It's Not So Much About Sex As It Is Power, They Told The Sheep Later During Counselling.

Do you really think this would be the best choice for a photograph to run on the front page of a newspaper?

Above the fold?

Really?

Actually, I think "Above The Fold" might not be a bad caption for the thing.

Anyway, evidently someone did indeed think this was the kind of thing that should be plastered all over town and delivered to every doorstep in the community.

The other big news story was that in large parts of the country, it is hot during the month of July.

God help us all.

Remember Minnesota, The Only Reason You Have Al Franken As Your US Senator Is Because I Decided You Could Have Him.

It wasn't easy. A part of me still longs for Al Franken's radio show. For the hate mail of the day. All I ever get are emails from some guy who thinks I should be impressed he's figured out my middle name and where I work. He calls me the Drug Commie. Wow. That's great. I wonder if he thought of that all by himself.

Sigh.

Sometimes though, I get a reminder of why I let Al Franken go. That my personal loss was a gain for greater society. Like a message in a bottle that washed up on my own personal beach far from Washington, D.C., a video link showed up in my mailbox today from The Center For American Progress. It shows why anyone who enjoys watching Jesus-freak bigots get bitch slapped, and in particular those on the front lines of the last great civil rights struggle in this country, owes me a bit of gratitude:




Part of me feels like a proud parent who's little boy has all grown up. Part of me still longs for a decent hate mail.

Sigh.

Mary Sammons Given Award For Some Reason.

SCOTTSDALE, Ariz.- The National Association of Chain Drug Stores today presented its Sheldon W. Fantle Lifetime Achievement Award to former Rite Aid CEO Mary Sammons, provoking awkward, polite applause among people with so little to do that they attend chain drug store awards dinners.

Seriously. I know a lot of the quotes and stuff in this post are made up, but they really did give her a lifetime achievement award. I swear.

"Throughout her career, Sammons has never been one to follow conventional wisdom. Her groundbreaking innovations in the world of retail should be a lesson to us all in outside the box thinking, and we at the NACDS are proud to honor tonight her lifetime of dedication, hard work, commitment, and near total lack of real achievement" said president Steve Anderson. "Conventional wisdom says we should be honoring conventional success, but we're proud tonight to break that mold."

During her tenure, Rite Aid's stock price declined almost 80%, wiping out millions of dollars in shareholder equity. Dozens of stores were also closed, and the company was saddled with an almost unmanageable debt burden which drove it to the brink of bankruptcy, all of which evidently is something to be very proud of.

"What the fuck?" said Tom Ryan, former CEO and chairman of CVS, a company that has gone from a regional drugstore player to the nation's largest pharmacy chain, upon hearing that Sammons would be sharing this year's award with him.

"Maybe it's just some sort of trick they're playing on Walgreen's." said a confused audience member, referring to the only one of the three major drug chains not honored with this award. Others theorized that the honor was more for Sammon's previous work with the grocery chain Fred Meyer, which ceased independent operations in 1999 and is now part of the Kroger Corporation.

Wait, no, that can't be it.

A member of NACDS who wished to remain anonymous speculated the award was probably for personal, as opposed to corporate, achievement, as Sammons was able to earn almost 3 million dollars in 2010 for running a company that hasn't turned a profit since 2006. She's also entitled to a base salary of at least $750,000 through 2012, and as much as $9 million if the company is sold. "You gotta admit, cashing in like that by creating a turd and then selling it would be a hell of an achievement" the source said.

At press time, that seems to be the only theory that makes sense. That or she blew someone.

A Groundbreaking Accomplishment By The Hardworking Professionals At Pfizer.

CORPUS CHRISTI,  TX- Surprise was the order of the day at this year's conference of the American Secular Society for the Promotion and Advancement of Disease, as drug manufacturer Pfizer came away with the organization's annual award for excellence in the promotion of ill health in the American populace.

"I understand the award going to an organization that ostensibly dedicates itself to the cure and prevention of disease may at first appear to be quite shocking" said ASSPAD's President Carlos Hickman after the award ceremony, which is held every year in America's fattest city. "But with the publication of a new scientific study indicating that the company's smoking cessation drug, Chantix, may actually increase the risk of heart disease by 72 percent, the true genius of Pfizer becomes clear. Don't you see? People try to quit smoking to lower their risk of disease, and Pfizer has developed a strategy in which these wellness seekers can still end up dropping dead! It's brilliant!"

Hickman added that ASSPAD was particularly impressed by Pfizer's efforts to defend and continue to market Chantix in light of increasing evidence of the medication's link to "loss of consciousness, visual disturbances, suicides, violence, depression and worsening of diabetes."

"They're taking the groundbreaking work done by GSK with Avandia and really building on it" said Hickman, whose organization broke from the North American Disease Society in 1998 in a dispute over NADS' decision to recognize Jehovah Witnesses for their refusal to accept blood transfusions. "So far there is no indication that Chantix will end up in any kind of risk management program the way Avandia did. As a matter of fact, as far as we can tell, Pfizer is going ahead full bore with promotional efforts to sell as much of this med as possible. It's pure genius!!"

"Ask your doctor if Chantix is right for you!" he concluded "You could save up to $30 on your first prescription."

Past recipients of ASSPAD's excellence in disease promotion award have included trans fats, alcohol, Blue Cross and Blue Shield of New Mexico, and Keith Richards. When reached for comment, a spokesman for Pfizer said the award was reflective of the corporation's overall goal of "MONEY!!!!!! GIMMIE GIMMIE GIMMIE MONEY!!!!!!"

Disclaimer- Everything in this post is made up, except for the newly published study linking Chantix to heart disease, even in people with no previous history of cardiovasular problems. And the previous links to loss of consciousness, visual disturbances, suicides, violence, depression and worsening of diabetes. Those weren't made up either.

A Little Thing That Bugs The Hell Out Of Me

You learn to make your way through the small talk when you work behind the pharmacy counter. Tiny talk. Microscopic talk. Talk you will look up and down and over and under with a magnifying glass and still, despite the best of your efforts, find it utterly empty of any meaning. The weather. Christ on a cracker there IS no weather where I live and I still spend at least an hour a day listening to people drone on about it. Sports. Yeah. The quickest way to get me to tune you out is to start talking about the team of large men who don't realize they're gay and their efforts to hit, carry, kick, or throw a ball of some sort over an imaginary line.

For some reason though, I heard the lady say her favorite baseball team was the Brooklyn Dodgers, and I wanted to punch her.

The Brooklyn Dodgers, you see, don't exist. They haven't since 1957. This means they cannot be your favorite team. They might have been your favorite team. Maybe you like the fact that they broke the color barrier when they signed Jackie Robinson ten years earlier, which would be very admirable, but the fact is, if you can remember the day the Brooklyn Dodgers last took the field, you qualify for Social Security. Why the fuck don't you tell me now how your favorite pet is a passenger pigeon, or better yet, buy yourself a goddamn clue with the dollar and twenty five cents you just saved using coupons form the paper and enter the world of reality?  The Dodgers are in fucking Los Angeles and have been since long before your pharmacist whose hair is turning grey was even born. Exactly how long will this take to sink in? The fact you still don't know what to do to operate the credit card reader you've been using at least once a week for five years doesn't give me a lot of hope.

The fact I get so bent out of shape about this makes me even madder at myself.  Sports are stupid, and I shouldn't even care. The fact I do pisses me off. This is usually where I go have a drink to break the hate cycle but it's not even noon. Goddamn it.

Stupid bitch.

A Uniquely American Story.

Who says good old-fashioned Yankee ingenuity is dead? This guy's a goddamn problem solver, that's what he is. To the website of Democracy Now!, which I've told you before you should be reading every day:

A North Carolina man who had no health insurance has admitted to recently robbing a bank of one dollar in order to be sent to jail to get free medical coverage. James Verone, a laid-off employee of Coca Cola, recently noticed a protrusion in his chest and had developed arthritis and carpal tunnel syndrome. Without health insurance or money for private care, Verone concluded his best option would be to go to prison. Verone told a local newspaper, "The pain was beyond the tolerance that I could accept. I kind of hit a brick wall with everything." Since being held in jail he has seen several nurses and has an appointment with a doctor Friday.

I'll also point out that the amount stolen in this case is about $999,999,999 less than the amount looted from the health care system by Florida Governor Rick Scott in his previous gig as CEO of hospital chain Columbia/HCA. Holding down expenses is important in the business world. I bet Coca-Cola wishes they could have this guy back.

Anyway, enjoy your upcoming holiday. That sound you hear in the background will be the Canadians laughing their ass off at us.

I'm Pretty Sure I Used To Date This One.

I Feel I May Have Been Unfair To Big Pharma Pud Suckers.

I mean, for over six years now I've written periodically about pharmaceutical rip offs, scientific shenanigans, and overall shady dealings. But pud sucking in health care is far from limited to the drug industry my friends. Today I'll even the score a little bit. To an item in last month's California Watch, a website you should have bookmarked long ago if you are the least bit interested in the affairs of The Golden State:

California Department of Public Health inspectors examined records at four hospitals owned by Prime Healthcare Services and found that 22 of 120 patients diagnosed with septicemia showed few symptoms of the disease. 

At one San Bernardino County hospital, a patient was diagnosed with septicemia even though records showed “no sign of infection,” inspectors found. At a Los Angeles County hospital, inspectors said seven patients diagnosed with septicemia showed signs of having urinary tract infections, a far less serious condition.

I've long said that incompetence, laziness, stupidity and greed are the four forces that rule the universe. Almost anything that happens can be explained with one of these four words, and this case is no exception.

Medicare pays bonuses of several thousand dollars per case for treating elderly patients with septicemia, federal records show. Prime Healthcare’s chairman, Dr. Prem Reddy, testified in a 2005 trial that his hospitals were reimbursed about $9,000 for treating a septicemia case – $6,000 more than a urinary tract infection.

What? You were thinking incompetence? No, no, no grasshopper. Greed is by far the most powerful of the four forces. Always assume greed is the driving force until you can prove otherwise.

I gotta say though, $3000 for treating a urinary tract infection? Really? I could diagnose and cure a UTI for $50 and still be making a fat-ass margin, and this fucker cooks the books for an extra $6K per case. Part of me admires that. The part that doesn't pay Medicare taxes.

To get some perspective, In my imagination I called Florida governor Rick Scott, elected last year after ripping off Medicare and Medicaid for over a billion dollars as head of the hospital chain Columbia/HCA.

"It's not a bad start" Scott didn't say. "But to assure he doesn't end up in jail, he should probably run for political office, and the amounts involved here are way too small to further one's political career. Stealing $18 million like this guy appears to have done is probably barely enough to get you elected to a city council seat, although the adamant denials he's done anything wrong are a good start. His next move should be an attack on the very programs he's profiting from if he ever wants to gain any traction with the voters."

"Or, considering he's in California, make a bad action movie or two, pretend he's fighting off aliens or something. Either way he needs to appeal to people's stupidity. because while greed is the most powerful force in the universe, stupidity is far more common."

I couldn't have said it better myself. I'm calling it today my friends. Get ready for Reddy for Governor in 2014, and be sure to think of him every time it hurts to pee.

Highlights From Friday's Pill Counting Action.

"Yes.....I'm calling about the pills I got from the pharmacy.....it's really serious. They made my penis like 10 inches long and 6 inches wide and I just had sex with my wife and she's crying and it gets in my way when I'm working out and...

Uuuuuuhhhhhhhh!!!!....sorry...masturbating....

....anyway my friends like to pet it all the time and .....

Uuuuuuhhhhhhhhh....masturbating again.....

....anyway I just wanted to thank you ....and tomorrow I'll be in to get some more. I'll be the one winking at you."

I wish I had a way of recording the voicemail. I know you'd appreciate it. The timing and delivery of the message actually took a little effort and talent, unlike so many other prank callers who get nervous and end up just rushing through it. I hung up thinking now that the slightly entertaining prank call barrier has been broken, perhaps someday I will get a halfway decent hate mail.

A clerk walked by on her way to the back and I overheeard her saying to a customer "Did you ever try to eat animal food when you were little? I used to all the time."

Yeah, it was definitely gonna be a highlights kinda day.

The morning was pretty much quiet except for the lady with the Cymbalta coupon card who raised holy hell when she was told it had expired. She whined and cried and bitched and moaned as if we were asking her to sacrifice her first born child. The situation was unjust, unfair, uncalled for and maybe even dangerous to her mental health. Despite this insult to her dignity, she would have her prescription filled, under protest mind you, and have it billed to her regular insurance.

Her copay was $0. That did nothing to change her perception of things.

On my way back from lunch I saw a man back into a woman's car and both of them get out to inspect the damage. The man declared to the lady whose car he just hit that  "you're not worth my time" and just drove off. It made me a little glad to know I'm not the only one who has to deal with assholes. It made me more glad to hand the lady the assholes license plate number. One of the nice things about pretending like I'm a real writer is that I always have a scratch pad and paper handy.

By the way, you read that correctly all you non-California retail pharmacists. I witnessed the accident on my way back from lunch. California pharmacists are required to have a lunch break thanks to a battle fought by the United Food and Commercial Workers union years ago. If you're not in California maybe you should give the UFCW a call. Unless you're on some starvation weight loss diet or something.

I was washing up before going back into the fray and noticed the "site" memo had been replaced again. It hangs in the breakroom and stresses the importance of keeping a clear "line of site" to deter shoplifters. Three times I have taken my ever handy pen, scratched out the error, replaced it with the correct "sight," and three times someone has made the effort to replace the defaced memo without changing the typo. That says it all about my employer really.

I was dealing with a woman who asked me to "go through my profile and delete the ones I'm not taking anymore, I think there are three or four of them" when I saw the little old man shuffle around the corner. He stopped at the endcap, started a little shuffle again, and slowly......slowly.....ever so slowly....leaned over a bit....then a bit more...then a little more...until he just kinda ended up on the floor. I ran out thinking I might have to wing some CPR or something and when I got to him he asked me where the garbage bags were. The little old guy literally shopped till he dropped and when he got there he was still thinking about how to spend his money. That is all American my friend.

The store manager asked me what a Brazilian wax was and  the look on the Assistant's face told me the manager was being pranked. I told the manager it was the gold standard in exterior car care.

My one professional function was to stop a Cipro prescription from being dispensed to a patient stable on warfarin. While I was waiting on hold to clear things up the customer comes to the counter with a bottle of Excedrin. I wanted to shove the Excedrin up this idiot's ass, but that probably would have led to catastrophic rectal bleeding. I remained calm and learned that saving someone's life can be extremely irritating.

I closed out the day by playing the prank voicemail for my supertech, who thought it was a call from a real customer. She started looking through patient's profiles to try to address the emergency. Now I love my supertech, but she obviously has a lot to learn about the ways of America. I went home, and she stayed after work to do some shopping, probably stopping long before she hit the floor.

Someone Goes To Bat For The Profession. Not Surprisingly, It Is Not One Of Our Professional Organizations.

June 6, 2011

Malcolm J. Broussard, RPh
President
National Association of Boards of Pharmacy
1600 Feehanville Drive
Mount Prospect, IL 60056

Dear Mr. Broussard:

As the only national nonprofit organization focused entirely on efforts to prevent medication errors, we are writing on behalf of the Institute for Safe Medication Practices (ISMP) Board of Trustees to voice our concern about a safety issue that has been illustrated by a wave of recent national advertising—promoting and rewarding the speed at which community pharmacies dispense prescriptions for patients. The National Association of Boards of Pharmacy (NABP) and its members should play a key role in discouraging speed as a primary marketing tool for pharmacy services.

One of the largest pharmacy chains, Rite Aid Corporation, now advertises a “15‐Minute Prescription Guarantee,” where up to three new prescriptions will be dispensed within 15 minutes (average of about 5 minutes) or less. If a pharmacy fails to meet the mark, the customer receives a $5 gift card. Although there are some caveats mentioned in the fine print, the message is clear that speed should be a primary motivator in choosing a pharmacy. This trend is not limited to just one pharmacy corporation; other chains as well as independent community pharmacies have, from time to time, initiated advertising campaigns that insinuate or offer similar prescription time guarantees to their customers.

We have heard from pharmacists who claim that their pharmacy’s management actually tracks pharmacist productivity based on the number of prescriptions they dispense and whether or not they meet time promises. A 15‐minute dispensing claim for up to three prescriptions can jeopardize public health by putting pressure on pharmacists to work as quickly as possible and discouraging them from checking the patient’s history and drug profile; looking for possible drug interactions or duplications and other drug use evaluation concerns; calling physicians’ offices for clarification; and educating patients about the proper use of prescriptions (e.g., meeting patient counseling regulations).

It is unacceptable to hold pharmacists to specific timeframes for preparing and dispensing medications, since any mistakes that occur can have devastating effects on patients. Time limits also help promote the idea that the dispensing of medications is a ‘quick in and out process’ that only involves counting tablets.

ISMP frequently receives reports from consumers about medication errors resulting in harm to them or a family member. All too often they observe that the pharmacist seemed so rushed that work could not be thoroughly checked. Examples of serious errors due to volume and workplace distractions have been published in the ISM Medication Safety Alert! Community/Ambulatory Care Edition newsletter.

We realize that there are many issues that need to be addressed to encourage greater adoption of pharmaceutical care and improve safety in community pharmacy practice, such as reimbursement for counseling. But the reality is that community pharmacy prescription programs and inducements for such (e.g., discount coupons) are detrimental to safety and the practice of pharmacy. We should not be educating consumers that the primary determining factor about where they should have prescriptions dispensed is speed.

Since NABP’s mission is to support state boards of pharmacy in protecting public health, ISMP requests that NABP explore and assist members in employing methods to eliminate inducements to consumers that insinuate or promise prescriptions will be dispensed within timeframes that may compromise patient safety.

Sincerely,
Lou Martinelli, PhD, PharmD 
Chair, ISMP Board of Trustees

Michael R. Cohen, RPh, MS, ScD, FASHP
President, ISMP

Cc:   ISMP Board of Trustees
Carmen Catizone, Executive Director, NABP 
William T. Winsley, MS, RPh, Immediate Past President, NABP