Wednesday, February 25, 2009

Snake Venom Is 100% Natural As Well.

Alternate Post Title: Love Your unregulated free market capitalism? Well then I Hope you have a home blood potassium monitoring kit. 

Because you're on your own my friends. Think we have an FDA that evaluates which drug products are safe enough to be sold without a prescription and which aren't? Well then meet Ameal bp and be enlightened. God where to start with the Ameal bp:

The key ingredient is AmealPeptide®, which consists of two bioactive tripeptides that are extracted from milk proteins during a patented production process. These natural, milk-derived tripeptides are safe and have no side effects.


Anytime you see the words, "no side effects" my friends, run. Run far away. Because you are being lied to. A sugar pill has side effects. Increased blood glucose levels. Water has side effects. Increased urine production. The only way for a substance to have no side effects would be for it to do absolutely, positively, nothing. 

Ameal bp, on the other hand, does claim to do something. It doesn't claim to diagnose, treat, cure, or prevent any disease, because any claim like that would classify it as a drug, and Ameal bp is a dietary supplement. Ameal bp makes it crystal clear that it makes no claims to treat, cure, or prevent any disease by including this handy chart on it's website and in its advertisements:



This chart looks nothing like Ameal bp is trying to say it lowers your blood pressure, which would prevent many diseases like heart attacks, strokes, or congestive heart failure. I totally don't get that impression at all when I see this chart. It looks to me like Ameal bp is kinda like whey protein or some other type of dietary supplement I would take to build my muscles after a good workout. That's what this chart says to me.

Specifically, Ameal BP  claims to be "a naturally occurring ACE inhibitor derived from enzymatically hyolized casein (milk proteins)" that has been "clinically shown to maintain healthier blood pressure"

Some of you in the professions just saw the words "ACE inhibitor" and shot scotch through your nose. If you are drinking scotch at the moment that is. Which you should be. You may have thought about the effects prescription ACE inhibitors, which don't try to bullshit their way through the "dietary supplement" loophole, have on pregnancies. Or of that annoying dry hacking cough that can happen with the prescription ACE inhibitors.  A cough that Ameal bp tries to tell you magically won't happen if you use an ACE inhibitor made from rotten milk. Just remember that claim comes from the same people who so convincingly say they are making no claims that they are preventing disease. 

While they are smart enough to not say anything about the pregnancy issue, they do come out and say their product inhibits the reaction that converts angiotensin I to angiotensin II. You know what happens when you do that? Your body secretes less of a hormone called aldosterone. Then you know what can happen? The level of potassium in your bloodstream can go up. 

That would be a side effect. One you can die from. I can guaranfuckingtee you if this shit in a box catches on, somebody, somewhere, who's having a hard time managing their hypertension with a slew of medications that includes a 20mEq daily dose of potassium chloride will see this in the vitamin section of a GNC store somewhere and end up dead.

In my perfect world, that person would be a card carrying member of the Libertarian party, whose philosophy makes things like Ameal bp possible.

To the rest of you I would say be careful, because you're on your own out there. 

Monday, February 23, 2009

Highlights From Friday's Pill Counting Action.

Sometimes your head doesn't clear up enough to process the memories until Monday, but it is always Friday that supplies the most pill counting highlights. Always. 

The day always starts with the checking of the voicemail. First message of the day; "Um.....hello?.......hello? The voice was soft and pleading, seeking help, or maybe just human companionship, at 2:34 in the morning, which was when the time stamp told me this person had connected with the machine. "Hello?".....a little softer this time. The person was giving up. Then a little click. The machine had won. 

The next voicemail, in its entirety; "What kind of message should I leave?" Well my dear customer, the answer to that question is really constrained only by the limits of your imagination. The day's weather forecast might be nice, or maybe some news headlines, just in case I woke up late and missed this information on my way into the store. Or maybe you could go a little avant-garde, that would be cool. I once had someone play Spinal Tap's "Sex Farm" into the voicemail machine. So far I think that's been the coolest voicemail I've ever received, but I'm sure with a little inspiration dear customer, you can top it.

11 hours and 50 minutes to go. 

First customer of the day had an urgent complaint. The kind that had to go to a person of authority. Since I'm basically Sulu sitting in the captain's chair when Kirk, Spock, and the guy you've never seen before who will be shortly killed are away from the Enterprise, the task fell to me:

"My wife's been getting loads of free stuff here, cartloads, and I need it to stop. We've been divorced 42 years and I'm tired of her using my good name."

I could almost identify the brand of gin on his breath. At first I thought Bombay Sapphire, but that was probably just because I wanted some Bombay Sapphire so badly at the moment. After more objective sniffing, I was sure it was the cheap Seagrams

"I'll take care of it." I assured the man I was insanely jealous of for being able to get away with being drunk at 9:30 in the morning. And that was that. Being Sulu isn't so hard sometimes. 

11 hours 30 minutes to go. 

A customer spent a good 5 minutes trying to convince me the house brand Tylenol PM and brand-name Excedrin were the same thing. He was arguing like his life depended on it. I wondered why he was so desperate, and I actually kept the conversation going longer than I normally would have just to see if I could find some reason why this was such a vital issue to him. I  never did, so I finally ended it with a "well they are both pain relievers, but this one will make you drowsy." 

That got me a death glare from the desperate customer. He had failed in his mission to bring me over to his point of view. 

Customer call: "Yeah.....I need my Septra refilled.....I'll spell it for you....o-m-e-p-r-a-z-o-l-e." 

For those of you not in the profession, Septra is an antibiotic. Omeprazole is used to treat acid reflux in the stomach. 

Doctor call: Yeah I'm phoning in a new prescription.....blah blah blah.......

Me: OK, just this time or do you want additional refills?

"Additional refills" Then a dead silence. I let the silence go on for awhile to see if it would sink in.

"Any particular number of additional refills?"

I'd never had a doctor call me an asshole before. I was feeling a little unprofessional about my snarkiness until he did that. 

Doctor call Number 2: "Yeah.....um.....Mr. Smith needs a refill of his Lipitor and the doctor OK'd it. Can you get that faxed over?"

Me: "You just said he OK'd it"

Nurse Dumbass: "So you'll send the fax?"

Me: "Uh, no, you just told me he OK'd it. How many times?"

Nurse Dumbass: "What?"

Me: And what was your name? 

"Nurse Dumbass"

It went in as OK'd per Nurse Dumbass 1 time. No fax was ever sent. 

6 hours to go.

A person called 3 times within 15 minutes to see if we had 180 tablets of Oxycontin 10 milligram. "The orange ones" It was very important they be orange. When you start getting calls like that on a Friday my friends, you don't need access to a window,  you know the sun has just gone down. 

Dusk was confirmed by the next call. "Yeah, I want some Viagra, but I don't have a prescription. What should I do?"

Let the Friday night begin. 

A customer asked me if the KY jelly could be found with the shaving cream. I so wanted to know what connection was being made in the customers mind between KY jelly and shaving cream, but I was interrupted by someone who asked where the diabetic candy was. 

I hate diabetics. The fact you think you're entitled to candy no matter your health condition is a big reason why you're in the position you're in fatass. Now I'll never know the mystery of the KY jelly shaving cream. Thanks for that.

My last customer was in a jam. He had left his Lexapro on the other side of the country and wanted to know if I might be able to fill it here. Easy enough when you work for a big-ass chain with a shared database. The customer was very grateful for this. "My wife was ready to overnight them to me" He said as I rang out his purchase. Meaning his wife was on the other side of the country. The man also refilled his Cialis and bought some condoms. 

So ended the Friday. For me. Although I'm sure the festivities continued all around town as I slept. 

Sunday, February 22, 2009

I Seriously Work With The Best Staff Ever. Or I Am Corrupting Them. One Of The Two.

It may shock some of you to read this, but I can be less than a joy to work with at times. It will surprise you beyond belief that there are times when I can be a bit....moody. Cranky even. 

Most of the time working with me is a fucking riot. But yeah, I have my days. 

Thing is, when the pharmacist is having a day, it infects the whole operation. A toxic wave will envelope the whole pill room, and everyone involved, techs, customers, front end employees, they'll all get a whiff. Those days have happened with me, and they're not fun, for me or anyone else. 

Saturday was threatening to be a day. I was coming off working two twelvers in a row, and it's so much easier to be cranky when you're tired. A customer had just tried to engage me in a 10 minute debate over two cough syrups. Two cough syrups with the exact same ingredient. Strike one. An eerie calm before the storm was descending over the pill room. A couple more strikes and it was gonna be a day. There was a tension in the air. 

My tech R__ took the next phone call. Let me give you the background on R___. Two months after she started, if you would have asked how R___ was doing, I would have said, "she's really nice, and she really tries, but I don't think she's gonna make it." She spent her workday nervous, making nervous mistake after nervous mistake, and just not moving fast enough to be of much value. I used to send her home early because it annoyed the hell out of me to be alone with her. She hung on though, and she's obviously a much better tech than from those days. I'd go so far as to say she's a good one. 

So R___ takes the call, and it's a moron who doesn't have any refills left on their prescription who couldn't understand the secret code pharmacies put on the bottle that indicate this, the words that say "NO REFILLS." The customer goes into crisis mode and asks what they are supposed to do. Yawn. The kind of shit that happens every day. 

I should say the kind of annoying shit that happens every day. Strike two was coming. 

R___ knows we're gonna give the moron enough to get through the weekend, but also knows she needs to ask first, just in case it's a druggie looking to score some extra Soma or something. "The customer on line one says they are out of Lanoxin and wants to know what they should do" she says.

"Tell them they're just gonna have to die" says the cranky, angry Drugmonkey

The key to what happened next is R___'s accent. It's soft and very up and down over the course of a sentence, almost musical in a way. She picks up the phone, hits the button below where the customer is on hold and says into the receiver;

"Hello ma'am? The pharm-a-cist says you will just have to die"

My head snaps around and we both burst out laughing. That's how far R___ has come. From barely competent to able to detect and diffuse a bad day coming. It was at that moment I said to myself "You have made great progress young one. I can feel the force is with you."  R___ will someday be a keystone tech.

My other tech is even better. Many of you have asked why I don't quit my retail gig. Some of you will now understand. 

 

Saturday, February 21, 2009

Of Course It's Not My Public Song Of Liberation.

That one belongs to Pearl Jam. Rearview Mirror. 

So Triumphant.

Climactic.

A neat and clean overcoming of the hand you were dealt:

i took a drive today
time to emancipate
i guess it was the beatings 
made me wise
but i'm not about to give thanks, or apologize

Testosteroney.

head at your feet, 
fool to your crown
fist on my plate, swallowed it down
enmity gauged, 
united by fear
tried to endure 
what i could not forgive

Conflict created.

saw things
clearer
clearer
once you, were in my...
rearview mirror...
i gather speed
from you fucking with me
once and for all 
i'm far away
i hardly believe, finally the shades...are raised...

Conflict overcome. Simple really.

That's my public explanation. Yup. Got away from Dad as soon as I could and made a nice life for myself. Cause I'm a smart problem solvin' type of dude.

Some of you are unfortunate enough to know that's not how it works though. Bruce knows.

`Cause the darkness of this house has got the best of us
There's a darkness in this town that's got us too
But they can't touch me now 
and you can't touch me now
They ain't gonna do to me
what I watched them do to you

You can't touch me now. That's how it ends. And the "They ain't gonna do to me what I watched them do to you" turns into some "whys?"

And the "whys?" They don't get clearer. As you get older and accumulate your own lifetime of flaws, the "whys" become murkier. No matter how much you focus that rearview mirror.

You remember it wasn't all concussions and drunken random belt whippings. You remember sometimes it was throwing the baseball around in the front yard and you remember sometimes it was going to ballgames and you remember sometimes it was being told you'd be going to the ballgame on Saturday and then spending Saturday looking out the window hoping you weren't due for a belt whipping. And it's not very clear at all because now you can see your own lifetime flaw collection developing.

And you know everyone develops a lifetime collection of flaws.

So say goodbye it's Independence Day
Papa now I know the things you wanted that you could not say
But won't you just say goodbye it's Independence Day

So you just end up being glad no one can touch you now. And you leave to go......you don't know where. And you cry every time you hear that stupid song. And you feel like sending Bruce Springsteen a card for Father's Day.

Being a father scares me more than anything in the world.

Sunday, February 15, 2009

An Earth Shaking Change Of Paradigm That Will Rock The Foundation Of Medicine.

Or a least Western medicine. Because the developed world seems to be where all the fatties are.

I'm sure you've heard the news by now my friends. In one fell swoop we are about to take a big chunk out of the nation's obesity rates, and the corresponding complications of diabetes, heart disease, strokes, and people who just look gross. 

For those of you unaware, I will let the cover of the latest issue of Glamour magazine fill you in. The great news is on the left hand side, right under the "8 Really Good Sex Ideas" 






Who would have figured? All we have to do to tackle the biggest public health problem this country faces is get some more sleep.

"I knew my theory seemed counterintuitive to many" Dr. Eric Faulk, a fictional person, didn't really say in the accompanying article. "But when I noticed that many extremely obese people seem to spend every.....goddamn....waking....moment of their lives stuffing Ho-Ho's, Doritos, Ding-Dongs, Funyuns, whipped cream, ham...pretty much any organic material they can get a hold of really, down their throats, then washing it down with a couple liters of Pepsi, I knew that getting these people to pass out would be the only way to cut their calorie count." 

"Some of them did manage to eat in their sleep" He didn't add. "This method will not work for everyone"

Timothy Rothwell, US chairman of the international drug manufacturer Sanofi-Aventis, hailed the new groundbreaking research in a press conference to introduce his company's new product, Bandecal®(zolpidem succinate)

"Sanofi-Aventis is committed to improving the lives of people around the world, and Bandecal® will do just that, for the fat ones, by letting them get the sleep they need to melt away those unwanted pounds. And at only $300 a month, it is quite the bargain, I mean, how much is a totally improved, new, sexy you really worth?" Rothwell,  who by all indications is extremely unattractive, didn't really say.

When asked how Bandecal® differed from the widely popular and inexpensive zolpidem tartrate now used as a prescription sleep aid, Rothwell didn't say "it has succinate on the end, and a picture of a fat person getting skinny on the bottle." The reporter was then escorted from the room.

In the same issue, Glamour's "8 Really Good Sex Ideas" broke the news  that women usually climax during the first 10 seconds of intercourse with little or no foreplay, and that a good way for a woman to arouse her male partner is to ask him to picture his mother sitting naked on the toilet shortly before making love. 

-Special note. Everything in this post is made up except for the picture of the Glamour magazine cover and the unattractiveness of Timothy Rothwell . I hope to hell you knew that already. 

Saturday, February 14, 2009

An Ode To Ex's. Or, A Single 40 Year Old Dude Looks Back, Because It's Easier Than Looking Forward.

C1- I hope we never meet again. I always want to remember your perfect 18 year old body the way it looked that night, with the soft morning sunlight starting to filter through the window. The image of you lying there while I wrapped a blanket around your sleeping self will never leave my mind. If I ever see a body that perfect again in the real world, it'll mean I'm an old pervert. Because I'm sure I'm saggier and wrinklier and much greyer than I ever thought I would be back then. I want to remember you the way you were that night though. I hope we never meet again. 

C2- I'm sorry. I'm so sorry and I will never be able to make it up to you. We were too young to get married, although you never seemed to come to that realization the way I did, which evidently shows where the problem was. You're a good person and I sincerely hope you're happy. The best way I can contribute to that though, is by staying out of your life forever. I'm so sorry.

S- I don't wanna be mean, but honestly, if it weren't for what happened for a few nights there, I probably wouldn't remember you at all. I don't want to call anyone a mistake, but what happened was a sign of my failure. 

M- You were a mistake. A big, fucking mistake. You were gorgeous. And selfish. And irresistible. And incredibly cruel. And beautiful. Physically beautiful.  You made me feel special and made me feel like crap at the same time. That takes talent. You taught me the most unnatural way to cry. Staring at a wall while tears just fell out of my eyes without a single sob for hours at a time. I always thought of that as C2's revenge. You didn't destroy me, but I really don't think you made me any stronger either. I was kinda happy the last time I saw you though, and noticed how you hadn't lost any of your baby fat.  You were gorgeous.

Woman whose name I can't remember #1- You were the opening number in my phase. Under different circumstances, yeah, I would have called you back. It takes awhile to recover from a headfuck like the one M put on me though, you know? 

It is kinda cool to say I did it with someone who worked for Victoria's Secret though. 

Woman whose name I can't remember #2- Yeah, I was in my phase, but honestly, under normal circumstances, no, I probably wouldn't have called you back. Jesus I never knew a woman could snore so loud. 

Woman whose name I can't remember #3- I'm kinda sorry. Maybe. It was probably wrong, after we saw that Sikh man wearing his turban, and you said. "God those Arabs who go around with that shit on their heads after what happened on 9/11 piss me off," to make the decision to woo your heart so I could purposely crush it. I only say that because I remember how much it hurt staring at that blank wall with silent tears rolling out of my eyes. But the fact remains not only were you a bigot, you were too stupid to even direct your bigotry towards the correct ethnic group. I suppose I'm sorry. A little. 

D- When we met I couldn't figure out if you were hitting on me or just trying to sell me a house. I guess since you vanished after the final papers were signed I have my answer. Jesus it was hot though. Your hair alone almost makes it worth considering buying another place. 

Woman whose name I can't remember #4- An encounter at an airport hotel with a PETA activist and model. The luckiest goddamn night of my life. Christ I can't believe I lost your number. Like you would have called me back anyway.

Woman whose name I can't remember #5- How many guys can say they've scored with TWO models! TWO! Jesus I had no idea you models smoked like chimneys though. Being with you was a constant search for where you were in all that smelly tobacco haze. That's what I remember most. 

M2- I was still in my phase, and you were not. I'd feel worse about it if you wouldn't have turned out to have been nuts. 

Woman whose name I can't remember #6- This one's embarrassing, as I really should remember your name. I mean, we saw each other a lot. I did work around your house. I think this one's a sign of me getting old as opposed to the impression you left on me. I liked you, really. And you did give me the best reason ever for being late to work. 

K- The end of the phase. An attempt at a real relationship that never should have been made. Three years and at the end all there was to show for it were two people who tore each other up emotionally like two cats put in a sack. We would have made great friends, but we sure as hell never will be now. Sigh. I hope you're well.

A- The undisputed, unchallenged, queen of hair. My dear you were a hair freak's dream come true. I wish circumstances had been different, and I hope things are better for you now. If they're not, for the love of God give me a call. 

H- I liked you, and ummmm.....yeah....it was way hot. I don't think I was ready for you yet though. You gotta admit we live on two different planets. I've got your book though. Autographed and everything...:)

To be continued.....I guess. 

Happy fucking Valentine's Day.  


Wednesday, February 11, 2009

I'm Not In A Good State Of Mind, But Still, A Good Quickie Is A Good Quickie.

So, I know I've been off of late, and I know why. Personal stuff. The kind of thing that consumes you when you're a part of it, but doesn't make for very interesting reading when you're not. I'll give you a clue. Here's how a good percentage of my thoughts at work of late have gone......

Looking down the card aisle from the happy pill room.....

"YOU'RE looking for a Valentine? YOU? Awww Jesus Christ monkey....."

5 minutes later........

"Oh holy mother of fuck.....look at that disgusting fat slob. You mean to tell me HE has someone who calls his sweaty ass a Valentine?"

I then go and check outdates for 15 minutes. I haven't checked outdates since I was an intern. I have to sneak another look......

"I am seriously going to hang myself. If that son of a bitch is getting some I am totally going to hang myself"

Not that I'm bitter. 

And not that I still can't appreciate part of a serious news story that sounds like a joke. From yesterday's New York Times coverage of allegations of possible wrongdoing in the recent corruption trial of Alaska Senator Ted Stevens:

For example, a witness for both the government and defense, Rocky Williams, was sent home to Alaska by prosecutors who did not tell defense lawyers, an act that angered Judge Sullivan. Ms. Morris said the decision was made because Mr. Williams was gravely ill, not because prosecutors, after interviewing him, had decided he might help the defense case.

Still, there is considerable evidence that Mr. Williams was truly sick, including the fact that he has since died.


I'll be better soon. Just as soon as the dregs of humanity stop rubbing their public acts of the birth ritual in my face. Which may be never. 

I wonder if there was a Mrs. Williams? 

Monday, February 09, 2009

Book Review #3. I Bet No One Has Ever Told The People At Q-Fever They Are The Onion Of Medicine.

I'm kidding. The phrase "The Onion of Medicine"  is the obvious one that comes to mind upon seeing Q Fever!: Medical Humor & Satire For Healthcare Professionals. I'm sure it's been said a lot. That's really not fair to Q Fever! though, because comparing something to The Onion is a sure fire way to make something look inferior. The Onion is the funniest fucking entity on God's green earth, and anything that goes up against it will be crushed.

So I totally won't say anything like Q Fever! Is like The Onion of medicine. Even though it's a book full of fake news stories. Kinda like The Onion. Except about medicine.  

And I won't point out that just like in The Onion's early days, sometimes the entire joke of a Q Fever story is contained in the headline, "Study: Obesity a Risk Factor for Pants Ripping in the Ass." Chuckle chuckle. Really no need to read the rest of the page though, you get the joke. There are more than a few shoot scotch through the nose moments however, such as when my sinuses got the alcohol rinse treatment upon seeing "Heart Transplantation Study Halted Abruptly; Transplant of placebo 'a disaster' researchers concede."

There are also parts that aren't like The Onion. There are top 10 lists, which are more like a rip off of David Letterman. I don't mind that though, as I kinda wish Dave himself would rip himself off from 20 years ago more. And the lists are kinda funny. Five of the "Top 10 Ways To Quit Smoking:"

-Cold Turkey

-Nicotine Patch

-Smoking Cessation Classes

-End-Stage Emphysema/COPD

-Widely Metastatic Lung Cancer

There are also case studies that invariably end in bad puns or photoshop gags, which you won't find in The Onion. Which means you could maybe kinda make a case for Q Fever! not being The Onion of medicine. Even though it kinda is. 

Or I should say was. The book is a collection of highlights from the Q-Fever! website, which is kinda like The Onion's, except geared towards medicine, and work on the website seems to have abruptly halted in 2005. There's some good stuff there though, and I would totally recommend you check it out. And if you're the type, like me, that keeps a little reading material around at work so you don't have to look at customers when not actively filling prescriptions, then the Q-Fever book should be right up your alley. 

Just like The Onion. 

Special Thanks to The Alert Reader who sent a copy of the book my way. 

Tuesday, February 03, 2009

A Quickie. It's Late And My Time Is Short.....

From today's New York Times......
Demand for lithium, long used in small amounts in mood-stabilizing drugs and thermonuclear weapons....
Some nights you catch a break and the posts just write themselves. Even if they are short. 

Monday, February 02, 2009

I Decide It Is Better To Light A Candle Than To Curse The Drug Topics Darkness. Drug Topics Blows Out My Flame.

I've abused Drug Topics, the leading pharmacy trade magazine, here in my blog garden more than a few times now, and like I've said before, the only reason I do is because they suck. The writing is sub-par, the topics less relevant to actual practicing pharmacists with each passing year. You may be shocked to hear this, but there was a time when I took Drug Topics home with me to read after work. That time is long gone. The only thing Drug Topics gets these days is a quick glance through to see if I can find any mockable potential blog material. I usually do. 

Now you all know Jim Plagakis is the exception that proves the rule. Jim is an outstanding writer and by all indications a stand-up guy. Drug Topics could save a lot of time and expense by just mailing out Jim's column and sparing us the rest of the magazine. 

I'm looking to eliminate negativity from my life though. Instead of just sitting around bitching, I thought awhile back, why don't I look for a way to help? I went to the Drug Topics website and found this under "Author Guidelines": 


"Viewpoint,"... consists of guest editorials written by pharmacists who have strong views on a given pharmacy-related subject. These commentaries should be 750-1,000 words long, and should be accompanied by a photo of the author


Hmmmmm.....well.....I have been known to have strong views on subjects from time to time, and I certainly should be able to string together 750 words. Gosh darn it, I'll do it!! Drug Topics, I'm here to help!!

I submitted a piece on January 3rd. And have heard absolutely nothing back. So much for that. Instead of using the term "rejection" though, I prefer to think of it as "The article too hot for Drug Topics to handle." Here it is:


I’m going to start by going out on a limb here. I’m going to say that the magazine you are holding in your hands right now is full of images of smiling, happy, pharmacists calmly serving happy, smiling patients. Probably as part of an article about how we can help patients manage their lives with diabetes or maybe make ten dollars by telling people to quit smoking. Why can I say this? Because almost every pharmacy magazine I have seen since the day I entered pharmacy school has covered some sort of story like this, with pictures of happy, calm, pharmacists and happy, calm, patients, in almost every issue they have printed. They are doing the profession a disservice.

Did you have a happy, calm day at work today?

Put down this magazine and take a look around the pharmacy blogosphere, where actual working pharmacists speak their mind every day without fear of rocking the boat or upsetting advertisers. What you’ll find is a plethora of blogs with names such as “The Angry Pharmacist”, “The Angriest Pharmacist”, or “Your Pharmacist May Hate You” You won’t find many pictures of smiles or serenity, or much talk about the latest ideas to implement Medication Therapy Management. At the point where the rubber meets the road, or rather, where the pharmacist meets the patient, pharmacy is a powder keg ready to explode, and everyone reading this magazine knows it, even if this magazine never bothers to mention it.

Something needs to change, and we can start by stopping the OBRA charade. I have no doubt that any pharmacist worth the paper their license is printed on will intervene to stop a dangerous situation. A serious drug interaction, an overdose, drug seeking behavior, none of that gets out the door, but I also know next to none of you are doing the complete nine-point OBRA counseling required with each new prescription. If you are, you work for an independent with a revenue stream separate from the filling of traditional prescriptions or for a chain outlet that is falling far short of its corporate business goals, Because you can’t do complete nine-point OBRA counseling and meet any corporate business goals that allow that corporation to raise its stock price. Because the insurance industry does not value your professional obligations enough to pay you to meet them. Neither do the corporations that pretend you can meet your professional obligations for $4. So we end up holed up behind the computer watching its productivity graph turn red, telling us we’re spending too much time with each prescription, trying to keep up with the flood of faxes, trying to keep up with the number of phone lines that exceed the number of pharmacy employees on duty, and hoping that our technician who just had his hours cut can steer the patient towards checking the box that says they didn’t want any counseling anyway.

Because there isn’t a graph on the computer that tells us when we’ve met our OBRA mandates, only a graph that tells us how many prescriptions we’ve managed to get out the door.

It doesn’t have to be this way. I used to work the graveyard shift for one of this country’s major pharmacy chains. I had a regular customer who told me she woke up early on days when she had to go to the drugstore because she knew if she came in at 5 in the morning she’d be able to talk to an actual pharmacist. A small chain in the city where I now work has advertised among its “5 reasons to being us your next prescription” “The ability to talk to a pharmacist” If a little old lady will get out of bed to make sure she can talk to one of us, if a nimble, start up business free from the constraints of old thinking can advertise access to one of us as a competitive advantage, that tells me people want us to meet our professional obligations, and there is money to be made by doing so. My gut tells me most of us want to do so as well, but first we have to break the paradigm that says professional obligations and corporate business goals are incompatible. The truth you’ve yet to read in this, or any other trade magazine, however, is that the gap between corporate business goals and our professional obligations to the public seems to be growing by the hour.

I’m afraid an explosion is coming.


I guess I can't blame Drug Topics for not publishing an article that kinda insults them. I'll also guess however, that it's better than anything you'll see in their next issue. 

Except maybe Jim's column.