharmacy the pharmacy would be elevated, the pharmacists would carry side arms, and have the authority to issue citations for disorderly conduct. I can dream can't I? Actually, the pharmacy I interned at had all of those things. The pharmacist/owner was always armed, he was a deputy sheriff, and the pharmacy was elevated. I cannot recall anyone ever giving us any grief in the 2 summers I worked there. Life was good.

"We have to find a way to get the carbon out of coal"

2008-03-30T20:24:00.003-04:00

That is what I just heard Hillary Clinton say during a speech out-take I just watched on CNN. This must be that new "green-thinking" we're hearing so much about.
...perhaps she will earmark spending to fund research on that sticky little carbon-in-coal dilema. I think that coal has probably been polluted with carbon!

People, I fear for the future...

Earth Hour... a useless waste of an hour in the dark

2008-03-29T14:59:00.000-04:00

http://www.google.com/intl/en/earthhour/

Anyone taking part in this? So we sit around in the dark for an hour? Sounds thrilling and like a good time for a nap.

If I hear the term "climate change" one more time I think I will puke. I guess someone figured out "global warming" was not happening, so now we call it "climate change"... My guess is people are not going to be falling for it much longer. Enviornmental toxins and heavy metals are way more dangerous to our daily lives and health, but since you cannot create global currency with it through the use of carbon credits its just not that "interesting" of a cause. Carbon is not a pollutant people!

Why does non-pharmacy management not get it?

2008-03-29T11:40:00.005-04:00

Why do they see customer service as a higher priority than patient safety? Profits and market share I assume. We have to emphasis our value and ability to positively effect profits and market share somehow or get out of the traditional retail model. Unless we figure out a way to change the way PBMs reimburse.. which seems improbable. Although, MTM is out there, how it fits into the retail pharmacy model now is not entirely clear.

A pharmacy manager got a "coaching" from a new grocery store manager who transfered in from a big box store which has "guests" for customers. The store manager had gotten wind that someone had told a customer they would not be served if they did not get off their cell phone. This was unacceptable and in stark contrast to the company's emphasis on customer service. We cannot inconvience the customer! The customer is here to have a pleasent expirience and we must kiss their ass as much as they demand. Ok I am paraphrasing here.. BUT the argument that we are healthcare professionals and must be sure our products and services do not cause injury or death to the customer does not seem to hold any merit in their eyes. Simply, they do not care how difficult it is for us to perform our "job". Under no circumstances is it acceptable to ask the customer to do anything to ensure their safety.

Now THAT is in stark contrast to everything a health professional ought to be about. Do no harm. There should be no question about our commitment to our patients, especially from a non-healthcare manager who treats the pharmacy department no different than the floral department or the bakery. Our dignity, self-respect, and integrity are nonexistent in their eyes.

We have to do something to get control of our profession or we are not going to have one. If this upsets you, you need to join The Pharmacy Alliance and get pharmacy back on track.

US Immigration and Gumballs

2008-03-01T11:22:00.000-05:00

Lee Scott Call your office. WalMart, Walgreens, CVS are you listening?

2008-02-12T22:46:00.004-05:00

USA Today Printed an article about pharmacy errors and high volume.

I wonder if anyone out there with the ability to change the path of retail pharmacy, currently on the path headed towards destruction, will listen? Now that PBMs are raping us on reimbursement more often than they used, thanks WalMart! Your $4 prescription plan is evil. "Under (Scott) Lee’s direction, the company has also taken the lead in addressing the U.S. health care crisis. Wal-Mart introduced $4 generic prescription drugs" The chains pimp us like cheap whores and try to squeeze ever last ounce of dignity and self respect we have out of us for the sake of high volume. Have to get that payroll down, cut tech hours, and beat last years weekly sales and RX volume. If you do all that and keep a smile on your face while taking it up the arse you just might get a bonus or gift certificates for the Olive Garden.

My favorite part of this USA Today expose was the guy with 2 years expirience as a pharmacist, who works 20 hours a week for CVS while attending law school, arguing in defense of CVS's coporate policies. Oh my *wiping tears* I haven't laughed that hard in a loooong time. This guy is going to be a damn good lawyer, but probably not a great retail pharmacist for very long. If you missed this little nugget check it out. I do not believe this man dispenses nearly as many pills as he takes.

Drive-Up Pharmacy Windows May Fuel Errors ...who'd have thunk it?

2008-01-29T09:47:00.000-05:00

Found at Pharmacist E Link Source: United Press International Publication date: 2008-01-23 Drive-Up Pharmacy Windows May Fuel Errors

The study, published in the International Journal for Quality in Health Care, found responding pharmacists attributed about 80 percent of dispensing errors to cognitive problems that Szeinbach said could be associated with various disruptions that interfere with their work.

Golfers trying to put a tiny ball in a little hole get more respect than pharmacists, and they aren't even trying to save lives! Wake up people! Distractions are deadly.

Pharmacy whore

2007-12-31T09:58:00.000-05:00

This issue has been weighing on my mind since I worked my butt off yesterday. I filled 221 scripts in 7 hours (although I had to stay an hour later to catch up) with 12 hours of tech help total (although I did keep the one tech an hour after close to help catch up), so 13 hours in truth. I did manage to help a few patients on the phone and in the store who had questions for me. In reality, though, I feel I didn't really do much professionally to help these patients manage their drug regimens, aside from the usual DUR on the computer. There was absolutely NO TIME to do it! Unless I wanted to stay 3 or 4 hours after close.

Then this morning I read JP's blog http://www.jimplagakis.com/?p=90
You know, I was just thinking about all this in regards to lack of pharmacy support help. Even if I wanted to counsel patients, do MTM, immunizations, or any number of other things to improve the quality of care that I provide to patients, I couldn't do it! Paying ME extra money won't get the job done, either. In fact, it would probably require support staff be cut even more.

I've been in pharmacy for 10 years now and I've noticed a drastic change in levels of staffing over the years. Every week the grocery chain pharmacy I work for (now only on-call) is cutting their tech hours, despite record sales, and exceeding budget sales volume. Why? $4 generics, drive thrus, razor thin margins.. To make any profit these chains have to squeeze every drop out of their employees, or so they think.

The pharmacist shortage, also, contributes to this. I am sure as the chains have to throw more $$ at pharmacist's to entice them to be their slaves, er.. come work for them, they have to pull that $$ from somewhere, so they cut support, non-essential employee payroll. The state doesn't come shut you down if you have inadequate tech help (in most states), but they usually frown on dispensing without a pharmacist present.

It is very upsetting to me. I do not want to work like that anymore. I want to practice pharmacy, not just serve as a license on the wall. The job is so stressful, so hectic, so unfulfilling and mindless at times. The idea of doing that for 30 or 40 years sounds about as appealing as being tortured for 30 or 40 years. Which is essentially what it is. All the money in the world is not worth ruining your physical and mental health to try, futilely in many cases, to help people who could not care less about anything other than their fuel perks, coupons, or how much their copay is. I just cannot allow myself to be abused like that anymore. I am not going to be some one's pharmacy whore.

How difficult can it be to design pharmacy software?

2007-12-06T17:01:00.000-05:00

I remember when I first used PDX software back in college... I thought it was horrible. Thinking back, though, I think if I had known more about what I was trying to do it would have been easier. How many things can and should prescription filling software do? A bunch I suppose, but basically it must do a few specific things

1. Fill Prescriptions
2. Price Prescriptions, 3rd party or cash
3. Reverse claims or transactions, 3rd party or cash

Perhaps, because I've been using PDX for over 10 years it seems straight forward to me. It makes sense to me. It uses words and phrases like:

check
fill
credit return
alternative plans

With this RX30 I cannot even figure out how to toggle between cash and 3rd party easily. And what is with all this fill, fill/refill, edit? What's the difference? Who cares? Why bother..

I, also, cannot figure out how to reverse a prescription. Well, I have part of it worked out, but I want to reverse it, rebill it for cash, and over ride the price. Sounds easy, but all this fill, refill, edit mode has me all confused. The options on the function keys change based on the mode, etc... so when I think a certain option ought to appear on the function keys, it isn't there anymore or its something else.

Maybe someday I will love RX30.. but today I have serious doubts. How difficult can it be to design a prescription software that actually makes sense??? Apparently, very difficult, because not many have have succeeded very often.

Its very frustrating. Its like driving in Pittsburgh. I can see where I want to go, but can't get there. Its like the Highland Park Bridge: want to go left? go right, but of course!

Arrrghhh!

Post-traumatic stress disorder and retail pharmacy

2007-12-02T20:11:00.000-05:00

This isn't a clinical post about PTSD in community pharmacy patients. This is a post about community pharmacists in retail pharmacy suffering PTSD.

Recently, I read this post http://oleapothecary.blog.com/2335808/ at Ole Apothecary's blog. Today I worked in a location for my former full-time employer that I haven't worked at in over 10 years. I knew this location was much busier than the location I had worked in for the last year. I was apprehensive all week thinking about going there, not knowing what to expect, but expecting the worst.

My last location, although, not unmanageably busy, had some of the rudest, crankiest, disrespectful customers I have ever had the opportunity of caring for. I have spent the last year being verbally and emotionally abused by these horrid people, the Critlans. Critlans are like hill billies who have crawled out from under some rock. They may look harmless (smell may be another story), but they lack the social mores of polite society.

After working in Critlanville for a year I am hard pressed to think of more than a small handful of customers I felt an endearing affinity for. Just hearing their voice on the phone, seeing their face at the counter, or their name in print would nearly send me into a panic attack. I began to avoid all customer interaction.

Today, in the other location, not far from the old, the customers pleasantly surprised me. No one swore at me today! No one got snarky with me when I asked them a simple question. These people were mostly very polite and even nice to deal with. I had a very nice day I wasn't expecting at all.

Now I wonder... this store isn't all that far from the other one, could it be that the negativity of the staff at the store has conditioned the customers to behave as they do? Could it be some sort of twisted codependent relationship? The staff and customers enabling this vicious cycle? I don't know. However, today my faith in the general goodness of people patronizing retail pharmacies has been somewhat restored. Perhaps someday I will heal from the hell of the last year.

The Un-PC Pharmacist has Moved to Indie Pharmacy

2007-11-30T21:46:00.000-05:00

So what am I going to complain about now? This new work place is considerably less stressful, more dignified and much more professionally fulfilling. Of course I've decided to continue working one day a month for my former employer so perhaps I'll find some interesting topics on those days. I have one day coming up this week there which I am so not looking forward to. I don't want to go! If this indie gig is successful hopefully I can quit the chain eventually.

The Idiots Guide to the Metric System and other measurements

2007-11-16T23:09:00.000-05:00

Does this book exist, yet? It ought to. I filled a prescription for a child post tonsillectomy the other day for Amoxil 800mg liquid bid. The doctor confirmed the dose was based on the child's weight. The doctor wanted 22.5mg/kg per dose. So in a 250mg/5ml suspension it comes to 16ml per dose. That is what I put on the label and gave mom a dosing spoon. 30 minutes later I got this call.

"Last time I checked, this is America! I need to know what 16ml is in English! The label on the pain syrup is fine, it says 2 teaspoonfuls or 10ml, but this antibiotic says just 16ml!"

I imagined giving her a lesson on metric vs English. She acted as if we had told her to give the child a dram or some apothecary nonsense. "Did you get a dosing spoon from us?" I feared perhaps we had overlooked that detail.

"Yes!"

"Well, if you look, there are ml and teaspoons measured on it. There are 5ml in each teaspoonful. So, you will give 15ml plus 1ml."

Loud annoyed sigh. "Alllriiiight then!" click

Head meet counter.

----------------------------

The new safeguard in place to make sure the correct person gets the correct prescription involves the register prompting you to enter the person's date of birth when you ring up the RX. I am ringing out a woman's son's RX.

"date of birth please"

As quickly as an auctioneer she rattles off a string of uncomprehensible numbers. "12394"

I enter 1231994 *buzz* incorrect

"Could you repeat that, please?" I say, because I realize my error, but I do not understand what date she means.

Exasperated sigh "12394" even faster this time.

I enter 01231994 *buzz* incorrect

"Ma'am, what is the birthday again?"

"12394!!"

"OK. Are you saying January 23 or December 3?"

She is now looking at me like I am the inconsiderate idiot here. "December 3!" giving me that 'duh' look.

I wanted to slap her.

Gez I hate people. People have no manners these days.

Take a Drug Test?

2007-11-14T10:04:00.000-05:00

NameThatDrug.com - The drug test

Obtrusive store managers and drunk a**holes

2007-11-11T11:48:00.000-05:00

Apparently, no one has ever pointed out to the managers at the store I've been working in for almost a year, that store managers have no professional authority or judgement when it comes to pharmacy patient matters. It saddens me a bit, but I think I now know why the store managers and owner adore the pharmacy manager so much and claim to have such a "wonderful working relationship", as the DM told me. ie bend over and take it. Don't get me wrong... I enjoy working with my partner, however, I think he could be a tiny bit less submissive. I understand a bit more about how the customers got to be so disrespectful and belligerent. Every time there's a disagreement these fools get rewarded with gift cards. Nothing like rewarding bad behavior. I'm no psychologist, but I think its got something to do with positive reinforcement...

The other day, approximately 10am, a man returned to the counter to pick up his Xanax & Lortab at the agreed upon time. This guy smelled as if he'd just left a breakfast buffet of beer, whiskey, and gin. I did not know this, yet, though. The technician rang up the 2 RXs for cash price, and this idiot slides a Medicaid card across the counter. Now why wait until after the RXs are filled??!?!?! This is common, though, so I hardly waste any energy getting upset about idiots like this.

SO the Rxs are rebilled only to find, you'll never guess, that the RXs are too soon to refill! Surprise surprise surprise... The technician explains this and that is the moment this fella who smelled like a fraternity house with the cocky grin went ballistic and starts dropping the F-bomb. "This is Fing ridiculous!" A whole sad story of excuses as to "why he needs the medication right now and why he cannot possibly fill it here tomorrow or anywhere else" ensues. I, using my years of experience and professional judgement, hear my BS detector going off loudly.

I do try to call Medicaid's help desk, only to get the "its either a holiday or were just too busy, call back later" message... gotta love government work. I try to call the doctor and it just rings and rings.. weird. Meanwhile this belligerent, impolite drunk is babbling the entire time, giving me those weaselly excuses and explanations, with the occasional "this is ridiculous!" "I need it!" "I can't get it tomorrow." I guess when you're on medicaid you've got places to see, people to meet with. Very tight schedule you know. Medicaid patients on narcotics go on vacation more often than I do. There must be a AAA travel planning component to the entire public assistance program.

Anyways, I'm fed up with the disrespect and annoyed, so I give the RX back to him and say, "I'm not filling these, take them somewhere else tomorrow when you get to where you're going." Totally reasonable, right? To a normal, sober person, but not this guy.
He starts demanding to speak with the manager.

"Sorry he is off."

"Well, there has to be someone else here!"

"Yes, ME! I am in charge in his absence"

"NO I want a store manager!" and he storms off.

I think, yea whatever, and go back to my regularly scheduled program. Thinking these store managers will do what they did when I was at all my other stores, throw up their hands and say "you'll have to contact pharmacy services. Nothing we can do, they just rent the space". Oh how wrong I was...

Within moments some semi-retired woman, who's name I know not, comes and gives me the "get over here" finger gesture and says "I need to speak to you". I feel as though Ive just been called to the principals office. Basically she wants to know what happened, what did the guy do, why can't I just fill the RX early. I simply say, "I am the pharmacist and I am not filling his prescriptions." and walk away. I do not need to explain this to some woman with an associates degree. I do not have time for this retardedness.

Well, long story short, apparently, Ms. store manager did not like my reply and went to the store owner. The store owner??!?! Can you believe this?? Some guy who just owns the stores, does no actual work in the store, does not deal with customer service. Luckily or unluckily I was off the next day. They call the pharmacy manager into the manager's office for a conference call with the owner about the incident. Even though I left him a note about the incident he claims he knows nothing. Great! I wish I had been there to make my case. On the other hand, I do not need drama.

Store managers, if you're reading this, what I expect when a customer complains to you about me is this.
1. Tell him you're sorry he is upset, but the pharmacy is a separate entity from your store.
2. Hand him a card to call the customer service center.
3. Send him on his way.

What not to do.
1. DO NOT embolden the customer by coming to me and questioning me about my professional judgement and things you know nothing about. Ask me later if you're curious, but not in front of the belligerent drunk guy.
2. DO NOT ask me to fill an RX early on a medicaid card. You may not give a shit about my license, but I sure as shit do!
3. DO NOT do that finger 'come hither' movement. You are not my mom.
4. DO NOT go crying to the store owner. He has more important things to worry about, I am sure.

On a separate, happy note, I am out of that place in one week. Therefore, I see no reason to go making this point to those managers. I do not want to create bad blood between them and the current manager. If he likes things that way, fine... I'll be sure to leave him a bottle of lube as a parting gift when I say my goodbyes.

Expess Pharmacy Lane

2007-10-06T12:43:00.000-04:00

The other day, we received a customer service complaint, forwarded from corporate. A customer of ours complained "the drive through would be wonderful if I could actually 'drive-thru' and drop off my prescription quickly. Instead, I have to wait 15-20 minutes in a line of cars, just to drop off a prescription."

I so wanted to call this person and explain the idea of not getting out of your car did not equate to 'express pharmacy lane', however, I decided to leave it to the PIC-manager. I hope he has the balls to tell her that, in a tactful way, of course. Tact is something that often eludes me. I've been described in the past as being 'too blunt' by friends, colleagues, employees, employers, etc.. Me blunt? nah!

Having a drive through only stretches the limited staff we have even thinner. Guess how many additional hours we received in our staff budget for the new drive thru? 3!! 3 more hours to manage an additional register/drop-off/pick-up portal. So now we do not just have one line of impatient angry customers, we have 2 lines of angry impatient customers who have to wait even longer to be served. Ah progress.

The drive thru is just another way for the 'instant gratification society' to find fault in their perception of the profession of pharmacy. In fact, I'm pretty sure they do not view us as professionals at all, anymore.

Sinus mints?

2007-10-03T21:57:00.000-04:00

Got a phone call today. tech tells me, "line 1 is all yours, no idea what they are asking for"

I pick up and the lady asks if we carry something. No idea what she has just said. It sounds like something "mints". This woman, however, speaks what we call "Crittlin" here. Think of it as a sort of Hill-billy speak. These folks speak some dialect of English, with a side of Pittsburgese. In fact she may well have started out saying "Yinz guys got any ah 'dem Neilmed Sinus "mints", n'at?" Crittlin is the term we affectionately call the local hicks who lack the usual social mores and lanuage skills of polite society. Think of them as critters who just crawled out from under a rock somewhere.

"Can you spell that, please?"

"N-e-i-l-m-e-d Sinus mints"

"Neilmed? did you say sinus mints? m-i-n-t-s?"

"...." silence

I punch up "neilmed" in mckesson SMO, and find this woman is saying "rinse", not "mints". Apparently its one of these rinses for cleaning out the nasal passages.

Hard to believe we speak the same language.

What if people were rewarded for achieving in our society?

2007-09-28T12:56:00.000-04:00

Rather than coddled and taken care of from cradle to grave? What if people were responsible for their own well being, their own survival? What if it wasn't the government's job to take care of your every need through social programs?

Somewhere a few weeks ago, I heard someone propose an income tax system that would encourage people to achieve and prosper. Now hear me out, I realize there are some flaws, but how much more flawed than our current income tax situation? Yes, its outlandish, but our current income tax system only coddles those living on the dole and does nothing to encourage them to achieve and get off it. Many people realize they will make less money if they get an entry level job, than they can get through entitlement programs.

The proposed income tax model went something like this:

Consider that those of lower incomes qualify and utilize more social government services. SO, would it not make sense that they fund more of their expenses through income taxes? Therefore, the lowest earners should pay the higher % of income tax, say 33%. As the income brackets increase, the % of income tax paid should decrease, as a reward for improving your economic standing and achieving. So ultimately, once you reach, say $200,000 annual income, you would pay the least % of taxes, or no income tax whatsoever.

Obviously, if you have a larger income you're going to be able to spend more, and pay more sales tax simply by being a consumer with a bigger bank account, right? You're also going to be able to contribute to others income by hiring others to work for you or do jobs you do not wish to do, maybe own your own business and put others to work.

OK I admit, I loved Reagan and I believe our country has it all backwards. I have a tendancy toward Libertarianism. I do not support government mandated redistribution of wealth. I see our current income tax model as confiscatory and punitive. It punishes those who achieve and are responsible, productive members of society and rewards those who are classified as victims.

Don't even get me started on capital gains tax. People shouldn't be punished through extreme taxation for investing and prospering in their investments.

Yes that is the way i see it, its political, but it makes sense to me. Hope i did not offend any one's sensibilities. I'm sure I probably did. You'll probably never in your life time see an income tax system like this. People who work in government like their jobs and sure as heck like being important, too. They would never actively work to put themselves out of work or minimize their important role in your day to day survival. They're the government, they're just here to help you.

Recruiters, why do they waste my time?

2007-09-27T22:29:00.000-04:00

Head hunters, recruiters, whatever you call them... these people never listen, do they? I put a resume up on a pharmacist career site. In my listing, along with my resume, I stated "Please contact via email, no phone calls please". Only one recruiter emailed! I received 7 calls the following monday. Now I don't know about you, my fellow retail pharmacist, but do you have time to take calls from recruiters ever? Let alone on monday? I've got 30 messages on my voice mail from damn recruiters. Of course, they never tell you anything until you talk to them. Then when you do speak to them, they tell you about jobs you don't want. I said no hospital, why are you calling me about hospital?

I, also, specified the geographic area I am interested in. Only one recruiter offered options in the area I specified. Why do they waste my and their time on areas I am not intereted in traveling to? I said I don't want to drive into the city, why are you telling me about a job in the city on the side furthest from my home? Do you know how to use mapquest?

I, then, reluctantly, in a moment of weakness, decided I would do an interview with a certain hospital. It was right at the edge of my geographic limit. I made the interview for 2 weeks in advance. I, and my family, then came down with illness the next week and knew I would be in no condition for an interview the following week, because of all the obligations to work and home I had. There would be no way possible I could squeeze this interview in. I was tired, stressed, sick, and cranky. We have tons of laundry and house work to catch up on and we're all feeling like crap. My kids are whiney and needy and completely annoying.

So I informed the recruiter a week in advance, that I want to cancel the interview and possibly reschedule. He calls me back and leaves me a voice mail, since I am sick and working like a dog and cannot possibly take a call. In his voice mail he quilt trips me and tells me how inconsiderate I am being. ME! I am being inconsiderate to him and the hospital while I and my family are sick! How dare I get sick, because 4 people went out of their way to schedule this interview. I have no idea what the rest of his message said, but I deleted it before I could hear the rest. I was just infuriated listening to this man berate me for canceling an interview for something as trivial as illness, a week in advance.

So, I think I may just pull my resume off this service. Clearly, the recruiters do not even follow instructions and only want to waste people's time and belittle them for having real life obligations.

I hate the drive thru

2007-09-21T22:41:00.000-04:00

Whoever conceived of this should suffer eternal damnation. I absolutely, cannot stand the drive thru. I refuse to use it. The techs can wait on it, but I will not. If a customer has a question I will go to the window, but I am not volunteering to use this thing.

First of all i cannot understand a thing these people are saying. I've called Diebold about it and they said it worked perfectly... well I still cannot figure out what name they are giving. "Was that Stone? Pone? Barone? Calhoun?" Its just an accident waiting to happen. I admit, my hearing isn't perfect, but who's is?

People seem to think its the "Express Lane", not just a drive thru. Some lady picking up said to my tech, "I'm a nurse! (why this statement was necessary, no idea, perhaps so I would know not to take her too seriously. oooh maybe I will get nurse hate mail hehe) And there is nothing 'express' about this at all. This took longer than coming into the store!"
Well, that is why it isn't called the "express lane", its so your lazy ass doesn't have to get out of your SUV and walk into the store.

The glass makes these people feel invulnerable and they can be as rude as they like. Not to mention yakking away on their cell phone, while gulping down a big mac or dragging on a cigarette (or a joint, yes this has happened!) while we're trying to verify the DOB and figure out the correct identity so we can actually give you the correct prescription.

Most of all, the drive thru does nothing to elevate pharmacy as a profession. All it does is trivialize our profession and make us appear as professional as a burger flipper at McDonalds. What is next? Drive thru med-express clinics???

Oh and that reminds me, this year, our company will be holding Drive-thru Flu clinics in select locations. How safe is this??? You're going to inject crap into someone and then they can just drive away?? What if they have a reaction? Are we going to be liable for this? Perhaps they will just sign some release. Who knows... sounds rediculous to me. I want nothing to do with that one.

My plan to be more positive

2007-09-21T22:23:00.000-04:00

Lately, I've been disgruntled. A bit under the weather with a bad cold and stomach bug, too. Have you ever worked in a pharmacy where some of the techs or pharmacists are little bit negative? Ready to gripe about the previous idiotic, rude customer as soon as they walk out of ear shot? I have a tendency to feed on the vibe around me.

I have been at the current location for about 10 months now. The vibe there can be less than positive. The customers are tough, many acting as if they just crawled out fro under some rock, lacking the social mores of polite society. Many just grunt or cuss at you. With the growth in business since I've started there, the growing pains have not helped. I am resolving to be less cynical, more patient, and positive in my dealings with customers. Especially, when i realized the other day, during a conversation with my boss about how crummy I've been feeling, that maybe some of these patients are feeling as yucky as I have been feeling; like gum stuck to the bottom of a shoe. Just hanging on and trying to get through the day.

Let's hope I can stick to it. I'll begin just as soon as my energy is back up. Man this cold sucks!

I can still be a negative jerk here, though, right? Gotta vent somewhere, don't I?

Do you have flax seed?

2007-09-12T20:39:00.000-04:00

Now I do not know why I insist on tryng to answer everyone's questions or give them the best recomendation. I suppose I just want them to be happy and get what they need. Is that so bad?

I hate when people ask me a question and then argue with me about my answer or reject my answer because they want me to give the the answer they want... but this one takes the cake!

It was slow, couple hours before closing. Now my store has just been completely reset and everything has moved. The pharmacy, the cereal, the diapers, the OTCs, everything! So I'm getting used to being asked where stuff is that isn't even a pharmacy/OTC item. A couple techs, my partner, and I are talking near the drop off window.

A young looking yuppie type getting close to retirement in his 50s, probably, comes to the window.
"Do you have flax seed?"

the techs all look to me. I walk over beside them at the window and say"if we have flax seed in a supplement it would be right there with the vitamins next to this window"

"NO, I want flax seeds" he says in an exasperated way. He seems impatient.

"So you don't want a capsule or a supplement? Well if we had flax seeds they would probably be over in the produce dept with the nuts and seeds."

"NO! I want ground up flax seed"

"In a capsule?" I say

"NO!! I want to sprinkle it on my cereal!" he seems angrier.

I'm thinking this is getting ridiculous, just grind the damn seeds up. "Well you might look in the cereal aisle next to the wheat germ and oat meal. it'd be there if we had it like that." I say cheerful as ever, thinking I have finally solved his problem.

"No no no forget about it!" he snorts and storms away...

Now where did I go wrong? Did I not give him every option I could fathom? I just don't get people...

Can you fire your trouble customers?

2007-09-12T10:12:00.000-04:00

Maybe you've read about this lately. Apparently,Sprint-Nextel "fired" customers who called customer service disproportionately more often. These customers had called 100s of times in 6 months about minor issues. The company decided these folks were costing more than the profit they represented, so they sent letters telling them Sprint-Nextel decided they would no longer serve these unhappy customers.
http://www.searchrank.com/blog/2007/07/when-is-it-time-to-fire-your-customers.html

I work in a retail setting and I know for a fact that "the customer is NOT always right". In today's increasingly litigious society, some customers a true liability. The costs to serve them negate any profit they represent. I would love to fire some of my customers! I say kudos to a company who tells it's PITA customers "no more!"

We have these one man, on social security, disability, public assistance, who constantly complains and threatens us that he is calling his attorney, Dallas-Hartman. Now I don't know how a man with no income retains a personal attorney, let alone pays his legal fees, so I'm not too frightened, but what if he did? He's already wasted our time on numerous frivolous complaints. What if he found some reason to tie us up in a court battle, just because he is such a bitter, litigious person? I sure hope my company would back me up. Still, why would I want to put up with this?

In the past I have told customers "no more". Go elsewhere. usually because of drug seeking tendencies, not usually just customer service issues. If a customer is plainly dishonest with me, I will also tell them not to come back. However, when they go to corporate and corporate kisses their ass by sending them coupons and gift cards I feel as if I'm not being backed up while they reward some a-hole for his horrible behavior.

PBMs making us do all the work?

2007-09-11T20:47:00.002-04:00

It sort of annoys me that PBMs dictate what they pay for, when they pay for it... and in some cases whether or not the claim will process based on whether or not your reason for them honoring you and the patient with an over ride is good enough. PBMs are basicly already screwing us, right? They dictate the reimbursent. So why are we such slaves to them? Well, it all goes back to a long history of our (retail pharmacy's) submission to them.

I got into a spat with a PBM agent today. The patient was new, brought us a RX that was for a huge amount of Percocet #300. I called the doc's office to verify the amount, but I was also informed by the lady at the office that the doc was in a different office and she had to call it while i was on hold to get the amount verified. She then gave me the doc's other # in case there were further questions.

So I went ahead and attempted to process the claim to the lady's medicare D. It was an odd Med D, Id never heard of before, Goldsomethingorother, it was processed by one of those places that cannot really do much, so then you call the plan directly, you may know the drill.

The claim did NOT process and came back 1 day too soon. We told the patient and she said that she was now taking #12, instead of #8 a day. She phoned her insurance company using the # on her card and told us to talk to "Rose" and they would over ride the RX.

So I called. The PBM that processed the claims pays the claim and knows the day supply, so you'd think they'd know what sig was on the RX they paid last month, right? I called the given # and asked for Rose, but Rose was on another call, so i spoke to some one else. This person told me the patient had received #210 Percocet for a 27 day supply on 8/22/07.

I told her my RX is a #300 for 25 days and that the customer said they would over ride it for us.

the PBM agent says "well did you verify the increase in dose with the doctor?" I had tried to call the doc at the # the person at his other office had given to me, but could only leave a voice mail, no one answered.

I said "well no. the customer said you would over ride it, so I called you."

"well did you call the other pharmacy?" she says

"No, i don't know where she filled it." I say

"I can tell you that. she got #210, a 27 day supply 8/22 at Rite Aid."

"Oh good" I say, "then you can over ride it? This is a 25 day suppy for #300"

"Oh call Rite Aid, then call back and we will over ride it" she says

"Wait a minute! you want me to call Rite Aid, verify the info you just gave me and call you back? Why would I DO THAT?!" I say

"well you need to verify if the sig is different"

"You just told me the day supply!"

"I cannot see what the sig was" she says

"If you care so much why don't you call? I'm just processing the claim through to you! She is your client and frankly i don't care enough to spend this much time on this calling you, calling the other pharmacy, then calling you back, when you could call and do the over ride all at once.!"

"Well you should care! she is YOUR patient and if you want her to get her medication you will make the calls. but if you don't really care that much, as you say, than don't do it" she says

"Fine!" i grumble "whats Rite Aids #?"

Can you believe that crap?! To make a long story short I did waste my time, I called Rite Aid, AND I called this Goldsleiger Med D place back and was transferred 3 or 4 times until ultimately another agent at the plan said "we cannot do an over ride for a narc without doing a utilization review. I cannot imagine any agent would have told you (the story above), but I apologize. We have to contact the doctor and get the over ride. Well call you when it is auth'd"

Good lord! luckily the patient was pretty understanding, but what a waste of time for a RX.. at least we made $50 on it. If I had wasted all this time for like 23 cents Id have been really annoyed.