Wednesday, June 29, 2011

The Grass Isn't Always Greener

I've been a pharmacist for many years now.

I personally know that there are positive and negative aspects to each area of the profession, whether retail, long-term care, hospital, or any other place that pharmacists are trying to escape. But, when it comes to decision-making in the workplace, no practice area is much better than the next.

So, let me tell you that that the grass isn't greener wherever you decide to go.

It doesn't matter where you decide to practice pharmacy, in every aspect of pharmacy, you aren't in control of your own professional destiny. Someone else will always be dictating your actions, and many times it won't be another pharmacist.

Wake up! Don't try to fool yourself. You can run all you want, but you can't escape it. Whether you practice retail pharmacy in Ohio, or hospital pharmacy in Alabama, there will always be someone else writing the rules and telling you how to practice your profession.

NOAH AND THE WHALE "Life Is Life" from john carrafa on Vimeo.

Saturday, June 25, 2011

ZDoggMD Calls Out The Sucker MDs

As ACynicPharmD, I think he makes a good point about the TV show docs, but you decide.

According to ZDoggMD -
He may have started out with good intentions, but his current incarnation foists hype, pseudoscience, and unproven “alternative” treatments upon millions of unsuspecting Americans who believe that his is the final word. After all, he has been duly annointed by She-Who-Shall-Not-Be-Named!

Source: ZDoggMD, Slightly Funnier Than Placebo

Keep Your Eyes Open And Your Wallet Shut

Are you still buying homeopathic products even after knowing that they don't contain any measurable active medication? Then put your wallet down and listen to Randi.

James Randi, best known as the world's most tireless investigator of pseudoscientific claims, continues to offer his still-unclaimed million-dollar reward for anyone who can produce evidence of paranormal abilities under controlled conditions.

Source: James Randi Educational Foundation

Wednesday, June 22, 2011

Stronger - A Short Documentary

Is winning so important? What do you gain by "winning", a small award and the approval of a few people who won't remember your name a week from now? You can be just as healthy and look just as good as this extremely honest gentleman well into middle-age and beyond without having to transition into the "dark side" of bodybuilding.

[Video link remove by source]

Tuesday, June 21, 2011

Blues Is A Healer

It's not always a pill that'll cure your ill. Sometimes, all it takes is the blues. But, don't just take my word for it. See what Carlos Santana and John Lee Hooker have to say about it.

Monday, June 20, 2011

Disco Can Save Your Life

This is no charade. Disco can save your life. Whether you're a brother or whether you're a mother, you're stayin' alive, stayin' alive - with hands-only CPR.

Source: American Heart Association

Sunday, June 19, 2011

The Meth Epidemic Follow-up

As a pharmacist being forced to become the local pseudoephedrine police, have you ever wondered why individual American States, instead of the Federal Government, have been burdened with combating the meth epidemic? Have you ever thought that perhaps big pharma had something to do with it? No way, right?

"The Meth Epidemic" follow-up tells the story of two potential solutions to the meth crisis and examines why neither was fully tried. It'll probably lessen your faith in our political leaders.

In the updated May 2011 film, FRONTLINE continues its investigation, this time focusing on how new policies in both the U.S. and Mexico have changed the cooking process in America — from the stockpiling of cold medicines by "super smurfs" to a new and dangerous method of meth cooking called "shake and bake."

In addition, after FRONTLINE'S original broadcast of the meth epidemic, the State of Oregon has passed new legislation to make pseudoephedrine prescription-only. State officials say the measure has all but eradicated meth abuse there. Are other states poised to follow suit?

Here's chapter 1/4 of "The Meth Epidemic" follow-up. Chapters 2-4 tell the real story.

[Original video link removed by source]

Saturday, June 18, 2011

Here Is.. The Night Shift Pharmacist

You dope fiends have really screwed the pooch with your drug seeking behaviors.

You have no idea what your constant pharmacy robberies have done to the retail pharmacist psyche, especially the night-shift pharmacists who are already live close to the edge anyway. Some of these pharmacists have vowed not to take it anymore, and are hoping for a fight.

Better seek help for your addiction problems while you can because I pity the next foolish armed criminal who tries to rob one of these guys. You'll need pain pills afterwards.

Friday, June 17, 2011

Florida Independent Pharmacists Are Tough

What was it that caused Florida to become the "pill-mill" hotbed state? Of all of doctors that dispense oxycodone in the United States, 85% of all the oxycodone carriers are in Florida.

Was it because of a lack of law enforcement against suspicious pharmacists?

I don't think anyone really knows the reason, but I wonder if the attitude of some independent pharmacists contributed to lawmakers finally cracking down on pill mills, increasing the liability of all community pharmacists, and almost legislating smaller, but honest, independents out of being able to provide pain care?

So, I talked to a few law enforcement officials about the problem. They said that some Florida independent pharmacists were uncooperative, and didn't seem as though they wanted to help address the problem, especially the ones whom law enforcement deemed suspicious.

As would be expected with criminals robbing independent pharmacies left and right, and with corrupt politicians and corporate competitors seemingly set on putting them out of business, I can understand why independent pharmacists have become so tough throughout the years, and perhaps a little gruff and uncooperative. But were they that uncooperative?

Those officials also sympathized with the law-abiding independent pharmacists' plight, but said something had to be done to stem the prolific prescription drug abuse problem. They then showed me this video of police officers cross-examining just one of the prolific pill-mill pharmacists located in South Florida.

Now I think I can understand law enforcement's side of the issue, he's one tough pharmacist. Maybe their uncooperative attitudes did have something to do with creating these new laws.

Wednesday, June 15, 2011

The Real Drug Nazi

Yes, there really was a pharmacist whom the world considered "The Drug Nazi".

His name was Victor Capesius, and he was the SS pharmacist-in-charge at the concentration camp Auschwitz nearing the end of World War II. It has been estimated, among other crimes against humanity, that he was personally responsible for sending approximately 8,000 people into the gas chambers and crematoriums at that camp.

The Real Drug Nazi
I just finished reading the horrific documentary novel entitled - The Druggist of Auschwitz. In it, Romanian author Dieter Schlesak tells the story of Victor Capesius, the apothecary at Auschwitz during its most active period as a Nazi death camp.

As described by the publisher - Adam, known as “the last Jew of Schäßburg,” recounts with disturbing clarity his imprisonment at the infamous Auschwitz concentration camp. Through Adam’s fictional narrative and excerpts of actual testimony from the Frankfurt Auschwitz Trial of 1963–65, we come to learn of the true-life story of Dr. Victor Capesius, who, despite strong friendships with Jews before the war, quickly aided in and profited from their tragedy once the Nazis came to power.

Interspersed with historical research and the author’s face-to-face interviews with survivors, the novel follows Capesius from his assignment as the “sorter” of new arrivals at Auschwitz — deciding who will go directly to the gas chamber and who will be used for labor — through his life of lavish wealth after the war to his arrest, eventual trial, and conviction.

The Druggist of Auschwitz further intimately details eye-witnessed accounts from Capesius's own prisoner pharmacist "colleagues" of the many other horrific atrocities that Capesius and the camp medical staff committed against thousands of innocent men, women, and children, some of whom Capesius knew personally before the war.

After being free from prosecution for approximately fifteen-years after the war, Capesius was eventually found guilty during the Frankfurt Auschwitz Trial of assisting in the murder of at least 8,000 individuals, a charge his lawyer acknowledged, but one he personally denied. Other charges against him were assisting in the gas chambers, supervising the liquidation of the gypsy camp, and administering intracardiac phenol injections to kill prisoners but, because of lack of proof, these were dropped.

Some witnesses alleged that Capesius had committed other crimes as well; it was suggested that he had enriched himself by taking prisoners’ last remaining possessions, including gold fillings taken from their teeth after they were gassed, or that he assisted Dr. Mengele in cruel “medical” experiments on inmates. No hard evidence was, however, found for these truthful allegations too, and Capesius was unjustly sentenced to only nine years in prison!

While I'd recommend this novel to others, I found The Druggist of Auschwitz a slightly difficult read as it bounces between the testimony of varied eyewitnesses from trial documents, the author's own notes from personal interviews of victims and perpetrators, including Capesius himself, and the narrative of the one fictional character, Adam. However, the author eases that difficulty by including an addendum of most significant figures, and the use of italic and roman font typefaces for differentiation.

I'd also recommend watching the excellent documentary entitled "Memorandum".

In it, you'll see Capesius and his other soulless mass-murdering medical cohorts on film showing their angry contempt at being brought to justice after years of living large on the spoils of their crimes. You'll find it hard to believe that this sixty minute documentary was actually made in 1965.

Related Links:
1. Auschwitz-Birkenau Memorial & Museum
2. The History of the "Business With Disease"
3. Life as a human guinea pig

Tuesday, June 14, 2011

Justice in Bubbaville

Do y'all remember that outrageous hospital incident in the small West Texas town of Kermit where two nurses were fired and then criminally indicted for reporting their concerns about incompetent medical care to the Medical Board of Texas?

Two of the three nurses who reported their concerns, Anne Mitchell and Vickilyn Galle, soon became victims of a retaliatory good 'ol boy network when they legally pressed their concerns of a doctor possibly endangering patients at their hospital. Both nurses were indicted for criminal conduct they did not commit. Galle eventually had the charges dropped against her, and Mitchell was quickly acquitted at trial.

Well, the good news is that justice has been served in Bubbaville today.

Robert Roberts, the small town sheriff who was just one of the perpetrators in this case of vindictive and illegal retaliation, was found criminally guilty of six charges by a jury of his peers: two third-degree felony counts of retaliation, two third-degree felony counts of misuse of official information, and two class A misdemeanor counts of official suppression. He's also been judged guilty by many in the healthcare profession as being a class A dumb-ass.

The trial judge has sentenced Roberts to four years felony probation for the two counts each of misuse of official information and retaliation. He's also been sentenced to serve 100 days in jail on each of the four felony counts. Unfortunately, that sentence is ordered to be served concurrently, not consecutively. Roberts will also have to pay a $6,000 fine.

But, the best news for other healthcare professionals working in that county who may be worried about retaliation for putting patient care first, is that as a result of the sentence, Robert Roberts will also be removed as Winkler County Sheriff and will have to surrender his peace officer's license.

The other two perpetrators, Dr. Arafiles and County Attorney Scott Tidwell, were indicted on similar charges and are still awaiting their trials.

Preventing The Perfect Rx Storm

Pharmacists, doctors, and patients need to work in tandem to help prevent the perfect storm from forming, which could lead to a continuing medication error.

ABC-15 News in Phoenix reports on a recent prescription error in which a patient received 50 mcg of liothyronine instead of the prescribed 5 mcg dose. The unfortunate young lady in this incident continued taking the misfill for months, and experienced all of the adverse effects one would expect from receiving 10 times the prescribed dose of her thyroid medication.

The perfect storm in which I'm referring happens when all of the following occur together -

1. A prescription order is entered incorrectly and a prospective DUR fails to catch it.
2. The pharmacist doesn't counsel the patient at the time of dispensing a new prescription.
3. The patient doesn't take the initiative to speak up to prevent errors.
4. The provider doesn't review the patient's prescription medications with each visit.

Of course, I don't know all of the sources that led to this error, and while not attempting to assess cause or blame, it seems to me that all four of these contributing factors occurred in order of succession, which may have allowed this incident to continue for so long. Any interruption in that perfect storm may have prevented the error from happening or continuing.

According to the video, the Arizona Board of Pharmacy is still investigating this incident. If you'd like to know the results of the investigation, who was involved, including any possible disciplinary actions, the board posts their meeting notices and meeting minutes online.

Monday, June 13, 2011

Is Your Pharmacist A Prick?

It's not always easy to tell the difference between a friendly pharmacist and a psycho prick.

PRICK - trailer from Colin Berry on Vimeo.

Saturday, June 11, 2011

KeySource Medical Wholesale License Suspended

What do you do when you're a drug wholesaler and a pharmacy that you sell drugs to decides to become involved in criminal activity? Should it be a wholesaler's responsibility to police it's customers? Should the wholesaler be considered an accomplice in that crime?

It looks the DEA might think so.

Robert L. Corso, Special Agent in Charge of the Detroit Field Division, Drug Enforcement Administration (DEA) announced yesterday the immediate suspension of the federal controlled substance registration of Keysource Medical, a wholesale supplier of pharmaceuticals.

According to the DEA news release -
“Pharmaceutical companies have a responsibility to ensure that the drugs they sell don’t end up in the hands of drug traffickers or businesses that are conducting their business illegally,” said Corso. “Prescription drug abuse in Florida, southern Ohio and northern Kentucky has risen to epidemic proportions, and Keysource Medical, should have known based on the large, frequent quantities, that their customers were diverting oxycodone into arenas that were not legitimate. This action is another reminder that the DEA is working hard to hold accountable those companies who choose to operate outside the law. [my bold]

I don't know the whole story behind this suspension, but I would think that the normal daily business activities of being a wholesaler, such as following legal protocol, verifying pharmacy licensure, accurate record keeping, and maintaining inventory control would be appropriate.

Why should a wholesaler be expected to investigate when one pharmacy happens to order more narcotics than another pharmacy? Why is it up to them to verify the legitimacy of their customer's orders? It seems to me that's too difficult a requirement, and that the DEA is expecting too much from pharmacy wholesalers.

Suspicion of diversion doesn't equal knowledge. There are actual patients with legitimate pain issues, and there will always be a pharmacy at the top of the quantity-ordered list.

The DEA has copies of the same records and it should be their responsibility to investigate if they think a pharmacy is diverting narcotics. It's the DEA's job to determine possible criminal activity. They have the authority, tools, training, and funding to investigate each pharmacy to "knowingly" find out if they're diverting or not.

Just like a pharmacist shouldn't be held liable for a patient's abuse of his or her medications, I think a wholesaler shouldn't be held liable for the criminal actions of one or more of their customers. It's slippery slope my friends.

I'm all for putting a stop to the increasing abuse of prescription narcotics and for holding the criminals accountable. But it's also very important to ensure that the innocent aren't punished for performing their roles in providing appropriate health care. What do you think?

Friday, June 10, 2011

Human Body - A Short Film

A doctor, who, buffeted by the scheme of things, is unable to transcend the part assigned him by the absurdity of that existence. Because he does not lack conscious knowledge of his condition, but refuses to act in the face of his portentous freedom, the doctor, an archetype of the anti-existential hero, deserves his fate.

Lacking the human stuff necessary to create and structure situations, he permits himself to be manipulated by patients, employers, criminals, the pharmaceutical industry, and the insurance industry; but he becomes, by submitting, a tool within the situations they create.

Never, consciously, does he attempt through an overt act, until too late, to establish his own essence, to rise above any manipulative value he possesses for others. As doctor he is a thing, an object, a tool; as man he is nothing.

Menschenkörper from Tobias Frühmorgen on Vimeo.

Thursday, June 9, 2011

Is There A Way To Mend A Broken Heart?

I think it finally happened. We just may have an answer to the Bee Gee's first question.

British-based researchers claim they may be just a decade away from perfecting a way to persuade the heart to rejuvenate – a process thought to be impossible just five years ago.

According to The Telegraph, researchers at University College London have discovered that a protein known as thymosin Beta 4, key to heart growth in the young, appears to reawaken dormant stem cells in the organ of adults.

They now hope to begin human trials in a few years after experiments on mice showed that it improved the performance of the heart by as much as 25 per cent.

Yeah, yeah.. I know. But the real question is - how can loser like me ever win?

Monday, June 6, 2011

Preventing An Escherichia coli Pandemic

Health experts around the globe are keeping a close eye on the deadly outbreak of Shiga toxin-producing E. coli O104, or STEC O104, infections which are centered in Germany.

The outbreak, which began in early May, is among the deadliest in modern history to involve E. coli, and has killed at least 22 people, sickened more than 2,000 across Europe and is now suspected in four cases here in the United States.

The exact source of this outbreak is still not known, but scientists said the suspicions about raw cucumbers, tomatoes, lettuce, bean sprouts, or other vegetables being a possible source are well-founded since cattle manure used in fertilizer can harbor E. coli.

So, while David Elder, director of regional operations for the Food and Drug Administration, said produce in the United States "remains safe, and there is no reason for Americans to alter where they shop, what they buy, and where they eat. The U.S. food supply is not in jeopardy.", I say that we hope for the best, but expect for the worst.

The best way we can treat this problem is through awareness and prevention. We won't have to worry about treating an pandemic infection if we can easily prevent one.

Practice Safe Sex
We need to assume that this deadly E. coli outbreak could easily spread throughout the world if people aren't aware of it, and try to discover new ways in which to inform the public and help prevent the spread.

As such, I'm asking the promiscuous young ladies in America to vigorously wash their vegetables with soap and water before use. Who knows where they've been beforehand?

Food-borne infections are dangerous enough. The last thing we need in this country is another deadly sexually-transmitted disease pandemic.

Image source: Standing at the Crossroads

Sunday, June 5, 2011

The Universal Sign For Pharmacists

Gang members have their own signs, military people have combat signs, and deaf people have signs they use to communicate with each other every day.

So why shouldn't pharmacists have their own signs too? Here's the first sign every community pharmacist should learn before they begin their career. It just may come in handy.

I have been robbed. from Travel Signs on Vimeo.

Friday, June 3, 2011

The Insurance Industry Is "IT"

If you're a pharmacist who thinks that you're in control of your professional destiny, think again. "IT" has already conquered the world, controls your every move, and cannot be defeated. If you don't believe me, just watch what experienced pharmacists who've been fighting this monster for decades have to say about "IT".

Thursday, June 2, 2011

Are You A Little Quick On The Trigger?

Well then, you'd better be quick on the with-draw. We don't take kindly to that type of back-shooting from either the good, the bad, or the ugly out here in the Old West.

Spot LILA - 2009 from Salvatore Logica on Vimeo.

Wednesday, June 1, 2011

America's First Serial Killer

In the late nineteenth century Jack the Ripper roamed the foggy streets of London, spreading fear and creating a legend of horror. But at the same time, in another great city located on the other side of the Atlantic, an equally cunning killer was claiming his victims.

Sporting a stylish walrus mustache and a fashionable fedora, H. H. Holmes built a castle of horrors in upscale Englewood, Illinois, just south of Chicago. His good looks and charm were well-known, but his sterling local reputation soon succumbed to international infamy once his horrific deeds were uncovered. While he confessed to 27 murders, of which four were confirmed, his actual body count was estimated to be as high as 200 victims.

H.H. Holmes, trusted neighborhood pharmacist, became known as America's first serial killer.

Source: H.H. Holmes, The Film.