Thursday, September 27, 2012

From The "Working Tirelessly To Protect The Public, And Getting Results!!" File.

Got this notification in my pile o' email the other day:

Forest Pharmaceuticals, Inc. is recalling the following items/lots because product may not maintain potency throughout its labeled shelf life.

Uh-oh. Sounds serious. We can't be having things on our pharmacy shelves when there is a chance that they might not be able to maintain potency.

If only we could ship back wrinkled old men when there's a chance they couldn't maintain their potency, but I digress.

This recall is to the pharmacy level. Affected product started shipping November 2011. 
Please immediately check inventory, quarantine, and discontinue distribution of the affected product and contact your wholesaler for directions.

Right away. Sounds like few things could be more important.

LEVOTHROID TAB 50MCG 100: Lots 1093992, 1094095, 1094096. Expiration 9/2012. 

LEVOTHROID TAB 75MCG 100: Lot 1094098. Expiration 9/2012

Emphasis mine. I got this notification on September 24th.

We all work for Dunder Mifflin my friends.

Tuesday, September 25, 2012

Random Thoughts From The 55th Monterey Jazz Festival.

The thing about jazz is that it's so...inefficient. This guy plays, then that guy plays, then a third one plays, it seems like if they'd just play together more often we could save a lot of time and maybe get this festival in on one day.

Ha ha.....kidding of course, but we all know that's exactly the type of thinking that'll happen when the corporations start to control the arts. Which is why my heart did a little happy dance when I saw the Best Buy tent had been replaced by one from Amoeba Music. Amoeba is awesome and if you are in Berkeley or San Francisco or Hollywood you need to stop reading this now and go check them out.  I scored a cherry vinyl copy of Miles Davis' "Bitches Brew," the seminal album that essentially invented jazz fusion. Contrast this with last time I was here when the Best Buy tent featured a giant ass display plugging the Beatles and "Guitar Hero." Which is exactly why you'd go to a jazzfest. To play a video game to the tune of "Yellow Submarine." I felt the grooves of Miles in my hands and knew that things were looking up.

That night I saw Tony Bennett, who reiterated a lesson first taught to me by Johnny Cash. Stay authentic to who you are. Cash and Bennett were both about as uncool as a person could get in the 70's, and both faced pressure from their record labels to become more "marketable." Neither did, and both ended their careers as cultural treasures and with their pride intact. For a counterpoint, look at Kenny Rogers. Kenny Rogers is a sad, sad man in many ways.

Anyway, Tony Bennett was really good. That's what I'm trying to say. I hope he made it up to San Francisco and maybe found his heart again.

Earlier in the day it was Trombone Shorty.




Let me tell you one thing about Trombone Shorty. You will like Trombone Shorty. You will not have a choice. Trombone Shorty's music will grab you by the nads and scream at you. "YOU WILL LIKE ME BITCH!!! WE UNDERSTAND EACH OTHER????"

And then you'll be all like, "Dude, no need to get all abusive on my testicles, you're fucking awesome."

Whereupon the music will say "Yeah, that's what I thought. Now listen to me school this muthafuckin' trombone"

Next thing you know it's an hour later and your ears are like, "Holy hell we may never have an experience like this ever again."

Click here for a tiny taste of what Trombone Shorty can do, but protect your testicles. 

If Trombone Shorty is music on fire, than the next day Esperanza Spalding was the cool soothing relief of relaxation. I saw her her a couple years ago, during the Best Buy days, and she was great, but I got the sense she was still, to some extent, proving herself to the industry. Her beautiful Afro was tied back, and it felt like she was still trying to please the normies a bit. A few months later she won her Grammy and the power that comes with it. This year the Afro was free and in all its glory. She was confident and sexy and leading us to where she wanted to go. Even an incredibly intrusive interruption by the Thunderbirds or The Blue Angels or whichever one of those jet fighter penis extensions in the sky our government puts up there to help recruit the next generation of thugs to enforce the will of the empire couldn't shit on Esperanza's parade. When they were gone I stood up, closed my eyes and put my hands in the air, felt the cool breeze in my face and the sounds of a strong woman descended from people the empire once held in slavery in my ear. It's a moment I never want to forget.

By the time I got over to the Amoeba Records tent, the line for an Esperanza autograph was hopelessly long, but I snuck around and snapped some pictures, which might put me somewhere on the stalker scale:



And just for shits and giggles, here's a random kid who seemed to be enjoying the festival:





There were other acts of course, the band of kids I suspected to be from some church-type organization that kicked ass, although I think they'd rather I say they played really well. The Norwegian fiddler, which sounds like some sort of oxymoron, the talented Meklit Hadero, who had the misfortune of being booked on an outdoor stage at night when the temperature was something like minus a hundred and ten degrees. There was Kettle Corn and Cajun food and so much fun I didn't even touch any alcohol. The last band I saw was called Ninety Miles, named after the political distance that separates its members, who are both Cuban and American. They wrapped me in a warm blanket of jazz for the long, cold walk home, told us of their performances in Cuba, and left me with hope that Best Buy would never, ever, be back.

It was a good weekend.

Say What You Will About My Republican Friends, But I Admire Their Commitment To Core Principles.


Remember John Kerry the flip-flopper? He voted for the war before he voted against it or something like that. Fucking wanker. He deserved to lose.

Not at all like my friends on the right. Steadfast they are. Decisive. Whether you like their decision or not you gotta admit the very definition of leadership is taking a position and then getting everyone else on board with your plan.

It just so happens we are electing a leader here in a couple of months. And you know, in these troubled times, maybe it would be a good thing to have a steady hand steering this nation. Someone strong, unwavering, dedicated to his vision of what's right and true. A real leader. Like this guy. Maybe he'll run for president one day:





Wait a minute.......Oh, crap.

Nevermind.

Tuesday, September 18, 2012

I Started This Night Intending To Write Onion-Like Satire About This, But It's Really Not Funny. CVS Is A Drug Pusher.

I mean, it would be really easy to do some tongue in cheek stuff about how the DEA protected the mom and pop drug dealers of Sanford, Florida from corporate chain competition when they pulled the controlled drug registrations of two CVS stores, and I got a couple hundred words into it, but....

I kept thinking about one of my favorites, back when I had customers. In her mid 30's, but maybe the mental capacities of a 12 year old. She was sweet and deeply troubled. Good Lord that woman had been through some shit that left her with pain both physical and mental, but you couldn't help but to see the goodness popping up through the surface of the storms that went through her mind. You have no idea how hard I rooted for her.

Now she's dead. Because another drugstore filled a prescription they had no business filling. Kinda like those two CVS stores in Sanford. Except those two CVS stores in Sanford were doing it a lot more often.

The DEA says those two stores were pumping out enough oxycodone to supply a city with eight times the population of Sanford. Which means people are almost assuredly dead now that wouldn't have been. People who lost their battle with demons that taunted them, with a little help from the friendly pharmacy that looked the other way. Mothers have no sons, lovers are alone, friends are only memories.

I'll bet you though, that every one of those tortured souls were asked at the pharmacy counter, not about the addiction that was destroying them, but if they had their annual flu shot. A few of the deceased probably met their end with a blood stream full of narcotics and antibodies against this year's  A/Victoria/361/2011 influenza strain.

If only there was great profit in getting them the help they really needed.

This is what your profession has come to. CVS is the single strongest player in the pharmacy field. On the cusp of being dominant. Walgreens just screwed themselves business wise and Rite Aid... is hardly worth mentioning. The independents have been devastated and the Wal-Marts and Safeway's that fill a few scripts do it mostly as a side business. Until an ambitious Vice-President decides he wants to make a name for himself by making the prescriptions profitable, which means he'll take a look at how CVS did it.

The accusations of bribery

The overcharging of the taxpayer.

The overcharging of their customers.

The person not a pharmacist who was perfectly able to do everything CVS expects of one.

The defiance of a body responsible for regulating the profession and protecting the public.

How the lax narcotic controls were preceded by lax controls of the materials needed to make crystal meth.

These are the people who now control your profession. Perhaps it's the onset of maturity, maybe it's the crankiness of stress, but you know, tonight, I just don't think it's funny.

CVS had the chutzpah to sue to challenge the suspension by the way, and says “We are reviewing the decision, evaluating our options and determining the best way to continue to serve our customers”

I might suggest, that if they were the slightest bit worried about the best way to serve their customers, none of this would have happened. I might suggest, that the best way to serve your customers CVS,  is not by enabling them in ways to kill themselves.

Back when we were in control of our profession, that used to be obvious.

Wednesday, September 12, 2012

It Takes A Village Sometimes, To Run A Pharmacy

HUNTSVILLE, AL, SEPT 10,2012, - In a devastating blow to the nation's pharmacies, Qualitest Pharmaceuticals announced today an immediate recall of one lot of the popular painkiller hydrocodone with acetaminophen tablets. According to a press release, it is possible that some tablets in the affected lot could exceed weight specifications, making them super-potent for both acetaminophen, also sold alone under the brand name Tylenol, and hydrocodone, a narcotic painkiller.

While the recall affects only one lot of one of a relatively unpopular strength of the med, pharmacists across the country worried about the impact to their bottom line.

"We sell a lot of hydrocodone stuff, I think" said some guy we've never seen before behind the counter at the Rite Aid in Monterey, California. "I mean, most stores do. I'm just here filling in for the week. What if we order some and it doesn't come in? Oh dear. If only we had an experienced staff pharmacist here. They would know what to do about this and the other million things that have come up in the last few days."

Across the country at Charmar Pharmacy in Bronx, NY, a pharmacist whose head wasn't up his ass explained "A lot of times, even though the actual recall is only for one lot of one strength, something like this can affect the whole supply chain as doctors and patients adapt to a particular product not being immediately available. Depending on how this plays out, this could have a big impact on our business."

In the United States, sales of all hydrocodone products are conservatively estimated at 45 trillion dollars a day. Actually maybe more like an hour.

However, in a surprising and apparently spontaneous display of support for their community pharmacies, customers across the nation lined up outside drugstores, clinics, hospitals and ambulance services to offer assistance.

"I heard there might be some super strength hydros this place might have to get rid of" said customer Byran Billups while waiting outside a Medicine Shoppe pharmacy in Dallas, Texas before the start of business. "I'm here to help."

Pharmacist Michael Haynard soon told the assembled crowd that while the store's hydrocodone came from a different manufacturer, and therefore was not subject to the recall, he did need some help moving some merchandise away from a broken water pipe.

"Sheeeeeeeeeeeeiiit" said Billups as he turned to walk away. It was a scene repeated across the country as customers who rushed to the aid of their local drugstore learned there were already procedures in place to dispose of recalled product.

Others meanwhile, were determined to stand by until they were the situation was under control. "Maybe they'll be a UPS strike or sumpthin, so they won't be able to ship the stuff back" said a customer outside a CVS pharmacy in Sanford, Florida. "I used to be able to count on these guys to always come through for me. I don't understand what's going on."

Saturday, September 08, 2012

Meanwhile, Over At CVS......

From the mailbag...I almost hesitate to post this, as I fear it might give the other "Big 2" an idea to rip off.

But what the hell, I'm not part of that rat race anymore. Here we go:

I go into work on Wed and we have been sent CVS "thank you" cards to be HAND WRITTEN by the pharmacist and given to the preselected ESI transfer patients when they pick up their RX's. It should say some of the following things: 
-thanx for choosing CVS
-offering flu shots
-offering text messaging
-soon will have electronic signing at pickup
-CVS can have your entire profile and screening for drug interaction
-one on one patient /pharmacist counseling with expert drug info
-Blah blah blah blah blah
-Card is in an envelope and presented to patient at pickup

Bwwwaaaahhhhaaahhhaaaaaaa.....damn good thing they're not having the techs do this. Intensive pharmcotherapy such as this is exactly why I applied to pharmacy school.

By the way, I think this might be a good place for a little mash up with some words by Ron Snow, Manager, Professional & College Relations at CVS Caremark. He wrote these for the Indiana Pharmacist’s Alliance quarterly magazine and they come via the blog of Jim Plagakis. Jim gave me the break that got me into my gig at Drug Topics, which probably contributed to me getting fired from my last job. Which means I owe JP one huge-ass favor:

I am not sure when the change started, but over the past few years I have noticed an inferiority complex growing among community pharmacists. For many years the proud neighborhood pharmacist was known as the most trusted professional, but now he/she has turned into someone with self-image issues. Why has this change taken place? The way I see it, this is a complicated issue with no easy answer.

Now back to my CVS source:

In addition we are calling every one of the ESI patients to give them the same info that is one the card and then we fax all of the calls made daily to the DM...In addition to THAT, the techs pass out 20% off coupons to each patient targeted for purchases in the front thru September. In addition to THAT, we are to delay the transfers of all ESI patients' rxs for an hour and then call the patient to find out why they are transferring...I think you already know this...

Yeah....no easy answer at all as to where those self image issues could be coming from....after 6 years of busting your ass for a doctorate...huh....yup, no idea.

Back to Ron:

What prompted me to think about this image problem was a recent conversation I overheard between a couple of new grads that was centered on their career choices. The first grad talked excitedly about his choice of starting a career with a hospital where he was confident that he would eventually get the opportunity to move into a “clinical” position in the not too distant future. The second grad sheepishly commented that he was “just going to work for so-and-so pharmacy” because he did not want to give up his 3 years of service with the company. I did not hear any passion of excitement in his voice about his future career plan.
Why did not this recent grad not show more enthusiasm for his community pharmacy choice?

Not a clue did you make your readyfill quota. What could it be?

I believe one reason is the focus/pressure that schools are putting on grads to complete a residency...Unfortunately, I have been informed numerous times by interns that they are left to feel inferior if they choose not to pursue a residency.

Really? You know...Here's just a wacky theory....I'm just gonna....maybe I shouldn't...it's kinda crazy.....oh what the hell....maybe.....

....they are. Just a little bit ahead in their professional development than the person who got a doctorate so they could be ordered to fill out these all day.





Just a crazy idea. Back to my CVS Deep Pill:

Its all so crazy...and so demeaning to the employees and NO health care info given to patients at all...I am an old school RPh and it is killing me...

I know, but if those pharmacy schools would just let up on their pressure to put kids in residencies, everything would be fine.

.I know you feel the pain also

Felt the pain. And hoping never to feel it again. You have no idea how much I want this clinic to offer me a gig. I want. To be. A Pharmacist again.

Sigh.

Friday, September 07, 2012

So, How Was Your Day Drugmonkey?

I'll tell you how my day was. Started off with this in my mailbag:

I printed out your recommendations and sent the paper in with (boyfriend of person who wrote me for some drug advice) who, I'm sure, was utterly embarrassed to take in a note from his girlfriend. Ha! ;-D But when he mentioned about my friend, who practices pharmacy, doc asked him what you suggested... and doc agreed... and seemed impressed as well.

Hell yeah that doctor was impressed. You know why? Because I am the friggin' MASTER OF PHARMACY!!!! that's why. You got a drug question and you go anywhere else you are cheating yourself my friends.

Also did some job fishing last night and got a little nibble today. I don't wanna jinx it by saying anything, but even if you're a hater who can't handle knowing someone with the Drug Library of Congress in their head is out there, you'd probably say something like:

"I wish that Drugmonkey would burn in hell, but man....that job couldn't be a better fit for him"

OK, you know what, I can't keep a secret. It's at a clinic that serves un and underinsured patients. How much of a  fairy tale would that be if I got this gig while Rite Aid continues their slide into bankruptcy? How much of a fairy tale?

So yeah, not a bad day. Keep your fingers crossed for me.

Tuesday, September 04, 2012

Tales Of The Jobless Life, Part One

Tomorrow's gonna be when the fecal material hits the fan. Two deadlines to meet on Friday and tomorrow's gonna be my last chance to throw up some good work. That's what writing feels like by the way, like when you know you're gonna throw up sometime today, but aren't really sure when.

Then.....all the sudden it vomits up...messy words splattering all over the place while you struggle to get them at least near to where they should be deposited. Then all you gotta do is spend a lot of time cleaning them up and you got you some writing work done. Anyway, I gotta throw up twice by Friday.

Today though, I had a Momsitting gig. Some of you may remember my dear friend who is caring for her mother with Alzheimer's. My current joblessness is a bit of a blessing for her, seeing as how she needs occasional time to run errands and catch up on life stuff and just de-stress a little for a few hours.

She needs occasional time and I have time in abundance. Pretty much a classic win win.

So today's idea was to teach Mom a card game. In particular, "war." For those of you not familiar, I'll tell you it's the simplest card game on the face of the earth. You throw down a card, then your opponent throws down a card, and the highest card wins. If you both throw down a card of equal value, war is declared, consisting of two cards face down and one face up, and the highest one wins the whole pile. This continues until someone is out of cards.

Again, pretty much the simplest game on planet earth. And I lost. Every time.

After awhile I started to be pretty sure I was giving Mom credit for hands that I had actually won. Which would be a sweet thing to do, if I were doing it on purpose. I wasn't. Today I was outsmarted at the easiest card game imaginable by an elderly woman with severe dementia.

I'm chasing my first serious job lead since Rite Aid's asshatery. And I'm hoping, mostly for my own mental health, that it might lead somewhere.

Seriously, You Guys Just Can't Get Enough Can You?



Twenty minutes? Really? Shouldn't you guys be monitoring flu shot quotas or something? Because honestly, I don't think it's possible to fire someone twice. You don't seem to realize you have no power over me anymore.

You suck you suck you suck you suck. See? I would never say stuff like that if I was still on your payroll. Ironic isn't it? If your goal was to shut me up you were about as effective as you've been in the pursuit of profit.

I also never would give the world the scoop about your "savings card" prescription pricing if I was still your employee. The whole time I worked for you, I never once told people how I saw that depending on the med, that "savings card" turns into a "rip off the customer" card.

I still haven't. Gone into the details of how that card can screw people over compared to other discount plans that are available. But we both know I could. So maybe you shouldn't piss me off. More than you already have.

Looks like any remaining power in our relationship rests with me now, yes? I use the sweet sweet irony to flavor my coffee every morning.

It does make me happy to know, however, that based on your outclick, you're learning about the outsized influence of big money in our electoral process.

There may be hope for you yet.