Favorite Question of the Week

As I'm limping out of the front of the store, 15 minutes past closing, bundled up in my warm jacket, deliriously happy to be out of that mad house, a man walking in, recognizing me as "the other pharmacist" (I'm not Mickey, you see) says, "Oh, is the pharmacy closed?"

We have closed at the same time for at least ten years, maybe longer. It's on the door, the pharmacy labels, the bags, our business cards, everywhere.

"I'm sorry, we're closed. Mickey will be here tomorrow morning."

But I wanted to say, "No, the night shift is a little late. Just go on back and wait for them..."

The Future of Vaccinations

"Researchers at MIT have come up with a method to create 'super effective' DNA vaccines by relying on an array of microscopic plastic needles that measure a mere 250 microns wide and 650 microns high, and if you were to compare it to the average human hair, it measures roughly 100 microns wide.The microneedles in action can disrupt only the most superficial layers of the skin while avoiding nerve endings and blood vessels, rendering them painless to deliver the vaccine compared to hypodermic needles."

Just in time, too, because I'm tired of 13 year old boys crying like little girls just before I gave them this year's flu shot. I'm not kidding. I had multiple little girls aged 8-12 roll up their sleeve and bravely take the flu shot this year, but two 13 year old boys cried. Jeez. Really?

Check out the PAINLESS VACCINATION.

Mr. Roboto's Burger

Robot Serves 360 Burgers Each Hour


The Alpha machine from Momentum Machines is said to be capable of "cooking up a storm with its tasty burger," and to produce “gourmet quality burgers at fast food prices.”

It uses a conveyor belt system where meat is freshly ground, shaped, and grilled, then cooked according to the customer's specifications. After cooking, freshly sliced tomatoes and pickles are added and the whole thing is wrapped up ready to serve.

The one in the picture doesn't look too bad, but I'd get a big kick out of seeing the ones that went haywire and wrapped up for people... the ones that if made by a human wouldn't make it to the customer. I speculate a cool website called "Damn you, Robot Burgers" much like "Damn you, Autocorrect."

And if you've ever been stuck in the drive thru line at In and Out Burger, 360 Robot Burgers per hour seems pretty fast...

COOL: Vitamin Reference Wheel

Your body needs vitamins to thrive and survive. Essential vitamins are found in every day foods. This handy wheel chart will help you plan your meals with foods that are loaded with each important vitamin.  Sections show the important vitamins A, B, C, D, E, and K and which foods have them.

It's HANDY DANDY!

Thanks to graphic designer Shannon Lattin, "It's easy to tell at a glance from the chart that unless you're eating vegetables, such as broccoli and spinach, or liver, you're probably not getting enough vitamin K. On the other hand, lots of foods can provide you with vitamin E and B3."

Read the Original Story

Playing with fire

That's what it is, really. It's like a child with a box of matches. Fire is so very magical, the ultimate chemical reaction. When something burns it is amazing to a child... and just like magic. Yet, the child doesn't realize the inherent dangers. Fire is useful, but used improperly is DEADLY. And unsupervised, it's only a matter of time until the child gets burned playing with fire... or worse...

Such is retail pharmacy, especially those in grocery stores like my national chain. You have all these corporate muckity-mucks trying to run a pharmacy like a grocery store, or much worse, like a automobile manufacturing plant. Like a child, they lack the wisdom and understanding of what pharmacy is really all about. Oh, they say they understand, but the actions are much different. When you under staff a pharmacy, you're playing with fire... and its only a matter of time until someone gets hurt, just like with fire. When you push pharmacists to the limit of their physical endurance, its only a matter of time until a serious mistake is made and someone gets hurt, or worse, dies. 

Profit is what drives any business, and pharmacy is no different. But what is different is the marketplace now. There is massive competition. Margins are thin. Grocers MUST decide whether they can handle the thin margins WITHOUT compromising patient safety. From corporate perspective, they're cutting tech hours left and right to increase the bottom line. It's a simple equation. That's the first thing they teach in you in business school... if business gets tough, cut the work force. But their calculations have failed to take into account the risk factor and what might happen... or rather what WILL happen, when you continue to push humans beyond their limits.

A colleague of mine works for another national grocery chain pharmacy. Awhile back there was an incident in one of their pharmacies where the wrong medication (methotrexate) was given to a baby with an identical name to that of the cancer patient it was intended for. Fortunately the error was caught early and there was no patient harm. The chain pharmacy immediately printed laminated cards with detailed instructions on how all pharmacy personnel are required to check name, date of birth, address, phone number, and medication for EVERY patient picking up medication. Every pharmacy employee was required to sign off that they would follow this protocol exactly and that the extra time needed to do this was fine with the company. These laminated cards were expected to be placed everywhere around the registers and even the input workflow computers. This is fine, but the people who designed these instructions really don't know what it is like at a busy pharmacy.

And once again, here is an example of a company not addressing the real issue. The error happened because the pharmacy was under staffed and overworked. Instead of addressing the real issue, they chose to place the burden solely on the pharmacists and staff... in other words, "don't blame US because you're under staffed, it's YOUR fault." Moreover, when a major mistake happens again, the company has conveniently placed a safety net for themselves... "Hey, we have a system in place to prevent that... it was the pharmacist's fault that the wrong medication was given to the patient... we regret that our perfect protocol was not followed... we're innocent."

Eventually there will be a busy pharmacy in my pharmacy chain, or one of our competitors... that has pushed the envelope too far. A baby will die, or someone will be seriously hurt. There will be lawsuits and news reports and the media will refer to articles and blogs like this one from pharmacists having sounded the warning call for years. The "perfect protocol" safety net will be revealed as a piss-poor way to handle the fact that the pharmacy was seriously under staffed. Then there will be huge settlements and payoffs... likely in excess of the money the company would have paid if they had just staffed the pharmacy responsibly and respected the pharmacists instead of working them to death. You would think that the corporate people would take that into account... but no, they'd rather roll the dice to save a few bucks on the bottom line. I'm sure at the top of their agenda is their bonus, not people's lives.

Please, corporate... wake up! Someone needs to take a stand, step up, blow the whistle. When you're dealing in healthcare, profit is the secondary motive AFTER patient safety. Otherwise, it's only a matter of time until someone gets hurt.

Mr. D-A-W

x

"That's D-A-W, you know. You got that right, Mr. R-X-Man?" And I'm not substituting my blog name for my real name. He did indeed call me "Mr. RxMan."

Mr. D-A-W is here again, dropping off another prescription for Xanax, brand only. His co-pay is $40, but he doesn't care because he insists on brand. And he wants to make sure he's going to get brand, so he reminds you every time.  Everyone in the pharmacy knows who he is... well, almost everyone. The new tech doesn't know who he is, but the rest of us know. Me and Mickey know that we're definitely not going to dispense anything but brand because it's D-A-W, you know. Mr. D-A-W told us so. Even though it's clearly written on the Rx "D-A-W" or "Brand Medically Necessary," Mr. D-A-W is going to point it out every single time.

Mr. D-A-W also wants to be recognized. And that's where the new tech made her mistake. She ticked him off but good last week by asking him to spell his last name. I saw what was happening and quickly stepped in to finish typing the script. I didn't want her to process it for generic and make things worse. And would you believe that Mr. D-A-W later complained to Mickey that the new tech didn't know his name and that upset him horribly and he needed to talk to the CEO of our company because he was so slighted? Mickey handled it in his usual way and we avoided having to hand out a gift card. Phew!

For some reason, though, Mr. D-A-W doesn't insist on brand Allopurinol (Zyloprim). We can actually still get that but it's about $400 for a bottle of 100. I guess having to have brand stops when it reaches a certain dollar amount. I've been tempted to ask him why he's not getting D-A-W on the allopurinol... but I don't want him to call the CEO.

Sunday, a Time to Laugh