Wednesday, March 14, 2012

Nation's Journalists Give Up, Will Just Report Once A Month CVS Probably Fined For Something Again.

TAMPA, FL- At its national convention here today, The American Association of Business Journalists agreed that any story about leading drugstore operator and pharmacy benefits manager CVS/Caremark that involved the company being the target of a law enforcement investigation, getting sued, reaching a settlement while admitting no wrongdoing, or assuring the public that despite this incident "we value nothing more than the relationship we have with our customers" is no longer officially newsworthy. The resolution was proposed, debated and passed nearly unanimously in a record 15 minutes.

"I admit I'm a little sorry to see the old newsroom staple of the 'shocking CVS' story come to an end" said Robert Mitchell of the Providence Journal. "I have fond memories of covering the trial of two CVS executives who were accused of trying to bribe a Rhode Island state senator, and the story about the CVS pharmacist who received over $4 million for exposing how the company was overbilling Medicaid was a compelling tale about the little guy prevailing over the giant corporation, but by the time we heard of how they were overcharging customers in their Medicare Part D plans, we were really stretching for a unique angle to present"

At one time, the abundance of material produced journalists who specialized in specific aspects of the company's legal troubles.

"My beat was the out of control CVS pharmacist" said Melinda Gomez of the Associated Press. "My editor assigned me the woman who wasn't a pharmacist who was able to do what CVS expected of its pharmacists with no trouble story, but by the time we got to the CVS pharmacist who used customer information to post a fake sex ad on Craigslist it was taking up so much time we made it a full time position. Or maybe that was after the CVS pharmacist who let a customer have an asthma attack when they were a couple dollars short. Wait. No. It was when the CVS pharmacist wanted to trade Xanax for sex. Oh hell, I don't remember. It all blends together after awhile."

Many agreed that the high point of the CVS as unethical news story came with the revelation that the company seems to be disregarding the obvious intention of the North Carolina Board of Pharmacy that pharmacists in that state should not work more than a 12 hour shift. 

"I've never met the man who wrote that story" said Mary Russel of the Columbus Dispatch, but his raw sexuality comes through in every word. The way he made that spokesman look stupid with just a few phone calls to CVS stores shows an intellect that I can't help but to find attractive."

Some expressed concern that CVS, once in the spotlight, may have started acting out in an effort to gain more attention.

"I remember joking that at least they haven't been busted for actual illegal drug sales, but almost right after that came the crystal meth story, and then the DEA suspending the license of two of their stores for going through almost 21 times the amount of oxycodone an average pharmacy does. It was almost like they felt the need to do something more and more outrageous to stay in the news. The only thing now I can think of  they haven't done is rape or kill anyone in cold blood."

"That I know of." He quickly added.

The resolution added that while these type of stories no longer met the definition of news, and reporters would no longer be assigned to cover them, it was still perfectly acceptable to say something about CVS doing something stupid in cases where space or dead airtime needed to be filled, as the company gives no indication of changing its ways. 

Monday, March 12, 2012

The Giant Drug Chains Are Cheapening The Profession Of Pharmacy You Say? What Possible Evidence Do You Have For Such A Claim? Oh. Well, OK Then.



DURBIN, BLUMENTHAL QUESTION POTENTIALLY DECEPTIVE MARKETING AT RITE AID

Concerned that “wellness ambassadors” recommending dietary supplements are mistaken for pharmacists and medical professionals

[WASHINGTON, D.C.] – U.S. Senators Dick Durbin (D-IL) and Richard Blumenthal (D-CT) today questioned potentially deceptive marketing practices at the drugstore chain Rite Aid which has GNC dietary supplement stores in more than 2,000 Rite Aid pharmacies nationwide.  In a letter to the President and CEO of Rite Aid, Durbin and Blumenthal express concern over the placement of “wellness stations” in stores, which are staffed by “wellness ambassadors” who take health questions from customers and often recommend dietary supplements – which have not been reviewed by the Food and Drug Administration (FDA) – to treat medical conditions. 

“We are writing to inquire about potentially deceptive marketing practices at Rite Aid Pharmacy stores that could mislead consumers seeking medical advice and direct customers to treat health conditions with dietary supplements,” the Senators wrote.  “We are concerned that Rite Aid customers seeking a prescription or an over-the-counter drug are misled into believing the wellness ambassador is a pharmacist or health professional qualified to dispense medical advice.  This potential for confusion could result in dramatic and dangerous consequences for consumers.” 

In many Rite Aids stores, the “wellness stations” are located near the pharmacy counter where customers seek medical assistance from qualified pharmacists.  Because of the close proximity to the pharmacy and the attire of “wellness ambassadors” – white coats similar to those worn by pharmacists – customers can easily be misled to believe the “wellness ambassador” is a pharmacist.  But the qualifications of a pharmacist and “wellness ambassador” are vastly different.  A typical pharmacist position requires a candidate to hold a doctor of pharmacy degree and complete a licensing examination while a “wellness ambassador” only requires a high school diploma or general education degree plus one year of experience in the retail or health care industry. 

Additionally, because “wellness ambassadors” field questions from Rite Aid customers about treatments for symptoms and health conditions, Durbin and Blumenthal are concerned that they could be making false and misleading claims by marketing or directing customers to purchase dietary supplements as treatments for health conditions.  The Federal Trade Commission Act prohibits marketing products through “unfair or deceptive acts or practices,” such as making explicit or implied medical claims that a dietary supplement can treat, prevent, or cure a specific disease or condition. 

[Text of today’s letter is below]

March 8, 2012

Mr. John T. Standley
President and Chief Executive Officer
Rite Aid Pharmacy
30 Hunter Lane
Camp Hill, PA 17011

            We are writing to inquire about potentially deceptive marketing practices at Rite Aid Pharmacy stores that could mislead consumers seeking medical advice and direct customers to treat health conditions with dietary supplements.

As a result of the partnership between Rite Aid and the dietary supplement retailer GNC Holdings, Inc., GNC stores have been placed in more than 2,000 Rite Aid pharmacies.  It has come to our attention that Rite Aid is establishing “wellness stations” within its stores, which are staffed by “wellness ambassadors” who take health questions from customers and recommend dietary supplements to treat medical conditions. 

Because these wellness stations are located near the pharmacy, we are concerned that customers seeking medical assistance are misled to believe the station is affiliated with the pharmacy.  The confusion is compounded by wellness ambassadors wearing white coats similar to those worn by pharmacists.  On Rite Aid’s website, the job description for wellness ambassadors only requires a “high school diploma or general education degree (GED), plus one year experience in retail or healthcare industry.”  In contrast, a typical pharmacist position requires a candidate to hold a doctor of pharmacy degree (Pharm.D) and complete a licensing examination.  We are concerned that Rite Aid customers seeking a prescription or an over-the-counter drug are misled into believing the wellness ambassador is a pharmacist or health professional qualified to dispense medical advice.  This potential for confusion could result in dramatic and dangerous consequences for consumers. 

Furthermore, we are deeply concerned that wellness ambassadors could be making false and misleading claims by marketing dietary supplements as treatments for health conditions.  The Federal Trade Commission Act prohibits marketing products through “unfair or deceptive acts or practices,” such as making explicit or implied medical claims that a dietary supplement can treat, prevent, or cure a specific disease or condition.  Because wellness ambassadors field questions from Rite Aid customers about treatments for symptoms and health conditions, we are troubled that customers could be directed to purchase dietary supplements, which have not been reviewed by the FDA or approved to be marketed like drugs. 

These practices raise questions about Rite Aid Pharmacy potentially misleading customers who trust your company to provide credible health information.  To ensure consumer safety and to better understand Rite Aid Pharmacy’s wellness stations and ambassadors, we ask for your response to the following questions: 

  • What training do wellness ambassadors receive to safely advise customers seeking product recommendations for medical conditions?
  • What steps does your company take to inform consumers that a wellness ambassador, wearing a white coat, is not a pharmacist or trained health professional?
  • What corporate plan is in place to ensure wellness ambassadors do not make unfounded medical claims that dietary supplements can prevent, treat, or cure health conditions?  If a corporate plan exists, how is it enforced?
  • Do wellness ambassadors take into account and advise customers of any dangers associated with a dietary supplement or drug that they recommend to customers?  For example, if a product should not be used by pregnant women, does the wellness ambassador ascertain whether a customer is pregnant before referring her to the product or caution the customer about the product’s risks?
  • Do wellness ambassadors solely or mostly direct consumers to dietary supplements as health aids?
  • Wellness ambassadors appear to employ tablet computers and software to assist them in their interactions with customers.  Does this software refer customers with specific symptoms to specific products?  If so, are these products dietary supplements, drugs, or both?
  • How many Rite Aid stores have wellness stations and wellness ambassadors?  Does Rite Aid intend to place wellness stations and ambassadors in all of its stores?


            Thank you for your consideration of this matter. 

Sincerely,



Richard J.  Durbin                                           Richard Blumenthal

Friday, March 09, 2012

I Bet It Feels Good As A Consumer To Know Pharmacies Have Powerful Prescription Checking Software.

Programs that can almost instantly pull up any potential problems with your prescription. Drug interactions, dosage problems, possible misuse, you know, that kind of thing.

Sometimes though, you really don't need all that technology.


Sunday, March 04, 2012

CVS Unveils Innovative Tool In The War On Cancer.

CHATHAM, NJ- In what CEO Larry Merlo described as an "exciting new development for the profession of pharmacy" CVS, the nation's second largest drug retailer, today announced the beginning of a unique clinical study into the effectiveness of prophylactic breast cancer treatment.  In cooperation with, apparently no one, 50 children given prescriptions for the common cavity prevention medicine sodium fluoride were instead given the breast cancer drug tamoxifen. Patients will be monitored over the course of their lives to measure the effect of an early-life course of tamoxifen on eventual rates of breast cancer development.

"Everyone talks about the role of pharmacy evolving into taking on more clinical functions" Merlo said at the office of CVS' corporate attorney. "And while the spread of pharmacist immunizations and medication therapy management services have certainly been steps in that direction, we are pleased today to become the first pharmacy organization to offer its own complete scientific study. We look forward to publishing our results and contributing valuable knowledge to the fight against this terrible condition."

Outside experts, while welcoming any effort to find a cure for a disease that kills almost 40,000 people a year, cited several problems in the study's design, including its rather large control group compared to number of active drug subjects, limiting its location to one neighborhood in this New Jersey town, and even the need to know how cancer meds affect healthy small children. One aspect drew almost universal praise however.

"We can rest assured that this is indeed a double blind placebo setup" said Robert Klinghoffer, director of clinical research at the Ohio State University school of medicine. "As it is obvious no one ever looked in any container of fluoride that went out of that store over the course of two months."

Seriously. Fifty fucking prescriptions. Over the course of two months. And no one bothered to look. This isn't a case of the occasional horrifying misfill. This is a case of obviously no one paying attention. Matching the markings to the picture is the last thing you do before you let a prescription go, or maybe I'm just a little old school that way.

Reached for comment, a Rite Aid spokesman said, "Oh sweet mother of mercy. Thank God this didn't happen to us during that 15 minute guarantee promotion."

(Thanks to the alert readers who tipped me to this story. A record number of them. Which tells me there are a lot of people out there who really.....really......hate CVS. )

Monday, February 20, 2012

Another Gift From Me To The Profession. A Practical Way To Deal With Corporate Short Staffing.

We've all been there. We've all looked up from our place behind the counter and seen a herd of screaming, foaming at the mouth barbarians. Chaos at the cash register. Anarchy at the in window. And a line of prescriptions to be done with no one available to work on them until things settle down.

And don't even ask for whom the phone rings. It rings for you.

I know it seems hopeless, and it is not unheard of for things to break down completely in these situations. I once worked at a 24 hour store that was behind for a solid month. You went in there at 3 in the morning, and you would have seen me in there cranking out prescriptions at full capacity and still not getting through the pill pile by the break of dawn. It doesn't always have to be this way though. Sometimes a little outside the box thinking can go a long way to keeping the capsules flowing.

Next time you're on the brink of breakdown, here's what you do. Walk over to the cash register and fuck something up. Just start pressing buttons at random until the thing locks up. Then page for one of the front end managers. Act stupid and humble when they arrive. You just don't get much practice running this goddamn thing, and could you bail me out?

My favorite fuck up is "accidentally" hitting the cash button when the customer wanted to pay with a credit card. That means the manager now has some skin in the game, because if that drawer doesn't balance, they're wasting a lot of time before they get to go home trying to track down why.

Then, when the front end manager starts to tinker with the register, and this is the most important part, WALK AWAY. Also evacuate any techs and cashiers you have from the area. Immediately go and answer the phone, start typing the pile of prescriptions into the computer, anything. Remember there is plenty of work to be done. Find some that is physically the furthest away from that cash register as possible and get to it.

It is regrettable that that manager must be sacrificed. That crowd of people will tear him to bits just as surely as if he were swimming with a school of sharks and developed a nosebleed. But the important thing to remember is he won't be able to get away. Once he fixes your fuck up and looks up to see.......no one....he will not have the testicles to leave an unmanned cash register in front of the crowd of crazed lunatics, who are now madder than ever for having to wait for him to fix the problem you created. The net effect? You now have an extra cashier. Leave him there until you make measurable progress towards catching up or your conscience breaks, whichever comes first. On Sunday I had the shift supervisor acting as my pharmacy cashier for a good 45 minutes. Poor bastard didn't have a choice.

Here's the best part. If you're good enough at it, that manager won't even realize how you fucked him. Again, the object is to act a little dumb. A little, "wow, I don't know what would have happened if you hadn't have come back" will go a long way towards keeping him from even realizing you just made him your bitch, and make it much easier for you to do it again.

I theorize this is similar to how pimps get started.

You Know What Happens When You Put Off Asking A Guy About His Jar? You Can Lose The Chance. Forever.

Blogpost original air date: November 21, 2006. Update follows.



The Melatonin Chronicles......Or Bizzaro Dream #2

The bizzaro dream is coming, I promise, but first the necessary background:

Detroit was ground zero for the dark, seething underbelly of the 60's. Everybody remembers the happy hippies of Woodstock, but we have tried to forget the very real anger that was just as much a part of that era. While the flower children were doing their thing, singing how we should just just smile on our brother and learn to love one another right now, Detroit bands like The Stooges and MC5 were letting us know what it was like to have your teeth kicked in by the cops and then be charged with assault. My kind of music. Now I love the MC5, but I haven't been listening to them much lately. You know how it is, music works it's way to the back of your collection for awhile, only to be re-discovered years later. Last night, however, the MC5 came back into my life as I slept.

In my dream, I had decided that it was time for me to learn to play the bass guitar, and so I had signed up for some classes at the local community college. The instructor enters the classroom, and it is none other than the bass player for the MC5. Sweet! I will finally be able to ask him about the jar!

"Um...the jar?" I hear you saying. You see, the first MC5 album I bought years ago had a rather, um....disturbing picture on the back. Here it is:





That jar has fascinated me from the day I first laid eyes on it. What could possibly be inside? Would I really want to know? The way the dude with the afro is pointing at it it almost looks like he's soliciting spare change so he can take the bus home after the gig. In my dream though, the mystery of the jar was about to be solved! I sat patiently though class, barely able to concentrate on the lesson knowing that this obsession of mine was about to be put to rest. After class, as I made my way up to the front of the room my heart rate quickened with anticipation........

Then I woke up. And my heart really was beating fast. Why the fuck would my brain be thinking in the middle of the night about a band I haven't consciously thought of in years? Why would the mystery of the jar surface now after lying dormant for so long? DAMN YOU JAR! I WILL UNLOCK YOUR SECRET SOMEDAY!

I'm thinking I should talk to my doctor about Ambien, and, um, maybe a few other things.

Update, February 20, 2012. Sent to me by a dear friend via Huffington Post:

LOS ANGELES -- Michael Davis, the bassist of influential late 1960s rock band MC5, has died of liver failure, his wife said Saturday. He was 68.

Rest in peace good sir. I hope the act that follows you in life is more substantial than the one that followed you here: 


Thursday, February 16, 2012

Highlights From Recent Pill Counting Action.

I was excited when I first heard of the 15 minute prescription filling guarantee, as the prospect of seeing outer space has always excited me. Visions of visiting distant galaxies and alien civilizations danced in my brain. I thought about the incredible learning experience I was about to undergo as I boldly went where before no man had gone.

What do you pack for time travel?

As some of you may be aware, Einstein's theory of relativity predicts that altering time is indeed possible. That if one were traveling faster than the speed of light, because that speed remains constant in your perception, other things must change in order to keep the equation of the universe balanced. One of those things is time. I wondered when the maintenance people would show up to fit our pharmacy with the powerful rockets that would enable us to calmly fill prescriptions, taking all the necessary and prudent precautions to make sure it is done right, while altering the timespace continuum to make it appear to you it was never done in more than a quarter of an hour. No matter how many people were in front of you. No matter how many times the phone would ring with someone demanding our immediate attention. No matter the number of times the old lady would come to within 5 feet of me while evaluating your drug interaction report to ask me if the Swiffer could be used on a hardwood floor. Once maintenance installed the rockets, none of this would matter.

Then I remembered that Einstein's plan actually made it possible to travel to the future, meaning 15 minutes of your time on the rocket ship would translate to maybe an hour in the rest of the universe. This would make the prescription filling process even slower, and I realized all that the 15 minute guarantee really meant is that you got a five-dollar gift card if you bitched that I took too long. Then I realized the five dollars wasn't my money and never thought of the 15 minute guarantee again.

Until today, when I finally noticed all the 15 minute guarantee signs had been quietly taken down. The store manager said this had been done long ago and that a 15 minute "pledge" was soon to come. A pledge is like a guarantee except you don't get paid. Which means I care even less about it. I moved on to matters more important.

I heard my Supertech ask a customer what their phone number was. "Yes" was the reply. It was gonna be a highlights kinda day.

The next customer asked me if I got to go home soon. It was 9:30 in the morning. Yup. Some days have highlights written all over them.

I got a report that the Pharmacy Manager was recording video of the store's management team not working hard enough to suit her using her cell phone. I wondered if maybe she had invented some sort of reverse speed of light backwards time thruster that gave her enough minutes to do this type of thing. Because I've got more than enough shit to worry about in the happy pill room without going around getting all Dick Tracy on the people up front. I was snapped out of this train of thought by the customer waving a bottle in front of my face asking if she could take this if she were pregnant. The bottle contained prenatal vitamins.

Shortly thereafter a man asked if he could use a thermometer to take his temperature and then put it back on the shelf and another person came to the counter with a parrot on their shoulder and bird shit all over their shirt. He asked if he could borrow the phone and I handed it to him. I asked what number he needed to dial and he said he didn't know in a tone of voice that indicated I should. This kind of thing doesn't even phase me anymore. Twenty years in the profession has made me numb to a man covered in birdshit who expects me to read his mind. Pharmacy students make of that what you will.

A man not covered in fecal material tried to talk me into giving him a Vicodin refill early by saying, "I gotta be honest, I just like taking it." Part of me appreciated this so much he almost got it.

The rest of the day flew by and towards the end I finally got a chance to look at the faxes that had been zapped from the corporate mothership that morning. Among them was one that contained only two things, my name, and a "0%" next to it. I really sucked at something. Perhaps this is the latest craze among the MBA's, motivating your people by making sure they have no idea how you are evaluating them. Or maybe the rest of the fax is on that rocket ship, gleefully whizzing by supernovas and giant planets at twice that magical speed of light, to be delivered sometime in the distant future. Out in space where I longed to be.

Perhaps if I read the work of Einstein in more depth, it will contain my answer. I plan on starting right now. 

Tuesday, February 07, 2012

My Favorite Lamp.

I didn't think anything about giving him the ProAir inhaler really. Probably didn't even remember doing it 5 minutes after it happened. I knew the man's wife was bedridden and suffering from Chronic Obstructive Pulmonary Disease, and while it was a source of minor irritation that he had let his refills run out on a Friday night, he was a regular customer and a decent enough guy, and I knew he had his hands full taking care of the woman he married. No big deal really.

"Don't worry about it Bob, we'll just take off a refill when we get the prescription." And Bob was on his merry way. I do remember he said thank you, which is more than a lot of them do.

The next time he was in he asked me what my favorite color was.

I told him blue because I tend towards that color when making wardrobe choices. An ex-girlfriend told me once it was a good color for me and that was that. I didn't think anything about it really. Just said blue and filled his prescription for OxyContin. Or tried to. Goddamn prior auth. It was when we got the PA form back I said a little curse just in case there was a God. "Diagnosis" the doctor had scribbled at the bottom, "terminal liver cancer." Go straight to hell Jesus. Seriously. This guy was decent and hardworking and all he wanted to get out of his day was to be able to take care of his sick wife when there wasn't another soul to help them. Nice one there omnipotent master of the universe. Whatever you are you are not just. You crated an awful, ugly world where we all get by on the occasional scrap of joy and where none of our stories will end well. 

A couple weeks later there was a blue box on the pharmacy counter. "Bob left this for you" the manager said. Inside was a blue lamp from IKEA and a note:

"I just wanted to thank you for being such a help to my wife and I over the years. In particular, I'll never forget the weekend you let her have her inhaler when I was foolish enough to run out of her refills. It showed a level of professionalism and caring that I really appreciate. Maybe once I feel better we can go out to lunch. My treat."

I never thought about that inhaler, and I never really noticed Bob all that much. He was just one of the endless blur of people that whirl through my workday. But to Bob I was an integral part of his life. That is the power of our profession. The dosage of Bob's OxyContin was twice as strong as last time. There's not going to be any lunch.

I wrote this by the light of that blue lamp, and every time I turn it on I'll remember Bob's stand against the ugliness of life. How he spit in the eye of the darkness as it inevitably took him down. His futile struggle for decency.

I owe him that much.





Sunday, February 05, 2012

I Have No Idea How This Stayed Under My Radar For So Long. And You Walgreen's Pharmacists Thought The Flu Shot Quota Was Bad

You HAVE to let this video run until the talk of Walgreen's starts. Or skip until around 3:25 in:





Thank you to the Moody Shrew, who finally tipped me to this