Thursday, January 08, 2009

A Letter To John A. Gans, APhA Executive Vice President and CEO

I saw your commentary in the December, 2008 issue of Pharmacy Today this afternoon. What wonderful words:

If you’ve started your MTM offerings but are still in the fledgling stage, is now the time to ramp up, do some marketing of what you have, or add services you’ve been thinking about? I hope so. Every time we look at the impact of pharmacist services on a chronic condition, the results show dramatic improvements in clinical, economic, and humanistic outcomes. Whether it’s diabetes or depression, your counseling, education, and coaching of patients can help them live longer, better lives. What better gift can you offer your patients during this holiday season?

I couldn't agree more. How exciting it will be once I have an opportunity to apply my services to the chronic conditions that afflict so many of my people. Yes, what better gift could I give them? I do have one question for you though.

What planet do you live on? It may interest you to know that your words, written in who knows what corner of the universe, reached me here on Earth, the pretty little blue and white planet third farthest from our sun. 

Actually it's probably no use to describe to you exactly where my planet is, as you are obviously somewhere very far away and very different. You see Mr. Gans, on Earth, most pharmacists work in places called "drugstores" or "retail pharmacies," and to the businesspeople who run the corporations that operate these "pharmacies" the concept of this "MTM" of which you speak is as alien as the neon fluorescent glow I imagine your beings as having as a result of the radically different respiratory processes that keep you alive in an environment so different than mine. 

Do you have water in your world? Are you carbon based? So many questions rush into a persons head once they realize they are talking to an alien being. 

On Earth Mr. Gans, the emphasis of the people who control the practice of pharmacy is simply to put as many pills as a prescription calls for in a bottle as quickly as possible, as many times a day as possible, while killing as few of our customers as possible, or at least deflecting their lawsuits. This means I am probably one of very few Earth-based pharmacists to have even seen your commentary. Most of my colleagues right now are simultaneously on hold, sending a fax, overriding a pointless DUR message, telling a customer where the cotton balls are while telling another for the love of God put that aspirin down because I just sold you a warfarin prescription. Many will do this for 12 hours non stop at a time. The only reason I saw your words was because I had a bowel movement which happily gave me the chance to sit down at work for a couple minutes. Somehow a copy of Pharmacy Today ended up next to the toilet seat.  

Do you have spaceships that take advantage of Einstein's theory of relativity, the part that makes time travel possible? Do you fight Klingons

All this effort, by the way, has recently been determined to be worth $4 for many prescriptions. Ask the people who control pharmacy on my planet what the biggest recent success in the profession has been, and they will tell you the ability to put pills in a bottle, as quickly as possible, while mostly not killing people, for $4. That is the definition of success in my pharmacy world.

What a wonderful place your planet must be. Even though I would surely die within seconds if I ever set foot on it due to lack of oxygen or a radically different atmospheric pressure, reading your words was like taking a soothing vacation to wherever this magical place you call home must be. 

Perhaps someday here on Earth, we will have a leader in our profession who will be as effective at reshaping the practice of pharmacy as you have been on whatever planet you live. Perhaps we will have some sort of association that could lead us into this paradise of pharmaceutical practice. An American Pharmacists Association. That's what I'd call it if we had one. I'll bet if we had one of those that was worth more than a warm cup of spit we could actually have a little hope of making some constructive changes in our profession. The way you have on your planet. 

Because Mr. Gans, if you lived on Earth and wrote those words and expected them to be taken seriously, I'd be laughing my ass off at you right now. 



The Alert Reader said...

Time travel, eh? Everything you know about physics really comes from the strangest sources, Dilbert.

Your rant is more entertaining... but he had a video. A really awkward one.

Dustin said...

Given the recent announcements by various grocery store pharmacies that they're giving away antibiotic prescriptions for free, four dollars is looking pretty good right now, isn't it?

kris said...

I think the chronic condition he is referring to is cluelessness on the customer's part perhaps stocking the clues by the cotton balls in aisle 3 would help...2 for 1 with coupon

Utah Savage said...

What a great read. And I wasn't sitting on the crapper. I read it hiding in my bunker.

I visited my pharmacist yesterday because I have some lung crud. A whopping dose of Prednisone and a Zpac. Two days into it and my lungs feel better, but I have roid rage, or crying jags. Nobody warned me that I'd be calling medicare and sobbing because I can't get suplimental insurance in UTAH the land that hates the disabled crazy bitches who should just fucking have the grace to die.

And get this--I come here for laughs. You make me feel human. You may hate me, but when I find you on twitter, I light up like a synthetic xmas tree.

Aaron V. said...

The sad thing is that I chuckled throughout this post, knowing it was all too true. Plus it's always good to throw a Klingon reference in there...

Anonymous said...

I have pretty much stopped reading pharmacy mags. When they started focusing so many columns on MTM and talking about it like it really exists in more than just someone's imagination or a scattered pharmacy here and there, that's when I realized these mags were NOT being written for RETAIL pharmacists and I felt as if I was intruding upon some parallel universe in which I was not invited. Those mags have no basis in reality...maybe we should start our own mag written for and by retail pharmacists OR we could just keep coming here and reading your great blog---you really should be paid for your great work!

Hopefully our love is enough!!

annpharm loyal fan

Anonymous said...

I'm not a pharmacist (yet) so over my long Christmas break from school I happened to pick up the referenced issue of Pharmacy Today, and I honestly almost fell out of my chair I was laughing so hard. I truly cannot imagine that Mr. Gans has ever observed typical retail pharmacy working conditions today. Probably he was just too busy listening to the CVS/Walgreens/etc. corporate suits who are assuring him that they are "really making progress in implementing MTM". It worries me that some of my fellow students actually believe the bs.

RainDrop said...

DrugMonkey, you should print this out and mail it to Mr Gans. Seriously. I'm sure he has an Earth mailing address. Does the APhA even know what retail pharmacists do???

Anonymous said...

I love how every time you call Humana, one of the options is "If you have questions about MTM, or service billing, press *number*"

And every time, I think to myself, "who the hell would have a question about MTM? How many times a day are THOSE reps bothered? I want their job! Actually... do they even have anyone working that department? Why is this ridiculous option before the important ones?"

I've only seen MTM done once (surprise... a Humana pt). And it was definitely, FOR SURE, the first time it was ever done at my store. It was probably the last time, too.

Anonymous said...

Great read.

Third closest isn't it?

Clueless RPh said...

What's MTM?

The Alert Reader said...

The Alert Reader said...

PS - Hillary will never escape the sniper fire incident. I'm glad.

The Alert Reader said...

HAHAHHAAHA watch the video link in the article.

"When did we start accepting as hard news sources bloggers -- annonymous bloggers, especially. It's a sad state of affairs in the world of media today, mainstream media especially, if they're going to rely on anonymous bloggers for their hard news information..."

I think Palin's been reading your blog. I am convinced.

DrugMonkey, Master of Pharmacy said...

Alert Reader,

I can say in all honesty I get a lot of hits from Wasilla......:)

12 steps said...

Pharmacy really is a joke, isn't it?
Yes, I work for CVS, probably the worst company there is to work for. I just love it when Tom Ryan says "we are going to make CVS the best place to work."

Between the PSI, PCI, Triple SSS, Workload Manager, Execution, Wait Time, GSR and the whole host of other endless corp bullshit, I actually enjoy pharmacy when I work at a friend's small town independant.
I hate CVS/Walgreens/etc. and I was the paragon nominee from my district! And the corp meeting in Orlando. What a load of bullshit, just hiding greed behind "patient care" as usual. And greed off the scale, cutting our hours despite us being the only store in the district that exceeded budget this year. 2 hours of Pharmacist overlap in a store doing 700+ scripts in a 14 hour day!

Pharmacy is dead, dead, dead. The single solitary good thing about it is the pay, and with Obama's national healthcare either it's going to plummet, or the buying power of the dollar will, or both, probably both.
We have to make sacrifices I'm told.
For what, the endless stream of disability/medicaid/drug addicts that come through the drive through to pick up their free Oxy?
And all those 30 ct Adderal rxs that cost the taxpayer $1K every month (remember, 14% efficiency), besides the $300 (2K to the taxpayer, remember, 14%) the mom gets for having their kid on the shit. Wow, no wonder all 6 of her kids are on it!

"Your Pharmacist May Hate You"???
Your Pharmacist does hate you, don't kid yourself!

At least we are seeing the cracks in the empire, Welfare checks (along with tax refunds for working people!) being froze in the Peoples republic of Kalifornia! Broken promises, I love it and they are our last hope, us working folks anyway!

People fuss about the politicians, well you elected them and their actions mimic those of the population. I've been a pharmacist (community only) since 1979, it used to be 89+% of the folks that come in our stores were kind and decent human beings. It's around 1/3 now, and that's being kind.