Hard Line

Pharmacy is an example of how the GOP engages stupid "watchdogs" to protect their interests. As far as business goes, pharmacy, tongue wagging, has accepted the lowest reimbursements, the most volume, and the least respect for it all. I would compare pharmacy to poor, religious conservatives who haven't thought about their watchdog status, how they're being used for their emotional, easily-broken-down complacency as a way to scare others into, eventually, obeying the GOP.

The hard line of this profession will ultimately lead to its demise. These words from a student who can't use his own profit-hoarding school as an example to get rights to make up a missed assignment for a missed class due to dental appointment. Anyone who is conservative because their employee is conservative is of a base base make and model. Trickle down economics does not work, retards.

The lameness continues...hey! I found a quarter!

It’s been a while since I’ve really written, but pharmacy continues to suck. Schools continue to stay out of touch with the barbaric realities of the “profession”, making zillions off of students who are increasingly having to beg for jobs that suck afterward. My school, in particular, is like a rich North Korea. How on Earth are for-profit schools legal? Can you imagine an institution that takes $40k a year from its students, while trading stocks with its investors, some of whom dare come and teach on certain days, staring in the eyes of the people whose blood is being sucked from loans. One of my friends, a real estate agent, says “they’re really taking advantage of you, aren’t they?”. It’s funny he should say that, because my school is not the sole recipient of all that I’m sacrificing financially and emotionally for this. Or are they?

It seems like pharmacy has been morphed into a profession for the gullible. The easily manipulated. And our slave drivers continue to dig deeper into wounds that frankly none of my colleagues are vocal enough complaining about. But start taking away their money and maybe they’ll get enraged? Paycuts are easily going to come.

I was at a resort town this weekend for a state pharmacy organization “conference” (in that, it’s just a way for students to pay to get advertised by a company’s most attractive and smooth-talking employees to believe their company is something it’s not---respectful of pharmacists). I took a girl I’m into and her cousin. They posed as an engineer and medical student since they are interested in those fields and it’d save a lot of introduction. We were at a theme party where 200 pharmacy students (mostly) and some industry people were inside drinking, and being shy to start dancing. Coaxing themselves into bravely having “fun” while worrying about midterms to come. While I’m inside, I see my classmates, only talking to each other, coyly greet me and go their separate ways. I am more open in my greetings with students from other schools, introducing them to my friends.

Suddenly, I’m approached by a girl wearing a leotard and another one wearing some kind of 80’s jumpsuit. They jump in front of me and say “Hey you! Wanna come dance with us?”. It was immediately apparent to me that they weren’t pharmacy students. There’s just no way a pharmacy student would dress up so boldly like that, nor be that confident with a stranger. I called them out as non-pharmacy students. They told me grudgingly that they were hired entertainers. There to help get the party started, but also make the party look fun. Wow, state pharmacy organization, you really DID recognize how much of socially awkward dweebs pharm students are.

My girl’s cousin was supposed to be a 2nd year student from a notable medical school in the state. He ended up rubbing elbows with a Board of Trustees member of the state organization. This member finds out in conversation that my friend is a “medical student” and he immediately starts apologizing about the students in attendance at the gathering. “I apologize for the lack of professionalism and maturity of the students here, we used to get good students, but now it’s different. They have simple minds,” he said in so many words. I was shocked to hear about this, but I felt some comfort: at least someone in this profession recognizes how lame the students being admitted are, how their paucity in life experience affects how the profession is being molded by them, and honestly, how this profession is going down the drain.

Who in pharmacy has a clue?

Observation

I am sitting with future pharmacists. They mirror current pharmacists. They are bizarre, obsessed, unable to function in normal society, left brain Nazis and still wouldn't see the big picture if you shot it with your iPhone. Through desire, parental pressure and outright emotional emptiness, the vast majority of these student pharmacists welcomed the idea of being fully indoctrinated and institutionalized by themselves and the school's they go to. But they've been training for this institutionalization since day 1. The obsession with grades.

The obsession with grades. If you are a grad student with any kind of measurable soul, you know that the personality of grad students around you will make life tough. An obsession with grades is the product of years of fear of not being "smart" enough, and like I said, emptiness. It's a cover up for any real internal substance. The inside of your 20-something grad student is ripe green---> the years of undergraduate training, social sacrifice and ignorance of the world around have taken their toll, and the result is not pretty. These students will harass professors to no end in order to gain 1 or 2 points on a question they clearly missed. They will discuss exam answers with each other for as many as 2-3 hours after the test, perpetuating the drama they experienced before, during and of course after the exam's actual occurrence. They need to know if they were right. They need to know how many they missed. They want to prevent that surprise when the grades roll in. Your behavior is a manifestation of what you think about, and 90% of the time, these students are obsessing about school. It's a poor existence.

My ex girlfriend just graduated from optometry school. We dated in undergraduate, and she was a pretty amazing person. Loving, not too obsessed and logical, not too consumed by school and the entire drama centrifuge of getting into a program. I recently asked her for recommendations for cheap optometry services for glasses and contacts. I had no idea what she had become after a 4 year hiatus of any meaningful exchange or conversation. She played the professional with me. She recommended more optometrists after I already got a prescription. She recommended me, a pharmacy student, look into Restasis for my eyes. I don't blame her for playing doctor, but her professional opinion sounded like she owed a friend a favor, or like it was copy and pasted straight from an optometry professional organization's website...if I may correlate, a student in my class today tried to discuss the "65 to survive" concept today as a way of mobilizing people to go to a state pharmacy organization's yearly conference. She literally read a statement monotonously. This is what my ex sounded like. She recommended I go on Restasis without ever giving me the exam. An optometrist of 30 years did not recommend this after an actual examination, but she did. This is an indication of what grad students learn in school, and upon coming out, thinking they're hot shit. She has no joined the phalanxes of delusioned new doctors who have been conned into believing health care is something it's not. Your patient will demand a drug after being empowered by the advice of actors on a Cymbalta commercial. Then, their insurance company WILL choose what drugs you go on, not your doctor. Pharmacists? They have doctorates, but are not doctors. Only in the academic (read: world of make believe) sphere will you ever hear pharmacists address each other as Dr.

Around me, actual RPhs are getting more and more frank about what they think of this "profession". "It's a job" says my preceptors, co-workers, and even district manager. Talk about a douchebag, the latter.

And that's the problem. Not the "chains". Not the "patients" and "insurance companies". PHARMACISTS have caused this downward spiral for pharmacy in general. They easily sell out. They lack the personality and assertiveness to stand their ground. They live a life of euphemisms, bonding about the weather and putting on a cardigan on Saturdays to play the "I am a professional out on the town tonight" ploy.

I am an un-grad student. I am a grad student. I just do my thing. I experiment with drugs all the time. I sleep with a lot of people. I travel all the time. I fiercely devour life around me and maybe get around to reading that evening. I work a ton of hours. And yet, I still get through school because any person with any power of observation can tell the education regimen is a scam to create enough contact hours to charge enough money to make your students obedient enough to allow the card holders responsible for engendering the New World Order to continue to exert their will.

As I write this, I have to guffaw to myself. I'm probably NOT the only person thinking this shit. I look around class and I see some people actively highlighting their notes as the teacher talks, I see some people lounging back and texting people on their phones, and I just locked eyes with a girl who seemed to be doing what I was doing---> surveying the surroundings for signs of something other than sedation. The problem is that the status quo is so pervasive. The suppression of free will is so great in this milieu. The type of student gravitating towards this kind of work is too predictably easily influenced.

I'm not on the dark side or anything. I've just become a pharmacist along with the rest of the pharmacists, before even getting my degree. When at work, I am there to make money. I act selfishly at work, roll my eyes the 7th time I get a question about whether Zyrtec or Claritin is better (APhA would call this "patient education"). I'll treat people who come in drive thrus and ring the bell in a poor way. This job is meant for money-mongering. And I'm completely fine with it and used to it. I'd advise any students currently in grad school to relax, start studying less, enjoy your youth; smell the flowers. Because you will remain unfulfilled. If you're thinking about going to pharmacy school, don't do it. There are no jobs :)

I think I know why...

I am suffering from pretty major depression, most likely catalyzed by the Accutane I took 6 years ago. I've had depression for 5 years and life gets difficult whenever something doesn't go my way. Is this why I'm angry at the pharmacy profession?

This is just a poem...that I'll edit for days to come

Sunday of a Million Years

Today was a Sunday of a million years
A vision of beauty
Tainted by pain
Lights of a blazing sun baked down on me
But you weren't there

In a clearing, the lawn and the sky were hand in hand at the horizon
People walked away from me
Their faces hidden by the back of their heads
I could see your face
But you weren't there

The weekend's behind me
Memories of maybe from Friday
Descend to realities on Sunday
You pray for the afterlife
On a Sunday of a million years

Rite Aid

I don't work for this company. But I currently finished doing an IPPE here about 2 hours ago. For such a well known name in chain pharmacy, I'd have to say the experience was eye-opening. So, I work for Walgreens as an intern. Everybody there complains about Walgreens. I interned with Target. Everybody there complains about Target. Rite Aid people complain too. However, they have a signicantly less sophisticated computer system and their counseling point stickies are among the most aggravating labels I've ever worked with.

My preceptor, a barbie, soft-spoken, under-intellectual woman of 35 years, on three seperate occasions, has attempted to teach me how to properly apply these counseling point labels to no success. Just so you know, the main label and counseling point labels all print out on the same sticky. The stickies are 5 different colored perforations with different counseling points for each color.

Around halfway through my internship, my preceptor switched my role from that of a thinking practitioner-in-the-making to that of a lick-and-stick subway sandwich artist. She obsessed and supervised my use of scotch tape to press down on the labels, pull them off the sticky backbone, fold them in half and still stick them onto the vial perfectly symmetrical. She admonished me for not being "pharmaceutically elegant" enough, and her economy of me as a robot intern filler dropped to about an eighth of original productivity from before just because of how tricky this was for me. For example, I'd pull the labels off of the backbone and suddenly the tape would stick to the sig label or to another part of the tape and just cause chaos; sometimes the paint from the colored parts of the sig label would bleed off onto the tape and 9n98ybg98d7ufng98d7fng987n9sd8fg7uns...it'd just be a mess. I'd have to reprint labels, take more mild verbal abuse for being too much of an idiot to do this as adeptly as her and so on. So, to avoid getting yelled at as often, I'd put only one or two of the counseling points (leaving off inane points like "Call your doctor if your symptoms don't improve") in hopes that she'd like "pharmaceutical elegance" as it pertains to counseling points that are actually useful to the patient. But unfortunately her staff pharmacist, who is 4 years younger than me, started bitching about "picking and choosing how to consult", wasting even more precious time that could have been used to fill their prescriptions uncompensated. So, today, I kind of perfected my skill by first prying off the labels by hand, THEN adding the tape on top, folding and THEN attaching the labels as straightly as possible on the side of the vial. In other words, I added the tape to the labels after they were detached and not before. The princess micromanager that she is, my preceptor noticed this and got ticked off. HAHAHA. The same outcome was achieved but she didn't like my means.

So does this label fable shed light on the types of pharmacists Rite Aid hires, or on the company as a whole? Was it a personal thing she had with me, such as a power trip? I do not know. I factored what fraction of my tuition, credit-hours wise, does to my IPPE. Basically, I paid $2,278 to be harassed by Barbie regarding how to apply a horribly designed set of counseling labels. I also learned that ALL retail pharmacists, doesn't matter what you work, work to avoid: their practice isn't guided by common sense or their particular circumstances, but by doing exactly how they were told from middle management to do things...I shall dubb it Conflict Aversion Pharmacy Practice. All in the name of avoiding reprimanding, correction and general visits from upper management.

Ugh. If just I had a word that started with R between "Conflict" and "Aversion", this acronym could be a self description. Am I destined to become this kind of pharmacist?

Who did Obama "appeal" to?

Look, APhA, you are sad.

I talked with a classmate today who doesn't seem to understand that pharmacists, just because they are capable of taking on the workload for certain physician/nurse tasks, may not ever do the things they were trained to do, or call the shots in how they're compensated for it. She was certified by APhA to give flu shots but the unfortunate truth is that she doesn't get paid to do it. Think about it: yes you are giving flu shots at your pharmacy, and having some role doing a task that is considered novel in pharmacy. Just because pharmacists are largely paid hourly, does this still mean we are being compensated for it, or that we're just passing on the buck to our employer? I don't believe pharmacists get paid more for this, it just adds to their headache since the work that was already yours to begin with has not necessarily gone away.

Stop and think for a moment, if you are an intern or licensed pharmacist: do you have any say whatsoever in your practice? I don't know the answer to this. Everytime I'm in the den of my employer who will remain nameless, I see pharmacists working registers, taking out the trash, being told when to take a break and what to do, filling out unnecessary forms...just doing a lot of bullshit tasks that no professional in law, accounting, or even medicine would ever deal with. But what makes pharmacists so different? Why were they so easy to take advantage of with money? All these professionals make a good deal of money---hell, I think lawyers have the potential to make much more me thinks. But how do pharmacists put up with this?

So does it make sense to say we as pharmacists are controlled by multiple other professions by virtue of our minority population? 500,000 nurses and maybe over 150,000 physicians in the state of California...how many pharmacists? 23,000. APhA vs. the AMA: what president in his right mind is going to address David as WELL as Goliath?

Is it better for my mental well-being to be as pie-in-the-sky as my classmate about things? That it's just going to "happen" when the time comes that our scope of practice is going to increase just because there is increased pressure on physicians? Yes, indeed we have petty immunization rights and freakish hoops to get through to prescribe, at the mercy of a physician in some cases. As per another blog I read by Jim Plagakis, the AMA has "bigger fish to fry" such as improving the state of affairs for PHYSICIANS.

The problem is, the APhA doesn't do the same for the professionals it represents: while heralding the old news issues of immunizing patients and screening for disease states, etc., the ugly, red-headed and freckled truth is that the average pharmacist just merely wants more humane working conditions, more help behind the counter, and more time with their patients. It seems like pharmacists will only be confrontational with an entity more faceless than their employers: big pharma, but they will never criticize or stand up to their employer for denying them a vacation time during summer (when the kids are actually out of school), or for making life hell by cutting staff, making it even more impossible to fulfill their professional duties to consult and monitor patients. APhA-ers will decry direct-to-consumer advertising like it's such a great cause and because EVERYBODY ELSE does it. They'll simply state "Biologic drugs need to be made into generics immediately so that these life-saving meds may reach the hands of patients who need them!" Come on, Profession-of-Pharmacy! Are we really this naive? Do we have no sense to actually think outside of the box for once about how our health care system works, and how, in this country, inventors are awarded and given incentives for developing ingenius things because they get to patent it? Unfortunately this all boils down to who and what APhA is all about: reinforcing Papa Physician as supreme and Mama Pharmacist as the domesticated, subservient housewife. If you're still reading, are you angry yet? Do you feel a fire to cut the crap and have a spine and actually take pride in the work you do?

It is for this reason that I am going to join the AMA for a year or so and assess why there is such a difference between them and the APhA even though both physicians and pharmacists become doctors. I'm not going to watch my future profession be squandered like this. Nobody is doing this to us: we are doing it to ourselves by obeying the status quo and letting people less knowledgeable than us be in the driver's seat.

Let's face it: only pharmacists can take responsibility for the shitty state of the profession. So I ask you: what common ground do we have that will unite us to actually make a difference? Cause it ain't the APhA...although they do have fun conferences.