The HCG Diet

HCG, is it truly a miracle diet drug?  With so many clinics offering therapy, and so many websites offering drops, I would like to offer a little truth on the matter....

I cannot deny the results that people have with HCG.  They seriously lose about a pound a day!  That is pretty amazing, but they pay for it, with their wallets.  Clinic visits can cost around a hundred dollars a pop, with a forty day course of injections plus needles costing roughly the same.  Drops on the internet are less expensive, but what do you know about homeopathic medicine?  Let's just say it is very interesting.  So take a look at these links and decide for yourselves. 

PowerPoint Presentation  Handout

This was one of my research projects, so the terminology may be confusing, and some information may seem lacking, but it was accompanied with a live presentation.  If you get confused, just post your questions and I'll get back with you.

Bottom line.... People lose weight with the diet, but they only eat 500 kcal a day.  Anyone will lose weight if  they do that, HCG or no HCG!

What do you think?  Would you recommend HCG or take it?

Entertainment

Is it ok to watch or listen to whatever they put out there today?  I'm tired of it, the music is all about sex, and it is all blunt, without even trying to be subtle.  TV just wants everyone to feel ok about all perversions.  Every show has a gay or lesbian couple, unwed teenage mothers, and allusions to inappropriate material with some kind of authority laughing like it is ok (i.e.  teenage sexual references with a parent just laughing like "kids these days ha ha...").

I'm so tired of it all.  It's not ok to glorify homosexuality, promiscuity, or drug and alcohol abuse.  Everyone wants to sit there and say, "things are bad today" or "things aren't like they used to be...", but everyone wants to sit down and watch these tv shows that are nothing but garbage.  Everyone likes two and half men, they let their kids watch it, but they wonder why our teachers are having relations with our kids, or why our kids dress/act the way they do.  It's because anything goes today, and whats worse is that some people don't even bat an eye at it.

I despise our culture today, I once completely enjoyed the clever euphemisms or zany actions that made no sense, but now I wish everyone would grow up.

Wonder why our leadership is so horrible????  It's because everyone is looking out for themselves, watching the things that are funny or make them feel good, not trying to maintain the sanctity of innocence.

News reporters, film and music executives, our government, Steve Jobs, Bill Gates, the founders of YouTube, myspace, Facebook, etc.... are all TERRORISTS.  Why you ask.....  because they have successfully distracted the entire American public enough to allow those with political/monetary agendas to have their way with us.

Don't believe me.  If we are in such a recession, why did Black Friday revenue exceed last year by 1 Billion dollars?  That's 1000 million dollars.  Do people really not have money, or are the so called 1% manipulating everything so that they can get their way?  Why did oil companies make record profits after 9/11 and the economic stress that it put on our country.  Was it a set up?  I pray that it wasn't.

I know that some companies are failing, but I wonder why.  Instead of due diligence, they do what feels good, because everyone should pursue their dreams at all costs, even if it means that their dreams fail. They fail because they took their profit and went to the Bahamas, or invested in some new dot com start up that allows you to put your favorite books online so that others can see what you read in case they like to read, blah, or bought a new Mercedes because that was their dream since they were a kid.  This instead of reinvesting into the company, making good decisions, and reaping the benefits later.  No, we want it all now, (just like the commercials make you feel it is ok to do).

Please don't believe that I haven't been guilty of these things as well.  I watch crappy shows still, though I try to stop myself.  Ive looked at stuff online that I'm not proud of, and made purchases when I really shouldn't have.  I am guilty too, but when will it be too much.  Ever? I'm going to step up and try to live what I write, but I doubt anyone else will step up, because that will infringe on someone else's right to BLAH BLAH BLAH.

ESPN

I just got done watching Oklahoma State have their way with Arizona on ESPN.  Sportscenter came on afterwards and I realized that I can't handle the anchors on there.  "What's Good, I'm Scott van Pelt..."  What's Good?  Is he supposed to be Sway from MTV?  I don't know what it is about everyone trying to be contemporary that annoys me.  Sportscenter, and ESPN for that matter, ensures that they have fast-talking, "hip" anchors that are always trying to be clever, but I've never really liked it.  You know how Stuart Scott gets up there and says something like, "Peyton Manning gets his Injured Reserve on," or shows a clip of Aron Rodgers escaping from a sack and makes some, "Everyday I'm Shufflin" reference. Sometimes it is clever, but most of the time it's no better than a pun.

This assimilation to the "fresh" culture has gotten ridiculous.  Before I go to far, I will say that I am guilty as well, but I feel the need to express frustration with the extreme side of things.  It's not hip-hop or hanging on to youth that I have a problem with, but rather the obsession with the fast pace.  Parents and grandparents constantly updating their status on facebook, middle aged people texting while driving, materialism and plastic surgery becoming a way of life, it's all getting to be too much. 

Just look at what we watch on tv and in movies. What happened to sitcoms that show everyday situations with positive endings?  Now every show has to be some fast talking, dry, sarcastic humor that gets exaggerated to try to make it funny.  Just watch The Middle or Modern Family to see what I'm talking about.

I will say that a middle ground is better than the corniness of Full House, but it's gone too far.  It will be hard for our children to be convicted about anything, because of this "anything goes" society in which we live. The only thing that is taboo to talk about God.  Isn't that insane?!

Think about it.  Family dinners and conversation gone because of TV, getting a good nights rest a thing of the past because of the Internet,  road trips and family night out reduced to silence because of mobile devices.  Not only that, the liberal minded authors and media out there make everything out to be acceptable.  Blunt sexual references, soccer moms booty-dancing, all profanity short of the F-word, it's all ok.  Public decency? What is that? Everyone is allowed to please themselves because they "deserve it."  I mean we work hard to live outside of our means by putting everything on loan.  Want a boat, get a loan..... even if you make $10.50 an hour and rent your home.  Go ahead, you deserve it.

The conservatives don't care about morals or decency anymore, because they are too concerned with squeezing every dollar that they can out of the American consumer.  No more fighting for what's right, there's money to be leveraged.  They build businesses that run on debt, make enough money to make payments on loans, and then they pay CEO's six and seven figured salaries and bonuses, and forget everything else.  If they can find a clever, "fresh" way to sell it, they do it.  Just watch Casino Jack, and you will see what I'm talking about.

I guess I'm a bigot, I don't think that the subject matter of entertainment is acceptable.  Non-traditional couples raising children, divorce just another thing you do in life (like college or something), and all of the others mentioned above. I wonder how hard the Republican Candidates will fight to uphold traditional marriage?  I guess it all depends on their popularity rating.  Don't get me wrong, I still care for and love these people that I am complaining about, but I don't like what I see. I'm just tired of the mind set of our country, and I'm prejudiced against ignorance.

Funny Story

Soooo...... I have night terrors.  Literally, I will wake up in the middle of the night screaming and yelling ready to fight.  One night I forearm shivered my headboard, and I thought I broke my arm.  Most nights my wife has to calm me down, but sometimes she has to just let me fight it out......... with no one.  I don't know who it is that I see, but it is a recurring thing to have someone standing at my door or at the foot of my bed when I have these dreams. 

Most of the time it is stressful for my wife, but last night was actually funny.  She tells me that I woke her up, and I was sitting up in bed with my arms straight out, one hand supporting the other.  Apparently I was holding a gun.  I wasn't pointing my fingers like a gun, I was holding a gun (in my mind anyway, not a real one). 

Now...... my wife is pregnant.  Before, she would spring out of bed and calm me down.  Last night, however, her belly stopped her from getting up, but it wasn't for a lack of trying.  Apparently she tried to get up to calm me down, but only her arms and legs were able to move.  She couldn't bend at the waist, so she ended up like a turtle on its back. She was able to sit up eventually, and she asked me what was going on.  Keep in mind that I DO NOT remember ANY of this. 

I guess I told her that I fired the gun, and that I couldn't find where it went.  The whole time that we talked, I had my arms out holding the gun (that wasn't there).  Eventually she had to say, "put...the....gun...down."  After she said that, I slowly lowered my arms.  Later on in the day, I get a text telling me that she was tired from the gun slingin.  All I said was, "did I do something in my sleep?"  Later she commenced to telling me this story, aaaaannnnddd she let me know that she told all the girls at her work.  She always let's them know about my antics during nightmares.

I think she should start recording it.  Hopefully we'll get some good footage.

Does anyone have any experience with this?  I have done a sleep study, but the night terrors weren't completely addressed.  Any suggestions?

30 minutes..... and I should have walked out.

I must confess that I am a fan of comedies.  I enjoy laughing and I have a thing for the absurd.  It's just how I am.  However, I decided to take my wife to see The Help today, but we arrived a little too late and (to my delight) decided to watch 30 Minutes or Less... Now, I wish we would have just watched The Help.  I don't know much about that movie, and it sounds like a chick flick, but after watching the other I feel like it probably would have been a better choice. 

I'm sure you know the synopsis of the movie, but let's recap.  Jesse Eisenberg is strapped with a bomb and has to rob a bank to avoid being blown up.  He recruits Aziz Ansari to help him do so, while Danny McBride and Nick Swardson follow behind (because they are the one's that strapped him with a bomb).  There are a few twists and turns that make the movie interesting, but it is the blatant use of crude humor that really makes the movie fail (in my eyes that is).  Not to mention the fact that this really happened, and the real guy actually died from the bomb exploding.

I am a fan of Danny McBride and liked what Nick Swardson did on Reno 911 as Terry (or Teh-rr-yyy-iiee), but their act is getting old to me. How many times can Nick Swardson play an awkward guy that tries to fit in, while being homoerotic, and making annoying faces?  Also, how many times can Danny McBride play a over-confident lackey that says something very funny just to explain why its funny until its not funny?

It's actually spelled out this way in the movie.  He is on the phone with a girl, and uses a euphemism to describe what he is talking about.  Now, in the right mood, what he was talking about could be funny, but   he ruins it by explaining what it means in a "that's just a euphemism for this literal, inappropriate thing", which he so often does, and it takes all of the humor away. 

Why can't we enjoy subtle humor?  Even if it is sexual in nature, why do these film-makers and actors feel it is necessary to put EVERYTHING so bluntly?  There is more humor in subtlety and in the scenario than there is when someone explains that a fart joke is funny because its about farts.  It's ridiculous.  I think that these two actors have really hit a time in their career where they need to try something different, and film-makers everywhere need to try to make movies that are less raunchy.  Why is it ok to be so disgusting today?

Michael Peña does a great job with his role as a hitman in the movie.  He is very funny with his delivery, and breaks away from the traditional Latino criminal by adding very humorous characteristics.  He is serious and funny without losing the seriousness (unlike McBride).  Aziz Ansari is pretty funny, but he is himself, which is still pretty funny.  Jesse Eisenberg does a really good job, and was a great choice as the lead character.  If it weren't for these three characters, I would count the movie a complete loss (although the supporting roles did pretty well). 

Anyway, let's just say symbolism and dry humor are a thing of the past with comedies today.  So if you want to go see something that will not stimulate your brain, or something vulgar that will probably offend some,  go see this movie.

P.S. I know this doesn't have anything to do with pharmacy, but I get tired of whining about my profession.

Medical Missions

I once asked a pharmacist that goes on medical missions if there was a job for her when she goes.  She said,

                     "Yeah, the most important job..... handling the meds." 

Now, I am so confused by that.  Countries that need medical missions don't have boards of pharmacy, and  they don't care which team member handles the meds, they just appreciate receiving the help. The one mission trip that I had the pleasure of being a part of had a medical branch and a church branch doing Bible School and giving supplies.  I don't remember a pharmacist on the medical branch (I was in school and was with the church), and I know they handed out meds. 

What I was asking her was, do they use her medical knowledge, or at least her drug knowledge.  I'm sure they would refer to her to see which Sulfonylurea was in stock or which ACE-inhibitor they had, but I wanted to know if we could be of use - medically (as I know God can use anyone for any purpose).  With Hurricane Irene hitting the Northeast, and Tropical Storm Jose brewing, I would like to think that pharmacists can do something other than supply system management, not that I think we are better than Doctors, but I think we are a valuable asset.  Our training and the overall desire of pharmacists to make a difference drive me to ask these questions. 

Can our profession develop into a pharmacist practitioner of sorts?  I know that some states allow pharmacists to prescribe certain medications, and most states allow collaborations between doctors an pharmacists to have standing orders (e.g. flu shots), but how far can we go?  I am trying to pose these questions in a positive light rather than in a whiny "woe is me" tone.  I have to admit that when I started pharmacy school, I just wanted to help my family and those close to me with the fruits that this profession bears.  Not that I didn't think of the little white haired ladies or the weather talking old men that we interact with so often, but my family was my primary concern.  Now I feel like I have a calling to do more.

Should I go to Seminary?  Should I go to medical school?  Should I stay where I am and see what kind of positive things God can do with a profession that has already given me such grief?  I'm not sure yet, but I will be praying and taking steps find out.

The State Board

I have decided that the State Board only acts as a good reference when I have a decision to make, but not the final say.  For instance, I am thinking about starting a pharmacy, but I'm thinking about obtaining my stock from Canada and India.  I also think that I will hire a lot of clerks and let them do the technicians work, but not paying them accordingly.  I think that with the extra money I will make all of my counters marble, and only reconstitute with the most expensive bottled water I can find. 

Obviously I won't be able to get away with this, but what if I could?  Would I make such decisions knowing that these are unethical things to do?  I'm gonna say no. 

The funny thing is, I think I have been doing that in other aspects of my life.  I think that I used to make decisions based on what I felt was right, then I would pray, and say "please let this be right."  Pharmacy school was one such decision, but I think most of my prayers were: "please help me get in" or "please help me pass this test."

Now, I think that God enjoys the fact that we include him in our lives, however, I think that there is more to choosing Him and obeying Him than just asking for help.  I don't want sit here and try to sound like I got "my way" with God.  Actually, I think that His will is served no matter where we are in our walk with Him. As long as we choose to believe in His Son (and our Lord) Jesus Christ, we will begin to be molded into a character that resembles His. 

There is, though, the next step.  This is not a statement saying, "Now it's up to us to earn our salvation,"  because we can't.  The Lord calls us and, when we choose to believe and have faith in Him, we are part of the Kingdom of Heaven.  What this is, though, is a statement about obedience.  The Bible says that if you love the Lord, you will keep his commandments.  Choosing to obey God is showing your love for Him.

So what does this have to do with the State Board?  Well it's just an illustration.  Once we are licensed, we are part of this profession of pharmacy.  We are involved in it's dealings.  When we use the law books and the governing bodies as suggestions rather than our guides (in the business of course) then we start moving further away from the common goal - Advancing the profession.  If I were to do the things above, I would be disrespecting those who care about the profession and removing myself from the right path. 

The same goes with our walk with Christ.  Without daily prayer to obtain guidance, and without feeding on the Bread of Life (the Word of God), we won't be on the path to be obedient.  Just as we can rest assured that we are pharmacists when we are licensed, we can rest assured that we are part of the Kindgom of Heaven when we accept Jesus as our Savior and call upon his name, believe in Him as the resurrected Son of God, and believe in Him as the atonement for the sins of the world.  Understanding the rules that govern our profession will help us to advance pharmacy in a positive way, just as seeking to understand the Word of God and praying daily to seek guidance, will help us to advance the kingdom as we love God and Obey. 

I plan to try praying and consuming the Word of God daily, so that I can entrust my whole life in Him, and understand how I should obey. So that Jesus' Holy Spirit can work through my life.  Watch Soul Surfer, the movie, then watch the documentary afterwards, the testimony in that girls life is truly a blessing.  What does it say to you?  Where are you in your walk with Christ?

Truly, A New Direction

When I started this blog, I wanted to write because I was so interested in how "Web 2.0" was changing how we interact, and I was excited to think that this could generate some extra income (still waiting on that income). As I wrote, I tried to find my voice and/or angle from which to create a niche. As I took this journey, I started to feel comforted reading other blogs and finding out that others dealt with the same situations daily. Soon I found out that writing was very therapeutic, and that it made things better by venting about them.

I began looking for a light at the end of the tunnel. I was very frustrated as a community pharmacist, and was hoping to find others that had some real insight. I will say that I have found some with insight, some with a lot of rage, and some with insight mixed with a blind loyalty to our profession. That being said, I feel that being involved in blogging helped a lot, but most of my anger truly subsided when I got a job in a hospital. A better fit for me.

I feel like I should apologize, though. There was a lot of bitterness in my early posts, and still some today. I was so eager to blast people for their selfishness and ignorance, that I lost sight of any humility or gratefulness. I have been truly blessed, and I am truly grateful. I have a wife who is pregnant with our first child, a home that I enjoy being at, and a job (not to mention a good one).

I'm saying this because I feel called to go down a different path. One that is driven by my faith in Jesus Christ. I plan to continue blogging, and to continue blogging about pharmacy, but in a different light. However, I cannot do this and be credible to this purpose without addressing the previous posts. If I didn't address the other posts, I would be a hypocrite, instead of one who is trying to be changed.

I feel that it is appropriate to tell you that I could not have this peace without answered prayers from the Lord. He helped me get out of retail, He got me into a less tumultuous situation, and He guides me today. I thank Him for all I have and can give, and I hope (and pray) that you will come to know Him as well!

Battles

As pharmacists we are in a unique position to fight battles daily. In the retail setting we can choose whether or not to dispense a pain med to someone who may be showing signs of dependency. In the hospital setting we may have to call to change a dose of medication due to renal function. As all pharmacists know, these choices are not always met with openness. In fact, people usually look at us as some sort of pharmacy police.

For example, I had a patient come in with a lortab prescription. He had recently filled another, and had been filling an alarmingly high amount in a short period of time. I told him
That I was not going to fill it. He told me that the doctor said it was ok, and I let him know that based on my professional judgment, that I would not fill it. After our conversation, he commenced to call his physician, who then called me. Now this was no nurse practitioner or PA, this was the doctor calling, and after hours at that. I told him that I couldn't fill it without something being different, and he said that he changed it from every six hours to every four to six hours. So, he had me....

I then told him, "ok I'll fill it," to which he responded, "yeah, I don't know why he's taking so Many." Well I think I figured out why, and that was because the doctor kept giving it to him. Now, I understand that the guy must have been driving the doctor crazy, so I get it, but I still felt strongly about the issue.

These are the day to day battles that we fight because of our beliefs, and they are worthy battles (though exhausting). But what about our other beliefs? I mean there is no way that I can separate my faith from work, because without the Grace of God, I wouldn't be here, abd the meaningful things that I do at work are driven by this faith.

That being said, I feel that it is time for us to allow our Faith to ignite and move us to take a stand for religious freedom like we take a stand for other things in life. I believe that we should no longer allow ourselves to be too comfortable to prevent us from starting a revolution! To not take such comfort and refuge in our paychecks, titles, homes, and sofas to stick our necks out there and do something we in which we believe.

One great example to consider is the Nativity Scene. Special interest groups raised such a fuss about them that Wal-Mart took them down from their stores, and fire houses were forced to remove them. Now isn't it time to stop letting these people take away the Christian traditions and beliefs that made this country what it is today? After all, that story is what Christmas truly is all about. We really need to boycott stores that are afraid to take a stand for Christian beliefs.

By the same token we need to remove officials from office that care more about money than morals. The Bible says to be in debt to no one, yet that is the American and American Government's way of life! When will we take a stand? Will it be too late?

Nostalgia Anyone?

While there are some parts of this video I can do without, you have got to watch the Kings of Leon video "Back Down South." If you didn't grow up in a rural area, you may not appreciate it, but if you did, this video is sure to take you back.

Another song that is more fitting to the season is "Chicken Fried" by the Zach Brown Band. One of the best parts:

"Thank God for my life, for the Stars and Stripes, may freedom forever fly, let it ring. Salute the ones who died, the ones that give their lives, so we don't have to sacrifice, all the things we love."

Great lyrics. Hope you had a great Independence Day. God bless you and God bless America!

Ancillary?

When I started thinking about going into pharmacy, I really couldn't tell you what a pharmacists' role in health care truly was. You could have told me that we are the most integral or the least integral, and I would have said ok. Once I started school, however, I felt as if we were the next best thing to physicians. Now that I have been working, I have come to realize that we are similar to mid-level practitioners with regards to scope of practice, and, for my situation, I would say as far as knowledge goes as well.

That being said, I have learned that we are looked at as ancillary in the medical field. Just like lab and dietary, we perform a service that supports healthcare. Our particular service is largely product based. While we are performing knowledge-based services more and more, in the form of consults, we still bear the title "ancillary." I witnessed this first-hand as one of the Officers of our hospital was walking high school students around, and stopped in to tell us that the student was being shown the ancillary departments.

I am fine with this notion, now. I mean, we have clinical duties associated with our services that are fulfilling, and at the end of the day we simply go home. However, as a recent graduate, I willl say that I wasnt always ok with this.

The point of writing this is to let future pharmacists know that what you see is what you get. Don't think that something changes once you get the degree. If you work in a pharmacy or have seen what goes on in one, be aware that everything stays the same, except for the paycheck. Now, is that good or bad? I guess that all depends on your goals!

A little strange

It's strange how the media portrays a picture of an America that is in so much trouble, yet it is left standing as if they are saying "how dumb" instead of "let's fix this." It's strange that when I do watch the news (which isn't often), all that I see is problem after problem with little in the way of offering solutions. When political dirty laundry gets aired to the American public, there is no outcry. I'm not talking about Weiner's photos or the selling of Obama's seat, but rather the leveraging of the American way of life to ensure that some CEO gets to live in his dream world (bonuses after bail out).

Funny how the politicians make little headway in finding solutions to the big problems facing us today, namely the economy, yet they manage to cater to special interests groups. For example, I heard that using God's and/or Jesus' name in prayer at public funerals for fallen soldiers is now banned (despite their beliefs?) The government has found the funds to remove God's name from court houses and monuments, but hasn't found a way to create more jobs. It's really sad that special interest groups get more attention than the general public, and I'm sure that it's because their pockets are deeper.

Well, just to let you know, when I went into the pharmacy in the retail setting, I prayed before my shift. When I go to the hospital now, I pray to Jesus before my shift. When I am making drips, I pray to God that they remain sterile. I pray before I do most everything, and God has blessed me. I wonder if our nation started praying again, if some of these problems would turn around.

So to all you members of special interests groups out there, if you have been to my hospital or pharmacy, God was consulted in regards to your meds. I'm sure that you actually take comfort in that, but work to reject his name.

Consulting

     I have recently began providing MTM for a company that contracts with insurance providers.   I have made a few calls and have started making headway.   In doing so, I have realized that.... this is not going to be easy. 

     Not only am I not personally associated with the patient, I am not even associated with the patient's pharmacy.  Therefore, I find it hard to believe that any doctor will listen to any recommendations that I may make.  Not only that, when I call the patients, they think I am trying to sell them something. When I call I basically tell them that I am a local pharmacist that is working with their insurance company, and that I will be reviewing their information.  Most of them really don't understand what's going on, and some of them are not interested in what I have to say.

   One of the patient's said that what she is on is working and she doesn't want to change.  That's fine, but what if it can save her money?  I didn't get into that with her yet, but I wonder if I should even call back.  She really didn't want to hear what I had to say (I don't think).  I can't help to wonder, though, if her doctor recommended Crestor over Simvastatin, would she take him up on that.  I mean he is a doctor with one class of pharmacology behind his belt, who probably receives all kinds of goodies for talking people into taking that medication. 

   Anyways, I just thought I would give an update on the MTM stuff.  I'm excited to start, but feel like it will take up a lot more time than I once thought.  Hopefully I will get a good grip on how to perform these services, and then I can cut out the middle man and work independently as a consultant. (Hopefully increasing my reimbursement rates as well).  Anyone else out there having any luck?

Bridge Program?

Why is there not a bridge program for a pharmacist anesthetist? If the nurses have a program to learn more about the pharmacological side, why then can't there be a bridge for us to learn more of the patient care side? I realize the nurses learn more than the pharmacological side of the profession, but I think that we are qualified enough to make the transition as well. Is there something out there, if not, shouldn't there be?

Service Oriented?

Can pharmacy sustain a new business model that is service oriented, rather than product oriented?  Looking around the pharmacy community, I notice that the big chains continue to try to compete with the other big chains by increasing their ability to provide a product-oriented service in a way that will stop their customers from utilizing their competitors.  Will we seriously have to see a 2 minute prescription guarantee with $0.99 charges before these "suits" realize that there is only so far that you can go?  Seriously,  how long can the chains try to out compete each other before they realize that the times "they are a changing."

Not that I want retail to take over pharmacist provided services like MTM and immunizations, but when the retail providers throw their weight behind something, positive outcomes usually occur.  Look at the immunizations, because CVS and Walgreens implemented these programs, it is now part of life.  "Oh yeah, I got my shot at my pharmacy, blah blah blah...."  Good.  Now they are trying out MTM.  These are all good things, but they also keep trying to suck their patients and their insurance companies dry by drawing them in with the promise of faster service and lower prices.

  GET OVER IT!!!! Try to revolutionize the field instead of perfecting the system that causes so much frustration from employees and customers alike.  One reason your customers leave is because the service is so crappy that they think it will be better at the next place. Then they get crappy service there and come back, NOT BECAUSE OF YOUR MORONIC "NEW" OFFERS!  You big wigs really really suck!  If you can allow your pharmacists to do their job, maybe your patients - wait I'm sorry- your customers/dollar signs will actually stay with you.

Do something good for once, help change the dynamic in which pharmacy operates.  I'm sure CMS will work faster for a global reimbursement model if you put your lobbyist up to it. Then you can suck the new business model dry too (I'm sure that will motivate you - consider that a "Call Out").

What now?

I recently applied and received my NPI number. This was actually really easy. The question is what now? Don't get me wrong, I love my new job, so I am not leaving. The thing is that I do not love all of my school debt, and I am looking to supplement my income. I found a list of MTM providers on the APHA website and got in contact with them.  All I have to do now is finish training with one company and I should be set up to provide MTM.

Does anyone know anything about these companies?  Is it worth signing up with them since I do not work at a dispensing pharmacy any longer?  I would like to eventually make this a full time thing, but I am just getting started.  I feel like I'm on the right track, but if some of you who have experience in this field know better (or agree) I would appreciate if you would let me know.

If (somehow) you have questions for me about any of this, just ask.  I'll try to do my best to help anyone out.  I feel like I am an entrepreneur trapped in the body of a debt-ridden, capital lacking, full time employee of the MAN.  (Even though this may be the best pharmacy job anyone could ask for...) I also feel like I would be willing to help anyone else who feels the same way I do.

Until the next time... Errbody dougie, Err, Errbody dougie

Not to brag but...

I just wanted to say that I was able to go to the doctor unexpectedly!

Why would I be excited by that, you ask? Because I was able to just tell the people at work that I would be late, and guess what, no big deal. Something that would have not been so easy in the retail world.

Just sayin...

Make no mistake, we are clinical....

You know as well as I do that I have had my doubts about our profession. The stories are the same throughout the profession, but today, today was different. I have been looking for ways to assert myself in my new job. I have volunteered to head up the investigational medication process; showed interest in learning how to manage VTE patients; and have just considered many other ways to take on more responsibility, while planning on how to get started. All that being said, I have still mostly been doing order verification. Until today...

Our ID physician is not with us at the moment, and we were given a heads up about this toward the end of the day. Basically we were told that we need to be proactive in antibiotic stewardship, of course I got excited and was looking forward to this opportunity. Little did I know that 2 hours later one of the physician's nurses would be calling for a consult. I don't know that I was completely ready, but I tried to handle it professionally with out freaking out.

I say freaking out, because it wasn't like they called and said "hey this person has an upper respiratory infection, what is gonna be the best option." Instead, this person had a UTI consisting of a postive culture for pseudomonas, that was none-the-less resistant to everything but gentamicin and tobra. This caused my mind to race. All of the red flags and warnings popped into my head about ototoxicity and nephrotoxicity, and the six step dose adjustments, so I had to tell the nurse that I would get back with her.

The other pharmacist and I put our heads together, gathered the information, and made our recommendation. Which I feel is pretty sound. Pretty exciting actually. So, today, I feel like a Doctor of Pharmacy.

Soooooo, In your face old friend who always trying to belittle me even though I went to school for a long time and I try to be cool with you everytime I hang out, but you still want to prove your better than me for some reason.

----- Sorry, had to get that out there.

The new link.

Please check out the new link on the top right side of the screen. It is my mother-in-law's new book. I just thought I would try to help her out. It is a children's book that would be good for any girl that thinks she is a princess. She wrote it for my niece when she was the flower girl in our wedding. It calmed her nerves and she did an awesome job, because she knew that she was the "Princess of the Bride." Then my mother-in-law decided to get it published. Anyway have a look, and again, thanks for reading.

PS: you can google it and order it fom sites like Amazon as well!

I think I have a hunch...

I think I found the reason for the rift between departments in my particular location. Some of the pharmacists find anyway to create the least amount of work possible. So when people call and ask for help, they defer them to anyone else they can. I can see the pharmacists' point in a way though. They think that if the task is something that the other staff can do themselves, they should learn how. Things like order entry and dealing with the automated fill machines. However, I can see the other side as well. If I had a question about the nursing process, I would call a nurse. So, when they have a pharmacy question, they call the pharmacy.

It probably wouldn't be so bad (in my eyes)if the other pharmacists were had the same point of view, but they don't. They (and I) would rather help in most ways that we can. Although this way of thinking would make the situation better for me, I dont think that it would close the divide between the departments (more speciically - the rest of the hospital and the pharmacy). I think that it would take a lot more to fix the damage done.

Should I have become a REAL doctor?

After hearing the same old line time after time, I start to wonder, should I have become a REAL doctor?   You know the line, "hey I know your not a doctor but...."

       Well check your references, because I technically am a doctor!!

  So why is it that our profession doesn't bear the coveted salutation (unless you are in an academic setting of course)? I mean Lou Holtz is holds the title  Dr. Lou from receiving an honorary doctorate degree in Football.

Are we too nonchalant to request that respect, or did we join the game too late to receive the honor? I guess the dentists joined early enough to insist on being called doctor. I mean it's not really a big deal, in fact when I graduated I didn't think twice about not being called doctor, but after a phone call from my friend I changed my mind. This friend and I haven't spoken in a while, and he was telling me about his mom's health. He said that her blood pressure was really high and the doctor's were having a hard time figuring out the problem.  However, before he told me this, he started the conversation by saying "I know you don't know nothin' because you're not a doctor but...."                               Hmmm.....

Okay, I admit, this is the same friend that tries to get me to tell him how much I make everytime we talk. He is also the same friend that would always want to beat me in everything when we were growing up. Unfortunately he has had some troubles in his life that lead him down the wrong path, and I pray that he makes it through, but you see my point. (Read this LINK at Student Doctor Network)

This just makes me wonder. Are we over trained for what we do, so that we really don't deserve the title? Also, is what we do really just a high paying dead end job? I don't know, I guess time will tell, but it is discouraging to hear about all of the money making opportunities the REAL doctors have (i.e. investigational studies, promotions, TV shows, etc...).  Especially when we are rewarded by being unknowingly ridiculed by those that use our services. Oh well, at least we get to go home at the end of our shift, and aren't married to our job like the other guys.

The Buck.... Never EVER Stops Here

Hospital pharmacy is really awesome. I am so glad that I made the switch. However, there is one big issue that I have noticed lately, and it is the fact that everyone passes the buck. If there is some kind of communication error or any kind of error, each department will try to escape any responsibility, and will pass the buck on to the next department. It wouldn't be so bad if it happened every once in a while but it is the FIRST thing that is done 100% of the time.

Example - Someone didn't receive their med
Doctor - "Nurse, why wasn't this med given"
Nurse - "Well pharmacy only sent one dose this morning, and thy take it twice a day."
Administration/nurse - "Pharmacy, why wasn't the second dose sent?"
Pharmacy - "No one ever called for the second dose"
Nurse - "We NEVER call for a second dose"
Pharmacy- "You ALWAYS call for a second dose"
Etc... Etc... Etc...

At what point does someone stand up and say, "I don't know why, here is the dose, and it won't happen again."?

Whats really sad is that pharmacy tries their hardest to pass the buck. The reason is that we constantly have to justify our position in healthcare provision. It's annoying to me that we are quicker to throw our hands up in the air to abdicate responsibility than we are to try to solve the root problem. We're to worried about looking bad, because then the doctors won't listen to our drug recommendations. That would mean all of the "clinical pharmacists" will have to verify orders. Oh no!

I guess it would be easier to take the blame if the nurses weren't so adamant that they are right about everything. Then there's the doctors, and I really don't want to get started about the doctors.

So now what...

Now that I have found a job that doesn't make me want to put a screwdriver through my eye everyday, I have found myself in a predicament.  No one wants to hear about how "perfect" my life as a pharmacist may turn out to be, but I have yet to find a reason to vent about this job.  I know that I can't continue to vent about retail pharmacy, as I have left it's evil clutches and have no intentions on ever turning back.  So what do I blog about?  You can be sure that I will use this tool to unleash my frustrations as they come about, but in the meanwhile, what should I do with this platform.  I guess only time will tell (with help from any possible suggestions), but I will definitely put some effort in finding something to talk about.  Hopefully things are going well for you, and if they aren't you can always listen to some Bone Thugs -N- Harmony as they always seem to have something to get me through.  (Listen to Don't Worry).

I almost... almost feel bad

It continues to amaze me that I was blessed with this opportunity. If you dislike your job or the people that you have to deal with. I would strongly advise you to look into hospital pharmacy. When I was in school, you would not have been able to convince me that I would enjoy being in the closed door pharmacy of a hospital (I'm technically not in the basement). I wanted to see and help the people, but I truly thank the good Lord for what he has given me here. So, I almost feel bad that I truly enjoy not having to deal with them.

That being said, it makes me realize (even more so) that it wasn't as much of the people that bothered me as the corporate structure. I wanted to help and counsel, but I knew that my timer would go red on me if I did. So, everyone that came to the consultation box made me mad, but it wasn't really their fault. Anyway, I suggest that you find your way out of whatever mess you're in and have faith that it all works out. Thanks again to all who comment (special thanks to the redheaded pharmacist).

First Day

The first day of my new job was amazing.  You actually get to sit down and you don't have to deal with insurance.  I can't believe that people in the world of pharmacy make almost as much as retail pharmacists, yet get to work in this kind of environment.  Retail pharmacists should have their salaries doubled for putting up with all that they do, but as for right now, it is what it is.  Anyway, just a quick update, more to come.  Thanks for reading.

A new direction...

So I did it, four months into it and the beast had the best of me. Retail pharmacy claimed another victim. I applied at a hospital and got the job (hallelujah!). I was worried about how my retail supervisor would react, but I told him what was going on and he understood. He just asked me to send him something in an email. This was Friday. So Monday I sent him a notice. Just before closing time, he calls to tell me that he is accepting my resignation effective today. Meaning that today was my last day. I was ecstatic! Considering that I was finishing a 14 hour shift, had another 14 the next day, off Wednesday, then another 14 hours thursday - by myself. The only thing I looked forward to was the three day weekend before my last week.

I thought I was doing them a favor by giving a two weeks notice, especially considering my location and the fact that no one wanted to drive out there. Apparently it wasn't a big deal, to them. However, had I been living paycheck to paycheck, I could have been devastated by this, but they had to do what they had to do. The fact was that they needed to give other people my hours, so the timing was perfect. I actually thank the Good Lord for this because it could have been ugly.

You know retail is a funny thing. They needed my hours because they cut some hours at other stores. In fact, they cut 7 pharmacist hours at my store. This is what's funny, because they continue to "roll out" new programs that increase the pharmacists workload. They stress completion of these tasks along with customer service yet completely understaff you to do so. We lost 20 tech hours and the front store lost 50 hours. People already line up 12 deep at the one register they they keep open up front (that the photo associate has to manage).

Our upper management told us that they would not lay off pharmacists like the other pharmacies had to, but four pharmacists in our district lost their hours due to cutbacks(hence not needing my two weeks notice). The big question is: How long can they keep this up before they realize that the more equipped we are to do our job, the better we can help the PATIENTS, and deliver that customer service? The moral of the story is: no staff member or customer is more important than their bottom line. In fact they have continued to say, "Were a business, our goal is to make money." This is true, but at what cost? Oh well, what am I saying? I'm done!!!!


P.S. Pharmacy students, unless you do a residency, you will never ever come close to the clinical side of pharmacy that the schools tell you exists. You are not an integral part of the healthcare team if you go into the community. No more than the people who give the handicap parking stickers to those who need to park closer to the store. Matter of fact, you may lose any of that ambition and sell out to the corporate monsters. My advise: if you want to be a clinician, quit pharmacy and go to med school.

Hospital pharmacy

Is hospital pharmacy any better? I recently interviewed for a hospital pharmacy job and it seemed as though there are similar issues that the pharmacists have with their jobs. Now I know all shift work will have it's ups and downs, but will hospital pharmacy be any better than than community? I guess I'll find out---- hopefully. Let me know if you have any stories or experiences that will help me with my decision to change my career path.