“The moral test of a government is how it treats those who are at the dawn of life, the children; those who are in the twilight of life, the aged; and those who are in the shadow of life, the sick and the needy, and the handicapped.” – Hubert Humphrey
passionate pachyderms
Pharmacist Steve steve@steveariens.com 502.938.2414
Linda S. Cheek, MD is a retired family practice/pain management physician. Trained in conventional medicine, she found quickly in her practice that it doesn’t heal disease, so she studied multiple traditional (and futuristic) forms of healing medicine, from herbal to energetic and incorporated those into her practice.
Linda was born in Northern Virginia, just outside Washington, DC, graduating from George C. Marshall High School. She got her Bachelors in Biology at the University of Texas at Austin. She then became a secondary science teacher in her first life as she moved around the country and world as an Air Force wife. She also got a Masters in Guidance and Counseling at Phillips University.
Many of her years as an Air Force wife were spent in San Antonio, Texas. Deciding there to fulfill her dream of becoming a doctor, she got her Doctor of Medicine degree from the University of Texas Health Science Center at San Antonio.
Finally achieving her ambition to become a doctor, she did her residency in Family Practice at Roanoke Carilion Hospital. She moved to rural Southwest Virginia to serve the underserved, and set up practice in Pulaski County, at the edge of Appalachia.
Through the course of her practice, she led many patients to healing their chronic diseases, from fibromyalgia to heart disease and diabetes.
CVS defended its actions, but still settled with the Oklahoma Board of Pharmacy, after the pharmacy board charged the drugstore chain with prescription errors, inadequate staffing, and other offenses.
The pharmacy board fined CVS Health $125,000 after receiving multiple complaints about errors and overwhelmed staff members, The New York Times reported last week.1 The board inspected 4 pharmacies in particular from mid-2019 to early 2020.
CVS Pharmacy agreed to Board Orders from the Oklahoma Board of Pharmacy to resolve the complaints filed against the 4 pharmacies, the retailer said in a statement provided to Drug Topics®. “The agreement is not an admission to the allegations within the complaints. We’ve agreed to settle this matter to avoid the time and expense of a protracted hearing process and to foster a positive working relationship with the Oklahoma Board of Pharmacy,” CVS Pharmacy said.
According to the article, in an audit, inspectors discovered an error rate of approximately 22%, or 66 errors out of 305 prescriptions. Some of the errors were minor, but others were more significant.1
At 1 CVS store in Bartlesville, Oklahoma, inspectors found a 6% error rate, including the wrong dose of an antibiotic for a 1-year-old and multiple errors involving the frequency of a narcotic.1
At the store, inspectors “witnessed a chaotic scene including the phones ringing almost all of the time, along with constant foot traffic and drive thru traffic,” according to a complaint, The New York Times reported.
The head pharmacist noted that she had lost a considerable amount of her support staff, so she “was not terribly surprised that an error could have occurred,” according to The New York Times.1
In its statement, CVS said that patient safety is the company’s “highest priority and we have an excellent safety record, however we are committed to continually improving by using technology and training to enhance accuracy, regularly measuring the quality of our pharmacy services, monitoring our performance to improve processes, and listening to feedback from our pharmacists and pharmacy teams.”
“Our decisions about staffing, labor hours, workflow process, technology enhancements and other operational factors are all made to ensure that we have appropriate levels of staffing and resources in place at each pharmacy for the safe and accurate filling of prescriptions. If a pharmacist has a legitimate concern about working conditions, we make every effort to address that concern in good faith,” CVS added.
CVS also agreed to distribute a memo to its pharmacists in Oklahoma highlighting a law that requires them to take action if working conditions in their pharmacies could lead to problems safely filling prescriptions, The New York Times reported.1 “The memo is to make clear that they are not to face retaliation for documenting and reporting such issues.”
Unfortunately they cannot test controlled substances, but apparently they do compounding and they analyze every batch before it is sent to the pt.
For those who have known allergies to what should be inert ingredients… this firm may be of some assistance to you and/or you get a generics from a different/new pharma that doesn’t seem to work like one you had taken previously… this could be a option… I don’t know what the cost is or other particulars… but… at least it is a option that few know about .
President Reagan’s words back abt 40 yrs ago … seems now to apply to many and many more industries and not just to our government. Our our insurance industry – and not just health – are more than willing to take your money and then use “vague terms” within the policy not to pay a claim. Our Florida condo got hit by Hurricane Michael (Cat-5) .. only the 3rd-4th time a Cat-5 had come ashore in the USA… I did not pay for wind or flood insurance because our unit is on the top floor and I put 150 MPH windows which was covered by 120 MPH metal hurricane shutters. But Michael took part – abt 20%- of the roof off of the complex – of course the roof was blown off over the top of our unit.
The ceiling our our condo is a concrete slab and was built in 1984 and no one had bothered to seal the penetrations and conduit runs… so water ran into our unit.. and we had a few inches of water in our unit because the water just kept running on down to the units below us, but all the flooring, all the baseboards, all the drywall from the floor and up 4′.. had to be replaced. Our insurance told us that the water in our unit was INDIRECTLY WIND DRIVEN – NO COVERAGE… I though OK… the Association was responsible for the roof… but the FL legislatures in 2009 passed a law that no association nor their insurance was responsible for any damage to a owner’s unit cause by failure of the common property – like the roof !
Being a pharmacist, I was always under the impression that the FDA was over the safety & purity of medications in our system. Well my faith in that federal agency has been totally shattered. I got one of Barb’s long acting pain meds filled in FL and for the first time she got some made by Rhodes Pharma (Purdue pharma company). When she started talking them she claimed that she was not getting an relief from them – the technical term is lacks efficacy – She had been taking this particular med for years and this is the first time this had happened… This med is a “12 hr dose – long acting med – and 2-3 hr after taking a dose – NOTHING… so thinking that it could be a solubility issue … so I instructed her to cut a tablet in HALF and take both halves. Another 2-3 hrs passed and NOTHING…. so I instructed her to CRUSH a tablet and take it… 2-3 hrs later NOTHING..
I have had other pts tell me that their medications – different opiate – from Rhodes pharma – DID NOT WORK…
I reached out to Rhodes Pharma, figured that they would want to analyze these tablets… at first the person I talked to was a little hesitate to have them analyzed but I asked the question that the Rhodes had no concern that this would suggest that raw opiate material may be being diverted at their manufacturing facility.
Reluctantly he agreed to pick up the tablets…. and having waited a month since they were returned, I reached out to Rhodes pharma to get the results of the analysis. I had to leave a voice mail for 5-6 days in a row before anyone would return my call. I asked when I was going to get a copy of the analysis of those tablets and was told – somewhat in a matter of fact tone that they were not going to analyze those tablets and that they were standing behind the analysis reports at the time of being manufactured.
So the fact that Barb took THREE TIMES HER NORMAL DOSE within 6-9 hrs without any noticeable efficacy was of little concern to them.
So not to be deterred, I reached out to Division of Pharmaceutical Quality Operations III Office of Regulatory Affairs U.S. Food and Drug Administration Office: 313-393-8189 and talk to a representative and this office handles only Michigan & Indiana. Sent the representative all the information that I had concerning this particular med… got a couple of emails from the representative but now a week or so later … can’t get a voice mail return call nor a response to a email.
Have you ever seen a picture or demonstration of a room that has a large family of roaches residing and when you turn the lights on…. they all scatter back into the hiding places ? That is the mental picture that I am getting on this particular issue.
I have read stories about pharma manufacturing plants overseas where various mandated documentation involving the production of medications have been proved to be falsified/fabricated and no actual reality as to what was really done.
Is it just an illusion that those working for the Feds and in turn for US… really don’t give a crap about the actual duties of their job ?
I have already advised our PCP of this issue – who had been prescribing this to her for years – and I hope that he will share with the 5 other prescribers in his practice. I would recommend to any pt that is being prescribed Rhodes Pharma products to request a product provided by one manufactured by a different pharma.
Hello, my name is Alexandria and I am a pharmacy technician of 8 years from Alabama. I must admit to you that this letter, this speech, was not easy to write down. I started and stopped more than once, and gave up hope that I could make a difference more times than I can count.
I believe the best way to start, would be to tell you my personal story.
In 2012 I was hired at CVS pharmacy, as a technician. In my state (at the time) the requirements were simply for the applicant to be a high school graduate, and over the age of 17 in order to be licensed in the state to work in the pharmacy. My mother and sister are pharmacists, so my first job being in a pharmacy simply made sense. Within a year I quickly realized that the field of pharmacy was not for the faint at heart. Within 18 months of being hired at CVS, I studied and sat for my national certification exam, and passed. Thus becoming a nationally certified pharmacy technician. I was extremely proud of this certification, but also came to realize that in my state, this certification meant very little. Though some employers do pay more for a nationally certified tech. In 2014 my career took a turn for the worst. I was living alone at the age of 19, and was working part time. It was at this point that it became mandatory for full time benefits to be offered to all full time employees, that is, employees working over 32 hours a week. Instead of CVS offering insurance and benefits to the employees that had been working these hours, they simply did something cruel. They sent out a statement saying anyone listed in the system as “part time” was not allowed to work over 29 hours a week, so they didnt have to offer them health insurance or benefits. This became the start of my downfall. Full time positions were hoarded, and the amount of shifts available for technicians to work became very slim. There was one particular week in January of 2014 where I was only scheduled to work one single, five hour, shift. FIVE. I quickly went from paying my bills, to living in absolute poverty. My car was repossessed, I was unable to keep my lights on consistently, and I was having to go to food banks to keep food in my pantry. I searched and searched for a full time pharmacy tech position, which landed me driving to a store an hour away, making less than $11 an hour, simply to keep my lights on and to have health insurance. Living this way took a toll on me mentally. I was placed in a psychiatric unit in April of 2014 at my own request, due to overwhelming depression and suicidal thoughts. My attempts were in vein however, and in September of 2014 I attempted to take my own life. As I was still in my mandatory wait period before my full time benefits at CVS went into effect, I immediately returned to work. I attempted suicide on a sunday, and was back working the following wednesday. I had no short term disability available to me, or even paid vacation, and I couldnt take off work. I had to pay my bills.
Lets fast forward to January of 2015. Things took a turn for the better. I found a CVS closer to my house, in need of a full time technician. I was able to transfer to this store, where I met some of the most influential people present in my life. The troubles at CVS were just beginning though. You see, each store is allotted an amount of hours they are allowed to schedule technicians to work. For example, every 11 scripts filled was equal to 1 hour a technician was allowed to work. So in a store doing about 500 scripts a day, 3500 scripts a week, they were allotted 318 hours to divide among their technicians to work per week. If this amount of hours was exceeded, consequences were severe. No overtime was allowed, period. This amount of technician hours began to dwindle, though the amount of business did not. The amount of stress the whole staff was under was extraordinary! As one who had just overcome a mental health crisis, this was not a healing environment, in fact it was harmful. I was given more and more responsibility the longer I was there, for the same amount of pay. In october of 2017 my sanity eventually left me, I began having intrusive thoughts of self harm, thoughts of suicide, and I decided it was time for my career at cvs to end.
There are a few points I would like to make regarding this part of my life. The first being the manager I had at my final CVS store was amazing, and is still a close friend of mine to this day. The pharmacists are held under such suffocating standards, where speed, and volume are valued over accuracy. Pharmacists are measured on EVERYTHING, how many scripts did you fill per hour? How many flu shots did you give? How many patients agreed to get their medications refilled?
I have watched pharmacist after pharmacist question their career choice. They all went to school to learn to heal the sick, not to become a victim of overwhelming corporate standards.
The second point being,patients are being harmed by these standards.
I once witnessed a pharmacist accidentally fill the restless leg medication “Requip” instead of the mood stabilizer “Risperdal” for an autistic child, a misfill that had potential to do honest harm to the patient had the error not been caught by their guardian. Simply because the time needed to thoroughly verify a prescription filled for a patient, is not available.
The third and final point is, the employees are being driven to the point of absolute mental exhaustion. The pharmacists are paid well, but at a cost to their well being if they cant keep up with the corporate standards. The techs, however, are the real victims here. Pharmacy techs are notoriously under paid and under appreciated. We, as a whole, are expected to do as much as we can, for as little amount of pay as possible. Most of my coworkers at cvs lived in government subsidized housing, and required government assistance to be able to feed their families. In my particular case, not being married and having no children, I was simply, poor. I had a roof over my head, clothes on my back, lights and water. But I couldnt afford to buy a decent amount of groceries, nor could I afford a car payment.
I then left CVS for Walgreens, who offered better pay. Though I quickly came to realize that, though the pay was better, the expectations were very much the same. The pharmacists are crushed to death, and the technicians get absolutely no recognition.
This brings me to present day,
I accepted a position at an independent compounding lab, which is an extremely different environment. The employees are treated more as equals, though still not paid, in my opinion, our worth.
I approached the owner of the business I work for, expressing my thoughts at a recent New York Times article published about the dangers of large chain retail pharmacies. I expressed interest in wanting to make a difference for pharmacy techs, wanting to bring light to how we suffer. My boss, bless his soul, stone walled my interests by simply saying “ If you want to make a difference, go to pharmacy school.”
All due respect to the owner of the business I work for, not having “PharmD” at the end of my name, does not make me less entitled to a job with safety, reliability, and mental stability.
Which brings me to why I am here with you. In light of the recent COVID-19 crisis, it has been brought to light just how under appreciated pharmacy staff, techs in particular, are. Many business offered free services to health care workers, and many pharmacists and technicians were denied these services, being told they were not essential healthcare workers.
I have several goals in sharing this information with you.
The first being, pharmacy technicians are the backbone of every pharmacy you can find. There is no pharmacy in this country that does not have at least one technician running the show behind the scenes. This being said, we are entitled to more rights and duties. Technicians in my state are not allowed to give injections, are not allowed to take verbal orders from doctors, nor are allowed to transfer prescriptions from another pharmacy. CVS takes this to an extreme, technicians are not allowed to do even the most mundane of technician duties and are all but banned from doing anything other than running a cash register, and counting pills. The national certification exam is an excellent qualifying exam in showing proof of a technicians abilities to follow procedure and law. There is absolutely no reason why techs should not be allowed to do the aforementioned duties. Pharmacists are extremely overwhelmed as it is, and allowing their techs to assist them more thoroughly would be an excellent benefit for every pharmacies efficiency, and patients safety.
My second goal being, pharmacy technicians deserve better pay than what we are given. I was started at CVS in 2012 at $9 an hour. When I left in 2018, holding the second highest position a tech can have and being nationally certified, I was at $12.18 an hour. Walgreens started me at much higher, $14 an hour, but the ability to get raises was not offered except in very rare situations, and there were some of my coworkers who had gone almost three years without getting a raise. There is no base line pay for pharmacy technicians, nor is our value acknowledged. There is no one fighting for the right for techs to have more pay, nor do most pharmacists acknowledge that their staff deserves better pay, and appropriate recognition.
My third and final goal is, mental health should be considered as important as physical health in this field. Mental health days should be given just like sick days, in fact, should be mandatory for each employee to take. I was suffocated at CVS, and I caused a lot of harm to myself and my overall well being by not taking time for myself to put the pieces of my mental well being back together.
So here I am, 25 years old, married, life is pretty great. But the shadows of the mental health struggles I went through in 2014 are still there. Pharmacy technicians are suffering at the hand of corporate leaders, being over worked and under paid and it is taking its toll on my coworkers mentally.
I hope this opened your eyes a little to the struggles of a small town pharmacy technician.
This is the beginning of my journey to make a difference, and I thought reaching out to you was the best place to start.
Thank you.
The above video clip is a simulation of the training program for pharmacy chain techs… to weed out those who can’t run at 110% for up to 12-14 hr days. There was a recent article in the New York Times about a OK board of pharmacy audit of 4 CVS pharmacies where it was uncovered that 22% of prescriptions filled had errors.. not all the errors were major life threatening errors… but a error is a error !
The 13th Amendment was signed in 1860 that abolished SLAVERY, and apparently replaced with the MINIMUM WAGE. CVS recently reported ONLY a 250 BILLION DOLLAR PROFIT for their last fiscal year and it is reported that their President Larry Merlo only gets paid 36.5 million/yr.
The fine that the OK BOP imposed on CVS Health amounted to only a FEW MINUTES of CVS’ annual profits…. just the cost of doing business their way.
You only have one health, but these pharmacy chains have very deep pockets to settle any damages that is done to pts that have entrusted their health to their understaffed/overworked Rx dept staff. It is almost a certainty that all thousands of those stores will be opened for business the very next day and may not even miss a single minute of business & profits.
Hi Steve, is there a chance you could publish this ASAP?
It would mean a lot to Nancy if there were a lot of pain patients watching. Thanks, V.
Hello, I'm not sure how many of you knew Al Knowles, he recently passed away and
his fiance is streaming his service today. Al had traveled to one of the FDA meetings
and Nancy said he'd met some of you who had been there.
It'll mean a lot to Nancy if people are watching. Al's death is another side to
this war - pain patients postponing important tests, surgeries, etc.
Knowing your pain won't be controlled or you'll face discrimination
when they find out you are a pain patient, is a big deterrent.
If Al had done a colonoscopy, it's very likely the cancer
would have been detected much earlier and he might
have had time to fight it. V.
------------------------------------
From Nancy Hodgeson:
Live Streamed Memorial services will occur at 6 pm Sunday Central Time, July 19th
and will public on Al Knowles FB page.. Because of Covid there will not
be a regular service. Thank you everyone for understanding.
There will be an ash releasing ceremony later from Costa Rica
after it is extremely safe to travel again. Please stay safe everyone.
This showed up in my inbox Does the word “HEALTH” in relation to CVS must primarily reference their bottom line “health” since they recently reported a 250 BILLION profit in their most recent fiscal year.
Recently there was this fine from Oklahoma pharmacy board from a audit from four of CVS’ stores where the audit showed ONE our of FOUR Rxs was MIS-FILLED – a 22% error rate. The fine imposed, represented only a FEW MINUTES of CVS’S annual corporate profits. Anyone who believes that such fines are going to make them adjust their corporate staffing policies is delusional. It would seem that anyone who continues to patronize a CVS store is putting their own health at risk. I am sure that the Rx dept staff at the CVS stores cares about pt safety, but you can only do so much when you are only provided a fraction of the staffing hours that would allow them do their job safely.
This was a SavOn pharmacy in a Albertsons grocery store
I recently herniated a disc in my back a little over a month ago that has not only caused me great pain but has also made me unable to work at the business I own without pain medication as I am on my feet for at least 5 hours, and do not have employees
My doctor prescribed me 40 Percocet but when I went to pick them up the pharmacist said I could not get them unless my doctor called in a prior authorization. Eventually they allowed me 28 instead of 40 without the prior authorization. The next week I was getting low and asked for another prescription from my doctor and he sent in another one. I got the same story about how I cannot pick it up without the PA but this time they didn’t even allow me to get the 28 and said I could not get any without it due to my insurance and that I could not pay cash.
I called my insurance and they said they didn’t have any problems with me paying cash for it and that it’s the pharmacist that makes that call. I called the pharmacist and he tried again to tell me it was all my insurance doing it before finally saying that it was him that didn’t want to fill it without the PA. This all happened on a Friday and now my doctor is gone for the weekend and I have no options to get relief.
From your website it does not seem like this is legal, as there are no reasons why I should be denied if he’s still willing to prescribe them if I get insurance to cover it, but won’t if I just want to pay cash. I am 29 years old and feel as though he is discriminating against me because of my age but cannot confirm that is why. I don’t know what to do but to lay in agony until Monday to get my doctor to call in on my prior authorization. It makes no sense to me why this needs to be the process when my doctor approves my treatment and I am willing to pay myself for it, and that the pharmacist repeatedly told me it was my insurance holding me up and his hands were tied until I talked to them and found that wasn’t the case, and he admitted it was him that didn’t want to prescribe it.
I would like to file a complaint but am not sure if my case is legitimate and if so where to file the complaint.
