How can Pharmacists Fight Back??

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Splenda88 said:
John Acevedo, PharmD PGY2...

I saw that yesterday where I am doing residency and a laughed... Why would someone go to pharmacy school and have to do 2-year post-grad training? Do some people know you only need a 3-year to be a full-fledged physician and the US and make bank (in the case of EM doc -- 350k+yr working 30-32 hrs/yr)...

You only need 2-yr PGY to become a FM doc in some provinces in Canada.
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Isn’t there also a movement to get pharmacists to do pgy3?

Even the most “clinical” pharmacist can’t do what a PA does, let alone a md/do
 
steveysmith54 said:
Isn’t there also a movement to get pharmacists to do pgy3?

Even the most “clinical” pharmacist can’t do what a PA does, let alone a md/do
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Well a PA/MD/DO cant do what a pharmd does lol

And what?! Pgy3?! Lol i didnt think pgy 2 was necessary to be a clinical pharmacist. Pgy 1 kinda makes sense. Residency itself seems like a fraud. Haha
 
VictorOfHungerGames said:
Well a PA/MD/DO cant do what a pharmd does lol

And what?! Pgy3?! Lol i didnt think pgy 2 was necessary to be a clinical pharmacist. Pgy 1 kinda makes sense. Residency itself seems like a fraud. Haha
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I think MD/DO can dispense meds in probably all US 50 states.
 
ranger99rx said:
It’s true that pharmacy doesn’t make money, only 2 pharmacies in my market made money last year.
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See....I know that overall, reimbursement continues to trend down and DIR fees continue to go up, leading to generally lower net profits, but I don't understand how a reasonably busy major chain pharmacy could actually be losing money. My small grocer pharmacy (about 1k scripts a week) is still healthily profitable. Net profit percentage compared to gross sales is down, but we still are making very healthy monthly net profits operating as a traditional retail pharmacy (I was attacked in an older thread for saying that/people said I must be reading my PNLs wrong and only looking at gross profits and/or my company isn't showing me all our costs vs revenue, but I get the same monthly detailed expense and profit sheet accounting uses to determine our EBITDA...it shows every single little cost we incur).

If bigger chain stores doing 2-4x our weekly script count are not profitable, there is some serious mismanagement going on there. I think what is happening is that big corporations feed off of and expect more profit each quarter to satisfy their shareholders. They see the reimbursement trends and just continue to try and slash labor to cook the books and cling to as much profit as possible in the short term, without thinking of the long term consequences.
 
Splenda88 said:
I think MD/DO can dispense meds in probably all US 50 states.
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No. Some states allow certain meds in certain situations for mds to dispense. Either way i was referring to the type of medical service, knowledge and expertise pharmacists have vs everyone else. I have doctor friends that only know about drugs that their specialty is related to. Some interventions i had to make due to side effects or interactions in the past, doctors didnt know about.

I still believe in being a pharmacist is a privilege and a noble job. Which is why i hate witnessing the current situation and being powerless to stop.
 
I believe there are a few PGY3 programs out there. I'd love to hear from the people who completed them.
 
Physician dispensing will replace pharmacies eventually. Americans are tired of dealing with middlemen.
 
BenJammin said:
Physician dispensing will replace pharmacies eventually. Americans are tired of dealing with middlemen.
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I don’t think so unless it pays like Dermatology or Oncology. It’s a lot of time and recordkeeping for dispensing fees. Physicians can see more patients and pay themselves more than running a dispensary. Dermatology has something like a 350% markup on the exotics, and some do thrive running a side business in cosmeceuticals.
 
Yeah not worth the hassle especially when pharmacy reimbursement is down the drain..
 
VictorOfHungerGames said:
Are you talking about independents? Typically reimbursements are more than that per script. Plus cash patients, otc products, compounding and now cdb rolling in you could be banking owning 3-4 indies that do about 8-900 a week. Thats if you know how to manage pharmacies.

Indies in heat zones are struggling but ones outside are going strong. Obviously, it could be better lol
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I think the real issue is reimbursement. Earlier Walmart and other grocery chain pharmacies were able to provide services even when not really being reimbursed because their patient would be spending money in the store. This is what really screwed chain pharmacies like walgreens and CVS because insurance would drop their reimbursement. Now the reimbursement rates arent even close to what they were in the past. Before Walgreens and CVS use to roll in cash because of reimbursements and now they are scrapping bottom dollars.
 
Splenda88 said:
I think MD/DO can dispense meds in probably all US 50 states.
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I would imagine. They can certainly do so in IL, but very few do because of the record keeping requirements. And certainly MD/Do's don't want the hassle of trying to bill insurance for a flimsy reimbursement. Nor do they want to keep a large inventory. The very few MD's that I've seen dispense, are mostly antibiotics and 1x acute use meds in rural settings.

Splenda88 said:
Show me the state law or provision that let RN dispense meds... Not aware of any.
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Rn's are allowed to dispense under the oversight of a physician....just like they can do all kinds of other things other the oversight of the physician. RN's used to dispense in ER and surgical units all the time before computer pharmacist review and pyxis/omnicel type machines. And RN's still dispense in emergency/stat situations. And yes, they also dispense in the very few doctor's offices that do physician dispensing of drugs.
 
Our fights must be successful. Apha is giving away memberships for free if you’ve been laid off or had hours cut. Brad is here watching.
 
BidingMyTime said:
Rn's are allowed to dispense under the oversight of a physician....just like they can do all kinds of other things other the oversight of the physician. RN's used to dispense in ER and surgical units all the time before computer pharmacist review and pyxis/omnicel type machines. And RN's still dispense in emergency/stat situations. And yes, they also dispense in the very few doctor's offices that do physician dispensing of drugs.
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Do you even work in a hospital?? The only reason why that nurses are allowed to override Pyxis to pull meds is because the director of pharmacy (not MD or DO) give them the ability to do so. In fact, the DOP at my hospital just pulled that privilege from nursing because 1.) they kept on pulling the wrong meds all the time and 2.) they will pull meds in anticipation of needing them for future use (even ****ing CIIs) without orders. Do you even realize how asinine you sound right now?
 
AlwaysContrary said:
Do you even work in a hospital?? The only reason why that nurses are allowed to override Pyxis to pull meds is because the director of pharmacy (not MD or DO) give them the ability to do so. In fact, the DOP at my hospital just pulled that privilege from nursing because 1.) they kept on pulling the wrong meds all the time and 2.) they will pull meds in anticipation of needing them for future use (even ****ing CIIs) without orders. Do you even realize how asinine you sound right now?
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Do you???

Talk about getting triggered over a neutral post. Its good to know that our precious pharmacy student knows more about the profession than an actual pharmacist.

There's nothing profound about your anecdote. It sounds like the DOP finally got around to getting the ADMs properly set up. My hospital had this setup implemented years ago. Of course, it doesn't stop the nurses from pulling meds from the ADMs. But it does force them to use the proper steps, minimizing med errors.
 
AlwaysContrary said:
Do you even work in a hospital?? The only reason why that nurses are allowed to override Pyxis to pull meds is because the director of pharmacy (not MD or DO) give them the ability to do so. In fact, the DOP at my hospital just pulled that privilege from nursing because 1.) they kept on pulling the wrong meds all the time and 2.) they will pull meds in anticipation of needing them for future use (even ****ing CIIs) without orders. Do you even realize how asinine you sound right now?
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No, because my point is still 100% true. Nurses dispense medications all the time under the supervision of a doctor. Does your hospital not have crash carts? Pyxis isn't the only thing that nurses pull meds out of to dispense. Regardless of what rules your facility has (and good for them for giving the DOP that power), the reality is DOP's/Doctors/Nurses all agree to the rules of the facility as part of their employment or doctor privileges. Doctors do NOT need the permission of a pharmacist to allow nurses to dispense medications, they only need their employer's permission if they are not self-employed.
 
BidingMyTime said:
No, because my point is still 100% true. Nurses dispense medications all the time under the supervision of a doctor. Does your hospital not have crash carts? Pyxis isn't the only thing that nurses pull meds out of to dispense. Regardless of what rules your facility has (and good for them for giving the DOP that power), the reality is DOP's/Doctors/Nurses all agree to the rules of the facility as part of their employment or doctor privileges. Doctors do NOT need the permission of a pharmacist to allow nurses to dispense medications, they only need their employer's permission if they are not self-employed.
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You might have different model from other hospitals, we have pharmacist present in during codes and they are the one running the crash carts.
 
CarbmonstaRX said:
You might have different model from other hospitals, we have pharmacist present in during codes and they are the one running the crash carts.
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We do not, we aren't even 24 hrs. Same with most rural hospitals. It is the big hospitals that can justify the staffing to have unit pharmacists ready to answer a code.
 
Luol Deng Fan said:
I don't get it. Why do you think they owe their pharmacists anything because the stock doubled? Also was this increase in stock value due to pharmacy, which from what I hear is declining in revenue? Walmart and other pharmacies paid their pharmacists top dollar when they needed them. Now they don't. Can't have it both ways. That's the way free markets work. Eventually your job might become obsolete. If i drive a taxi, I can't complain to the govt that uber is stealing my business.
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actually some places have very limited uber or doesn't have as much privilege because taxis complained lol
 
Lyric9059 said:
In the past 1 year, Walmar’s Stock has almost doubled. They beat earnings easily in the last quarter and our president has given them billions of tax cuts. The economy is supposedly great and Walmart is making a ton of money and is buying a bunch of companies here and there.

During this period of time, you would think that Walmart will appreciate its staff and pharmacist. But that did they do? They fired 40% of their pharmacists. People that have given their lives to this company. They are cutting hours left and right, denying raised and cutting bonuses. One could ask, if they are doing this during this economic boom, what will they do during the next recession?

Thus far, pharmacists have remained timid and indolent and flat out indifferent. We have all assumed that it will never get to us, but it looks like this last one got our attention and a lot of people are asking,” what can we do?” Well that is what I plan on answering here.

1. We need to force them to decrease class sizes. How do we achieve this? Do we need to send more money to uslesss organizations like Apha and Ashp etc? Absolutely not! We can however tear our preceptor licenses into pieces! The moment there is a scarcity of Preceptors, pharmacy schools will decrease classroom sizes immediately. You can do this right now. Go and grab it and tear it. Don’t renew it. Close up shop. You would get the attention of the greedy idiots that own these schools by so doing.

2. Contact your legislators and congress. Very recently, Texas abolished the plumbers board. They got together, they spoke up, they got on the news and within weeks, it was restored. Let us directly complain to and force our state boards or whoever to re-instate the pharmacist : Pharmact tech ratio. It was 1:3, but they changed it to 1 Pharmacist to unlimited amount of techs. Ordinarily you would expect something like this if there was a shortage of pharmacist. But in this case, there is an excess of pharmacist. So there was absolutely no sensible explanation besides corruption or bribery by big chains. Let us bombard our state board with calls.

3. We should be able to sue pharmacy schools for the deception and lies. It should be illegal to charge 100-200k for a profession where no one gets 80hrs. New grads should get deferrement till they can get 80hrs.

4. Make more videos. Speak up! Blog away! Share these threads.

5. Get together and sue your stateboard. They no longer represent us.

6. Do not renew your Apha membership. Boycott the mid year conference. We need these organizations to feel our pain. They need to earn the money we pay. They haven’t delivered so far. Apha keeps making trainings and videos that they use to train techs to replace. Apha need to make it clear that their trainings cannot he used for anybody that isn’t a pharmacist.

Please suggest more and more ideas in this thread. We need to fight back. We can build an online coalition without forming a union.
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Dear colleagues, there are numerous opportunities to become wealthy in this country. I came across “government contract” 4 years ago. I was shocked to discover that you do not need a pharmacy degree to sell drugs to U.S Government.

You can set up your business as a broker to buy these contracts then sell them to another contractor.

Many contractors that supply to government have no clinical knowledge or any pharmacy related skills.

We need to work together to protect our profession. SMH on why we spent 6 years and $$ but “government contracting” was never mentioned in our curriculum.

I’m currently doing this as a side gig and if you’re interested please send a private message to me.
 
Deja said:
actually some places have very limited uber or doesn't have as much privilege because taxis complained lol
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I don't agree with those places doing that but that is a different debate all together. Point is pharmacist are owed nothing by walmart. I have more compassion for the hourly associates because they really get treated like ****. A lot of pharmacists think that if they aren't being coddled it's employer abuse.
 
BenJammin said:
Physicians in Texas are suing the state for the right to dispense out of their office. The AAPS president Kristin Held even said that physicians don't need pharmacists and that we should support her because the PBMs are putting us out of business.
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lol how does us helping her help us
 
anua said:
Dear colleagues, there are numerous opportunities to become wealthy in this country. I came across “government contract” 4 years ago. I was shocked to discover that you do not need a pharmacy degree to sell drugs to U.S Government.

You can set up your business as a broker to buy these contracts then sell them to another contractor.

Many contractors that supply to government have no clinical knowledge or any pharmacy related skills.

We need to work together to protect our profession. SMH on why we spent 6 years and $$ but “government contracting” was never mentioned in our curriculum.

I’m currently doing this as a side gig and if you’re interested please send a private message to me.
Click to expand...

why does this remind me of the movie war dogs
 
BenJammin said:
Physicians in Texas are suing the state for the right to dispense out of their office. The AAPS president Kristin Held even said that physicians don't need pharmacists and that we should support her because the PBMs are putting us out of business.
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Well, I certainly wouldn't support that, but I wouldn't worry about it either. Physicians can dispense of their offices in Illinois, but very few do so. 1)it's only going to be independent doctors, and they are ever decreasing. Health systems (at least none that I'm aware of) don't allow their employed physicians to dispense. With independent doctors, none of them want a huge inventory, not to mention the record keeping requirements, so few do it. I only know 3 physicians who actively dispense out of their offices, none of them do it for chronic meds, it is for basic stuff like antibiotics and other 1x meds, for rural patients.
 
I'm not sure how ins billing works with dispensing physicians.....but that would be another huge headache that most physicians wouldn't want to deal with. Pharmacies have volume to make up for low reimbursements, but physicians who dispense don't have that.
 
Lubeckd said:
The hunters, then farmers, then industrial revolution, then globalization and now AI. Overnight a lot of traditional jobs disappear. Ironsmith .etc. A lot of in danger of disappearing.
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AI will change the profession of pharmacy forever. AI doesn't mean our jobs will disappear, but it will change how we work. It also may mean reduction in pharmacist hours that is needed, unfortunately. This is another reason why we can't have these Money hungry corrupt pharmacy schools from flooding the market. We will have to Adapt and maximize efficiency if the profession is to survive. This goes to both Community and Hospital pharmacy setting. Flooding the market with pharmacists will only impede and devastate our ability to adapt and survive.
 
BidingMyTime said:
Well, I certainly wouldn't support that, but I wouldn't worry about it either. Physicians can dispense of their offices in Illinois, but very few do so. 1)it's only going to be independent doctors, and they are ever decreasing. Health systems (at least none that I'm aware of) don't allow their employed physicians to dispense. With independent doctors, none of them want a huge inventory, not to mention the record keeping requirements, so few do it. I only know 3 physicians who actively dispense out of their offices, none of them do it for chronic meds, it is for basic stuff like antibiotics and other 1x meds, for rural patients.
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Physicians have right to do anything they want. It is our job to figure out a way to work together with physicians so both parties can be profitable and mutually beneficial.
 
Drakulie said:
AI will change the profession of pharmacy forever. AI doesn't mean our jobs will disappear, but it will change how we work. It also may mean reduction in pharmacist hours that is needed, unfortunately. This is another reason why we can't have these Money hungry corrupt pharmacy schools from flooding the market. We will have to Adapt and maximize efficiency if the profession is to survive. This goes to both Community and Hospital pharmacy setting. Flooding the market with pharmacists will only impede and devastate our ability to adapt and survive.
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but how???

it just seems that nobody has been successfully trying to stop those pharm schools.... :nailbiting:
 
In general, you can fight back by:
- Refusing to work for anyone except yourself or an independent business (e.g., refuse to work for corporations, academia, the government, etc.).
- Leaving the profession.
- Running for political office and convincing either a handful of powerful, rich people and/or a critical mass of the general public to support your vision.

You could work on a campaign to advocate for making the process of getting into pharmacy school or getting licensed as a pharmacist more rigorous, but you have a lot going against you:
- The working conditions for most pharmacists are not bad enough that most pharmacists would be willing to risk it all for the possibility of slightly more job security or slightly better working conditions.
- Most unemployed pharmacists who have nothing left to lose will jump ship the moment they are offered a job with decent pay and benefits.
- The general public has no idea of or concern for the plight of pharmacists. (I am actually not convinced that it is for the greater good to support making pharmacy services less accessible and more expensive by decreasing the supply of pharmacists.)
- Not to mention, you're fighting against big corporations and powerful institutions with deep pockets.

I will say that I feel bad for applicants who receive misinformation from college recruiters or academic advisers and are unduly influenced to enroll in pharmacy school. Or applicants who obviously are not prepared to succeed in the profession and are still admitted. But to what extent does this happen? Do we have any data to indicate that this is a major contributor to the problem? Maybe the first step is doing the research and having the data to convince lawmakers that pharmacy school applicants need better protections. But doing research takes time, money, and skills...

At the end of the day, there aren't 100s of people dying because of the pharmacist oversupply (or if there are, we don't have the data to support such a claim), so I wouldn't expect any dramatic government interventions in the near future. Heck, even if we did find a correlation between death and the pharmacist oversupply, I doubt it would lead to any big changes. I mean, we've known that physicians have a higher rate of suicide than the general population for several decades, and systemic changes to address this systemic problem continue to move very slowly.
 
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