Live Streamed Memorial services for a PAIN WARRIOR

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.


					

				

CVS: Another case of profits are more important than pt care and safety ?

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.

CVS Fined for Safety Issues at Oklahoma Pharmacies.. prescription errors and inadequate staffing

If a pharmacists wanted to practice medicine… why didn’t they go to medical school ?

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. 
Thank you for your time,

Music teacher writes song to help everyone get thru the pandemic

https://youtu.be/x1M_rJqGIjE

This could be one of the future leaders of our country ?

death of despair (suicide) due to under/untreated pain

CVS is Destroying the Profession of Pharmacy: Part 6

CVS is Destroying the Profession of Pharmacy: Part 6

https://pharmacistactivist.com/2020/July15_2020.shtml

How to find a INDEPENDENT PHARMACY BY ZIP CODE

With each issue in this 6-part series of commentaries regarding CVS, an even larger number of responses and experiences are forwarded to me. There appears to be no limit to the evil, greed, and lies of this company. This commentary includes the experiences of two very courageous, and now former, CVS pharmacists, as well as excerpts from Ellen Gabler’s third article on the dangerous working conditions, errors, and harm to patients, at CVS and other chain pharmacies in the July 16th issue of The New York Times.

Lisa Cairo’s experience

I first came to know Lisa at the beginning of the Pharmacotherapeutics course in which I was one of the faculty participants. As the course coordinator, I would come to the classroom around 7:30 am to be certain that the AV equipment, etc. were ready for the start of the 8 am classes. One student, Lisa Cairo, was already in the classroom studying when I would arrive. I was surprised by her early arrival and learned that she had two young children, had a 2-hour commute each way between her home in New Jersey and Philadelphia, and that to arrive in time for her 8 am classes, her train’s departure time from her hometown was 5:30 am. The hours each day of her train commute and early arrival at our college were the primary times that she could devote to studying her coursework. I was very impressed by her commitment to learn and attend classes, while also fulfilling her responsibilities as a wife and mother and working part-time in a pharmacy.

Following her graduation I did not have any communication with Lisa for a number of years until I received the following email message from her at 12:55 am on June 20:

“I am writing in regards to your articles about CVS. I was employed with CVS for 16 years both as a technician and as a pharmacist. During my last few years at CVS, pharmacy supervisors were constantly changing. I had been at my store during that time for about 8 years and was currently the PIC (pharmacist in charge). I had a 24-hour store where on a Monday dispensing 750 prescriptions was typical. I was maintaining the numbers and doing everything I was supposed to. I gave excellent customer service and because I lived in the area and had 6 children in the school system, customers felt comfortable confiding in their pharmacist.

One day I was called to the office and told I was immediately being moved to their slowest store which barely did 100 prescriptions a day. Rumor had it that a pharmacist from another store who liked to play teacher’s pet wanted my hours, worked her magic, and got what she wanted. My customers were so upset that they were calling me at my new store and I would tell them to call the 1-800 number and voice their opinion. There were so many angry customers that the supervisor called me and told me to stop giving out the 1-800 number. I was one of the strongest pharmacists in the district put into a store where I was useless. The supervisor refused to move me to a busier store.

During that time I became pregnant with my daughter. One day while entering information into the computer I looked down at the floor and saw a puddle of blood. I excused myself from the pharmacy to clean up and then went back to work. Within a few minutes there was another puddle of blood on the floor despite the layers of paper towels I had used to prevent something from occurring. At this point, my technician’s face was white as a ghost and I was afraid for my baby. I called the store manager and said that I had to lock up and drive myself to the hospital. I told the manager that I would call the supervisor along the way. I did call the supervisor who scolded me for closing up before a replacement arrived. My visit to the emergency room determined that I was most likely pregnant with twins and that the heavy bleeding was the result of losing one of them. My discharge papers from the emergency room stated that I should take one week off from work, and work no more than 8-hour shifts unless a stool was provided for my use. My supervisor said stools were not allowed and that 8-hour shifts were not available. Eight-hour shifts were available at my previous 24-hour store so that was a lie I was being told. I was told that, if I could not work when I was scheduled, I would need to go on early disability. I was capable of working but they refused to make exceptions for my condition. I continued to work but I hid a bunch of boxes in a corner as a makeshift stool to get me through until I went on disability. I knew that once I had the baby I was moving on to another position. CVS didn’t actually fire me but they did everything they could to make it difficult and uncomfortable for me.

My marriage was never a solid one and I had made a mistake. Several years later I filed for divorce. Because I received a higher salary than my ex, I had to pay him out. When I filed for divorce, I also applied for a PharmD program because I knew that the PharmD would be necessary to remain stable in the work force as a single parent. I didn’t want to be at risk for a lay-off or unable to find a job like so many pharmacists with a bachelor’s degree in pharmacy are now discovering. So I now have student loans to repay. It’s okay. I now have my PharmD degree.

There was one other big change in my life. I began pharmacy school when my oldest daughter, Nicole, was 6 months old. I wanted to give her everything I didn’t have as a child. She saw me walk the stage at graduation when she was in kindergarten. I tried to lead by example. I did my very best to be a good role model. But it wasn’t enough. Nicole became addicted to drugs. I saw it early on and intervened. My ex denied that there was a problem and said it was a phase that she would grow out of. It was a very tough period of time with her lying and stealing from me, and my waiting up late at night wondering where she was. I was the disciplinarian while my ex was not concerned.

I received my PharmD degree in May 2017. I was on top of the world. My world crashed July 22, 2017. Nicole died from an overdose of heroin that was laced with fentanyl. Life has not been the same. I missed many of my kids’ events because I worked endless hours for CVS. My relationship with my children would most likely be different if I didn’t work the grueling shifts I did. I hope something comes about with what you are doing. I felt helpless when I left CVS.”

I responded to Lisa that her message brought me to tears and asked that she provide me with her phone number so that I could speak personally with her. She provided it to me and we spoke later that day. Lisa followed with a quick email and photo “to show you how beautiful my Nicole was.” I responded:

“She is beautiful, Lisa, and could have been a model. Her beauty is an inspiration looking forward to help your younger children achieve what Nicole might have achieved.”

Most of Lisa’s experience at CVS was during the last 20 years. However, more recently she has been working as a hospital pharmacist. Many current CVS pharmacists would say that the working conditions at CVS are even worse now than when Lisa was employed there. I highly commend and greatly appreciate her sharing her experience with me so that I may communicate it with the hope that other pharmacists can learn from it and take action to avoid circumstances that can have such a destructive impact.

Shayra Ramirez’s experience

Shayra Ramirez worked for CVS for more than 25 years, most recently in Florida UNTIL last August. Ellen Gabler’s comprehensive coverage in two stories in The New York Times earlier this year (“How Chaos at Chain Pharmacies is Putting Patients at Risk”) captured what Shayra has experienced and motivated her to share her own experience:

“In the last two years patient service/care in CVS has been declining steadily, mostly due to the lack of technician hours. Our technicians have a key role in keeping the pharmacy going, by entering the prescriptions in the system, physically counting and preparing the medication, attending the register, dealing with insurance, etc. The lack of tech hours made our work very hard, as we had to deal with a bigger workload with no help, and the situation became so hectic that, after months of written complaints to CVS management, I led a meeting of five pharmacists with the District Manager in April, 2019. Our main complaint was that the lack of technician help did not allow time for pharmacists to keep proper track of expired medication, interactions, appropriate drug and dosing, etc. We asked for a solution in order to avoid putting patients at risk. In that meeting it became crystal clear that CVS was only worried about meeting metrics (immunizations, prescriptions, etc). We were told that increasing the hours for technical help was out of the question, and that we were obligated to meet the metric scores required. When I asked how we were supposed to do so, the District Manager said that he didn’t have an answer and that that was our problem. They showed no interest whatsoever in dealing with our concerns about patient safety. I was very vocal at that meeting and it was obvious that neither my District Manager nor my Supervisor were happy with my comments. My colleagues who attended the meeting, as well as myself, immediately became persona non grata for CVS management.

From that moment on, we kept receiving pressure from management to increase the metrics while they continued cutting technician hours, and some of these pressures included write ups for some of my colleagues with the threat of termination. Finally, my time came: in late August last year, my District Manager had me come to the office, after more than ten days pressuring me personally to persuade our patients to receive vaccines (I guess there is monetary gain from it, as it is a big part of the metrics). I then challenged him when he was saying that ‘the company stresses immunizations because they care about the well-being of our patients,’ because it seems that what they really want is to meet their goals with the vaccines; and he did not like that.

On August 29th, I was out of town on vacation while West Palm Beach was under Hurricane Alert. I entered in the CVS Human Resources website and I found no access to most of my regular things on my account and a note encouraging me to apply for Cobra to cover my medical expenses…starting August 30th!! With my arrival date in Florida unclear due to the weather, I was fired and nobody in CVS had the decency to warn me. A funny thing is that the Sunday after (9/1/19) my District Manager sent me an email telling me that all my shifts for that week were covered. I guess he meant ‘next’ and all the weeks of my life because I had been fired, but not even there did he have the decency to communicate it to me.

A few days later, I received the letter of termination in the mail. The formal reason for my being fired is that I contradicted a company policy because I rang up a personal sale for myself in the register for one of my own medications (again, due to a lack of help and trying not to distract my technicians from more important work). Under normal circumstances, this would have resulted in just a verbal or written warning (our policy was that personnel in charge are to be given 3 formal warnings before letting people go). In my case, I was immediately terminated. In my case, this is a clear case of retaliation.

I mention all this because I felt very angry when I read in The New York Times article, ‘When a pharmacist has a legitimate concern about working conditions, we make every effort to address that concern in good faith,’ CVS said in a statement. This is not true. There is no concern at all, and CVS management does not like to be challenged in order to improve the quality and safety of the pharmacy service for their patients.

Obviously, they don’t want me working for the company anymore because I speak too clearly for them. I told the District Manager that I felt we were harassing patients to get vaccines and that I also felt like I was selling myself in order to meet the metrics, the goals, and ultimately, his bonus. It is disappointing that with 25 plus years of service, I was terminated this way only for trying to address something we pharmacists knew long ago: we are putting our patients at risk, and I believe it has not been a fair way to treat me or the patients.”

Shayra Ramirez wrote personally to Ellen Gabler at The New York Times to voice her appreciation for her articles about the terrible working conditions at CVS and the subsequent increased risk of harm to patients, and for Ms. Gabler so effectively increasing public awareness of these dangers at CVS stores. Shayra has demonstrated exceptional courage in voicing her concerns to CVS management. Her concerns for the safety of her patients resulted in retaliation and termination, but will have the result of emboldening others to take a strong stand against a company whose greed and evil must no longer be tolerated. CVS will be hearing more from Shayra and those of us who support her!

Ellen Gabler and The New York Times

As I prepare this issue of The Pharmacist Activist on July 16, I have received Ellen Gabler’s story in today’s New York Times, titled, “CVS Fined for Safety Issues at Oklahoma Pharmacies.” The article begins:

“In a rare public rebuke of the nation’s largest retail pharmacy chain, state regulators in Oklahoma cited and fined CVS for conditions found at four of its pharmacies, including inadequate staffing and errors made in filling prescriptions.

While the fine of $125,000 on Wednesday was small for CVS Health – it paid its chief executive $36.5 million in total compensation last year and is the country’s fifth largest company – the move validated concerns raised at multiple drugstore chains across the country by pharmacists and technicians who say understaffed workplaces are putting the public at risk.”

The article includes a number of examples of errors, and the results of a visit from Oklahoma Board compliance officers to a CVS store at which they “witnessed a chaotic scene including the phones ringing almost all of the time, along with constant foot traffic and drive thru traffic.” In an audit, “the officers found an error rate of nearly 22 percent, or 66 errors out of 305 prescriptions.” In another CVS store, “inspectors said a computer screen showed more than 99 prescriptions waiting to be filled and more than 99 calls needing to be made.” The article also includes an interview with a former CVS district leader who had the courage to repeatedly voice concerns about the budgets for staffing, and who was subsequently terminated.

Ms. Gabler has provided a valuable service for consumers and the profession of pharmacy by exposing the consequences of corporate greed and negligence. This article and her two previous articles earlier this year should be required reading for all pharmacists and pharmacy students. Pharmacists and pharmacy students should challenge our professional organizations and colleges of pharmacy to take actions in addressing the dangerous workplace conditions that exist. We should no longer tolerate their silence!

Daniel A. Hussar
danandsue3@verizon.net

CVS Fined for Safety Issues at Oklahoma Pharmacies.. prescription errors and inadequate staffing

CVS Fined for Safety Issues at Oklahoma Pharmacies

https://www.nytimes.com/2020/07/16/business/cvs-pharmacies-oklahoma.html

The state faulted the company for prescription errors and inadequate staffing, a rare action that followed complaints at drugstore chains across the country.

In a rare public rebuke of the nation’s largest retail pharmacy chain, state regulators in Oklahoma cited and fined CVS for conditions found at four of its pharmacies, including inadequate staffing and errors made in filling prescriptions.

While the fine of $125,000 on Wednesday was small for CVS Health — it paid its chief executive $36.5 million in total compensation last year and is the country’s fifth-largest company — the move validated concerns raised at multiple drugstore chains across the country by pharmacists and technicians who say understaffed workplaces are putting the public at risk.

CVS also agreed to distribute a memo to its pharmacists in the state, highlighting a law that requires them to take action if working conditions in their pharmacies could lead to problems safely filling prescriptions. The memo is to make clear that they are not to face retaliation for documenting and reporting such issues.

In a statement, a CVS spokesman said the company agreed to the terms to “avoid the time and expense of a protracted hearing process and to foster a positive working relationship” with the Oklahoma State Board of Pharmacy. The spokesman said the action did not constitute an admission of guilt by the company on all counts.

The state board inspected the four pharmacies from mid-2019 to early this year after receiving multiple complaints about errors and overwhelmed staff members.

One of those errors occurred last year when a developmentally disabled teenager received one-fourth of his prescribed dose of anticonvulsant medication from a CVS in Owasso, a suburb north of Tulsa, according to a complaint filed by the board. The boy took the incorrect dosage for 18 days, during which his seizures became uncontrollable, causing him to fall and hit his head, said his father, Aron Brown.

The convulsions were “nonstop” and “violent,” Mr. Brown said. “You have no idea what kind of shame we feel about this — that we couldn’t figure out what was going on.”

As part of its agreement on Wednesday, CVS will pay a $75,000 fine for that incident — the highest amount allowed under state law for this case — and its Owasso pharmacy will remain on probation for two years. While pleased the board had addressed the matter, the boy’s parents said they were worried that the action was not strong enough, and that it could allow other patients to be harmed in the future unless CVS made substantial changes to its business.

“A $75,000 fine? That is nothing to them,” said the teenager’s mother, Rachel Banning. “These things are going to keep happening if they don’t fix their staffing issues.”

Pharmacists in dozens of states have accused CVS, Walgreens and other major pharmacy chains of putting the public at risk of medication errors because of poorly staffed and chaotic workplaces, The New York Times reported in January.

In letters to state pharmacy boards and in interviews with The Times, pharmacists said they struggled to keep up with an increasing number of tasks — filling prescriptions, giving flu shots, tending the drive-through, answering phones and calling patients — while racing to meet corporate performance metrics they characterized as excessive and unsafe.

The pharmacy chains, including CVS, have pushed back on employees’ complaints, saying staffing is sufficient and errors are rare.

Most state investigations focus on pharmacists, not conditions in their workplaces. In Oklahoma, the state board has begun investigating broader workplace issues when responding to complaints and doing routine inspections.

In mid-January, two board compliance officers went to a CVS in Bartlesville, Okla., to investigate a complaint of a mislabeled prescription. There, they “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 filed against CVS.

The officers discussed the error with the head pharmacist, noting that she said “she had lost a considerable amount of her support staff, and that the pharmacy was operating with little help, so she was not terribly surprised that an error could have occurred.”

In an audit, the officers found an error rate of nearly 22 percent, or 66 errors out of 305 prescriptions. Some of the mistakes were minor and would not affect a patient — such as the incorrect name of a prescribing physician — but others were more significant, like instructions for medications that were unclear or substantially different from what they should have been.

Days later, a prescriber complained of insufficient staffing at a pharmacy in Moore, about 10 miles south of Oklahoma City, saying calls were placed on hold for up to 60 minutes. Compliance officers reported finding one pharmacist and one technician who had fallen behind on work.

The officers recorded a 6 percent error rate, according to the complaint. Some of the errors were substantial, including the wrong dose of an antibiotic for a 1-year-old, the incorrect frequency for an antiviral drug (every two hours instead of 12) and multiple errors involving the frequency of a narcotic.

There were several reported errors involving testosterone; in one case, the dose was doubled for a female patient. The compliance officers also noted mistakes related to blood pressure, gastric disorder and steroid medications that had been dispensed to or entered for the wrong patients.

Errors were also flagged in a complaint about a pharmacy in Choctaw, east of Oklahoma City, in February. Inspectors said a computer screen showed more than 99 prescriptions waiting to be filled and more than 99 calls needing to be made.

When asked about the backlog, the pharmacist said that employees were several days to weeks behind, according to the complaint, adding that they had been given an extra 17 hours of technician help but could not find anyone who would work only 17 hours.

A teenager received a quarter of his prescribed dose of anticonvulsant medication from CVS, leading to uncontrollable seizures, according to a complaint.

Similar staffing concerns were detailed in the case involving the disabled teenager. The pharmacist on duty that day, according to the complaint, was responsible for checking 194 prescriptions in a six-hour shift, about one every two minutes.

The store’s lead pharmacist told the board that he had no control over staffing, and that while he complained about the issue to his district leader, she also had no power to make changes.

That district leader, Amanda Dixon, who is a pharmacist, told The Times in an interview this week that “district leaders were repeatedly voicing their concerns about the budgets” for staffing at CVS pharmacies last year.

Dr. Dixon said that many pharmacies in her 19 stores were short-staffed, that customer complaints were on the rise and that she was worried about patient safety. She had worked for CVS for almost six years until November, when, she said, she was terminated for a policy violation involving another employee, although she believes she may have been retaliated against by the company because of the board’s investigation.

In its statement on Wednesday, Michael DeAngelis, the CVS spokesman, said that “if a pharmacist has a legitimate concern about working conditions, we make every effort to address that concern in good faith.” He added that any suggestion the company retaliated against a district leader was false.

In addition to the fines, the state board said it “strongly recommended” that the company follow through on nearly a dozen recommendations for all of its Oklahoma pharmacies, including increased training for technicians and changes to how staffing needs were determined.

The board also advised eliminating tasks that might overburden pharmacists and removing some metrics they are required to meet. Phone calls pharmacists often must make, it said, could be outsourced to a corporate call center.

Mr. DeAngelis said the company would review the board’s recommendations, noting that CVS had reduced its overall metrics this year and was planning to increase staffing in the fall to help handle vaccines for flu season.

Dr. Thomas Kline, MD, PhD: Medical Myths Revealed: July 2020 Catching up

https://youtu.be/AVruj_FdcfQ

I have been away from my YouTube channel to work on some research projects

Dr. Thomas Kline, MD, PhD: Medical Myths Revealed: DEATH of the CDC guidelines

https://tinyurl.com/ybu63tnq (link to full AMA letter) 17 pages destroys all the things dangerous and wrong with the 4 year old Guideline that has not worked one iota and has destroyed the lives of 4-7 million people by convincing doctors to stop pain regimes in those. Write your congress people, the CDC, RETRACT THE GUIDELINE PENDING FDA APPROVAL.