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User Comments
07.24.10 - 7:44 am
while, IMO, this thread has
while, IMO, this thread has digressed into a diatribe ... Collectively, we are educated with a whole array of laws that apply to us... almost exclusively as a Pharmacist/health care professional. I am not aware of any "education" that we are provided as to what our rights are as an employee.
With some 200,000 - 300,000 Pharmacists and some 20,000 indys pharmacies... it is clear that the vast majority of us are EMPLOYEES and it is hard to argue with.. that our EMPLOYERS would rather keep us "in the dark" about what our rights are as an employee.
I know for a fact that many employers will tell employees that they MUST do something or another because they are professional/salaried...BUT... the fact is ... if the EMPLOYER limits something as simple as limited bathroom breaks... the employee is then covered under OSHA rules/regulations.
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07.21.10 - 7:33 pm
It doesn't matter who agrees
It doesn't matter who agrees with what.. other than the legal dept of the patent holder. I don't know of any compounding pharmacy that has the resources to take on the likes of Pfizer or any other of the major Pharma's in the courts over a patent infringement lawsuit.
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07.20.10 - 9:26 pm
as long as the prime logic statement is valid
"... NEVER say ALWAYS and NEVER say NEVER ... because someone will ALWAYS prove you wrong..."
No health care professional can speak in absolutes about therapies and/or outcomes.
One of my favorite quotes is "never promise more than you can deliver... and always deliver more than you promised"
If a health care provider promises a patient a "rosy" outcome of a therapy and the outcome comes up short... unlikely the patient will look favorably on the health care professional level of expertise... and unlikely to get positive referrals for future business.
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Back to PONDERING PROFESSIONALISM: Personal responsibility and confidence »
07.20.10 - 9:02 pm
If another employee was
If another employee was offended ... whose to tell if some customers/patients was equally offended.
Maybe writing up the employee was a bit much -- if this is the first time that he was advised to avoid such topics while in a public area within the store where customers could over-hear the conversations.
If this had been addressed with the employee before... then IMO .. management had the right to put their concerns in writing.
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07.14.10 - 9:41 pm
Walgreen's was all the rage
Walgreen's was all the rage in pushing their "POWER PROGRAM" in Fl and AZ.. where they were cutting store's Rx dept hrs and staff and having staff push pts into auto refills - so that they could do them via two centralized Rx centers in Florida and centralized call centers. I have not seen/heard anything from this program for ~ one year.. seems to be at the very least ON HOLD.
I have a family friend who is a nurse in Florida - works for a ped - she said that Walgreens was flooding their office with refill requests authorization via faxes. As we all know, peds do not provide a lot of refills - just by the vary nature of their patient base.
She has been telling their patients to go to CVS or RiteAid.. the only way she sees in making a dent in all the faxes from Walgreens.
As I recall, when Walgreen first announced this program... they were going to have it nation-wide within a year or two... Got into FL first followed by AZ... and then the whole expansion seem to drop into NEUTRAL.
I read the transcript from the AZ board meeting with Walgreen execs... about getting permission to do this in AZ... talk about SPIN... but then it is claimed that 25% of the state pharmacy board members are EMPLOYEES of corporate pharmacy... while corporate pharmacy competes with one another... IMO .. they will not vote against anything that will lessens corporate pharmacy's collective ability to gain market share..
What is good for pharmacy may not necessarily be good for the patient we serve nor Pharmacists individually or collectively. Because patients have been beaten into submission by their insurance companies or decisions by their employers.. what they want/need may have little impact on how pharmacy provide services evolves.
If one doubts this... how many fewer Rxs would mail order firms be filling if they charged the same prices as retail/community and/or their service was not mandated by their insurance or employer?
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07.14.10 - 9:14 pm
Closing price today is $0.98
Closing price today is $0.98 and the last time that they paid a dividend was Jan 2008. Any stock < $5.00/share is considered a PENNY STOCK. Revenue outlook is +/- 1% for next fiscal year... given at least a 3% CPI... they are going to be at least 2% IN THE HOLE !
They are LOSING ~ $0.02 for every $1.00 in gross revenue. Almost 70% of their revenue is from Rx dept... a area that is most likely not going to show any increase in % gross profit and generally declining. But Chapter 11.. will just allow them to screw all their creditors and landlords and give them a "fresh start" to start bleeding money once again. Maybe dumping their debt will reduce their overhead enough that they can show a positive bottom line .. at least for the short term.
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07.14.10 - 9:02 pm
why do you think that the
why do you think that the "fast food style of operating a retail pharmacy" is properly serving the present day patient? Corporate pharmacy seems to be more interested in generating profits and grabbing market share. If getting Pharmacists to be able to generate more revenue - without a major increase in over-head - seems to me... a prime part of their business model. All they have to do is convince Pharmacists that they are becoming a larger (active) part of the health care system and relegate the filling of Rxs to some off-site as much as possible.
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07.08.10 - 2:50 pm
Don't feel bad.. I was fired by a corporate for being insubordinate for REFUSING to make tech deliver off the clock using their own cars.
They so knew that they were in the wrong that they offered me FOUR WEEKS pay if I signed an agreement that I would not sue them. How often does a corporation fire someone for insubordination and offer them a severance package?
IMO- good will with a corporate employer - not just corporate pharmacy - has a half-life of about 4-8 hrs.. It all seems to revolve around "..what have you done to help the corporate bottom line today ..."
Then if you do elect to go with "...I'll do whatever corporate wants..." and you get caught at it.. corporate will come back with "... employee did not follow P&P..."
It is kind of like betting on a coin toss "... Heads I win .. Tails you lose ..."
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07.07.10 - 10:31 pm
I am glad that your tenure with corporate pharmacy has been so blissful. But having built from the ground up my own successful indy pharmacy, HME and even programming my own pharmacy software package in the late 70's. I have a perspective of how pharmacy can be practiced in a era that today's corporate Pharmacists will never have the privilege to experience... I have some 30 yrs of community/retail experience... so I don't consider working in community as a "sell-out"
I chose not to work much in community anymore because of the unrealistic expectation that the typical corporate pharmacy has of its employees.
Working in LTC is no "rose garden" but at least I can go to the restroom when I need to and I have an uninterrupted meal break. I don't have to deal with insurance billing issues - since there is an entire dedicated dept that does that... If I am not satisfied the "safety" of an order... I just throw it back to the nursing staff and put it in "clinical hold" until clarification or justification is provided. I have up to three other RPh's working with me and we all are free to stop and consult one another on a medical/pt issue without someone asking us why we are not "cranking them out "
As a temp, I work more hours than I really want to...but .. can schedule days off at my discretion ... in fact ... I have already taken 5 weeks of vacation
year... and will probably take 2-3 more before the year is out...
During my career, I have chaired numerous committees at the state level as well as severing on the BOD at the state level and on steering committees at the National level as well as traveling to both THE HILL and State capital to lobby.
I have seen "the system" function at first hand.. some consider me pessimistic... maybe so.. all I know that I remain very skeptical of the ulterior motives of the major players that has influence on how we Pharmacists practice.
Looking at the decreasing number of Pharmacists that belong to at least one pharmacy organization... the majority - IMO - are too apathetic to be skeptical.
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07.06.10 - 9:57 pm
According to your profile.. you have yet to FILL THE FIRST RX UNDER YOUR PHARMACIST'S LICENSE.
When you have eight years of experience working under your own license - and not just an observer - and dealing with the consequences for your own decisions. We will see just how much your opinions at that point in time mesh with your current opinions.
Of course, I chose not to work for one of those $4 pharmacies or ones that believes that our service and some of the drugs we dispense.... should be GIVEN AWAY.
Perhaps, they have such a waiting list of people wanting them to fill their Rxs that corporate could care less if their Pharmacists piss off prescribers in the area.
The prescription belongs to the patient... the prescriber cannot refuse to give the pt the Rx... they can decline to call it into or electronically transmit the Rx to any facility.
All the prescriber has to do when asked by the patient why they won't call into a particular pharmacy... all they have to say is "... we have had some problems with them and we are not encouraging our patients to have their Rxs filled there...but you are free to use whatever pharmacy that you wish ... here is your Rx ..."
The patient bond at a indy will probably be harder to break... but not so much with a chain...
Because I work in LTC ... I have to get my Rxs filled at a local chain... I know that all the Pharmacists there are alumni of my alma mater and would not know them if I ran into them outside of the store ... because I typically deal with the lead tech.
If my PCP told me that he had a problem with that store and suggested another one... I would consider switching because I believe that he has my best interest in mind.
I would question my PCP more than the average patient... and because of being a fellow healthcare professional I believe he would share his concerns... which I don't think would happen with the average pt.
Since 90%+ of the Rxs are paid by a PBM... the patient would have no financial incentive to second guess their PCP... after all they literally put their life in the PCP's hand... why would they question a "questionable pharmacy/pharmacist" in their PCP mind?
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07.05.10 - 10:57 pm
You are SOOOO NAIVE .... I have seen/heard of prescribers who will REFUSE to call in Rxs to a particular pharmacy for some reason or another... They will hand you a written Rx and you can take it where ever you want... They can very easily put a question as to the quality/reliability of a particular pharmacy in the patient's mind.
Unless you are in a very large metro area.. typically the local prescribers are very close knit bunch... think doctor's lounge at the local hospital... and trying to somehow push the issue... will not win you any friends in the local medical community.
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07.05.10 - 8:09 am
All of us everyday
All of us everyday bend/circumvent/work around rules/laws to make sure patients have what they need. Unjust laws can take years to change..the consequences to these two "kids" and the financial impact on our society, as a whole, could be for several decades.
As Pharmacists, we should know "the system" better than the "average joe".. just telling them that they are not OLD ENOUGH to buy Plan B and sending them on their way.... could be consider unprofessional by some and could border on mental cruelty by others.
if there was ever a time that a patient needed counseling ... this was it !
score one for ethics and morals ... and ZIP for professional judgment !
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07.04.10 - 9:02 pm
while they may read the hand addressed letter... hand addressed letters don't fund re-election campaigns. All one has to do it look at the sizable number of Congress who would not have local meetings with the electorate before they voted for the "national health insurance" legislation and the attitude of some toward the voters in their district when they did.
My local Representative voted AGAINST the health care bill before he VOTED FOR IT.. when his vote really counted. They are all going to be on vacation and off to run for re-election soon..and they only work from noon on Tues to the afternoon on Thursday each week. IMO... this bill will not see the light of day in this session of congress and the vast majority of the House will not be back in Jan.
A article in this month's NCPA Journal labeled GAME CHANGER claimed that Pharmacists were getting the opportunity to work with diabetics in disease management because ..."..Traditionally diabetes self-management education/training (DSME/T)have been LIMITED TO HOSPITAL SETTINGS, but falling REIMBURSEMENTS have created an access void for patients..."
So it would now appear that Pharmacists are "good enough" for diabetic education.. Of course there is a lot of training that must be done ... but would appear that all the CDE's are being thrown under the bus ... because whatever was being saved ... was not enough to be considered a decent return on investment for their services.
Don't forget to stuff your "hand written envelope" with money when you send it to your representative !
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07.04.10 - 8:56 pm
Without empathy and
Without empathy and compassion for our fellow man... what are we ?
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07.04.10 - 8:43 am
Morally/ethically we are
Morally/ethically we are bound to do what is best for the patient. A couple of years ago it was ILLEGAL to sell Plan B to anyone under 18 ....now it is 17 ... why did the cut-off change... did a bureaucrat's daughter/son who was 17 do they same stupid thing .. and couldn't buy Plan B and screwed up their life?.. so the age limit was lowered? I don't know all the particulars but from what you have said... I probably would have found a "work-around" to take care of what was needed to be taken care of.
How many times have each of us done something stupid in our lives... we were just not caught at it or it did not impact the rest of our lives.
It is a very sad day when we let ethics and morals overrule our empathy and compassion at any given point in time.
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07.04.10 - 8:29 am
She said what she thought
She said what she thought should happen - sell the product...but she did not have enough back-bone to follow through with her convictions.
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07.04.10 - 8:26 am
If it has been a weekend
If it has been a weekend ..the "window of opportunity" to use Plan B may have passed by the time that she got hold of her PCP... IF SHE HAD A PCP in the first place.
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07.03.10 - 5:55 pm
if she wanted the law
if she wanted the law circumvented... she should have taken upon herself to make it happen not suggest that someone "under her" circumvent the law.
What is unfortunate is that by the time that this pair could "legally" buy this product... they could be parents... still in high school or worse yet... high school drop outs struggling to "do what is right"
On the other hand... if pregnant... all three of them ( or more) may end up being "supported" by society for years or decades because some bureaucrats has decided that even though a person is old enough to become pregnant ... they are not old enough to make the decision to take/buy Plan B.
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07.03.10 - 9:00 am
Here is the definition of a Ponzi scheme
A Ponzi scheme is similar to a pyramid scheme in that both are based on using new investors' funds to pay the earlier backers. One difference between the two schemes is that the Ponzi mastermind gathers all relevant funds from new investors and then distributes them. Pyramid schemes, on the other hand, allow each investor to directly benefit depending on how many new investors are recruited. In this case, the person on the top of the pyramid does not at any point have access to all the money in the system.
So Social security may be more of a PONZI scheme than a PYRAMID scheme... It is not about getting rich... it is more about getting a HIGH RETURN for the monies invested in the scheme. To that point... those who were first in SS got a very high return on their investment and every generation since then has - and will get - a much lower return... and those at the end of the baby boom generation may not even get the money back that they put into the system.... so it may be a stretch to even call SS an INVESTMENT.
The ORIGINAL retirement age was 65... when the average life expectancy was 62...meaning 50% of the people died by the time they reached 62... and there was something like 50 people paying in for every one receiving benefits. Today that number has shrunk into the mid single digits...and yes the FULL RETIREMENT age is now up to 67 - depending on when you were born... so in 70 yrs the life expectancy has moved up some 16+ yrs and the full retirement has move up TWO!... Plus the system now allows one to start drawing at 62 ...plus the system now pays out survivor benefits as well as disability benefits... something the system was never designed to do.
Like all Ponzi schemes... SS is approaching its "crashing point".. it has recently went into a negative cash flow and Congress has robbed the so-called "trust fund" so that it is full of paper IOU's.. The first baby boomers will be at Medicare's door Jan 1st,2012... So Congress is going to have to face some difficult tasks... there is no money in the trust fund to pay for the promised services that everyone has paid into...
I am sure that many will welcome a national health insurance... all of us healthcare professionals will literally become employees of the government WITHOUT all the benefits of being a government employee.
Our society is like a "pitch-in dinner" and over the past 40-50 yrs... more and more people are coming to eat and fewer and fewer are really pitching in! Congress has used untold accounting tricks to make up for those who won't/can't pitch-in.. Congress has promised 130+ TRILLION in benefits... TWO TO THREE TIMES what the entire country is worth...if it was sold.
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As a salaried professional...
As a salaried professional... you are expected to work without supervision. I do know that as a salaried staff... if you show up for work and leave later... they are required to pay you for the ENTIRE SHIFT/DAY., even if you leave minutes after you show up. I know that if an employer does not allow bath room breaks to salaried staff ... they are in violation of OSHA and could put at risk the employee(s) as continued to be classified as "exempt"/salaried
here is a reference to OSHA and bathroom breaks
There is not a federal law that specifically applies to the number and duration of bathroom breaks. However, there are Occupational Safety and Health Administration (OSHA) regulations which require employers to provide adequate bathroom facilities, and prevent employers from imposing "unreasonable restrictions" on bathroom use. The intent of these regulations is that employees are able to use bathroom facilities promptly, recognizing that the frequency of bathroom visits necessary may vary among employees, depending on factors such as the temperature, medical conditions and the effects of medication, and fluid intake.
In production environments where the absence of one or more individuals can adversely affect a productive work flow, OSHA recommends the adoption of a signal system, so that employees can request relief by signaling for another employee to take the spot on the work station. If employees are not being forced to wait an unreasonable amount of time for bathroom use, a system like this complies with OSHA regulations.
In regards to meal breaks... most states prohibit food in the Rx area... and diabetics must eat regularly.. that is probably a ADA issue. Some state Pharmacy regulations require that a bathroom be part of the licensed pharmacy area.. which means that the bathroom is adjacent/attached to the pharmacy.
The whole issue is a spider-web of regulations between the Fair Labor Standards Act, OSHA and ADA.
The bottom line is that the more that an employer tried to limit what/how a salaried employee does their job... the more at they are at risk of the employee being declassified as exempt... which puts them at risk of having to pay previous time/over time > 40 hrs/wk that the employee has worked.
Which is the one of the best reasons that the employer does not want its employees to understand what rights they have under the law... other than what is stated in the P&P book.