Retail Health Clinics

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Get help with your application

Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.

I am not against these clinics but I don't like the idea that they are own and run by CVS, Walgreens because they pretty much ruined the pharmacy profession.
 
Advertisement - Members don't see this ad

Not that I am disagreeing with any of you...

But the whole gamut of retail pharmacies is only the answer to Americas cry for convenience and speed. Having worked in a pharmacy for a little over a year, CVS to be exact, I see and feel the stresses myself. Hell, even today I had 45 year old woman scream and spit at me when I told her that her medicaid drug was not available in generic and she'd have a copay of $10 instead of $2.

But what people fail to realize is that above the store level pharmacy is nothing but people who are there for business and have no clue of the laws of pharmacy. My prime example of this is one day a guy brought in a horrid forgery of a script for a narcotic and so as due with law, we contacted doctor and doctor said call the police. He returned a few hours later, we called police and he was arrested with is child present.

After he paid bail or what not, being a few days later, we received a call from our DM saying that we are no longer allowed to call the police on such cases w/o authorization directly from him due to our irresponsibility in this incident [due to child being present, the man attempted to sue]. Along with that, the Pharmacist in Charge had a write-up issued.

So in sum, has this style of pharmacy ruined "pharmacy?" Possibly, it all depends in what you expect to derive from "pharmacy."
 
Not that I am disagreeing with any of you...

But the whole gamut of retail pharmacies is only the answer to Americas cry for convenience and speed. Having worked in a pharmacy for a little over a year, CVS to be exact, I see and feel the stresses myself. Hell, even today I had 45 year old woman scream and spit at me when I told her that her medicaid drug was not available in generic and she'd have a copay of $10 instead of $2.

But what people fail to realize is that above the store level pharmacy is nothing but people who are there for business and have no clue of the laws of pharmacy. My prime example of this is one day a guy brought in a horrid forgery of a script for a narcotic and so as due with law, we contacted doctor and doctor said call the police. He returned a few hours later, we called police and he was arrested with is child present.

After he paid bail or what not, being a few days later, we received a call from our DM saying that we are no longer allowed to call the police on such cases w/o authorization directly from him due to our irresponsibility in this incident [due to child being present, the man attempted to sue]. Along with that, the Pharmacist in Charge had a write-up issued.

So in sum, has this style of pharmacy ruined "pharmacy?" Possibly, it all depends in what you expect to derive from "pharmacy."

Frankly, I've never seen a pharmacist call the police. Getting involved with the police seems like it would waste too much time and stress.
 
Frankly, I've never seen a pharmacist call the police. Getting involved with the police seems like it would waste too much time and stress.

I don't understand why it's a waste of time to call the cops? Would you rather get into a fight with an addict? Sometimes, you just have to use common sense.
 
Is Walgreens doing the coupons now too? I saw one that we (CVS) price matched today. My PIC said she got one in the mail and was wondering if she could get it priced matched. It is probably good that Walgreens is doing it, maybe then after everyone price-matching the other stores coupons, it will eventually find out that it isn't getting the business like it used to and everyone will stop. What are y'alls thoughts?
 
When the corporations step in, this just means more people have to work. Instead of a Nurse Practitioner working in an office from 8-5, the NP would have to work different shifts like a pharmacist. Why can't health care people have normal hours like 8-5?? Heck I would go for 8-7.
 
If you must ask then you are beyond explaining.....

First of all, I'm not a pharmacist, and I'm not planning to become one. I was a health care professional for over 20 years in the military and was witness to a great deal of evolution and change in the standard of care in that setting (for example, when I was pregnant with my now 23-year-old, ultrasound exams were rare, but now they're almost routine). I left direct healthcare about 10 years ago and went into administration, and have since moved on to education (non-health care).

However- I asked the question to find out if the person who made the statement was willing and/or able to articulate an opinion on it. It would be interesting to me to find out if the opinion came from someone who has been in pharmacy for a long time (and could offer a brief comparison), or if the statement came from someone who recently became a pharmacist (in which case, I'd wonder how a corporate impact could affect a whole system so quickly).

Personally, I think an attitude of "If you don't understand, then I'm not going to be bothered with you" is pretty dangerous in a healthcare setting, too. I wasn't trying to be glib; I am genuinely curious about the destructive powers of Walgreens and CVS. As a consumer, my opinion of Walgreens is actually quite high, as they've been incredibly helpful in a situation that involves my family, but I'm open to other opinions.

So come on.... if you're willing to give the input and opinions, I'm willing to read them.
 
Advertisement - Members don't see this ad
When the corporations step in, this just means more people have to work. Instead of a Nurse Practitioner working in an office from 8-5, the NP would have to work different shifts like a pharmacist. Why can't health care people have normal hours like 8-5?? Heck I would go for 8-7.

That would be a nice idea if people only got sick or hurt from 8-5 M-F. The reality is they don't so we don't get to work 8-5. I figure if you want normal hours get a desk job in a cubie somewhere.
 
First of all, I'm not a pharmacist, and I'm not planning to become one. I was a health care professional for over 20 years in the military and have moved on to education.

However- I asked the question to find out if the person who made the statement was willing and/or able to articulate an opinion on it.

Personally, I think an attitude of "If you don't understand, then I'm not going to be bothered with you" is pretty dangerous in a healthcare setting, too.

So what are you doing hanging around a pharmacy forum? Not that I want you to feel unwelcome. It seems a strange place to hang out if you have never been in the profession and are not planning to get into it....
 
Not that I am disagreeing with any of you...

But the whole gamut of retail pharmacies is only the answer to Americas cry for convenience and speed. Having worked in a pharmacy for a little over a year, CVS to be exact, I see and feel the stresses myself. Hell, even today I had 45 year old woman scream and spit at me when I told her that her medicaid drug was not available in generic and she'd have a copay of $10 instead of $2.

But what people fail to realize is that above the store level pharmacy is nothing but people who are there for business and have no clue of the laws of pharmacy. My prime example of this is one day a guy brought in a horrid forgery of a script for a narcotic and so as due with law, we contacted doctor and doctor said call the police. He returned a few hours later, we called police and he was arrested with is child present.

After he paid bail or what not, being a few days later, we received a call from our DM saying that we are no longer allowed to call the police on such cases w/o authorization directly from him due to our irresponsibility in this incident [due to child being present, the man attempted to sue]. Along with that, the Pharmacist in Charge had a write-up issued.

So in sum, has this style of pharmacy ruined "pharmacy?" Possibly, it all depends in what you expect to derive from "pharmacy."

Same thing happened in our company. Supervisior said he had to be notified along with store managemnet before anyone could call the police. There attitude is fill, fill ,fill and don't cause any problems. When we get an obvious forgery or any other problem we tell the customer we can't fill it and they leave.
 
So what are you doing hanging around a pharmacy forum? Not that I want you to feel unwelcome. It seems a strange place to hang out if you have never been in the profession and are not planning to get into it....

Lol.... reasonable question.

I found the forum while searching for information for my daughter, who's trying to get into school. I do miss health care (to a certain extent), and the forum is pretty interesting, so I hung out. I'll probably go away eventually after she gets admitted and is in school, but to this point, I've gotten a ton of great information from here and have been able to pass it on to her (she doesn't do forums).

Sometimes my perspective on things has been helpful around here, and I've never tried to pass myself off as a pharmacy professional. Still, my perspective on certain things (like grad/prof school admisions, and the ever-present 'I just figured out I want to be a pharmacist, how do I do that TODAY' questions) that has been helpful (I think).
 
First of all, I'm not a pharmacist, and I'm not planning to become one. I was a health care professional for over 20 years in the military and was witness to a great deal of evolution and change in the standard of care in that setting (for example, when I was pregnant with my now 23-year-old, ultrasound exams were rare, but now they're almost routine). I left direct healthcare about 10 years ago and went into administration, and have since moved on to education (non-health care).

However- I asked the question to find out if the person who made the statement was willing and/or able to articulate an opinion on it. It would be interesting to me to find out if the opinion came from someone who has been in pharmacy for a long time (and could offer a brief comparison), or if the statement came from someone who recently became a pharmacist (in which case, I'd wonder how a corporate impact could affect a whole system so quickly).

Personally, I think an attitude of "If you don't understand, then I'm not going to be bothered with you" is pretty dangerous in a healthcare setting, too. I wasn't trying to be glib; I am genuinely curious about the destructive powers of Walgreens and CVS. As a consumer, my opinion of Walgreens is actually quite high, as they've been incredibly helpful in a situation that involves my family, but I'm open to other opinions.

So come on.... if you're willing to give the input and opinions, I'm willing to read them.

I've gotta go to work "in the system", but I'll try to answer your question briefly, having been someone who has been in the system for a long, long time.

We like to bash CVS, Walgreens, etc....all the big corporations, but they are filling a niche - that is the desire for society right now to have what they want "fast & cheap". They don't necessarily care for quality or service - which is why you don't expect the toaster your daughter might get as a wedding present to last her married life. When it breaks, it doesn't get fixed - it gets tossed.

In pharmacy, many people just want the drug fast & they certainly want it cheap. Why do we hate coupons? For a number of reasons - a coupon shopper doesn't really care about the care & service you give as a pharmacist - obviously - they're willing to transfer part of their records out to seek $15. For us, we see that to be short sighted because we've all been put in the position of having to transfer back an rx into a file which now has an interacting drug. No one probably knew about it - probably not even the prescribers since these same people often will doctor shop. Transferring rxs is also time consuming.

Now - why do some of us dislike the CVS/Walgreens urgent care places? Because it adds to this "drop in" mentality of medicine - something like getting your nails done by just walking into the shop. They don't have your medical record. Its easy to tell them just exactly what you want to tell them to get what you want (most don't want amoxicillin). Those who do use these walk in clinics for things like inhalers, steroid creams, vaginal antifungal rxs....often have medical issues which need to be followed by a physician (yeah he can have an NP or PA) - but the point is continuity of care. Corporations don't particularly care about continuity - hence the "ruining" of pharmacy comments. When your own employer is offering to encourage the transfer of business from another pharmacy - it fine for the business, but goes against the grain of us as pharmacists. We respect our colleagues & what they provide for their patients in the way of pharmaceutical services and we hate to see that care be interrupted by a $15 coupond. Likewise, our colleagues treat us with the same respect.

Is this the fault of the corporations - no. They're filling an economic niche which society created. You like Walgreens & you probably like their coupons. However, they are notorious for working their pharmacists excessively (as is CVS) & some of these corporations put rx #s and speed above quality of care. You don't see that as a consumer and probably don't even care about the time it takes us to really fill your rx correctly.

But, to call our attitude "dangerous" is a huge assumption. Many of the people on this forum work in dangerous situations & directly because corporations don't care about the professionalism we once valued highly. Before you get too judgemental about those of us who disparage corporate pharmacy culture, spend some time reading this forum. It really is too long a process to explain how medicine in general & pharmacy, in particular have changed in 20 years - thats what Mountain was trying to get across.

I've really gotta get to work now.....but thats a nutshell & very, very basic.

Corporations are in this for the money - not for public health & they are filling a gap which exists within society right now - difficult access to healthcare. This discussion is better suited (& has gone on) in Topics in Healthcare, IMO.
 
Is this the fault of the corporations - no. They're filling an economic niche which society created. You like Walgreens & you probably like their coupons. However, they are notorious for working their pharmacists excessively (as is CVS) & some of these corporations put rx #s and speed above quality of care. You don't see that as a consumer and probably don't even care about the time it takes us to really fill your rx correctly.

But, to call our attitude "dangerous" is a huge assumption. Many of the people on this forum work in dangerous situations & directly because corporations don't care about the professionalism we once valued highly. Before you get too judgemental about those of us who disparage corporate pharmacy culture, spend some time reading this forum. It really is too long a process to explain how medicine in general & pharmacy, in particular have changed in 20 years - thats what Mountain was trying to get across.

Thanks for the response; I'll go check out the Topics section for more. ;-)

Now then- was my "huge assumption" about the earlier responses any huge-r of an assumption that my question wasn't worth answering? We all make asusmptions, we all make judgments in out daily life. I understand that pharmacists work in dangerous situations, but I would counter that with a lot of other workers in a lot of other fields, many of them considerably dirtier and less prestigious or financially appealing than pharmacy in particular and healthcare in general. Reference mining in the past week or so.....

I would say that a lot of fields have changed considerably over the past 20 years. Really, the fields that don't change with the times are often overrun by up-and-coming technology (for example, how many pay phones now compared to 20 years ago?). People who don't change with the industry are quickly identified as dinosaurs at best, or become molasses in the works and actually hinder the facility/company/corporation/field.

But yeah, I understand this isn't the right place for this discussion, so I'll meander over to the Topics section.

I do appreciate your thoughts on this, though. Have a good day. 🙂
 
On the subject of Retail health Clinics, I think they are long overdue.
 
If a DM told me to not call the police without his permission if someone tried to pull forgery on my watch, I would promptly tell him to **** off. I'm not going to be an accessory to a crime. What are they going to do, fire you? Yeah, let's see what they say when you sue their asses for wrongful termination.
 
I am not against these clinics but I don't like the idea that they are own and run by CVS, Walgreens because they pretty much ruined the pharmacy profession.

Wow!!! What a completely idiotic statement. You can blame the demise of Pharmacy on two groups of people. Neither of them have headquarters in Rhode Island (CVS) or Chicago (Walgreens).

The first seismic event in the destruction of community pharmacy practice was made by the Republican members of The House of Representatives and The United States Senate. When this group decided to destroy President Clinton's Health Care Plan (not that as a good plan) without offering a plan of their own, they basically said we have no interest in involving ourselves in this issue unless we can use it as a club against our opponents. That meant, NO politician would meddle in this area for a long time for fear of losing his/her job.

Enter the real destroyers of community pharmacy, the insurance industry and their good friends, the P.B.M.'s. IN the middle nineties is when these two combined to reduce pharmacy reimbursement to the point where we are now. Pharmacy is piece work. You need to fill a great deal of prescriptions to make a living. This is when all of the small community pharmacies started to disappear across the country.

As someone who worked for independent pharmacies for almost 20 years, I would have been happy to be right next door to a Walgreens or CVS. We always offered more personal service than the chains could. You just can't do it at AWP-18% +1.25.

CVS and Walgeens would be happy to have the reimbursement of the late 80's. They struggle with the profit margins at this level of reimbursement.

So, DON'T blame this on the chains. It's the PBM's that have destroyed the practice of pharmacy at the community level. The politicians opened the door and the PBM's took advantage of this cowardly action.
 
If a DM told me to not call the police without his permission if someone tried to pull forgery on my watch, I would promptly tell him to **** off. I'm not going to be an accessory to a crime. What are they going to do, fire you? Yeah, let's see what they say when you sue their asses for wrongful termination.

Exactly...

I was about to post to this effect, but wanted to see if someone else would come to this realisation, instead. 👍

Follow the law. Narcotics laws are not 'red tape', they are there to serve an important purpose, and should NEVER be sacrificed for the sake of expediency in dispensing, no matter who tells you to. As a pharmacist, you're the one there with the license, and it's your duty to be a partner in the prevention of drug diversion.

And regarding the details of that incident, itself... If described accurately, the PIC actually had acted in the best interest of the child, as well, by reporting a drug abuse crime. And, who knows, someone walking in with a forged Rx for a narcotic, with a child at the counter- it may not even have been his kid, and there are implications of child endangerment and abuse, as well as contributing to the delinquency of a minor. As a pharmacist, s/he was MANDATED under a proponderance of drug enforcement laws, child endangerment laws, etc, and etc, to report to the proper authorities.
 
Well we have kind of taken this topic in 5 different directions. Thats okay kind of boring around here lately.

The problem with forged scripts is getting verification in a timely manner that the RX was forged or altered. I am not about to break the law and I do my best to insure all rx's are legit. I am not going to accuse someone of forging a prescription unless I know for a fact it is forged. Come on it takes two days for a Doctor's office to get back to me on a drug interaction question. By the time I call and leave messages and get put on hold the alleged forger is long gone.

My philosophy is everyone who is genuinely in need of a controlled substances gets it without any more hassles than a normal rx. If a few people get over on me than that’s fine. The bottom line is I want the people who need the meds to get it.

The flip side of that is an attitude that quite a few pharmacists have in my company. They assume everyone getting as controlled substance is a drug abuser. They look for any reason not fill controlled substances. I do not think this is good patient care or a good buisiness practice.
 
Poor physicians. Poor pharmacists. The system is broken and no one can fix it. Stop whining and get back to work or find another profession to darken with your pessimism.

No job is perfect, but I will create the environment in my pharmacy. Corporate can tell me what signs to put up and establish inventory control policies, but the delivery of healthcare will be up to me. If I have to call the police twice a week to maintain what I've created, so be it. If a corporation is stupid enough to squander the resource that I am, there's another job just up the street.

I support the idea (as it's presented) of health clinics. I encounter people on a daily basis who have to scrounge around for healthcare. As long as the services are provided for a reasonable fee, I don't care who provides them.
 
..So, DON'T blame this on the chains. It's the PBM's that have destroyed the practice of pharmacy at the community level. The politicians opened the door and the PBM's took advantage of this cowardly action.

and CVS doesn't own Caremark and PharmaCare, two of the biggest PBMs in the world? And doesn't Walgreens also own Walgreens Health Initiatives (WHI), another huge PBM? Before you call someone an idiot, get your facts right first. Don't reply to my post just yet; just clam down, take a couple of xanxa and let this swirl in your head first.

You are a great mentor. Keep up the good work, old timer.
 
No disrespect to anyone but,


THAT WAS SUCH A BURN!!!! lol.


Enjoying reading this thread.
 
Thanks for the response; I'll go check out the Topics section for more. ;-)

Now then- was my "huge assumption" about the earlier responses any huge-r of an assumption that my question wasn't worth answering? We all make asusmptions, we all make judgments in out daily life. I understand that pharmacists work in dangerous situations, but I would counter that with a lot of other workers in a lot of other fields, many of them considerably dirtier and less prestigious or financially appealing than pharmacy in particular and healthcare in general. Reference mining in the past week or so.....

I would say that a lot of fields have changed considerably over the past 20 years. Really, the fields that don't change with the times are often overrun by up-and-coming technology (for example, how many pay phones now compared to 20 years ago?). People who don't change with the industry are quickly identified as dinosaurs at best, or become molasses in the works and actually hinder the facility/company/corporation/field.

But yeah, I understand this isn't the right place for this discussion, so I'll meander over to the Topics section.

I do appreciate your thoughts on this, though. Have a good day. 🙂

You're very welcome!

And - yes....your "huge" assumption was huge-r (sic) than the assumption that the question was not worth answering simply because most of us come here with some perspective on the field. You, admittedly, don't.

If you want to contribute something - great - contribute. Your opinion as a consumer is certainly as valid as any other consumer. We appreciate your input as a consumer. But, if you're here to ask a question, which might have been addressed a number of times - either here or on other forums...then, yes....the assumption becomes a bit disconcerting. I've often suggested someone use the search function to get an answer to a previously asked question. I honestly don't understand how choosing not to educate you on the complicated ins and outs of politics, PBMs, corporate influences, MACs, AWPs, AMPs, etc....could be interpreted by you as "dangerous".

There have been many, many topics on this forum about the problems pharmacists have with staffing, external pressures, laws, restrictions - it goes on and on.

I'm not sure what your reference to changing with technology has to do with this topic. Pharmacy has undergone many, many changes most of which you'd have absolutely no knowledge of & it would be beyond this thread to go into the detail.

You reference to miners has no bearing here - we are not miners nor do we compare our jobs nor our job risk to miners. This is not a matter of how "dirty, prestigious or finanacially appealing" the job is. The point originally made was the influence large corporations have had - not just the practice of pharmacy, but the inroads they are making into medicine. It is a professinal argument Is that a good thing or a bad thing? Probably neither. There are certainly arguments to be made for all sides & there will ultimately be some kind of "place" for them - just as there are for any kind of alternative care.

However....if you have no knowledge of any of the political & professional factors which influence how we feel, but are interested for your daughter's sake - just lurk and read more threads. Don't get bent out of shape because we don't want to go over the same road we've traveled many times before.

As you've seen....there are many, many opinions within the professional community - and....they're all valid!!! You've got opinions from young pharmacists, who as Mountain has said have taken this thread on one direction - a valid one - pressure put on independent decision making of a pharmacist by a coporate supervisor to override an on-the-spot decision.

Then - you have the opinion of Old Timer who has a long history of an independent, with his perspective on the political pressures of the 80's & 90's & the developments of the PBMs. Again, one to be respected.

My history is as long as Old Timer's but different as I've been (& still am) in the practice of both inpt & outpt....so, I'm more of the opinion that the system is broken so the clinics offer a "place" for those who can't find the resources to get care - someone mentioned that earlier.

But, that does not negate the influence, which, IMO, will always be negative - the influence the large corporations will have on independent medical decisions. That is one of the basic reasons why a century ago it was decided that a physician could not own a pharmacy.

Now.....one wonders - why can a pharmacy "own" a medical clinic??????

This is an extremely complicated & difficult problem within healthcare & one in which many of us who are in the business have a hard time sorting out and certainly it is widely debated within the political realm.

Forgive us for not wanting to spend the time to go over the extensive history.
 
Advertisement - Members don't see this ad
You're very welcome!

And - yes....your "huge" assumption was huge-r (sic) than the assumption that the question was not worth answering simply because most of us come here with some perspective on the field. You, admittedly, don't.

If you want to contribute something - great - contribute. Your opinion as a consumer is certainly as valid as any other consumer. We appreciate your input as a consumer. But, if you're here to ask a question, which might have been addressed a number of times - either here or on other forums...then, yes....the assumption becomes a bit disconcerting. I've often suggested someone use the search function to get an answer to a previously asked question. I honestly don't understand how choosing not to educate you on the complicated ins and outs of politics, PBMs, corporate influences, MACs, AWPs, AMPs, etc....could be interpreted by you as "dangerous".

There have been many, many topics on this forum about the problems pharmacists have with staffing, external pressures, laws, restrictions - it goes on and on.

I'm not sure what your reference to changing with technology has to do with this topic. Pharmacy has undergone many, many changes most of which you'd have absolutely no knowledge of & it would be beyond this thread to go into the detail.

You reference to miners has no bearing here - we are not miners nor do we compare our jobs nor our job risk to miners. This is not a matter of how "dirty, prestigious or finanacially appealing" the job is. The point originally made was the influence large corporations have had - not just the practice of pharmacy, but the inroads they are making into medicine. It is a professinal argument Is that a good thing or a bad thing? Probably neither. There are certainly arguments to be made for all sides & there will ultimately be some kind of "place" for them - just as there are for any kind of alternative care.

However....if you have no knowledge of any of the political & professional factors which influence how we feel, but are interested for your daughter's sake - just lurk and read more threads. Don't get bent out of shape because we don't want to go over the same road we've traveled many times before.

As you've seen....there are many, many opinions within the professional community - and....they're all valid!!! You've got opinions from young pharmacists, who as Mountain has said have taken this thread on one direction - a valid one - pressure put on independent decision making of a pharmacist by a coporate supervisor to override an on-the-spot decision.

Then - you have the opinion of Old Timer who has a long history of an independent, with his perspective on the political pressures of the 80's & 90's & the developments of the PBMs. Again, one to be respected.

My history is as long as Old Timer's but different as I've been (& still am) in the practice of both inpt & outpt....so, I'm more of the opinion that the system is broken so the clinics offer a "place" for those who can't find the resources to get care - someone mentioned that earlier.

But, that does not negate the influence, which, IMO, will always be negative - the influence the large corporations will have on independent medical decisions. That is one of the basic reasons why a century ago it was decided that a physician could not own a pharmacy.

Now.....one wonders - why can a pharmacy "own" a medical clinic??????

This is an extremely complicated & difficult problem within healthcare & one in which many of us who are in the business have a hard time sorting out and certainly it is widely debated within the political realm.

Forgive us for not wanting to spend the time to go over the extensive history.

👍
 
and CVS doesn't own Caremark and PharmaCare, two of the biggest PBMs in the world? And doesn't Walgreens also own Walgreens Health Initiatives (WHI), another huge PBM? Before you call someone an idiot, get your facts right first. Don't reply to my post just yet; just clam down, take a couple of xanxa and let this swirl in your head first.

You are a great mentor. Keep up the good work, old timer.

I don't need Xanax. CVS did not by Caremark until 2 months ago, not in the early 1990's. WHI and Pharmacare are bit players in the PBM market with Medco, Caremark and Express Scripts as the big players. The resultant control of the market by PBM's allowed by our *****ic politicians is waht caused CVS to need to bou Caremark.

So keep to the facts. It's the declining reimbursement that turned community pharmacy into high volume, high stress piece work. It's the PBM's that drove the reimbursement down. It's the politicians who are owned by the PBM's that created the conditions. The only thing I did not factor in is the greed of the Drug Companies whose price increases rival third world inflation rates.

If you want to dispute what I said, bring some facts. Until then, your premise that the chain industry caused what happened to community pharmacy remains false and misguided. They reacted to the market conditions, they did not drive the market conditions...
 
If you want to dispute what I said, bring some facts. Until then, your premise that the chain industry caused what happened to community pharmacy remains false and misguided.

I did not say the retails ruined community pharmacy but rather the professional practice of pharmacy. Pharmacy is much more than just community pharmacy. This is a direct quote (yes I am quoting myself):

I am not against these clinics but I don't like the idea that they are own and run by CVS, Walgreens because they pretty much ruined the pharmacy profession.

Don't ask me to give you facts on something I did not say.
 
I agree with you that it is the PBM's fault that reimbursement is so low. However, couldn't the big chains all refuse to get in contracts or not accept these PBM's? In my opinion, that is the only way reimbursements will increase is if the big chains stop taking the plans (even though this will probably never happen).
 
Not only is reimbursement low but also the cost of drugs is much higher for community pharmacy, just a couple of reasons why community pharmacy is suffering. No business is going to pay you more than it needs to. That's just business. That's capitalism.

In addition, the retails can negotiate better terms because of their numbers and frankly the PBMs believe they don't need community pharmacies as long as they have the retails. The retail chains are making record profits because of their negotiating power but also because they have expanded their business beyond traditional pharmacy including PBMs.
 
I did not say the retails ruined community pharmacy but rather the professional practice of pharmacy. Pharmacy is much more than just community pharmacy. This is a direct quote (yes I am quoting myself):
Don't ask me to give you facts on something I did not say.

They are one in the same. The reason the chains put so much pressure on the pharmacists is because as reimbursement falls productivity must rise. Rising productivity means more output per unit of time. That is what destroyed the practice of pharmacy at the community level.

However, couldn't the big chains all refuse to get in contracts or not accept these PBM's? In my opinion, that is the only way reimbursements will increase is if the big chains stop taking the plans (even though this will probably never happen).

That would be a violation of the Anti-trust laws. Which by the way, the insurance industry (along with Major League Baseball) is exempt. There are some contracts CVS refuses to sign and I am sure the same is true of Walgreens.
 
They are one in the same. The reason the chains put so much pressure on the pharmacists is because as reimbursement falls productivity must rise. Rising productivity means more output per unit of time. That is what destroyed the practice of pharmacy at the community level.
.
By saying this, you are agreeing that the retails have harmed the practice of pharmacy including community pharmacy. Those are your words, not mine.
 
I'm not agreeing with you at all. That was chains reaction to the reduction in reimbursement. That is the cause. Independents have done the same thing or gone out of business. You have no choice. You have to do more. The chains would not be doing what they are doing w/o the reduction in reimbursement.
 
Do you honestly think the chains started to put pressure on pharmacists just when the PBMs reduced reimbursement? It has always been "get them in and out ASAP". That is the retail mentality. That's how it was, how it is and how it will be. Didn't Walgreens start the drive thru concept years before the PBMs started to reduce reimbursement? So, don't tell me the PBMs indirectly created the retail pharmacy concept. You can't blame the PBMs on this one.
 
i HAVE called the police, twice, as an intern. once, the pharmacist found a forgery. the second time, the patient threatened both myself and the pharmacist [she didn't like her generic fiorinal, thought we were intent on killing her, and wanted to settle the score with her fists] so we had the cops meet her at the store when she came in for said a$$ kicking.

i now, happily, work in a hospital!
:hardy:
 
Do you honestly think the chains started to put pressure on pharmacists just when the PBMs reduced reimbursement? It has always been "get them in and out ASAP". That is the retail mentality. That's how it was, how it is and how it will be. Didn't Walgreens start the drive thru concept years before the PBMs started to reduce reimbursement? So, don't tell me the PBMs indirectly created the retail pharmacy concept. You can't blame the PBMs on this one.

Gee the mother of a sick child who just came form the pediatrician or the caregiver on the way home from the hospital with a discharged patient sees the drive through as reduced/unprofessional service....
 
I wonder how she got her prescriptions before the drive thru was created? How would a poor mother be able to feed her sicken child without the transfer coupon? When you can't make an argument, just use a sick child. For example, the PBMs are reducing reimbursement so they can pass on the saving to poor families with a sick child. So, you shouldn't complain, old timer.

I am in no way supporting the PBMs but it is a stretch to blame the PBMs for creating the retail pharmacy concept. You can't blame Caremark and PharmaCare, but then support CVS. You can't blame WHI, but then support Walgreens. These huge PBMs are own by your pals, CVS and Walgreens.
 
Gee the mother of a sick child who just came form the pediatrician or the caregiver on the way home from the hospital with a discharged patient sees the drive through as reduced/unprofessional service....


in my mind, a store with a drive through is completely degrading. i didn't spend six years of my life in college to work in a window like i'm selling french fries.

how can you possibly deliver good care when shouting into a microphone. and, all i every hear from people is horror stories.
exhibit A:
http://fastfoodpharmacy.blogspot.com/2007/08/heat-makes-em-crazy.html
 
in my mind, a store with a drive through is completely degrading. i didn't spend six years of my life in college to work in a window like i'm selling french fries.

how can you possibly deliver good care when shouting into a microphone. and, all i every hear from people is horror stories.
exhibit A:
http://fastfoodpharmacy.blogspot.com/2007/08/heat-makes-em-crazy.html

👍

sorry Old Timer - gotta agree here. There is absolutely NO good way to counsel that mom with a sick child in the car via a drive thru.

You lose all the facial/physical responses that you get when you try to counsel a pt/parent & there is no way you can "show" how to draw that oral syringe down to 1.2ml to give the child decadon, ranitidine or whatever.

Drive thrus are a curse on pharmacy & IMO (opinion only) an insult to our professionalism.
 
Now....lets bring things a bit up to date so you can all follow the Senate & House hearings.

Community pharmacy is united in its support of a bill sponsored by Nancy Boyda (D-Kan) & Jo Ann Emerson (R-MO) that would reimburse Medicaid participating pharmacies (nearly all) based on RAC (retail acquisition cost = what the pharmacies pay vs AMP = average manufacturer price).

This bill is an attempt to fix a huge flaw in the currently approved Medicaid pharmacy reimbursement legislation (Deficit Reductin Act of 2005 = DRA) which changes payment from AWP = average wholesale price to AMP (a 30% loss on each Medicaid rx).

The current DRA limits Medicaid payment for generic drugs at 250% of the lowest AMP for a particular drug. Small community pharmacies cannot purchase generics at the prices chain pharmacies can. Nor can they negotiate the rebates with wholesalers. (Hard to believe, but this is really true!).

Additionally, the DRA expands the number of drug products subject to federal limits & there is no corresponding requirement that states (which is a state determination) must adjust dispensing fees to compensate accurately for the actual costs associated with operating & providing professional services.

In short - this is catastrophic for small local pharmacies & actually for chain pharmacies in small rural towns (WVU - are you listening???) Some pharmacies are considering one of the few options available - not accept Medicaid (sometimes a whole community population), close completely (sell out to a chain), or continue to do business & go bankrupt (sometimes a viable option, if there is a lot of debt).

Sooooo....what can chains do that small local pharmacies cannot do? They can purchase & "subsidize" the lower performing locations.

Just to pick out one chain - Walgreens (altho...I could cite many, many chains - I don't have a bone to pick particularly with Walgreens). What have they done to expand & "pick up" extra monetary income to make up for the loss in lower served areas? Well - they paid $850 million dollars for Option Care Inc which provides home infusion services to 40,000 patients via 100 pharmacies.

This is the fifth acquisition Walgreens has made in the last 2 years to strengthen its position - both in the pharmacy market & financially. It has acquired TakeCare Health Systems in June (your in-store health clinics), Medmark Specialty Pharmacy Solutions, SeniorMed (a provider to residents in assisted living & Schraft's A Specialty Pharmacy (a national provider of advanced fertility medications).

They have come right out & said, their focus is on high utlilization patients.

Although, Old Timer, I might have agreed with you 10 years ago that PBMs were the reason for the initial demise.....currently it is the corporate ability to buy out the competition and the current administration's desire to decrease payment to all healthcare providers (medicine, dentistry, pharmcy...there is NO dentist in my county which will take Medicaid as payment for dental services).

Corporations have the money & they have the ability to consume & destroy anyone who might stand in their way. The beauty of it is, though.....they'll hire anyone - someone who'll respond to their blinking buttons & time frames. So - their customer service "stinks" No number of coupons wil keep people there who are treated poorly or who can't take time to speak with a pharmacist in depth. So, they still get transfers out. But, they might get that mom thru the drive-thru - particularly when its for an amox rx which the child has received about 5 times before. They don't want your consultation & it really does fall on deaf ears.

All it will take is for corporate pharmacists to stand up & say - no, I'm not going to pay any attention to your blinking buttons on how fast I process an rx - or whatever. I know that mom has gotten amox 5 times before...but,what I really do need to ask is - is she finishing the whole thing? Does the daycare provider give the dose? Can I "fish out" if there is a money issue & is she giving it to 2 kids as well as one? You can't get this stuff out of a drive thru & you can't get it if you're so busy you're robotically reading the label & watching mom's head go up & down. You gotta get to know mom, but you won't do that thru a drive thru. But - you get your numbers & that is what the corporation looks for. Unfortunately, that is what we as professionals have "settled" for as well.

Seriously - I KNOW Option Care & their pharmacists. They will do what they want & need to do in the time frame they need to do it in - NOT what some corporation says. All you have to say is - what is the risk of a mis-mix of a 5 day 5-FU infusion??? Trust me - they don't have any blinking lights when they're mixing a chemo pump or 7 tpns for a pt. But - amox suspension - not so much, perhaps.....

Don't you think the corporations have talked long & hard about the 20/20 segment??? I know the one I work for when I do retail has & the emphasis has been significantly reinforced that pts must be counseled (a CA state law) & KNOW exactly what they are signing for. If you can't counsel (due to language or other inability, you decline the rx & find someone in the area who can provide sufficient services in the language required.)
 
Advertisement - Members don't see this ad