Just think about it.. all wars has some “trigger” that starts them… often those involved in any war.. there is tensions that build before that first domino falls. It is no big secret that most/all of the BOP’s do very little about anything other than drug diversion. There are three forces on the horizon that may cause the first domino to fall..
The first is all that has happened with/around pharmacy compounding… especially sterile compounding.. BOP’s are going to be forced to act/react… by the legislature and the media… to think that the BOP’s are going to stop at the sterile compounding part of pharmacy may well be unrealistic. Most likely, the BOP’s are going to be forced to track errors… that gets to a patient and it is taken by the patient.. whether the patient experiences any harm or not. With the growing surplus of RPH’s, BOP’s may have little hesitation in revoking licenses … rather than a suspension… because there are RPH’s waiting in the wings to fill that job slot.
Secondly, Obamacare is now a fact, starting in 2014. Anyone who believes that nothing is going to change in our healthcare system is probably in for a rude awakening. All in healthcare will be asked to do more with less.
Third, is the push by APHA and NABP for accreditation of pharmacies… which will now probability be accelerated by all the previous issues.
How many RPH’s working in the corporate world believe that we are in a nearly constant conflict of “us vs them”… them being the employers, insurers, pts
We RPH’s are responsible for the legal operation of the Rx dept… if “legal” includes not making any medication errors … then the typical working environment is going to have to change.
As a RPH, if you are placed in the position of your BOP starting a real strict enforcement of the practice act and your employer expecting ever increasing volume with the same or less staff along with meeting untold number of metrics. What are you going to do? keep complying with the employer’s demands and hope that you don’t make one or more serious mistake?
If RPH’s take a stand and decide that adhering to the practice act is the most important thing that they can do…. then….
Your employer is going to be caught between the cost of operating a safe Rx dept and what the PBM’s/ACO’s are willing to pay.
It would appear that all the dominoes are in place… how much and what kind of force is it going to take to make the first one topple ?
Filed under: General Problems
Papa’s John is headquartered locally for me Louisville, KY and here is a statement from Papa John’s CEO John Schnatter today
http://www.whas11.com/home/Papa-Johns-CEO-Says-Obamacare-Will-Up-Pizza-Price-178951971.html
This is just one of a multitude of franchisors/franchisees that claims that they are going to cut staff hrs, cut staff, not expand..
I suppose some of us never stopped eating ramen noodles; just not putting the flavor packet laden with MSG and the unhealthy fats.
It does us no good to get our panties in a wad.
Affordable health care might mean less superfluous redundancy, etc. or not, but if MDs actively are denying oldsters quality medical care en masse, it’s time for a PEOPLE’s revolt against the physicians. Seems to me group practice was designed for sharing equipment costs, and recouping individual solo practice costs. If the providers can clam together, why not the patients seeking care? In effect, one might turn the table over and say that physicians are at the receiving end of a group practice benefits of providing group health services to those who’ve already paid for them. Physician, and other health professionals are responsible in a society for providing these services. And, don’t anyone mention socialism, communism, or fascism, as the insurance companies themselves, the PBMs said they’d run their businesses the ol’ capitalistic way, for a profit at competitive prices.
Bansheeism isn’t the province of only those with Rhode Island Reds, if we’re going to get our undies in a bunch.
The one thing I fear will happen with Obamacare is cutting of reimbursements to providers. If the docs are cut, then you can watch for a wave of docs to stop taking Medicare, Medicaid, and maybe some insurance plans. A cut to prescription reimbursement will effect all of us and we can expect a cut in salaries. The mood of Congress is to reduced the debt. Reminds me of these corporations. When a corporation begins thinking abut cutting expenses, the first thing they do is start cutting the number of employees and employee benefits and maybe salary too. The government is likely to proceed along those same lines. As Congress grapples with the costs of Obamacare, and, like you said Steve, I think Obamacare is here to stay, they are going to be looking at ways to cuts costs.
There is one thing that I question with regard to cuts in reimbursement to providers. If the docs start refusing Medicare, Medicaid, and all these government programs, it would not surprise me if the government forces them to take it. I know this may sound like a wild notion in America…the supposedly free and democratic country. But, don’t be surprised if it happens.
The more I have tried to get things improved within my chain, the more I have come to realize that it is ‘us vs them’. I think most all chain pharmacists will agree with me that that everything is a one way street. The chain wants us to do all sorts of stuff, but when we want them to do something, it never happens. If there are any pharmacists naive to believe that what I am saying is not true, then just try to get one thing done within your chain. And, I am not talking about something out of the ordinary like a drink machine in the pharmacy. I am talking about getting a new printer and other equipment. Or,just try getting a ‘no cellphone’ sign approved so that you can put it at the drop off window. These chains are too busy with their metrics and crazy crap like calling customers and pestering them at home. They are too busy wanting everything in auto-fill and we do double work by filling rx’s for people that never come to pick up their meds. These chains act like we have all the time in the world to do all this time wasting crap. I am of the opinion that we need to write a document that states things we want done and every single one of us send it to our companies corporate offices. When it comes to things they want done, they want everyone ‘on the team’. Hey…we are a team! But, when we want something done, we learn that the company is not on our team!
Steve, I fully agree with you that if pharmacists are responsible for the legal operation of the pharmacy then something must change. It amazes me that we still have the same design of pharmacies that we have had for a 100 years. A pharmacist and techs are exposed to all sorts of interruptions and noise. The chains never consider that these things cause prescription errors. At some point, with all the rx mistakes being made, these BOP’s are going to have to address that issue. We cannot get the most simple thing done to reduce distractions. At my job, everyday, someone sticks their head in the window with a cellphone at their ear and they are talking loud to someone on the phone. Talk about a distraction!!! These folks are nuts. They stick their heads in the window and talk on their cellphone. We can hear everything they are saying. Is nothing personal to them? I sent 30 emails to the home office of my chain concerning a sign in the window. At first, I made my own sign and stuck it in the window. The DM came along and took it down. Do you think that all those emails got an approval for a sign to go in the window? If you think I succeeded then I have a bridge to sell you. The DM told my pharmacy manager to tell me to shut up or I was going to get in trouble. But, I have copies of all those emails. If any of you folks make a bad prescription error and you think it was caused by someone on a cellphone in your window, then let me know. If we work for the same chain, I will send you copies of my emails and you can sue the SOB’s.
“As a RPH, if you are placed in the position of your BOP starting a real strict enforcement of the practice act and your employer expecting ever increasing volume with the same or less staff along with meeting untold number of metrics. What are you going to do? keep complying with the employer’s demands and hope that you don’t make one or more serious mistake?”
Steve, I will tell you one thing…I am completely, totally amazed at the crap that pharmacists will endure! Pharmacists are the most gutless, spineless bunch of people you will meet. They live in some dream land. The reality is that world is changing, and as you say, pharmacy is on the verge of change too. Pharmacists can be a spineless bunch of cowards or they can fight for the right things. Those things are a better work environment, the right to manage a pharmacy in a manner that is safe for customers to get rx’s filled there, and to do their job without being constantly harassed by upper management. The first thing that should be done is get these MBA masters of the universe out of the practice of pharmacy. I am all for profit. But, the most important thing is providing medications to patients in a safe manner and providing good service. If a chain cannot do this and make a profit, then they should go out of business.
“Your employer is going to be caught between the cost of operating a safe Rx dept and what the PBM’s/ACO’s are willing to pay.”
Steve, this is the coming war! Obamacare will be the start of the war. You just watch Obamacare squeeze the insurance companies and thus the PBM’s. As Obamacare forces these insurance companies to add high risk people, the profits for insurance companies will decline. The pharmacy chains will be squeezed. As they are squeezed, they will squeeze us.
Having thought about it for a while, I think we need a strong pharmacy ‘network’. The biggest hindrance to pharmacy is the isolation of pharmacists. We must come together as a collective. Since no strong organization has arisen, then maybe an internet network would be the next best thing.
@Peon… all companies will be categorized how much and what kind of cost that they will have in 2014 to cover their employees based on 2013 payroll…It they have >50 FTE’s they will be a LARGE EMPLOYER.. any employee <30 hrs/wk will be exempt the employer the cost of providing coverage.
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It is all over FOXNEWS that most of the franchisees of the larger franchiser - restaurants in particular - are already planning on cutting all/most employees down to 29 hr/wk so that the employer will not have to foot the cost of Obamacare.
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Stryker - artificial hips/knees.. announced today 5% of the work force is getting laid off.. because of the 2.3% tax on medical products next year.
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With the surplus of RPH's... will it be less costly for an employer to have 3 RPh's/store working 29 hrs each - no benefits - than two full timers? Same with techs if they can be found to work PT.
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won't have to close the pharmacy for lunch.. because most days there will be a overlap of RPH's.. my MBA mindset.. says that we can provide better service to customers... win-win
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Our first "cut in pay" may not come in $$/hr...but reduced hrs/wk and benefits !
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My advice to everyone ..is.. if your spouse doesn't have a job... have him/her to start looking for one... don't take on any new debt... get rid of as much debt you already have.. We may not see all the dust settle on this until 2015-2016..
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You may have to go back living like you did in college.. Ramon Noodles anyone?
That is the problem Steve, in this volatile period of time pharmacists ARE the dominoes!