U.S.A. FIRST FOR THIS NON-AIRLINE PASSENGER!

No better day than Thanksgiving Day to say that my 2012 vacation will not involve airlines or foreign countries. 

To the airlines, I say, no thanks, I won't put up with your greed next year.  And, to interests beyond my shores, I won't be spending any euros or pounds next year.  I will set my sights on blazing a new personal trail in a country I still haven't seen entirely---The United States of America, land where my fathers died, land that I love.

I plan to hop onto my internal combustion chariot and explore states that I have not yet visited. So, you flying companies can sell your extra leg room to someone else (extra leg room? It's the &%$%( exit row! How dare you steal my wallet and then offer to help me find it?)

No passport, no currency exchange, no security.  My fellow citizens and residents of the United States, why let all those folks do you such a big, hairy favor of letting you visit, when there must be many places right here at home that you've never seen, and can keep you off an airplane for a long time? I still have 29 states I've never set foot in, and, as Phil Ochs, sang, there is "beauty that words cannot recall."  I haven't seen Hawaii's volcanoes, Yellowstone's volcanoes,  haven't yet left my heart in San Francisco, haven't seen more of the Rocky Mountains, haven't enjoyed our own western forests and islands. 

So, stick this in your carry-on, you airborne barons.  No friendly foreign skies for me. Only the terra firma under the stars and stripes.  Go sit in your own exit row!

DOCTORS, WE CALL YOU TO HELP, NOT CRITICIZE

As a pharmacist, I find that my relationships with prescribers over the years have been generally cordial and mutually respectful.  I certainly tip my hat to the challenging and perpetually busy role of the modern physician, P.A., or Nurse Practitioner,  and these healthcare professionals have shown concomitant respect for me, especially when they call for some vital piece of  basic drug information which they know I know off the top of my head, and they are very grateful to have made the call. 

But, even though the recognized role of us pharmacists has expanded greatly over the last 30 years, there has remained a subset of caregivers who resent our  involvement in healthcare, and are quick to condemn my utterances even when they are made with knowledge and in good faith.  I'm not talking about any foolhardy attempts  to match wits with the champions--I and most pharmacists simply don't have time to play that game. It is when I, or any another pharmacist,  contact the prescriber with a sense of urgency and based upon our knowledge and experience,  and get snubbed in that context, that we scratch our heads. Why do they seem to treat us worse than they treat a mosquito?

The prescriber anger  toward us druggists often emerges over the simple question about a dose.  If we report to them that they have ordered too great (or sometimes, too small) an amount of drug for the patient, usually we get a simple explanation and maybe even a thank-you for calling if we do catch something inappropriate.  But, we do not call doctors to challenge their judgement.  We call out of concern for the patient based upon our experience with drugs.  We are asking for enlightenment, not argument. 

Sometimes we may contact the prescriber about a drug interaction, usually a very critical one, and it may be an issue that has landed pharmacists in official disciplinary difficulty, and patients in the hospital or maybe even the E.R.,  for dispensing the dangerous pharmacotherapy.  At least we ought to be greeted with a polite discussion of the subject, and not the childish, irate, "I've been prescribing that combination for years, now just shut up and fill the prescriptions!"  I have been the recipient of variations on that theme for a long time.

When it comes to the provisions of the Controlled Substances Acts,  the pharmacist's duty is unambiguous. We are required to fill only those controlled-drug prescriptions that represent a legitimate medical use, and the law, U.S. federal law in particular,  says that if it is for anything else, then the document or order in front of us is "not a prescription.."  This could not be more true now, given the reports of prescription drugs being the major culprit in the Nation's drug abuse.  Still, we want to fill bona fide prescriptions for our pateints, so, physicians, we shall contact you if we suspect otherwise. It is our job to deal with drug-related problems, and we shall do so.

Prescribers, we are fellow members of your healthcare team. We call to help you, not criticize you. But, too often, you quickly mistake help for criticism.  It is not criticism now, and never was.

MY FATHER, WHO ART IN HEALTHCARE (or, LIFE'S A HOSPITAL, AND THEN YOU STILL DIE!)

I was glad to spend considerable time helping to take care of my father last month during his last days, but I also recall his lifelong relationship with the healthcare world.  Thankfully, he was healthy all of his life except the final six months,  but he, like the rest of us, thought it was wise to engage  healthcare services.  Reflecting upon his death, I recall that long caravan of engagements---doctor visits, medication, procedures.  But, he still died.

Sounds like a goofy, naive statement---he still died.  I say that in a moment of amazement because I also remember how much time, and expense (despite insurance) healthcare consumed out of my Dad's life.  I conclude, "Life's a hospital, and then you die." Dad, what was the sum total of your, and my, preoccupation with being a patient?  Did healthcare really keep you well, or did it eat away at as as surely as the cancer that took your life did?

In his last 20 years, could my Dad have simply avoided the healthcare system, and lived even better? Could I do the same thing?  Now, at age 60, could I decide to perceive healthcare as just so much technological bling, and refuse to wear it? Sometimes I feel as if "going to the doctor" is just a fad.

As a pharmacist, I've had a bird's eye view of healthcare, and if you work in pharmacy, so have you.  Solving medication problems gives us our livelihood, but for patients in general, medication certainly gives people something to do, something to argue about, something to occupy the time on earth that Ecclesiastes describes as mere vanity and miserable business.  I would rather occupy my time by being grateful for my lot, and just smiling at the morning sun, thankful for another day of life that God, and not medicine, has given me.

Debut!

Greetings, and a first welcome from this new command center of the PHARMOCIST!

I have been a pharmacist in the western world for many years. My blog name, PHARMOCIST, is an acronym for a once commonly used pricing code where P stood for 1, H for 2, and so on. Pharmacists would record their actual costs in such codes to prevent others from estimating their gross margins. I remember such a time, but I also remember the rise of clinical pharmacy and the progress from product orientation to patient orientation. Most of all, however, I remember the great pain of the many indignities that I and other pharmacists have endured because we somehow bought into the notion that serving others meant servitude at the hands of others. No more! I start this new blog today with freedom and dignity in view for pharmacy professionals.

In the old White Pages telephone books, one could find long lists of toll-free numbers to this and that liberation organization. There were fellowships for women's liberation, gay liberation, and senior citizen liberation. I am very tired of us being denied freedom while others rejoice in theirs. It is time for pharmacy liberation!